Exploring measurement invariance by gender in the profile of mood states depression subscale among cancer survivors
The Profile of Mood States-Short Form (POMS-SF) is a well-validated tool commonly used in medical/clinical research. Less attention has been paid to the measurement invariance of the POMS—the degree to which the structure and items behave similarly for different groups (e.g., women and men). This study investigated the measurement invariance of the POMS Depression subscale across gender groups in a sample of cancer survivors.
The POMS Depression subscale has 8 items (Unhappy, Sad, Blue, Hopeless, Discouraged, Miserable, Helpless, and Worthless). Invariance was measured using multigroup confirmatory factor analysis. This study used data from American Cancer Society Studies of Cancer Survivors-II, a population-based survey of adult cancer survivors (n = 9170).
We found factor structures and factor loadings were invariant for gender groups, but moderate differential item functioning (DIF) in the question containing the word blue.
With regard to cancer survivors’ gender, we found the Depression subscale of the POMS-SF had configural invariance, and partial metric and scalar invariance. This suggests that results should be interpreted with caution, especially when gender is considered important. More broadly, our finding suggests that questions with the word blue may introduce DIF into other measures of depressive mood. More research is needed to replicate these findings in other samples and with other instruments.
KeywordsDepression Patient-reported outcomes Measurement invariance Differential item functioning
The American Cancer Society (ACS) Studies of Cancer Survivors (SCS) was funded as an intramural program of research conducted by the ACS Behavioral Research Center. We wish to acknowledge the cooperation and efforts of the cancer registries and public health departments from the states of Arizona, California (Regions 2–6), Colorado, Delaware, Illinois, Iowa, Maine, Massachusetts, Michigan, Nebraska, New Jersey, Pennsylvania, Washington, and Wyoming. We also thank the staff of the hundreds of hospitals that reported cases to the participating cancer registries. Lastly, we are grateful to the thousands of cancer survivors, their physicians, and their loved ones who contributed to the collection of these data. The authors assume full responsibility for analyses and interpretation of these data.
This study was funded by an intramural program of research conducted by the American Cancer Society’s Behavioral Research Center.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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