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 variable s age, gender, and race for all items from the Center for Epidemiologic Stu dies Depression (CES-D) scale using data (N = 2340) from the New Haven comp onent of the Established Populations for Epidemiologic Studies of the Elder ly (EPESE). The proportional odds of blacks responding higher on the CES-D items "people are unfriendly" and "people dislike me" were 2.29 (95% confid ence interval: 1.74, 3.02) and 2.96 (95% confidence interval: 2.15, 4.07) t imes that of whites matched on overall depressive symptoms, respectively. I n addition, the proportional odds of women responding higher on the CES-D i tem "crying spells" were 2.14 (95% confidence interval: 1.60, 2.82) times t hat of men matched on overall depressive symptoms. Our data indicate the CE S-D would have greater validity among this diverse group of older men and w omen after removal of the crying item and two interpersonal items. (C) 2000 Elsevier Science Inc. All rights reserved.