Psychometric Examination of the Center for Epidemiologic Studies Depression Scale with Older American Indians: The Native Elder Care Study

Abstract

We sought to examine behavioral health indicators for an early adolescent population of American Indians/Alaska Natives (AI/AN) within an urban setting in Washington State. We conducted secondary data analyses from a randomized clinical trial implemented in local middle schools that compared AI/ANs (n = 43), non-Hispanic Whites (n = 620), and other racial/ethnic minority youth (n = 527) across a variety of behavioral health risks. AI/AN youth reported significantly more depressive symptoms than other racial/ethnic minorities as well as non-Hispanic Whites. They also reported more discrimination, more generalized anxiety, and were more likely to have initiated substance use, in comparison to non-Hispanic Whites. Psychosocial screening and early intervention are critically needed for AI/AN youth.

A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known?

“…Thus, age and education tend to moderate depressive symptoms in variable ways, depending on the setting and sample. Across studies, a high level of social support and self-efficacy (Schure and Goins, 2017) was found to be a buffer (protective factor) against depressive symptoms (Roh et al, 2015;C¸ayır et al, 2017;Schure and Goins, 2017).…”

“…We use the terminology AI/ANs to denote research specifically conducted with these groups (excluding Native Hawaiians). In addition, older AI/ANs have been found to have higher rates of depressive symptomatology, with one study finding 13.24 per cent of elders having clinical depression (Schure and Goins, 2017). On the basis of limited research available on Native Hawaiians, rates of depression range from 8 to 12.2 per cent (Salvail and Smith, 2007).…”

“…Six studies identified the prevalence of depression within the AI/AN and Native Hawaiian population, with rates varying by region and tribe (Kaholokula et al, 1999;Beals et al, 2005a;Roh et al, 2015;C¸ayır et al, 2017;Schure and Goins, 2017). All studies determined that a risk factor for depression was trauma at either the individual, family or community level.…”

Gender differences in the assessment of depression in American Indian older adults: The Strong Heart Study.

“…More recently, the 20-item and 12-item CES-D scales were tested in a sample of older AI adults in the Southeast region of the U.S. (Schure & Goins, 2017). While their findings determined high internal reliability and concurrent validity of the full 20-item and the 12-item CES-D scale scores, the 12-item scale resulted in a 1-factor model, as opposed to a 3-factor model (Chapleski et al, 1997).…”

Traumatic Stress, Social Support, and Health Among Older American Indians: The Native Elder Care Study

“…The scale is reliable and valid in diverse populations (Radloff, 1977) and demonstrates good internal consistency with both American Indian youth (Manson, Ackerson, Dick, Baron, & Fleming, 1990) and adults (Somervell et al, 1993). The Cronbach's alpha for the Elder Care Study sample is 0.87 and showed good convergent and divergent validity (Schure & Goins, 2017). The cut-point score most commonly used to indicate those at risk for clinically significant depression is ≥16, but a lower cut-point of 12 may be more appropriate for older adults (Lewinsohn, Seeley, Roberts, & Allen, 1997).…”