title: Not saying I am happy does not mean I am not: cultural influences on responses to positive affect items in the CES-D.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Aging and Mental Health Disparities, Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Boulevard, MHC 1400, Tampa, FL 33612, USA. yjang@fmhi.usf.edu
authors.forename: Yuri
authors.initials: Y
authors.lastname: Jang
authors.forename: Kyung Hwa
authors.initials: KH
authors.lastname: Kwag
authors.forename: David A
authors.initials: DA
authors.lastname: Chiriboga
mesh_terms: D000069:Acculturation; D000339:Affect; D000368:Aged; D001213:Asian / Q000523:psychology*; D003469:Culture; D003863:Depression / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D007723:Korea / Q000208:ethnology; D008297:Male; D017533:Marital Status; D008603:Mental Health; D011569:Psychiatric Status Rating Scales; D014481:United States; D044465:White People / Q000523:psychology