Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2025
Reliability, item functioning, and gender bias of the CES-D Scale in community-dwelling older adults: findings from the ELSA cohort.
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Sá-Junior Antonio Reis de, Petrilli-Mazon Vitor A, Schneider Ione, Wang Yuan-Pang, Oliveira Cesar
Аннотация
OBJECTIVE: To evaluate the item performance of the Center for Epidemiologic Studies Depression Scale.
METHODS: The participants were adults aged = 50 years from the English Longitudinal Study of Ageing. Using classical test theory and item response theory, data from 11,612 participants were analyzed to estimate reliability, item discrimination (a), and item difficulty (b). Differential item functioning analyses were used to determine whether men and women responded differently to items despite similar depressive symptom levels.
RESULTS: The Center for Epidemiologic Studies Depression Scale demonstrated adequate internal consistency (a = 0.80; ? = 0.85), with marginal reliability (0.65). Around 60% of the participants reported at least one depressive symptom. All items showed moderate to high levels of discrimination (a > 0.66), with "slept restlessly" being the most frequently reported (b = 0.43), and "felt lonely" being the least (b = 1.59). Four items - "slept restlessly," "felt lonely," "felt sad," and "could not get going" - had significant differential item functioning, with women more likely to report these items than men at equivalent symptom levels.
CONCLUSION: The Center for Epidemiologic Studies Depression Scale items showed acceptable reliability and effectively captured varying depression severity. Despite some differential item functioning, no substantial gender-related measurement bias was found, supporting the scale's use for screening in older adult populations.
METHODS: The participants were adults aged = 50 years from the English Longitudinal Study of Ageing. Using classical test theory and item response theory, data from 11,612 participants were analyzed to estimate reliability, item discrimination (a), and item difficulty (b). Differential item functioning analyses were used to determine whether men and women responded differently to items despite similar depressive symptom levels.
RESULTS: The Center for Epidemiologic Studies Depression Scale demonstrated adequate internal consistency (a = 0.80; ? = 0.85), with marginal reliability (0.65). Around 60% of the participants reported at least one depressive symptom. All items showed moderate to high levels of discrimination (a > 0.66), with "slept restlessly" being the most frequently reported (b = 0.43), and "felt lonely" being the least (b = 1.59). Four items - "slept restlessly," "felt lonely," "felt sad," and "could not get going" - had significant differential item functioning, with women more likely to report these items than men at equivalent symptom levels.
CONCLUSION: The Center for Epidemiologic Studies Depression Scale items showed acceptable reliability and effectively captured varying depression severity. Despite some differential item functioning, no substantial gender-related measurement bias was found, supporting the scale's use for screening in older adult populations.