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Cross-Cultural Confirmatory Factor Analysis of the CES-D in Spanish and Mexican Dementia Caregivers

Published online by Cambridge University Press:  10 January 2013

Andrés Losada ,
Mª de los Ángeles Villareal ,
Roberto Nuevo ,
María Márquez-González ,
Bertha C. Salazar ,
Rosa Romero-Moreno ,
Ana L. Carrillo  and
Virginia Fernández-Fernández
Andrés Losada*
Affiliation:
Universidad Rey Juan Carlos (Spain)
Mª de los Ángeles Villareal
Affiliation:
Universidad Autónoma de Coahuila (Mexico)
Roberto Nuevo
Affiliation:
Hospital Universitario de Getafe (Spain)
María Márquez-González
Affiliation:
Universidad Autónoma de Madrid (Spain)
Bertha C. Salazar
Affiliation:
Universidad Autónoma de Nuevo León (Mexico)
Rosa Romero-Moreno
Affiliation:
Universidad Rey Juan Carlos (Spain)
Ana L. Carrillo
Affiliation:
Universidad Autónoma de Coahuila (Mexico)
Virginia Fernández-Fernández
Affiliation:
Universidad Rey Juan Carlos (Spain)
*
Correspondence concerning this article should be addressed to Andrés Losada-Baltar. Facultad de Ciencias de la Salud. Departamento de Psicología. Edificio Departamental II. Avda. de Atenas, s/n. 28922 Alcorcón-Madrid (Spain). Phone: + 34-914888941. E-mail: andres.losada@urjc.es
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Abstract

The Center for Epidemiologic Studies-Depression Scale (CES-D) is the most frequently used scale for measuring depressive symptomatology in caregiving research. The aim of this study is to test its construct structure and measurement equivalence between caregivers from two Spanish-speaking countries. Face-to-face interviews were carried out with 595 female dementia caregivers from Madrid, Spain, and from Coahuila, Mexico. The structure of the CES-D was analyzed using exploratory and confirmatory factor analysis (EFA and CFA, respectively). Measurement invariance across samples was analyzed comparing a baseline model with a more restrictive model. Significant differences between means were found for 7 items. The results of the EFA clearly supported a four-factor solution. The CFA for the whole sample with the four factors revealed high and statistically significant loading coefficients for all items (except item number 4). When equality constraints were imposed to test for the invariance between countries, the change in chi-square was significant, indicating that complete invariance could not be assumed. Significant between-countries differences were found for three of the four latent factor mean scores. Although the results provide general support for the original four-factor structure, caution should be exercised on reporting comparisons of depression scores between Spanish-speaking countries.

La Escala del Centro para Estudios Epidemiológicos (CES-D) es la más utilizada para medir sintomatología depresiva en la investigación sobre cuidadores. El objetivo de este estudio es analizar su estructura dimensional y su equivalencia de medida entre cuidadores de dos países de habla hispana. Se entrevistó a 595 mujeres cuidadoras de familiares con demencia de Madrid, España, y Coahuila, México. La estructura del CES-D se analizó mediante análisis factoriales exploratorios (AFE) y confirmatorios (AFC). Se encontraron diferencias estadísticamente significativas entre las medias de 7 ítems. Los resultados del AFE con la muestra total respaldan claramente una solución de 4 factores. El AFC de la estructura de 4 factores revela cargas elevadas y significativas para todos los ítems (excepto el 4). Al imponer restricciones de igualdad para valorar la equivalencia entre países, el cambio en chi-cuadrado fue significativo, indicando que no se puede asumir una equivalencia completa. Se encontraron diferencias significativas entre países para tres de las cuatro puntuaciones medias en los factores latentes. Aunque los resultados proporcionan un apoyo general a la estructura original de cuatro factores, se debería tener una cierta cautela a la hora de informar sobre comparaciones en puntuaciones en depresión entre países de habla hispana.

Keywords

AlzheimercaregivingdementiadepressionSpanish-speakingLatinoAlzheimercuidadoresdemenciadepresiónhispano hablanteslatinos
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 15 , Issue 2 , July 2012 , pp. 783 - 792
Copyright
Copyright © Cambridge University Press 2012

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References

Aguilera-Guzmán, R. M., Carreño-García, M. S., & García, F. J. (2004). Características psicométricas de la CES-D en una muestra de adolescentes rurales mexicanos de zonas con alta tradición migratoria [Psychometric properties of the CES-D in a sample of Mexican rural adolescents from areas with strong migratory tradition]. Salud Mental, 27, 57–66.Google Scholar
Alzheimer's Disease International. (2009). Alzheimer's Disease International. WorldAlzheimer Report. London, England: Alzheimer's Disease International Retrieved from http://www.alz.co.uk/research/files/WorldAlzheimerReport.pdfGoogle Scholar
Aranda, M. P., & Knight, B. G. (1996). The influence of ethnicity and culture on the caregiver stress and coping process: A sociocultural review and analysis. The Gerontologist, 37, 342–354. http://dx.doi.org/10.1093/geront/37.3.342Google Scholar
Berr, C., Wancata, J., & Ritchie, K. (2005). Prevalence of dementia in the elderly in Europe. European Neuropsychopharmacology, 15, 463–471. http://dx.doi.org/10.1016/j.euroneuro.2005.04.003CrossRefGoogle ScholarPubMed
Brodaty, H. (2007). Meaning and measurement or caregiver outcomes. International Psychogeriatrics, 19, 363–381.http://dx.doi.org/10.1017/S1041610207005182CrossRefGoogle ScholarPubMed
Calvete, E., Estévez, A., Landín, C., Martínez, Y., Cardeñoso, O., Villardón, L., & Villa, A. (2005). Self talk and affective problems in college students: Valence of thinking and cognitive content specificity. The Spanish Journal of Psychology, 8, 56–67.Google Scholar
Campo-Arias, A., Díaz-Martínez, L. A., Rueda-Jaimes, G. E., Cadena-Afanador, L. P., & Hernández, N. L. (2007). Psychometric properties of the CES-D Scale among Colombian adults from the general population. Revista Colombiana de Psiquiatría, 36, 664–674.Google Scholar
Cook, R. D., & Weisberg, S. (1983). Diagnostics for heteroscedasticity in regression. Biometrika, 70, 1–10. http://dx.doi.org/10.1093/biomet/70.1.1Google Scholar
Flora, D. B., & Curran, P. J. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9, 466–491. http://dx.doi.org/10.1037/1082-989X.9.4.466CrossRefGoogle ScholarPubMed
Golding, J. M., & Aneshensel, C. S. (1989). Factor structure of the Center for Epidemiologic Studies Depression Scale among Mexican Americans and Non-Hispanic whites. Psychological Assessment, 1, 163–168. http://dx.doi.org/10.1037//1040-3590.1.3.163CrossRefGoogle Scholar
González, V., Stewart, A., Ritter, P., & Lorig, K. (1995). Translation and validation of arthritis outcome measures into Spanish. Arthritis and Rheumatism, 38, 1429–1446. http://dx.doi.org/10.1002/art.1780381010Google Scholar
Hilgeman, M. M., Durkin, D. W., Sun, F., DeCoster, J., Allen, R. S, Gallagher-Thompson, D., & Burgio, L. D. (2009). Testing a theoretical model of the stress process in Alzheimer's caregivers with race as a moderator. The Gerontologist, 49, 248–261. http://dx.doi.org/10.1093/geront/gnp015CrossRefGoogle Scholar
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling, 6, 1–55. http://dx.doi.org/10.1080/10705519909540118CrossRefGoogle Scholar
Knight, B. G., & Sayegh, P. (2010). Cultural values and caregiving: Updated sociocultural stress and coping model. Journals of Gerontology: Psychological Sciences, 65B, 5–13. http://dx.doi.org/10.1093/geronb/gbp096CrossRefGoogle ScholarPubMed
Knight, R. G., Williams, S., McGee, R., & Olaman, S. (1997). Psychometric properties of the Centre for Epidemiologic Studies Depression Scale (CES-D) in a sample of women in middle life. Behaviour Research and Therapy, 35, 373–380. http://dx.doi.org/10.1016/S0005-7967(96)00107-6CrossRefGoogle Scholar
Llibre Rodriguez, J. J., Ferri, C. P., Acosta, D., Guerra, M., Huang, Y., Jacob, K. S., … 10/66 Dementia Research Group (2008). Prevalence of dementia in Latin America, India, and China: A population-based cross-sectional survey. Lancet, 372, 464–474. http://dx.doi.org/10.1016/S0140-6736(08)61002-8Google Scholar
Losada, A., Márquez-González, M., & Romero-Moreno, R. (2011). Mechanisms of action of a psychological intervention for dementia caregivers: Effects of behavioral activation and modification of dysfunctional thoughts. International Journal of Geriatric Psychiatry, 26, 1119–1127. http://dx.doi.org/10.1002/gps.2648CrossRefGoogle ScholarPubMed
Losada, A., Peñacoba, C., Márquez-González, M., & Cigarán, M. (2008). Cuidar Cuidándose. Evaluación e intervención interdisciplinar con cuidadores familiares de personas con demencia [Caregiving caring of yourself. Assessment and multidisciplinary intervention for family caregivers of people with dementia]. Madrid, Spain: Obra Social Caja Madrid.Google Scholar
Losada, A., Robinson Shurgot, G., Knight, B. G., Márquez, M., Montorio, I., Izal, M., & Ruiz, M.A. (2006). Cross-cultural study comparing the association of familism with burden and depressive symptoms in two samples of Hispanic dementia caregivers. Aging and Mental Health, 10, 69–76. http://dx.doi.org/10.1080/13607860500307647CrossRefGoogle ScholarPubMed
McCauley, S. R., Pedroza, C., Brown, S. A., Boake, C., Levin, H. S., Goodman, H. S., & Merritt, S. G. (2006). Confirmatory factor structure of the Center for Epidemiologic Studies-Depression Scale (CES-D) in mild-to-moderate traumatic brain injury. Brain Injury, 20, 519–527. http://dx.doi.org/10.1080/02699050600676651CrossRefGoogle Scholar
Moniz-Cook, E., Vernooij-Dassen, M., Woods, R., Verhey, F., Chattat, R., de Vugt, , … INTERDEM group (2008). A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging and Mental Health, 12, 14–29. http://dx.doi.org/10.1080/13607860801919850CrossRefGoogle ScholarPubMed
Muthén, B., & Asparouhov, T. (2002). Latent variable analysis with categorical outcomes: Multiple-group and growth modeling in Mplus. Mplus Web Notes, 4. Retrieved from http://www.statmodel.com/download/webnotes/CatMGLong.pdfGoogle Scholar
Muthén, B., & Christoffersson, A. (1981). Simultaneous factor analysis of dichotomous variables in several groups. Psychometrika, 46, 407–419. http://dx.doi.org/10.1007/BF02293798CrossRefGoogle Scholar
Muthén, L., & Muthén, B. (1998–2006). Mplus user's guide (4th Ed.). Los Angeles, CA: Muthén, L., & Muthén, B..Google Scholar
O'Rourke, N. (2005). Factor structure of the Center for Epidemiologic Studies-Depression Scale (CES-D) among older men and women who provide care to persons with dementia. International Journal of Testing, 5, 265–277. http://dx.doi.org/10.1207/s15327574ijt0503_5CrossRefGoogle Scholar
Pinquart, M., & Sörensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18, 250–267. http://dx.doi.org/10.1037/0882-7974.18.2.250CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: A Self-Report Depression Scale for research in the general population. Applied Psychological Measurement, 1, 385–401. http://dx.doi.org/10.1177/014662167700100306Google Scholar
Reyes-Ortega, M., Soto-Hernández, A. L., Milla-Kegel, J. G., García-Ramírez, A., Hubard-Vignau, L., Mendoza-Sánchez, H., … Wagner-Echegaray, F. A. (2003). Actualización de la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). Estudio piloto en una muestra geriátrica Mexicana [Updating of the Center for Epidemiologic Studies-Depression Scale (CES-D). Pilot study in a geriatric Mexican sample]. Salud Mental,26, 59–68.Google Scholar
Roth, D. L., Ackerman, M. L., Okonkwo, O. C., & Burgio, L. D. (2008). The four-factor model of depressive symptoms in dementia caregivers: A structural equation model of ethnic differences. Psychology and Aging, 23, 567–576. http://dx.doi.org/10.1037/a0013287CrossRefGoogle ScholarPubMed
Schreiber, J. B., Stage, F. K., King, J., Nora, A., & Barlow, E. A. (2006). Reporting Structural Equation Modelling and Confirmatory Factor Analysis results: A review. The Journal of educational research, 99, 323–338. http://dx.doi.org/10.3200/JOER.99.6.323-338CrossRefGoogle Scholar
Schulz, R., O'Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes. The Gerontologist, 35, 771–791. http://dx.doi.org/10.1093/geront/35.6.771CrossRefGoogle ScholarPubMed
Soler, J., Pérez-Sola, V., Puigdemont, D., Pérez-Blanco, J., Figueres, M., & Alvarez, E. (1997). Validation study of the Center for Epidemiologic Studies-Depression (CES-D) in affective disorders in Spanish population. Actas Españolas de Psiquiatría, 25, 243–249.Google Scholar
Stata Statistical Software Release 11.0. (2009). Stata Statistical Software Release 11.0. College Station, TX: StataCorp.Google Scholar
Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 4–70. http://dx.doi.org/10.1177/109442810031002CrossRefGoogle Scholar
Williams, C. D., Taylor, T. R., Makambi, K., Harrell, J., Palmer, J. R., Rosenberg, L., & Adams-Campbell, L. L. (2007). CES-D four-factor structure is confirmed, but not invariant, in a large cohort of African American women. Psychiatry Research, 150, 173–180. http://dx.doi.org/10.1016/j.psychres.2006.02.007CrossRefGoogle ScholarPubMed
Ximénez, C., & Revuelta, J. (2010). Factorial invariance in a repeated measures design: an application to the study of person-organization fit. The Spanish Journal of Psychology, 13, 485–493.CrossRefGoogle Scholar
Yu, C. Y. (2002). Evaluating cutoff criteria of model fit indices for latent variable models withbinary and continuous outcomes. Los Angeles, CA: University of California.Google Scholar