Investigating the Factor Structure of the BSI-18 among African American Women Open Access

Abstract

The factor structure of the BSI-18 has been examined in a number of minority populations. It has been validated as a measure of general psychological distress, but found unable to identify the specific clinical syndromes it was designed to assess: Depression, Somatization and Anxiety. However, it has not been validated in African Americans. This study therefore aimed to investigate its factor structure in African American women.

Data from 208 African American female employees of a hospital in the southeastern United States were subjected to factor analysis. Exploratory Factor Analysis (EFA) was carried out in order to extract the number of factors, and Confirmatory Factor Analysis (CFA) done to validate the factor structure. CFA was also performed to determine whether the data fit the model proposed and tested by Derogatis, the developer of the BSI-I8. Derogatis' model comprises of four factors: the first factor is Depression; the second is Somatization; the third factor is Anxiety and the fourth factor is Panic.

The EFA of the data supported the four factor structure model proposed by Derogatis. However, the third factor was Panic and the fourth factor Anxiety. When the EFA was repeated to yield three factors, in keeping with the design of the BSI-18, the first factor was Depression, the second Somatization and the third Panic. The BSI-18 was also assessed as a measure of overall psychological distress. The CFA failed to confirm the factor structure of the BS1-18 in this sample. It was also found to be invalid as a measure of overall psychological distress. The results also revealed an overlap between the symptoms of Depression and those of Anxiety in the women. Furthermore, they showed that somatization symptoms may not be an indicator of psychological distress in African American women.

The findings are consistent with previous research that shows that African Americans express symptoms of mental health disorders differently from white Americans. Further research into the validity of the BSI-18 in African Americans therefore needs to take place. In addition, research into the manifestations of psychological distress in African Americans is necessary for the development of more suitable measures.

Table of Contents

I: INTRODUCTION.......................................................................................................... 1 II: BACKGROUND AND REVIEW OF THE LITERATURE....................................... 2 A. The Brief Symptom Inventory................................................................................... 2 B. Psychological Distress and African Americans.......................................................... 4 C. Theoretical Basis: Factor Analytic Theory.................................................................. 8 III. METHOD................................................................................................................... 10 A. Subjects.................................................................................................................... 10 B. Sampling and Recruitment....................................................................................... 11 C. Measures................................................................................................................... 11 D. Human Subjects Protection...................................................................................... 12 E. Analysis..................................................................................................................... 12 IV. RESULTS................................................................................................................... 13 V. DISCUSSION............................................................................................................. 20 A. Findings of the Factor Analysis............................................................................... 20 B. Conclusions............................................................................................................... 24 C. Strengths and Limitations......................................................................................... 25 D. Implications.............................................................................................................. 26 E. Recommendations..................................................................................................... 27 REFERENCES................................................................................................................. 29

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Psychology, Clinical Health Sciences, Public Health Health Sciences, Mental Health
Keyword	African Americans Factor Structure Validity Confirmatory Factor Analysis Mental Health Exploratory Factor Analysis Brief Symptom Inventory-18
Committee Chair / Thesis Advisor	Thompson, Nancy J, Emory University
Committee Members	Wingood, Gina M, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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