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What do network members know? Network members as reporters of depression among Caucasian-American and African-American older women
- Authors:
- HELLER Kenneth, VIKEN Richard J., SWINDLE Ralph W.
- Journal article citation:
- Aging and Mental Health, 17(2), 2013, pp.215-225.
- Publisher:
- Taylor and Francis
Perceived stigma makes many older adults reluctant to seek help for mental health problems. The authors asked whether family members and friends could be accurate proxy informants. African-American and Caucasian older women (n=153; mean age 75 years) previously screened for depression nominated up to five network members (NMs) two of whom were contacted as informants. NMs completed an informant version of the CES-D, described their closeness to the participant, the extent of the participant's support from family and friends, and their assessment of the participant's typical coping strategies. These reports were used to predict participant CES-D, Hamilton depression scores, and Structured Clinical Interview (SCID) depression diagnoses concurrently and at six-month and one-year intervals. NMs’ estimates of participants CES-D status were highly correlated with participants own CES-D scores, and also predicted Hamilton depression scores and SCID diagnoses concurrently and at six months and one year later. NMs’ ratings of participants’ use of positive coping also predicted depression at six months and one year. The authors conclude that NMs were able to accurately predict depression even one year later. They suggest that future research should test the possibility that NMs might be recruited as allies in encouraging earlier treatment and providing support to older adults through difficult life transitions.
Screening for depression in African American and Caucasian older women
- Authors:
- HELLER Kenneth, VIKEN Richard J., SWINDLE Ralph W.
- Journal article citation:
- Aging and Mental Health, 14(3), April 2010, pp.339-346.
- Publisher:
- Taylor and Francis
The purpose of this study was to assess the performance of a 2-choice (yes/no), 10-item shortened form of the CES-D (Center for Epidemiological Studies-Depression Instrument) in both African American and Caucasian older women. The CES-D is a widely used screening instrument, but its use has been questioned for routine screening because of its length and the complexity of its 4-choice format. There is also little data available about its suitability in low-income African American respondents. Telephone screening for depression followed by in-home diagnostic interviews were conducted in a community sample of 256 Caucasian and 186 African American low-income older women who ranged in age from 64 to 94 years. Standard receiver operator curves were plotted to determine the sensitivities and specificities of the screening instrument at different cut-scores against a criterion of SCID-based diagnoses of current major depressive episode (CMDE). The results demonstrated that the sensitivity and specificity of the 10-item scale and an even shorter 5-item version was slightly higher for African American than for Caucasian women. While both short forms produced significant numbers of false positives against a criterion of CMDE, many of the women identified by the screen did have significant depressive symptomatology. Significantly, fewer African American women received a diagnosis of CMDE primarily because they did not show diminution of functioning associated with their depressive symptoms. The article concludes that short, easy to administer forms of the CES-D can provide useful information in working with older patients. Clinicians should be aware of ethnic differences in symptom expression and levels of functional impairment.