TY - JOUR
T1 - Sex differences in the psychometric properties of the Center for Epidemiological Studies-Depression (CES-D) Scale in older Filipinos
AU - Afable, Sanny D.
AU - Cruz, Grace T
AU - Saito, Yasuhiko
N1 - Funding: The authors would like to acknowledge the LSAHP project, which was conducted by the Demographic Research and Development Foundation and funded by the Economic Research Institute for ASEAN and East Asia, Jakarta, Indonesia. Further, this study was developed from the corresponding author’s thesis, which won the grand prize for the Loretta Makasiar Sicat Prize for the Social Sciences of the Philippine Social Science Council and was also supported by a grant from the Josefina V. Cabigon Memorial Scholarship by the University of the Philippines Population Institute.
PY - 2023/6/14
Y1 - 2023/6/14
N2 - The literature has yet to fully account for sex differences in the symptomatology and measurement of depressive symptoms, especially in developing settings like the Philippines. Thus, we established the factor structure and assessed the reliability of the 11-item version of the Center for Epidemiological Studies–Depression (CES-D) Scale for assessing depressive symptoms in older Filipino men and women. Using cross-sectional data from 5,209 community-dwelling Filipinos aged 60 and above from a nationally representative survey, Confirmatory Factor Analysis (CFA) and methods in Item Response Theory (IRT) were applied to provide complementary insights into the properties of the scale and its individual items. CFA supported the multidimensionality of the scale. The scale is also sex-invariant, but the relationship between the subfactors and the higher-order factor may differ between men and women. In addition, findings from IRT analysis confirmed the overall utility of the CES-D scale, but positively stated items were found to be internally inconsistent with the rest of the scale. The scale is desirably informative for assessing more severe symptoms, although sex differences were found in the precision of individual items. In general, the 11-item CES-D Scale is an adequate multidimensional tool for assessing moderate to severe depressive symptoms in the older population, especially in older men.
AB - The literature has yet to fully account for sex differences in the symptomatology and measurement of depressive symptoms, especially in developing settings like the Philippines. Thus, we established the factor structure and assessed the reliability of the 11-item version of the Center for Epidemiological Studies–Depression (CES-D) Scale for assessing depressive symptoms in older Filipino men and women. Using cross-sectional data from 5,209 community-dwelling Filipinos aged 60 and above from a nationally representative survey, Confirmatory Factor Analysis (CFA) and methods in Item Response Theory (IRT) were applied to provide complementary insights into the properties of the scale and its individual items. CFA supported the multidimensionality of the scale. The scale is also sex-invariant, but the relationship between the subfactors and the higher-order factor may differ between men and women. In addition, findings from IRT analysis confirmed the overall utility of the CES-D scale, but positively stated items were found to be internally inconsistent with the rest of the scale. The scale is desirably informative for assessing more severe symptoms, although sex differences were found in the precision of individual items. In general, the 11-item CES-D Scale is an adequate multidimensional tool for assessing moderate to severe depressive symptoms in the older population, especially in older men.
U2 - 10.1371/journal.pone.0286508
DO - 10.1371/journal.pone.0286508
M3 - Article
C2 - 37315084
SN - 1932-6203
VL - 18
JO - PLoS ONE
JF - PLoS ONE
IS - 6
M1 - e0286508
ER -