how do adolescents define depression? - cIRcle - University of ...

Chapter II: Literature Review
Tools Used in Assessing, Measuring, and Diagnosing Depression in Adolescents
Assessing depression is an important process because the outcome may potentially have a
very profound impact on the young person being assessed (e.g., access to services, is
hospitalized, or denied access to services [Reynolds & Johnston, 1994]). To determine the
presence or absence of depression in adolescents, virtually all researchers and practitioners use
assessment procedures (Reynolds, 1994b). Still, there does not seem to be a gold standard-type
instrument for assessing adolescent depression. Measures of psychopathology, either in the form
of interviews or questionnaires, can generate a wide range of prevalence estimates, depending on
the precision of the scoring criteria. However, those estimates are only as good as the
classifications systems used (Costello et al., 2005).
Research is needed to establish the extent to which measures and operational definitions
accurately classify young individuals (Kazdin, 2001) as having or not having a change in their
level of depression. Available tools still lack precise elements of time, core symptoms of
adolescent depression, and good validity, reliability, internal consistency and sensitivity to
change in adolescent depression. In the following section, I discuss an interview and a self-report
tool that have been used extensively in assessing depressive symptomatology in adolescents.
Costello, Egger, and Angold (2005) indicate that the highly structured psychiatric
interviews, first established decades ago for adults, are integral for diagnosing psychopathology.
One of the semi-structured diagnostic interviews presently used for children and adolescents in
the age range from 6 to 18 years is the Schedule for Affective Disorders and Schizophrenia,
School-Aged Children ( Kiddie-SADS; K-SADS; Puig-Antich & Chambers, 1978) (Brooks &
Kutcher, 2001; Merrell, 1999). The entire interview takes two to three hours (Kaufman et al.,
1997). It is used to elicit information on a wide range of emotional and behavior problems
(Merrell, 1999) and designed to assess and diagnose episodes of psychopathology (Brooks &
Kutcher, 2001), with a separate section for depression. The K-SADS classification criteria follow
the DSM standards (APA, 1994). Trained mental health professionals and researchers, qualified
to make psychiatric diagnoses, often use this measure to assess an individual's condition and
provide a diagnosis. A revised version of the K-SADS is referred to as the Present and Lifetime
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