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Use of item response theory to understand differential functioning of DSM-IV major depression symptoms by race, ethnicity and gender

  • L. A. Uebelacker (a1), D. Strong (a1), L. M. Weinstock (a1) and I. W. Miller (a1)

Psychological literature and clinical lore suggest that there may be systematic differences in how various demographic groups experience depressive symptoms, particularly somatic symptoms. The aim of the current study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of depression symptom severity, there are demographic differences in the likelihood of reporting DSM-IV depression symptoms.


We conducted a secondary analysis of a subset (n=13 753) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) dataset, which includes a large epidemiological sample of English-speaking Americans. We compared data from women and men, Hispanics and non-Hispanic Whites, African Americans and Whites, Asian Americans and Whites, and American Indians and Whites.


There were few differences overall, although the differences that we did find were primarily limited to somatic symptoms, and particularly appetite and weight disturbance.


For the most part, individuals responded similarly to the criteria used to diagnose major depression across gender and across English-speaking racial and ethnic groups in the USA.

Corresponding author
*Address for correspondence: Dr L. A. Uebelacker, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA. (Email:
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Psychological Medicine
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