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A symptom profile of depression among Asian Americans: is there evidence for differential item functioning of depressive symptoms?

Published online by Cambridge University Press:  20 February 2014

Z. Kalibatseva*
Affiliation:
Department of Psychology, Michigan State University, East Lansing, MI, USA
F. T. L. Leong
Affiliation:
Department of Psychology, Michigan State University, East Lansing, MI, USA
E. H. Ham
Affiliation:
Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, USA
*
* Address for correspondence: Ms. Z. Kalibatseva, Department of Psychology, Michigan State University, East Lansing, MI 48224, USA. (Email: [email protected])

Abstract

Background

Theoretical and clinical publications suggest the existence of cultural differences in the expression and experience of depression. Measurement non-equivalence remains a potential methodological explanation for the lower prevalence of depression among Asian Americans compared to European Americans.

Method

This study compared DSM-IV depressive symptoms among Asian Americans and European Americans using secondary data analysis of the Collaborative Psychiatric Epidemiology Surveys (CPES). The Composite International Diagnostic Interview (CIDI) was used for the assessment of depressive symptoms. Of the entire sample, 310 Asian Americans and 1974 European Americans reported depressive symptoms and were included in the analyses. Measurement variance was examined with an item response theory differential item functioning (IRT DIF) analysis.

Results

χ2 analyses indicated that, compared to Asian Americans, European American participants more frequently endorsed affective symptoms such as ‘feeling depressed’, ‘feeling discouraged’ and ‘cried more often’. The IRT analysis detected DIF for four out of the 15 depression symptom items. At equal levels of depression, Asian Americans endorsed feeling worthless and appetite changes more easily than European Americans, and European Americans endorsed feeling nervous and crying more often than Asian Americans.

Conclusions

Asian Americans did not seem to over-report somatic symptoms; however, European Americans seemed to report more affective symptoms than Asian Americans. The results suggest that there was measurement variance in a few of the depression items.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

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References

Alegría, M, Takeuchi, DT, Canino, G, Duan, N, Shrout, P, Meng, XL, Vega, W, Zane, N, Vila, D, Woo, M, Vera, M, Guarnaccia, P, Aguilar-Gaxiola, S, Sue, S, Escobar, J, Lin, KM, Gong, F (2004 a). Considering context, place, and culture: the National Latino and Asian American Study. International Journal of Methods in Psychiatric Research 13, 208220.Google Scholar
Alegría, M, Vila, D, Woo, M, Canino, G, Takeuchi, D, Vera, M, Febo, V, Guarnaccia, P, Aquilar-Gaxiola, S, Shrout, P (2004 b). Cultural relevance and equivalence in the NLAAS instrument: integrating etic and emic in the development of cross-cultural measures for a psychiatric epidemiology and services study of Latinos. International Journal of Methods in Psychiatric Research 13, 270288.Google Scholar
Ankenmann, RD, Witt, EA, Dunbar, SB (1999). An investigation of the power of the likelihood ratio goodness-of-fit statistic in detecting differential item functioning. Journal of Educational Measurement 36, 277300.Google Scholar
Breslau, J, Aguilar-Gaxiola, S, Kendler, KS, Su, M, Williams, D, Kessler, RC (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine 36, 5768.Google Scholar
Breslau, J, Javaras, KN, Blacker, D, Murphy, JM, Normand, ST (2008). Differential item functioning between ethnic groups in the epidemiological assessment of depression. Journal of Nervous and Mental Disease 196, 297306.Google Scholar
Chang, SM, Hahm, BJ, Lee, JL, Shin, MS, Jeon, HJ, Hong, JP, Lee, HB, Lee, DW, Cho, MJ (2008). Cross-national difference in the prevalence of depression caused by the diagnostic threshold. Journal of Affective Disorders 106, 159167.Google Scholar
Cohen, AS, Kim, S, Wollack, JA (1996). An investigation of the likelihood ratio test for detection of differential item functioning. Applied Psychological Measurement 20, 1526.Google Scholar
Flora, DB, Curran, PJ (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods 9, 466491.Google Scholar
Hambleton, RK, Bartram, D, Oakland, T (2011). Technical advances and guidelines for improving testing practices. In IAAP Handbook of Applied Psychology (ed. Martin, P. R., Cheung, F. M., Knowles, M. C., Kyrios, M., Littlefield, L., Overmier, J. B. and Prieto, J. M.), pp. 338361. Wiley-Blackwell: Hoboken, NJ.Google Scholar
Heeringa, SG, Wagner, J, Torres, M, Duan, N, Adams, T, Berglund, P (2004). Sample design and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research 13, 221240.Google Scholar
Hicks, MHR (2002). Validity of the CIDI probe flow chart for depression in Chinese American women. Transcultural Psychiatry 39, 434451.CrossRefGoogle Scholar
Huang, FY, Chung, H, Kroenke, K, Delucchi, KL, Spitzer, RL (2006). Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. Journal of General Internal Medicine 21, 547552.Google Scholar
Jang, Y, Kim, G, Chiriboga, D (2005). Acculturation and manifestation of depressive symptoms among Korean-American older adults. Aging and Mental Health 9, 500507.Google Scholar
Kalibatseva, Z, Leong, FTL (2011). Depression among Asian Americans: review and recommendations. Depression Research and Treatment 2011, 320902.Google Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 30953105.Google Scholar
Kessler, RC, Üstün, TB (2004). The World Mental Health Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.Google Scholar
Kirmayer, L, Jarvis, GE (2006). Depression across cultures. In The American Psychiatric Publishing Textbook of Mood Disorders (ed. Stein, D. J., Kupfer, D. J. and Schatzberg, A. F.), pp. 699715. American Psychiatric Publishing: Arlington, VA.Google Scholar
Kirmayer, LJ, Young, A (1998). Culture and somatization: clinical, epidemiological, and ethnographic perspectives. Psychosomatic Medicine 60, 420430.CrossRefGoogle ScholarPubMed
Kleinman, A (1982). Neurasthenia and depression: a study of somatization and culture in China. Culture, Medicine, and Psychiatry 6, 117190.CrossRefGoogle ScholarPubMed
Kleinman, A (1988). Rethinking Psychiatry: From Cultural Category to Personal Experience. Free Press: New York, NY.Google Scholar
Kleinman, A, Good, B (1985). Culture and Depression. University of California Press: Berkeley, CA.Google Scholar
Lee, S (2002). Socio-cultural and global health perspectives for the development of future psychiatric diagnostic systems. Psychopathology 35, 152157.CrossRefGoogle ScholarPubMed
Leong, FTL, Lau, ASL (2001). Barriers to providing effective mental health services to Asian Americans. Mental Health Services Research 3, 201214.Google Scholar
Lu, A, Bond, MH, Friedman, M, Chan, C (2010). Understanding cultural influences on depression by analyzing a measure of its constituent symptoms. International Journal of Psychological Studies 2, 5570.Google Scholar
Markus, HR, Kitayama, S (1991). Culture and the self: implications for cognition, emotion, and motivation. Psychological Review 98, 224253.Google Scholar
Marsella, AJ (1987). The measurement of depressive experience and disorder across cultures. In The Measurement of Depression (ed. Marsella, A. J., Hirschfeld, R. M. A. and Katz, M. M.), pp. 376397. Guilford Press: New York, NY.Google Scholar
Marsella, AJ, Kinzie, D, Gordon, P (1973). Ethnic variations in the expression of depression. Journal of Cross-Cultural Psychology 4, 435458.Google Scholar
Marsella, AJ, Sartorius, N, Jablensky, A, Fenton, F (1985). Cross-cultural studies of depressive disorders: an overview. In Culture and Depression (ed. Kleinman, A. and Good, B.), pp. 299324. University of California Press: Berkeley, CA.Google Scholar
Murray, CJ, Lopez, AD (1996). The Global Burden of Disease. A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Harvard School of Public Health: Cambridge, MA.Google Scholar
Muthén, BO, du, Toit SHC, Spisic, D (1997). Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes (www.statmodel.com/wlscv.shtml). Accessed 20 January 2014.Google Scholar
Pennell, BE, Bowers, A, Carr, D, Chardoul, S, Cheung, GQ, Dinkelmann, K, Gebler, N, Hansen, SE, Pennell, S, Torres, M (2004). The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. International Journal of Methods in Psychiatric Research 13, 241269.Google Scholar
Rogler, LH, Mroczek, DK, Fellows, M, Loftus, ST (2001). The neglect of response bias in mental health research. Journal of Nervous and Mental Disease 189, 182187.Google Scholar
Ryder, AG, Yang, J, Zhu, X, Yao, S, Yi, J, Heine, S, Bagby, RM (2008). The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology 117, 300313.Google Scholar
Takeuchi, DT, Hong, S, Gile, K, Alegría, M (2007). Developmental contexts and mental disorders among Asian Americans. Research in Human Development 4, 4969.Google Scholar
Tanaka-Matsumi, J, Marsella, AJ (1976). Cross-cultural variation in the phenomenological experience of depression: I. Word association studies. Journal of Cross-Cultural Psychology 7, 379396.Google Scholar
Teresi, JA (2006). Different approaches to differential item functioning in health applications. Advantages, disadvantages and some neglected topics. Medical Care 44, S152S170.Google Scholar
Thakker, J, Ward, T (1998). Culture and classification: the cross-cultural application of the DSM-IV. Clinical Psychology Review 18, 501528.Google Scholar
Thissen, D (2001). IRTLRDIF v. 2.0b: software for the computation of the statistics involved in item response theory likelihood-ratio tests for differential item functioning (www.unc.edu/~dthissen/dl.html). Accessed 17 December 2013.Google Scholar
Uebelacker, LA, Strong, D, Weinstock, LM, Miller, IW (2009). Use of item response theory to understand differential item functioning of DSM-IV major depression symptoms by race, ethnicity, and gender. Psychological Medicine 39, 591601.Google Scholar
Weissman, MM, Bland, RC, Canino, GJ, Faravelli, C, Greenwald, S, Hwu, HG, Joyce, PR, Karam, EG, Lee, CK, Lellouch, J, Lepine, JP, Newman, SC, Rubio-Stipec, M, Wells, JE, Wickramaratne, PJ, Wittchen, H, Yeh, EK (1996). Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association 276, 293299.Google Scholar
Williams, DR, Gonzalez, HM, Neighbors, H, Nesse, R, Abelson, JM, Sweetman, J, Jackson, JS (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks and non-Hispanic whites: results from the National Survey of American Life. Archives of General Psychiatry 64, 305315.Google Scholar
Zane, N, Yeh, M (2002). The use of culturally-based variables in assessment: studies on loss of face. In Asian American Mental Health: Assessment Theories and Methods (ed. Kurasaki, K. S., Okazaki, S. and Sue, S.), pp. 123137. Kluwer Academic/Plenum Publishers: New York, NY.Google Scholar