Content Validity of the Geriatric Depression Scale in Inpatient Health Care Settings

H.Edward Fouty, Erica L. Ailes, Katelyn D. Brown, Chelsea L. Morgan, Erin Sivertsen, Karen Y. Briceno, Cassandra R. Smith, Daniel Guzman, Christopher T. DeVries, Christina M. Diluccia, Whitney L. Catoe, Stephanie C. Betancourt, Kristy M. McLarnan


The content validity of the Geriatric Depression Scale (GDS) for use in inpatient health care settings was evaluated. Clinical experience has shown that one or more questions may not be appropriate in such settings. These questions ask about behaviors or feelings with which the examinee may not be able to identify with because they have been in an inpatient setting during the past week. Twenty-five Subject Matter Experts (SMEs) evaluated the GDS-30 as to whether each item appropriately assesses the construct of depression for inpatients in a medical care setting. SMEs were identified by an online search of the Florida Division of Medical Quality Assurance database; inclusion criteria are presented. Nineteen SMEs held a Ph.D. and six held a Psy.D. Years of post-licensure practice experience ranged from 10 to 48 years with a mean of 23.12 years (SD = 10.07). Using the Content Validity Ratio, four questions emerged as inappropriate (statistically significant at, or below, an alpha level of .025). The lack of content validity of these questions necessitates their omission when psychometrically assessing depression in elderly inpatients. Recommended revised cutoff values are presented. Utilizing the recommended modification to the GDS presented here should reduce false positives when psychometrically assessing depression in elderly inpatients.


GDS; inpatient; medical settings; elderly; depression

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M. Dennis, A. Kadri, and J. Coffey, “Depression in older people in the general hospital: A systematic review of screening instruments,” Age Ageing, vol. 41, no. 2, pp. 148-154, January 2012.

J. Onishi, Y. Suzuki, H. Umegaki, H. Endo, T. Kawamura, and A. Iguchi, “A comparison of depressive mood in older adults in a community, nursing homes, and a geriatric hospital: Factor analysis of

Geriatric Depression Scale,” J Geriatr Psychiatry Neurol, vol. 19, no. 1, pp. 26-31, March 2006.

T. L. Brink, J. A. Yesavage, O. Lum, P. H. Heersema, M. Adey, and T. L. Rose, “Screening tests for geriatric depression,” Clin Gerontol, vol. 1, no. 1, pp. 37-43, October 1982.

J. A. Yesavage et al., “Development and validation of a geriatric depression screening scale: A preliminary report,” J Psychiatr Res, vol. 17, no. 1, pp. 37-49, 1983.

S. Heidenblut, and S. Zank, “Screening for depression with the Depression in Old Age Scale (DIA-S) and the Geriatric Depression Scale (GDS15): Diagnostic accuracy in a geriatric inpatient setting,” GeroPsych, vol. 27, no. 1, pp. 41-49, March 2014.

J. I. Sheikh, and J. A. Yesavage, “Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version,” Clin Gerontol, vol. 5, no. 1-2, pp. 165-173, June 1986.

P. D’Ath, P. Katona, E. Mullan, S. Evans, and C. Katona, “Screening, detection and management of depression in elderly primary care attenders: 1. The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions,” Fam Pract, vol. 11, no. 3, pp. 260-266, September 1994.

O. P. Almeida, and S. A. Almeida, “Short versions of the Geriatric Depression Scale: A study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV,” Int J Geriatr Psychiatry, vol. 14, no. 10, pp. 858-865, October 1999.

D. A. Dillman, J. D. Smyth, and L. M. Christian, Internet, Mail and Mixed-Mode Surveys: The Tailored Design Method, 3rd ed. Hoboken, NJ: Wiley, 2009.

S. L. Jackson, Research Methods: A Modular Approach, 3rd ed. Stamford, CT: Cengage Learning, 2015.

C. H. Lawshe, “A quantitative approach to content validity,” Pers Psychol, vol. 28, no. 4, pp. 563-575, December 1975.

F. R. Wilson, W. Pan, and D. A. Schumsky, “Recalculation of the critical values for Lawshe’s Content Validity Ratio,” Meas Eval Couns Dev, vol. 45, no. 3, pp. 197-210, July 2012.

D. Bijl, H. W. J. van Marwjik, H. J. Ader, A. T. F Beekman, and M. Haan, “Test characteristics of the GDS-15 in screening for major depression in elderly patients in general practice,” Clin Gerontol, vol. 29, no. 1, pp. 1-9, January 2005.

K. Jongenelis et al., “Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients,” Int J Geriatr Psychiatry, vol. 20, pp. 1067-1074, November 2005.

E. L. Lesher, and J. S. Berryhill, “Validation of the Geriatric Depression Scale: Short form among inpatients,” J Clin Psychol, vol. 50, no. 2, pp. 256-260, March 1994.


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