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

Abstract

Background: The 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 CES-D scale for research, we performed confirmatory factor analysis of 12 - item CES-D in a nationally representative sample of Black and White adults in the United States. Methods: We used data from the National Survey of American Life (NSAL), 2001-2003. A total number of 3,570 Blacks (African Americans) and 891 non-Hispanic Whites were included in the present study. Confirmatory factor analysis was carried out on the 12-item CES-D scale using multi-group structural equation modeling (SEM). Results: For both Blacks and Whites, best fitting model was found to be the 3-factor model, indicating invariance of factor structure between Blacks and Whites. 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 poor loadings in Blacks than Whites (i.e. “as good”). Conclusion: There is invariance in factor structure but lack of invariance in factor/item loadings among Blacks and Whites. These findings have implications for cross-racial studies of depressive symptoms using CES-D among Blacks and Whites. Further research is warranted to scrutinize the role of socio-economics and culture in explaining lack of invariance of CES-D scale between Blacks and Whites.

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