Development and preliminary validation of an image-based instrument to assess depressive symptoms

Depression has high social and economic costs, making the reducing of potential barriers to screening of utmost importance. The use of non-verbal, image-based items might help to widen accessibility to depression screenings due to their potentially increased ease of interpretation and language-free nature. In this view, the paper presents two studies exploring the feasibility of assessing depressive symptoms using a set of image-based items consisting of 36 emoji. In study 1, 430 online-recruited young adults participated to investigate whether they ever felt in the way depicted by each emoji during the last week. Results showed that 33 emoji had significant, theoretically coherent correlations with the 10-item version of the Center for Epidemiologic Studies Depression Scale. Next, a subset of 10 emoji were selected for potential inclusion in a brief depression assessment. In study 2, using a sample of 482 young adults, the 10-item emoji-based assessment showed acceptable internal consistency, and theoretically consistent convergent and divergent validity with depressive symptoms, and big-5 personality traits. Further, the emoji-based screening instrument showed remarkable accuracy in identifying individuals showing depression symptoms. Overall, results indicate that the selected emoji represent a promising alternative to text-based items when assessing depressive symptoms among young adults.