Does “no ” mean “sometimes”? How older adults respond to the same depression symptoms with different response formats

In this report we describe problems associated with the administration of binary choice response questionnaires, with particular attention to depression measures given to older adults. A convenience sample of 77 respondents aged 70+ completed two different versions of the 8-item Center for Epidemiologic Studies-Depression (CES-D) scale. Versions were identical except for having either two- or four- response option formats. Within-person responses were compared to determine equivalence across formats. We found that a binary-response option format over- or under-estimated depressive symptomatology. Thus, a four-response option for the CES-D may be a more precise estimate of currently experienced symptoms. Keywords response format; survey methods; depression; older adults The purpose of this study was to (1) describe concerns about the use of binary response option formats, and (2) conduct a direct comparison of two versions of the CES-D, a binary choice yes/no option and a four-choice response option, in a sample of older adults. The Center for Epidemiologic Studies-Depression (CES-D) scale is widely used in population studies, to estimate the level of depressive symptoms in a given sample, and clinically as a screening instrument for depression. The original CES-D consists of a twenty-item questionnaire with a four-response option format (Radloff, 1977). Numerous variations of the original scale have been used in clinical as well as in field studies of older adults (Kohout