Depression among Asian American Adults: Unique CES-D Structure

Background: While studies in CES-D (Center for Epidemiolgic Studies Depression Scale) have consistantly reported a four factor contruct for European-background Americans, inconsistent factor structures were reported for other populations. The purpose of this study is to examine the factor structure of the CES-D among Asian American adults residing in Baltimore-Washington DC metropolitan area, which has the fastest growing Asian population.

Method: 877 Asian Americans, 18 or more years old, completed a self-reported questionnaire at several community organizations, churches, and local ethnic businesses. Construct validity was assessed using exploratory factor analysis (EFA) and tested using confirmatory factor analysis (CFA) on a separate subset of Asian Americans (Korean, Chinese, and Vietnamese).

Results: EFA showed a two factor construct for the 20 item scale. The 16 items of the interpersonal, depressed affect, and somatic-retardation components were loaded as a single factor. The other factor consisted the 4 items of the positive affect component. CFA for the two factor model fit consistently across the three subgroups of Asian Americans.

Conclusions: Depression structure of Asian American adults differ from those of European-American adults. Study data suggest further studies of cultural background in understanding of the concept of depression. We speculate that interpersonal issues closely associate with emotional and physical depression for Asian Americans who often experience more interdependent cultural-influences than those of individualism. Further studies with non-immigrant groups by those in homelands, are suggested to confirm the two factor model, which may help identify unique acculturation stressors and mental health issues among Asian American immigrants.