Gender bias in the measurement properties of the center for epidemiologic studies depression scale (CES-D)

Stommel, Manfred; Given, Barbara; Given, Charles W.; Kalaian, Hripsime A.; Schulz, Richard; McCorkle, Ruth

doi:10.1016/0165-1781(93)90064-n

Cited by 124 publications

(41 citation statements)

References 20 publications

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“…Prevalence rates of clinically significant levels of depressive symptoms among prostate cancer patients, for example, range from 11% to 37% 16. In a group of 708 US patients with mixed cancer diagnoses, the average score on the CES-D was 13.2,17 more than 5 points higher than our mean of 7.69.…”

Section: Discussioncontrasting

confidence: 63%

Quality of life and cancer-related needs in patients with choroidal melanoma

et al. 2013

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Aims To assess quality of life (QoL) indices and their associations with treatment modality, sociodemographics, and cancer-related needs in choroidal melanoma patients. Methods Patients (N=99) treated at the University of California, Los Angeles for choroidal melanoma within the prior 5 years (M = 2.05) completed questionnaires assessing demographics, cancer-related needs, vision-specific QoL, depressive symptoms, and concern about recurrence. Visual acuity, comorbidities, treatment modality (radiotherapy, enucleation), and years since diagnosis were gathered from medical records. Primary analyses were multiple regressions. Results Although concern about cancer recurrence was elevated, QoL was better than in other oncology samples and comparable to healthy samples on some outcomes. Enucleation was associated with worse vision-specific QoL, and presence of comorbid diseases was associated with worse vision-specific QoL, depressive symptoms, and concern about cancer recurring (all ps<.05). Patients who experienced at least one stressful life event in the past year (versus no events) reported more depressive symptoms (p<.01). Report of more unmet cancer needs was associated with worse vision-specific QoL, depressive symptoms and more concern about recurrence (all ps<.05), uniquely explaining 5%–12% of the variance. Conclusions For choroidal melanoma patients an average of two years after treatment, number of physical comorbidities and unmet cancer needs were the strongest correlates of poorer QoL.

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Section: Discussioncontrasting

confidence: 63%

Quality of life and cancer-related needs in patients with choroidal melanoma

et al. 2013

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“…The variability of factor structure reported has been attributed to differences in demographic variables of study populations [e.g., Callahan and Wolinsky, 1994;Edman et al, 1999;Manson et al, 1990]. Results from other investigations have been consistent with Radloff's [1977] original four-factor model [e.g., Clark et al, 1981;Golding and Aneshensel, 1989;McCallion and Kolomer, 2000;Roberts et al, 1990;Stommel et al, 1993], although specific items loading on each factor have varied.…”

Section: Introductionmentioning

confidence: 52%

“…However, as evident in factor analytic investigations of the CES-D [e.g., Roberts et al, 1990] as well as other measures [e.g., Wright et al, 2001], the factor structure of item responses can differ between men and women. These dif ferences can be attributed to various factors, including the possibility that women and men have dif ferent response patterns to different items on the CES-D [also see Stommel et al, 1993] and that their experience with symptoms differs. Indeed, in the military setting it has been observed that women have greater dif ficulty in coping with combat-related stressors and have more severe depressive symptoms than do men [Breslau et al, 1997[Breslau et al, , 2000Wagner et al, 2000].…”

Section: Discussionmentioning

confidence: 99%

“…Radloff [1977] asserted that the CES-D, to be considered a useful tool for epidemiologic research, ''ymust have adequate reliability and validity and a similar factor structure within each subgroup of the population'' (emphasis original) (p 398). In other words, the CES-D factor structure must have adequate validity in order to ensure unbiased outcomes; that is, free of measurement bias within and across populations [e.g., Cole et al, 2000;Dean et al, 1994;Dean and Salem, 1998;Stommel et al, 1993]. Since its development, the CES-D scale has been subject to numerous factor analytic investigations in an attempt to validate its psychometric properties and applications.…”

Section: Introductionmentioning

confidence: 99%

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Factorial validity of the center for epidemiologic studies-depression (CES-D) scale in military peacekeepers

Boisvert

McCreary²,

Wright

et al. 2003

Depress. Anxiety

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Despite widespread use of the Center for Epidemiologic Studies Depression Scale [CES-D], there are no investigations that examine its factor structure in a military sample. Separate confirmatory factor analyses were performed on responses to the CES-D obtained from 102 female and 102 male Canadian military peacekeepers in order to compare the fit of a four-factor intercorrelated (lower-order) model to a four-factor hierarchical (higher-order) model. The intercorrelated and hierarchical models fit the data well for both women and men, with hierarchical models fitting the data slightly better for women than men. These findings suggest that, for military women and men, the CES-D can be used to measure a set of distinct but interrelated depressive symptoms as well as a global construct of depression. Implications and future directions are discussed.

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“…One of the earliest studies examining measurement bias due to gender differences used the widely known Center for Epidemiological Studies-Depression (CES-D) scale. Eliminating five CES-D symptoms with gender bias helped reduce the mean difference in levels of depressive symptomatology between adult males and females (14). Callahan and Wolinsky examined the factor structure of the CES-D due not only to gender, but also due to race/ethnicity in an older population, showing that five items contributed to disparities (15).…”

Section: Introductionmentioning

confidence: 99%

Measurement Differences in Depression: Chronic Health-Related and Sociodemographic Effects in Older Americans

Yang

Jones

2008

Psychosomatic Medicine

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Objective We evaluated the influence of five chronic health conditions (high blood pressure, heart conditions, stroke, diabetes, and lung diseases) and four sociodemographic characteristics (age, gender, education, and race/ethnicity) on the endorsement patterns of depressive symptoms in a sample of community-dwelling older adults. Method Participants were adults aged 65+ from the 2004 Health and Retirement Study (N=9,448). Depressive symptoms were measured with a nine-item Center for Epidemiologic Studies-Depression scale. Measurement differences attributable to health and sociodemographic factors were assessed with a multidimensional model based on item response theory. Results Evidence for unidimensionality was equivocal. Therefore, we used a bifactor model to express symptom endorsement patterns as resulting from a general factor and three specific factors (“dysphoria,” “psychosomatic,” and “lack of positive affect”). Even after controlling for the effects of health on the psychosomatic factor, heart conditions, stroke, diabetes, and lung diseases had significant positive effects on the general factor. Significant effects due to gender and educational levels were observed on the “lack of positive affect” factor. Older adults self-identifying as Latinos had higher levels of general depression. On the symptom level, meaningful measurement noninvariance due to race/ethnic differences were found in the following five items: depressed, effort, energy, happy, and enjoy life. Conclusions The increased tendency to endorse depressive symptoms among persons with specific health conditions is in part explained by specific associations among symptoms belonging to the psychosomatic domain. Differences attributable to the effects of health conditions may reflect distinct phenomenological features of depression. The bifactor model serves as a vehicle for testing such hypotheses.

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Gender bias in the measurement properties of the center for epidemiologic studies depression scale (CES-D)

Cited by 124 publications

References 20 publications

Quality of life and cancer-related needs in patients with choroidal melanoma

Quality of life and cancer-related needs in patients with choroidal melanoma

Factorial validity of the center for epidemiologic studies-depression (CES-D) scale in military peacekeepers

Measurement Differences in Depression: Chronic Health-Related and Sociodemographic Effects in Older Americans

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