The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61442

Zara E. Sadler, MS¹, Barbara Tilley, PhD², Philip F. Rust, PhD¹, Rebecca Knapp, PhD¹, Linda M. Kaste, DDS, PhD³, and Stephen McLeod-Bryant, MD⁴. (1) Department of Biometry and Epidemiology, Medical University of South Carolina, 135 Cannon Street, Suite 303, P.O. Box 250835, Charleston, SC 29425, 843-876-1100, sadlerze@musc.edu, (2) Department of Biometry and Epidemiology, Medical College of South Carolina, 135 Cannon Street, Suite 303, P.O. Box 250835, Charleston, SC 29425, (3) Department of Pediatric Dentistry, University of Illinois at Chicago, College of Dentistry, 801 S. Paulina Street, Chicago, IL 60612, (4) Medical Directors Office, South Carolina Department of Mental Health, 2414 Bull Street, P.O. Box 485, Columbia, SC 29202

Findings from the NHANES III sample indicate that the proportion of major depression for US residents, 20-39 years, is higher for Non-Hispanic (NH) Whites than for NH Blacks and Mexican Americans. Do these racial/ethnic differences reflect true differences in mental health status or errors associated with the measurement instrument? Validation of diagnosing major depression in standardized health surveys among cross-cultural young and middle-aged persons from these racial/ethnic groups is lacking. The Diagnostic Interview Schedule (DIS) is based on DSM-III criteria for diagnosis of major depression and results in an 8-factor structure. Comparison of this 8-factor structure for NH Whites, NH Black, and Mexican Americans in NHANES III shows that, regardless of race/ethnicity, the 8-factor structure fits well, although the 8-factor model did provide a better fit for NH Whites and NH Blacks than for Mexican Americans. Item bias was also assessed to determine if differential in the proportion of respondents diagnosed with major depression was an artifact of item construction, or the lack of neutrality across race/ethnic groups in this sample. Of the 16 items measuring lifetime depressive symptoms, only the worthlessness item exhibited differential item functioning (DIF) for the race/ethnic groups in the sample. Misclassification based on this item was not sufficient to explain differences in prevalence. Thus racial/ethnic differences in prevalence is not explained by differences in factor structure or by DIF.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• Articulate the process for assessing differences in the factor structure and item functioning of lifetime depressive symptoms for selected race/ethnic groups.
• Discuss racial/ethnic differences in the factor structure and item functioning of lifetime depressive symptoms which could possibly explain racial/ethnic differences in depression prevalence.

Keywords: Assessments, Depression

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.