Journal of Clinical Epidemiology
Volume 53, Issue 3 , Pages 285-289, March 2000

Test of item-response bias in the CES-D scale:

experience from the New Haven EPESE Study

  • Stephen R. Cole

      Affiliations

    • Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA
    • Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02215, USA
    • Corresponding Author InformationCorresponding author. Tel.: (617) 278-0872; fax (617) 731-3843.(Stephen R. Cole)
    • ,
  • Ichiro Kawachi

      Affiliations

    • Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02215, USA
    • ,
  • Susan J. Maller

      Affiliations

    • Department of Educational Studies, Purdue University, West Lafayette, IN 47907, USA
    • ,
  • Lisa F. Berkman

      Affiliations

    • Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02215, USA
    • Department of Epidemiology, Harvard School of Public Health, Boston, MA 02215, USA

Received 31 March 1999; received in revised form 28 June 1999; accepted 19 July 1999.

Abstract 

We present results of item-response bias analyses of the exogenous variables age, gender, and race for all items from the Center for Epidemiologic Studies Depression (CES-D) scale using data (N = 2340) from the New Haven component of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). The proportional odds of blacks responding higher on the CES-D items “people are unfriendly” and “people dislike me” were 2.29 (95% confidence interval: 1.74, 3.02) and 2.96 (95% confidence interval: 2.15, 4.07) times that of whites matched on overall depressive symptoms, respectively. In addition, the proportional odds of women responding higher on the CES-D item “crying spells” were 2.14 (95% confidence interval: 1.60, 2.82) times that of men matched on overall depressive symptoms. Our data indicate the CES-D would have greater validity among this diverse group of older men and women after removal of the crying item and two interpersonal items.

Keywords:  Depressive symptoms, CES-D, Psychometrics, Item-response bias

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PII: S0895-4356(99)00151-1

Journal of Clinical Epidemiology
Volume 53, Issue 3 , Pages 285-289, March 2000

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