Measurement properties of the centers for epidemiological studies depression scale (CES-D) in a sample of African American and non-Hispanic White pregnant women

J Nurs Meas. 2009;17(2):91-104. doi: 10.1891/1061-3749.17.2.91.

Abstract

This study investigated the appropriateness of using the CES-D scale for comparing depressive symptoms among pregnant women of different races. Black and White women were matched on education, age, Medicaid status, and marital status-living arrangements. The matching procedure yielded a study sample of 375 in each ethnic group. Using a confirmatory factor analysis, the fit of several factor models for the CES-D was evaluated. One CES-D item, "everything was an effort", showed a low item-total correlation (0.04 among blacks, 0.22 among whites) and was excluded from further analysis. After imposing the constraints of equal factor loadings and factor covariance across both groups, a two-factor model with 19 CES-D items provided a good fit. Only the loading for the "was happy" item displayed a small difference between the two groups. Furthermore, the correlations between the original 20-item and the unbiased 18-item scales were r = 0.994 for Whites and r = 0.992 for Blacks. The results suggest that the 20-item CES-D can be used to compare depressive symptoms in White and Black pregnant women without introducing significant ethnic-racial bias in the measurement of these symptoms.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / psychology*
  • Cross-Cultural Comparison
  • Depression / diagnosis*
  • Depression / ethnology*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Matched-Pair Analysis
  • Michigan
  • Middle Aged
  • Pregnancy / psychology*
  • Psychological Tests*
  • Psychometrics
  • Reproducibility of Results
  • White People / psychology*