Depression and suicidal ideation and behavior measurement invariance: A comparison of foreign-born and U.S.-born service members.

Abstract

This study examined if screening scores for depression and suicidal ideation and behavior can be interpreted comparably across U.S.- and foreign-born service members using data from the Army Study to Assess Risk and Resilience in Servicemembers. Data from 18,208 service members across various stages of their military career were used; all analyses used data that were adjusted using combined analysis weights, which resulted in a weighted sample of 567,337 (9.8% identified as foreign-born). A series of increasingly constrained multigroup measurement models were fit using structural equation modeling to assess for measurement invariance. Results suggest scores derived from the entry questions of the Composite International Diagnostic Interview Screening Scale for a major depressive episode can be interpreted comparably for hypothesis testing when samples include both U.S.-born and foreign-born service members. In contrast, response patterns to two entry screening items from the Columbia-Suicide Severity Rating Scale suggested nonequivalence in how scores were interpreted across groups; post hoc logistic regressions were conducted to further probe the nature of variance. Scores on items regarding passive ideation and suicidal behavior varied by sex, age, race/ethnicity, and English proficiency between U.S.- and foreign-born groups. Findings indicate caution is warranted when using the Columbia-Suicide Severity Rating Scale entry items when utilizing samples that include U.S.- and foreign-born service members and highlight the importance of attending to the intersectionality of factors such as nation of origin, sex, age, race/ethnicity, and English proficiency when screening for suicidal ideation and behavior. (PsycInfo Database Record (c) 2026 APA, all rights reserved).