Confirmatory Factor Analysis of the 12-Item Center for Epidemiologic Studies Depression Scale among Blacks and Whites

Abstract

BackgroundThe Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used tools to measure depressive symptoms in epidemiological studies. Given the importance of cross-racial measurement equivalence of the CES-D scale for research, we performed confirmatory factor analysis (CFA) of the 12-item CES-D in a nationally representative sample of Black and White adults in the United States.MethodsWe used data from the National Survey of American Life (NSAL), 2001–2003. A total number of 3570 Blacks (African-Americans) and 891 non-Hispanic Whites were included in the present study. CFA was carried out on the 12-item CES-D scale using multi-group structural equation modeling.ResultsFor both Blacks and Whites, the best fitting model was found to be the 3-factor model, indicating invariance of factor structure between Blacks and Whites. A statistically different fit of the models with and without constraints indicated lack of invariance of factor loadings between Blacks and Whites. Some of the positive (i.e., “as good” and “hopeful”) and interpersonal (i.e., “people were unfriendly”) items showed poor loadings, even in the 3-factor solution that allowed separate domains for positive affect, negative affect, and interpersonal problems. Despite the good fit of our final model, more items (i.e., “as good,” “hopeful,” “keeping mind,” and “everything effort”) had poorer loadings in Blacks than Whites (i.e., “as good”).ConclusionThere is invariance in factor structure but lack of invariance in factor/item loadings between Blacks and Whites. These findings have implications for cross-racial studies of depressive symptoms using CES-D scale among Blacks and Whites. Further research is warranted to scrutinize the role of socioeconomics and culture in explaining the lack of invariance of the CES-D scale between Blacks and Whites.

Psychiatric Disorders Differently Correlate with Physical Self-Rated Health across Ethnic Groups

“…Our findings can be explained by the literature on ethnic differences in the degree to which mental disorders are somaticized [ 32 ]. Non-White ethnic groups such as Hispanics [ 32 ], African Americans [ 44 ], and East Asians [ 33 ] may have a higher tendency for somatization of mental health symptoms than non-Hispanic Whites. Studies have shown that women in general [ 32 ], and ethnic minority women in particular [ 45 , 46 , 47 ], have a high tendency for somatization of psychiatric disorders such as depression.…”

Positive and Negative Affect More Concurrent among Blacks than Whites

“…The study showed worse item loadings for positive items, namely “as good” and “hopeful,” in Blacks than Whites. In the final model with a very good fit to the data, the item “as good” showed poor loading for Whites and Blacks, however, the item “hopeful” showed good loading for Whites but poor loading for Blacks [ 42 ].…”

“…Whether or not race alters simultaneous experience and presentation of positive and negative affect is still unknown [ 29 , 30 ]. While some studies have suggested that the factorial structure of depression scales is invariant across racial groups [ 39 , 40 , 41 ], other studies have shown that the degree by which positive and negative affect correlate may depend on race and ethnicity [ 29 , 42 , 43 ]. While there is an ongoing debate whether or not positive and negative affect similarly represent depression among Whites and Blacks [ 38 , 39 , 40 , 41 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ], there are studies showing higher reliability of negative affect despite lower reliability of depression measures for Blacks compared to Whites [ 40 , 41 , 44 ].…”

“…While positive and negative affect are main factors in several depression scales [ 41 , 49 , 50 , 55 ], different populations may differ in how they experience or express positive and negative affect simultaneously [ 41 , 55 ]. Considering the gap in the literature on racial and ethnic variation in the concordance between positive and negative affect endorsement [ 29 , 41 , 42 , 43 , 45 , 46 , 47 , 48 ], more research is needed on moderating effects of race and ethnicity on the reciprocal links between positive and negative affect [ 41 , 56 , 57 ].…”

Educational Attainment Better Protects African American Women than African American Men Against Depressive Symptoms and Psychological Distress

“…Response items ranged from (0) rarely or none of the time to (3) most of the time, with a sum score potentially ranging from 0 to 24. The full and modified version of the CES-D are valid in African Americans [ 26 , 27 , 28 ] (Cronbach’s alpha = 0.76).…”