JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (6): 793-798.doi: 10.3969/j.issn.1674-8115.2021.06.015

• Public health • Previous Articles     Next Articles

Validity and reliability of the Chinese version of Defeat Scale in men who have sex with men

Shang-bin LIU1(), Hao YANG1, Chen XU1, Jing-wen DONG1, Xiao-yue YU1, Yong CAI1, Dong YUAN2(), Ying WANG1()   

  1. 1.Shanghai Jiao Tong University School of Public Health, Shanghai 200025, China
    2.Shanghai Municipal Center for Disease Control, Shanghai 200336, China
  • Online:2021-06-28 Published:2021-06-29
  • Contact: Dong YUAN,Ying WANG;;
  • Supported by:
    National Natural Science Foundation of China(71673187);Leader of Public Health Discipline in Shanghai(GWV-10.2-XD13);Construction of Key Disciplines in the Fifth Round of Shanghai Public Health Three-year Action Plan(GWV-10.1-XK15);The Top Training Program for Undergraduates Guided by the Achievements in the Training of Outstanding Talents in Shanghai Jiao Tong University School of Public Health(17ZYGW23)

Abstract: Objective

·To test the reliability and validity of the Chinese version of Defeat Scale (DS) in the men who have sex with men (MSM) in Shanghai and Shenyang, China, and explore its value in judging the depressive state of the population.


·A cross-sectional survey was conducted among 530 men over the age of 18 who had made sex with men in the past 6 months in Shanghai and Shenyang. DS and Patient Health Questionnaire-9 (PHQ-9) were used. Excel 2010 was used to establish the database, and SPSS 23.0 and Amos 25.0 software were used to analyze the reliability and validity of the data. Shapiro-Wilk test was used to determine whether the data obeyed normal distribution. Exploratory factor analysis and confirmatory factor analysis were used to verify its structural validity of DS. Spearman correlation coefficient was conducted to evaluate the content validity. Cronbach's α coefficient and Spearman-Brown coefficient were used to evaluate the reliability of DS. Binary Logistic regression was used to determine whether defeat can affect depression, and then, receiver operator characteristic (ROC) curve was used to determine its diagnostic value.


·The data of DS and PHQ-9 did not obey the normal distribution. The exploratory factor analysis showed that two factors including decadence (13 items) and low sense of achievement (3 items) could be extracted. Explained variance of the scale was 69.35%. The confirmatory factor analysis showed that each item of the revised two-factor model was greater than 0.50, and the minimum value was 0.52. The model fitted well [ χ2/df =3.430<5; root mean square error of approximation (RMSEA)= 0.068, standardized root mean square residual (SRMR)=0.043, all<0.080; normed fit index (NFI)=0.944, incremental fit index (IFI)=0.959, comparative fit index (CFI)=0.959, goodness of fit index (GFI)=0.909, Tucker-Lewis Index (TLI)=0.958, all>0.900]. The Cronbach's α coefficient of DS of the 16 items was 0.934, and the Cronbach's α of two dimensions, namely "decadence" and "low achievement" were 0.962 and 0.758, respectively. With depression as the dependent variable and DS score as the covariant, binary Logistic regression was carried out. The results showed that β value was 0.178, P=0.000. Odds ratio (OR) value was 1.195 and 95% confidence interval (CI) was 1.147-1.245. The area under the curve (AUC) was 0.891, P=0.000. The maximum Youden index value was 0.667, its corresponding DS score was 21.5, and its sensitivity and specificity were 87.0% and 80.7%, respectively.


·The Chinese version of DS has good reliability and validity in MSM, and also has the value in judging the state of depression in this population.

Key words: defeat scale (DS), men who have sex with men (MSM), reliability, validity

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