@article{ref1,
title="The CES-D in Chinese American women: Construct validity, diagnostic validity for major depression, and cultural response bias",
journal="Psychiatry research",
year="2010",
author="Li, Zhixia and Hicks, Madelyn Hsiao-Rei",
volume="175",
number="3",
pages="227-232",
abstract="Previous studies of the Center for Epidemiologic Studies Depression Scale (CES-D) in Chinese Americans describe internal reliability and factor structure. We report CES-D construct validity and diagnostic validity for major depression in a probability sample of 168 community-dwelling Chinese American women. Internal consistency was satisfactory (Cronbach's alpha=0.86). Good construct validity was indicated by significantly higher mean CES-D scores for respondents who reported lower social support, worse self-perceived general health, or stressful life events, including intimate partner violence. Cultural response bias was found, with positively-stated CES-D items (e.g. &quot;I was happy&quot;) producing higher depression scores in immigrants and subjects who preferred to speak Chinese. Diagnostic validity for major depression was assessed using the Composite International Diagnostic Interview. A CES-D cut-off score of 16 had sensitivity of 100% (95% CI: 44% to 100%), specificity of 76% (95% CI: 69% to 82%), PPV of 7% (95% CI: 3% to 19%) and NPV of 100% (95% CI: 97% to 100%). Our findings suggest that the CES-D is useful for screening out non-depressed subjects in a first-stage assessment. However, it should be followed by a diagnostic tool in Chinese American women with scores above the cut-off in order to identify those with clinical depression.<p /><p>Language: en</p>",
language="en",
issn="0165-1781",
doi="10.1016/j.psychres.2009.03.007",
url="http://dx.doi.org/10.1016/j.psychres.2009.03.007"
}