Test of item-response bias in the CES-D scale: experience from the New Haven EPESE Study

We present results of item-response bias analyses of the exogenous variables age, gender, and race for all items from the Center for Epidemiologic Studies Depression (CES-D) scale using data (N = 2340) from the New Haven component of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). The proportional odds of blacks responding higher on the CES-D items "people are unfriendly" and "people dislike me" were 2.29 (95% confidence interval: 1.74, 3.02) and 2.96 (95% confidence interval: 2.15, 4.07) times that of whites matched on overall depressive symptoms, respectively. In addition, the proportional odds of women responding higher on the CES-D item "crying spells" were 2.14 (95% confidence interval: 1.60, 2.82) times that of men matched on overall depressive symptoms. Our data indicate the CES-D would have greater validity among this diverse group of older men and women after removal of the crying item and two interpersonal items. (C) 2000 Elsevier Science Inc. All rights reserved.