BACKGROUND: Proper evaluation of the generalizability of an instrument is critical for its use across different social contexts such as caregiver status. OBJECTIVE:To examine the differential item functioning of the Center for Epidemiologic Studies Depression (CES-D) Scale, patterns of response to each item of the CES-D Scale attributable to caregiver status was assessed.STUDY DESIGN:Using a cross-study comparison method, a sample of 58 matched pairs of Korean American caregivers and noncaregivers was used for matched moderated regression analysis on the CES-D Scale. RESULTS:The authors identified three items that vary according to caregiver status in the present study: Item 2 (My appetite was poor), Item 4 (I felt that I was as good as other people), and Item 14 (I felt lonely).CONCLUSIONS:Beyond assessing the level of depression through total CES-D scores, it is important to examine variations in the items of the CES-D Scale across different social contexts.J Am Psychiatr Nurses Assoc, 2009; 15(4), 240-248. DOI: 10.1177/1078390309343713
Amirkhanyan, A.A., & Wolf, D.A. ( 2003). Caregiver stress and noncaregiver stress: Exploring the pathways of psychiatric morbidity. Gerontologist, 43, 817-827.
2.
Arnault, D.S., & Kim, O. ( 2008). Is there an Asian idiom for distress? Somatic symptoms in female Japanese and Korean students. Archives in Psychiatric Nursing, 22, 27-38.
3.
Black, S.A., Markides, K.S., & Miller, T.Q. ( 1998). Correlated of depressive symptomotology among older community dwelling Mexican Americans: The Hispanic EPESE. Journal of Gerontology, Series B, Psychology Sciences and Social Sciences, 53, s198-s208.
4.
Center on Aging Society (2005). How do family caregivers fare? A closer look at their experiences. Retrieved March 5, 2007, from http://ihcrp.georgetown.edu/agingsociety/pdfs/CAREGIVERS3.pdf
5.
Cuéllar, I., & Paniagua, F. A. (Eds.). (2000). Handbook of multicultural mental health: Assessment and treatment of diverse populations . San Diego, CA: Academic Press .
6.
Farran, C.J., Miller, B.H., Kaufman, J.E., Donner, E., & Fogg, L. ( 1999). Finding meaning through caregiving: Development of an instrument for family caregivers of persons with Alzheimer’s disease . Journal of Clinical Psychology, 55, 1107-1125.
7.
Gelin, M.N., & Zumbo, B.D. ( 2003). Differential item functioning results may change depending on how an item is scored: An illustration with the center for Epidemiologic Studies Depression Scale. Educational and Psychological Measurement , 63, 65-74.
8.
Holland, P.W., & Wainer, H. ( 1993). Differential Item Functioning. New York: Lawrence Erlbaum.
9.
Kim, J.H., & Theis, S.L. ( 2000). Korean American caregivers: Who are they? Journal of Transcultural Nursing, 11, 264-273.
10.
Kim, M.T. ( 2002). Measuring depression in Korean Americans: Development of the Kim Depression Scale for Korean Americans. Journal of Transcultural Nursing, 13, 109-117.
11.
Kim, M.T., Han, H.R., Shin, H.S., Kim, K.B., & Lee, H.B. ( 2005). Factors associated with depression experience of immigrant populations: A study of Korean immigrants. Archives of Psychiatric Nursing, 19, 217-225.
12.
Kim, S., & Rew, L. ( 1994). Ethnic identity, role integration, quality of life, and depression in KoreanAmerican women. Archives of Psychiatric Nursing, 8, 348-356.
13.
Kong, E.H. ( 2007). The influence of culture on the experience of Korean, Korean American, and Caucasian-American family caregivers of frail older adults: A literature review. Taehan Kanho Hakhoe Chi, 37, 213-220.
14.
Lee, E.E., & Farran, C.J. ( 2004). Depression among Korean, Korean American, and Caucasian American family caregivers. Journal of Transcultural Nursing , 15, 18-25.
15.
Lee, E.E., Farran, C.J., Tripp-Reimer, T., & Saddler, G. ( 2003). Assessing the cultural appropriateness of Finding Meaning Through Caregiving Scale for Korean caregivers. Journal of Nursing Measurement, 11, 19-28.
16.
Noh, S., & Avison, W.R. ( 1996). Asian immigrants and the stress process: A study of Koreans in Canada. Journal of Health and Social Behavior, 37, 192-206.
17.
Noh, S., Avison, W.R., & Kaspar, V. ( 1992). Depressive symptoms among Korean immigrants: Assessment of a translation of the Center for Epidemiologic Studies-Depression Scale . Psychological Assessment, 4, 84-91.
18.
Noh, S., Kaspar, V., & Chen, X. ( 1998). Measuring depression in Korean immigrants: Assessing validity of the translated Korean version of the CES-D Scale. Cross-Cultural Research, 32, 358-377.
19.
Perreira, K.M., Deeb-Sossa, N., Harris, K.M., & Bollen, K. ( 2005). What are we measuring? An evaluation of the CES-D across race/ethnicity and immigrant generation. Social Forces, 83, 1567-1602.
20.
Radloff, L.S. ( 1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement , 1, 385-401.
21.
Radloff, L.S., & Locke, B. ( 1986). The community mental health survey and the CES-D scale . In M. Weissman, J. Myers, & C. Ross (Eds.), Community surveys of psychiatric disorders (pp. 177-189). New Brunswick, NJ: Rutgers University Press.
22.
Rao, C.R., & Sinharay, S. ( 2006). Handbook of statistics: Vol 26. Psychometrics. Amsterdam: North-Holland.
23.
Rassler, S. ( 2002). Statistical matching: A frequentist theory, practical applications, and alternative bayesian approaches. New York: Springer-Verlag.
24.
Reeves, T.J., & Bennett, C.E. ( 2004). We the people: Asians in the United States (Census 2000 Special Report No. CENSR-17). Washington, DC: U.S. Census Bureau.
25.
Roberts, R.E. ( 1980). Reliability of the CES-D scale in different ethnic context . Psychiatric Research, 2, 125-134.
26.
Roxburgh, S., & Xu, Y. ( 2006). Role occupancy, gender, and depression: A comparison of Mexican Americans and non-Hispanic White Americans. Paper presented at the annual meeting of the American Sociological Association , Montreal, Quebec, Canada.
27.
Shafer, A.B. ( 2006). Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung. Journal of Clinical Psychology, 62, 123-146.
28.
Shin, K.R. ( 1993). Factors predicting depression among Korean-American women in New York. International Journal of Nursing Studies, 30, 415-423.
Um, C.C., & Dancy, B.L. ( 1999). Relationship between coping strategies and depression among employed Korean immigrant wives. Issues in Mental Health Nursing, 20, 485-494.
31.
U.S. Department of Health and Human Services. ( 2001). Mental health: Culture, race, and ethnicity-A supplement to mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
32.
Youn, G., Knight, B.G., Jeong, H.S., & Benton, B. ( 1999). Differences in family values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers. Psychology and Aging, 14, 355-364.
33.
Young, M.A., Fogg, L.F., & Choi, E. ( 2002). Studying group differences in psychopathology with matched moderated regression. Understanding Statistics, 1, 1-12.
