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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 7/2016

01-07-2016 | Original Paper

Depression symptoms across cultures: an IRT analysis of standard depression symptoms using data from eight countries

Authors: E. E. Haroz, P. Bolton, A. Gross, K. S. Chan, L. Michalopoulos, J. Bass

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2016

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Abstract

Purpose

Prevalence estimates of depression vary between countries, possibly due to differential functioning of items between settings. This study compared the performance of the widely used Hopkins symptom checklist 15-item depression scale (HSCL-15) across multiple settings using item response theory analyses. Data came from adult populations in the low and middle income countries (LMIC) of Colombia, Indonesia, Kurdistan Iraq, Rwanda, Iraq, Thailand (Burmese refugees), and Uganda (N = 4732).

Methods

Item parameters based on a graded response model were compared across LMIC settings. Differential item functioning (DIF) by setting was evaluated using multiple indicators multiple causes (MIMIC) models.

Results

Most items performed well across settings except items related to suicidal ideation and “loss of sexual interest or pleasure,” which had low discrimination parameters (suicide: a = 0.31 in Thailand to a = 2.49 in Indonesia; sexual interest: a = 0.74 in Rwanda to a = 1.26 in one region of Kurdistan). Most items showed some degree of DIF, but DIF only impacted aggregate scale-level scores in Indonesia.

Conclusions

Thirteen of the 15 HSCL depression items performed well across diverse settings, with most items showing a strong relationship to the underlying trait of depression. The results support the cross-cultural applicability of most of these depression symptoms across LMIC settings. DIF impacted aggregate depression scores in one setting illustrating a possible source of measurement invariance in prevalence estimates.
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Metadata
Title
Depression symptoms across cultures: an IRT analysis of standard depression symptoms using data from eight countries
Authors
E. E. Haroz
P. Bolton
A. Gross
K. S. Chan
L. Michalopoulos
J. Bass
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 7/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-016-1218-3

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