Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-04T21:06:21.816Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychological distress across the lifespan: examining age-related item bias in the Kessler 6 Psychological Distress Scale

Published online by Cambridge University Press:  21 September 2011

Matthew Sunderland ,
Megan J. Hobbs ,
Tracy M. Anderson  and
Gavin Andrews
Matthew Sunderland*
Affiliation:
Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, St Vincent's Hospital, Sydney, Australia
Megan J. Hobbs
Affiliation:
Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, St Vincent's Hospital, Sydney, Australia
Tracy M. Anderson
Affiliation:
Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, St Vincent's Hospital, Sydney, Australia
Gavin Andrews
Affiliation:
Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, St Vincent's Hospital, Sydney, Australia
*
Correspondence should be addressed to: Dr Matthew Sunderland, CRUfAD, Level 4, O'Brien Centre, St Vincent's Hospital, 394–404 Victoria Street, Darlinghurst, NSW 2010, Australia. Phone: +612 8382 1437. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Old age respondents may differ systemically in their responses to measures of psychological distress over and above their actual latent distress levels when compared to younger respondents. The current study aimed to investigate the potential for age-related bias(es) in the Kessler 6 Psychological Distress Scale (K6) items.

Methods: Data from the 2007 Australian National Survey of Mental Health and Wellbeing were analyzed using Item Response Theory to detect the presence of item bias in each of the K6 items. The potential for item bias was assessed by systematically comparing respondents classed as young (16–34 years), middle aged (35–64 years), and old aged (65–85 years). The significance and magnitude of the item bias between the age groups was assessed using the log-likelihood ratio method of differential item functioning.

Results: After statistical adjustment, there were no biases of significant magnitude influencing the endorsement of K6 items between young and middle-aged respondents or between middle-aged and old age respondents. There was a bias of significant magnitude present in the endorsement of the K6 item addressing levels of fatigue between young and old age respondents.

Conclusions: Despite the identification of significant item bias in the endorsement of K6 items between the age groups, the magnitude and influence of the bias on total K6 scores is likely to have little influence on the overall interpretation of group data when comparing psychological distress across the lifespan. Researchers should be cautious, however, when examining individual levels of fatigue related to psychological distress in older individuals.

Keywords

Kessler 6item biasdifferential item functioningage comparisonsvalidityitem response theory
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 2 , February 2012 , pp. 231 - 242
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G. and Slade, T (2001). Interpreting scores on the Kessler Psychological Distress Scale (K10). Australian and New Zealand Journal of Public Health, 25, 494–497.CrossRefGoogle ScholarPubMed
Baker, F. B. (2001). The Basics of Item Response Theory. College Park, MD: ERIC Clearinghouse on Assessment and Evaluation.Google Scholar
Benjamini, Y. and Hochberg, Y. (1995). Controlling for false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society, Series B, 57, 289–300.Google Scholar
Browne, M. W. and Cudeck, R. (1993). Alternative ways of assessing model fit. In Bollen, K. A. and Long, J. S. (eds.), Testing Structural Equation Models. Newbury Park, CA: Sage.Google Scholar
Cohen, A. S., Kim, S-H. and Baker, F. B. (1993). Detection of differential item functioning in the graded response model. Applied Psychological Measurement, 17, 335–350.CrossRefGoogle Scholar
Embretson, S. E. and Reise, S. P. (2000). Item Response Theory for Psychologists. New York, NY: Lawrence Erlbaum Associates, Inc.Google Scholar
Ernst, C. and Angst, J. (1995). Depression in old age: is there a real decrease in prevalence? European Archives of Psychiatry and Clinical Neuroscience, 245, 272–287.CrossRefGoogle Scholar
Fassaert, T. et al. (2009). Psychometric properties of an interviewer-administered version of the Kessler Psychological Distress scale (K10) among Dutch, Moroccan and Turkish respondents. International Journal of Methods in Psychiatric Research, 18, 159–169.CrossRefGoogle ScholarPubMed
Furukawa, T. A., Kessler, R. C., Slade, T. and Andrews, G. (2003). The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychological Medicine, 33, 357–362.CrossRefGoogle ScholarPubMed
Grayson, D. A., Mackinnon, A., Jorm, A. F., Creasey, H. and Broe, G. A. (2000) Item bias in the Center for Epidemiologic Studies Depression Scale: effects of physical disorders and disability in an elderly community sample. Journal of Gerontology: Series B, Psychological Sciences and Social Sciences, 55B, 273–282.CrossRefGoogle Scholar
Henderson, A. S., Jorm, A. F., Korten, A. E., Jacomb, P., Christensen, H. and Rodgers, B. (1998). Symptoms of depression and anxiety during adult life: evidence for a decline in prevalence with age. Psychological Medicine, 28, 1321–1328.CrossRefGoogle ScholarPubMed
Hong, S-I., Hasche, L. and Bowland, S. (2009). Structural relationships between social activities and longitudinal trajectories of depression among older adults. Gerontologist, 49, 1–11.CrossRefGoogle ScholarPubMed
Hu, L. T. and Bentler, P. M. (1998). Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods, 3, 424–453.CrossRefGoogle Scholar
Jorm, A. F. (2000). Does old age reduce risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine, 20, 11–22.CrossRefGoogle Scholar
Kessler, R. C. and Ustun, T. B. (2008). The WHO World Mental Health Surveys. Cambridge: Cambridge University Press.Google Scholar
Kessler, R. C. et al. (2002). Short screening scales to monitor population prevalence and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976.CrossRefGoogle ScholarPubMed
Kessler, R. C. et al. (2010a). Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative. International Journals of Methods in Psychiatric Research, 19, 4–22.CrossRefGoogle ScholarPubMed
Kessler, R. C., Birnbaum, H., Bromet, E., Hwang, I., Sampson, N., and Shahly, V. (2010b). Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R). Psychological Medicine, 40, 225–237.CrossRefGoogle ScholarPubMed
Kim, S.-H. and Cohen, A. S. (1995). A comparison of Lord's chi-square, Raju's area measures, and the likelihood ratio test on detection of differential item functioning. Applied Measurement in Education, 8, 291–312.CrossRefGoogle Scholar
Muthén, L. K. and Muthén, B. O. (2010). Mplus Users’ Guide Sixth Edition. Los Angeles, CA: Muthén & Muthén.Google Scholar
Navas-Ara, M. J. and Gomez-Benito, J. (2002). Effects of ability scale purification on the identification of DIF. European Journal of Psychological Assessment, 18, 9–15.CrossRefGoogle Scholar
O'Connor, D. W. and Parslow, R. A. (2009). Different responses to K-10 and CIDI suggest that complex structured psychiatric interviews underestimate rates of mental disorder in old people. Psychological Medicine, 39, 1527–1531.CrossRefGoogle ScholarPubMed
Raju, N. S., van der Linden, W. J. and Fleer, P. F. (1995). IRT-based internal measures of differential functioning of items and tests. Applied Psychological Measurement, 19, 353–368.CrossRefGoogle Scholar
Samejima, F. (1969). Estimation of latent ability using a response pattern of graded scores. Psychometrika Monograph Supplement, 34, 100.Google Scholar
Slade, T., Grove, R. and Burgess, P. (2011). Kessler Psychological Distress Scale: normative data from the 2007 Australian National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 45, 308–316.CrossRefGoogle ScholarPubMed
Snowdon, J. (2001). Is depression more prevalent in old age? Australian and New Zealand Journal of Psychiatry, 35, 782–787.CrossRefGoogle ScholarPubMed
Sunderland, M., Slade, T., Stewart, G. and Andrews, G. (in press). Estimating the prevalence of DSM-IV mental illness in the Australian general population using the Kessler psychological distress scale. Australian and New Zealand Journal of Psychiatry.Google Scholar
Teresi, J. A. and Fleishman, J. A. (2007). Differential item functioning and health assessment. Quality Life Research, 16, 33–42.CrossRefGoogle ScholarPubMed
Teresi, J. A. et al. (2007). Evaluating measurement equivalence using the item response theory log-likelihood ratio (IRTLR) method to assess differential item functioning (DIF): applications to measures of physical functioning ability and general distress. Quality Life Research, 16, 43–68.CrossRefGoogle ScholarPubMed
Thissen, D. (2001). IRTLRDIF v 2.0b: Software for the Computation of the Statistics Involved in Item Response Theory Likelihood-Ratio Tests for Differential Item Functioning. Chapel Hill, NC: University of New Carolina. Software and user's manual available at: http://www.unc.edu/~dthissen/dl.html.Google Scholar
Thissen, D., Steinberg, L. and Kuang, D. (2002). Quick and easy implementation of the Benjamini-Hochberg procedure for controlling the false positive rate in multiple comparisons. Journal of Educational and Behavioral Statistics, 27, 77–83.CrossRefGoogle Scholar
Trollor, J. N., Sachdev, P. S., Anderson, T. M., Andrews, G. and Brodaty, H. (2007). Age shall not weary them: mental health in the middle-aged and the elderly. Australian and New Zealand Journal of Psychiatry, 41, 581–589.CrossRefGoogle Scholar
Tsang, A. et al. (2008). Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders Journal of Pain, 9, 883–891.CrossRefGoogle ScholarPubMed
van den Linden, W. J., and Hambleton, R. K. (1997). Handbook of Modern Item Response Theory. New York, NY: Springer-Verlag.CrossRefGoogle Scholar
Vink, D., Aartsen, M. J. and Schoevers, R. A. (2008). Risk factors for anxiety and depression in the elderly: a review. Journal of Affective Disorders, 106, 29–44.CrossRefGoogle ScholarPubMed
Wang, W-C., and Yeh, Y-L. (2003). Effects of anchor item methods on differential item functioning detection with the likelihood ratio test. Applied Psychological Measurement, 27, 479–498.CrossRefGoogle Scholar
Wolter, K. M. (2007). Introduction to Variance Estimation. New York, NY: Springer.Google Scholar
Woods, C. (2009). Empirical selection of anchor for tests of differential item functioning. Applied Psychological Measurement, 33, 42–57.CrossRefGoogle Scholar