Not saying I am happy does not mean I am not: Cultural influences on responses to positive affect items in the CES-D

Yuri Jang, Kyung Hwa Kwag, David A. Chiriboga

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39 Scopus citations


Objectives. Given the emphasis on modesty and self-effacement in Asian societies, the present study explored differential item responses for 2 positive affect items (5 = Hopeful and 8 = Happy) on a short form of the Center for Epidemiologic Studies-Depression scale. The samples consisted of elderly non-Hispanic Whites (n = 450), Korean Americans (n = 519), and Koreans (n = 2,030). Method. Multiple Indicator Multiple Cause models were estimated to identify the impact of group membership on responses to the positive affect items while controlling for the latent trait of depressive symptoms. Results. The data revealed that Koreans and Korean Americans were less likely than non-Hispanic Whites to endorse the positive affect items. Compared with Korean Americans who were more acculturated to mainstream American culture, those who were less acculturated were less likely to endorse the positive affect items. Discussion. Our findings support the notion that the way in which people endorse depressive symptoms is substantially influenced by cultural orientation. These findings call into question the common use of simple mean comparisons and a universal cutoff point across diverse cultural groups.

Original languageEnglish
Pages (from-to)684-690
Number of pages7
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume65 B
Issue number6
StatePublished - Nov 2010

Bibliographical note

Funding Information:
The Survey of Older Floridians was supported by the Administration on Aging (Grant No. 90AM2750; Jennifer Salmon, PhD, Principal Investigator). The Mental Health Literacy among Korean American Elders project was supported by the National Institute of Mental Health (Grant No. 1R21MH081094-01A1; Yuri Jang, PhD, Principal Investigator).


  • CES-D
  • Differential item function
  • Korean


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