Assessing a culturally appropriate factor structure of the Center for Epidemiologic Studies Depression (CES-D) scale among Japanese Brazilians

Abstract

Different cultures often express identical symptoms in different ways. The original four-factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) might not be appropriate for all cultural groups. This study aimed to investigate the factor structure of the CES-D among Japanese Brazilians and to examine relationships between the CES-D and Japanese language proficiency. Participants were Japanese Brazilians (n = 136). Exploratory and confirmatory factor analyses were conducted to determine the structure of the Portuguese CES-D. The relationships were examined using the generalized linear model. We tested the five CES-D models on Japanese Brazilians and found these models did not satisfactory meet goodness-of-fit criteria. Therefore, we performed post-hoc factor analyses on the CES-D and determined a best-fit structure composed of four factors, namely: ‘Depressed Affect/Somatic Symptoms’, ‘Loneliness/Sadness’, ‘(Absence of) Positive Affect’ and ‘Interpersonal Difficulties’. Two items functioned differently from the original model and the structure differed from models developed among Brazilian or Japanese samples. Internal reliability and construct validity were acceptable. Japanese language proficiency, a measure of culture retention, was significantly related to subscores for the absence of positive affect. This suggests a complex relationship between language and cultural background that can affect reporting on instruments such as the CES-D.

Keywords:

• CES-D
• Japanese Brazilians
• factor structure
• confirmatory factor analysis
• Japanese language proficiency

Acknowledgements

We thank the Japanese Brazilian Associations in northeastern Brazil for providing the opportunity to contact Japanese Brazilians for this study.

Disclosure statement

The authors declare that they have no conflicts of interest.

Notes on contributors

Takashi Asakura is a professor in the Laboratory of Health and Social Behavior at Tokyo Gakugei University. His research interests include mental health, the socio-cultural environment, ethnic minorities and adolescents.

Gilbert C Gee is a professor of Community Health Sciences at the University of California-Los Angeles. His research focuses on determining how racism and other forms of structural disadvantage contribute to health and healthcare disparities. He also examines local neighborhoods and issues of environmental justice using a multi-level and life-course perspective.

Kyoko Asakura is a professor of the Department of Nursing Education and Administration at Graduate School of Medicine, Tohoku University. Her research interests include psychosocial stress, professional nurse autonomy, social capital and migration of health professionals.

Additional information

Funding

This work was supported by a Grant-in-Aid for scientific research from the Japan Society for the Promotion of Science [grant number 19490011].