Correlates of depressed mood in normal children

Two instruments which have been proposed as measures of clinical depression in children and an ad hoc teacher rating were given to a group of 109 normal children. The Children's Depression Inventory (CDI), the Peer Nomination Inventory for Depression (PNID), and a teacher rating of depression were given along with the Conner s Teacher Rating Scale (TRS), teacher ratings of somatic complaints, peer popularity, and absenteeism, and peer ratings of popularity to examine the behavioral correlates of depressed mood in normal children. While few sex differences were found on mean depression scores, different patterns of correlations were found for the two sexes. For males, there were no significant correlations among the three depression measures, but all three depression measures were correlated with unpopularity and conduct problem ratings on the TRS. For females, the three depression measures were adequately intercorrelated. The teacher rating of depression was correlated with general deviance as measured by the TRS, but the CDI and PNID were correlated with TRS ratings of conduct problems, with peer ratings of unpopularity, and with teacher ratings of somatic complaints. Implications for the issue of the possible existence of a clinical syndrome of depression in children were discussed.     

Self-Report,Peer-Report,and Teacher-Report Measures of Childhood Depression: An Analysis by Item

We explored the low correlation among different types of childhood depression measures at the item level. The items from the Children's Depression Inventory (CDI), Peer Nomination Inventory of Depression (PNID), and the Child Behavior Checklist-Teacher Report Form (CBCL-T) were combined, and both first- and second-order factor analyses were conducted. Results indicate that self-report, peer-report, and teacher-report assessments of depression measure generally uncorrelated constructs. Second-order analysis suggests that depression as a global construct is being measured to some degree by items from all three instruments. Canonical analysis was employed to identify items that best predicted CDI, PNID, and CBL-T summary scores simultaneously. Also, the relationship between specific items with similar content was investigated. Results from these analyses generally supported a conclusion that the three types of measures yield scores that are primarily independent and that the use of summary scores is not masking stronger relationships within measures. These findings have implications for clinical practice and construct elaboration.     

Depression, suicide ideation, and aggression among high school students whose parents are divorced and use alcohol at home.

106 high school students from a small rural high school completed the Children of Alcoholics Scale, Zaks and Walters' Aggression Scale, Beck Depression Scale, and a modified version of the Beck Scale of Suicide Ideation. Analyses of variance showed boys were not experiencing suicide ideation any more than girls; suicide ideation was similar across the four grades, but on aggression alcohol-dependent boys scored significantly higher than girls, and in Grade 9 boys' scores were significantly higher than those in Grade 10. The sophomores' scores on alcohol dependency were significantly lower than the freshmen's scores. Boys and children from divorced homes had higher scores on aggression than girls and children from nondivorced homes. Children from homes in which alcohol was used had higher depression scores than children from nonalcoholic homes. Freshman girls and sophomore boys had higher depression scores than senior boys and girls. A Pearson r of 0.28 between scores on alcohol dependency and suicide ideation was significant, but research is needed to understand better the associations of thoughts of suicide and drug-alcohol dependency among these high school students so strategies for prevention and intervention can be focused.     

Self-report, peer-report, and teacher-report measures of childhood depression: an analysis by item.

We explored the low correlation among different types of childhood depression measures at the item level. The items from the Children's Depression Inventory (CDI), Peer Nomination Inventory of Depression (PNID), and the Child Behavior Checklist-Teacher Report Form (CBCL-T) were combined, and both first- and second-order factor analyses were conducted. Results indicate that self-report, peer-report, and teacher-report assessments of depression measure generally uncorrelated constructs. Second-order analysis suggests that depression as a global construct is being measured to some degree by items from all three instruments. Canonical analysis was employed to identify items that best predicted CDI, PNID, and CBL-T summary scores simultaneously. Also, the relationship between specific items with similar content was investigated. Results from these analyses generally supported a conclusion that the three types of measures yield scores that are primarily independent and that the use of summary scores is not masking stronger relationships within measures. These findings have implications for clinical practice and construct elaboration.     

Selective responsiveness of chronically ill children to assessments of depression.

Many investigators have noted that depression is a common symptom among pediatric cancer patients. However, prevalence rates vary widely across studies. This variation in prevalence rates may be due, in part, to selective reporting of patients based on measures used and environmental cues. In this study, we evaluated 50 chronically ill pediatric patients (19 cancer and 31 diabetic patients) for their use of selective reporting of depression. Factors in the 2 x 2 design were Intervention (disclosure videotape and cartoon videotape) and Examiner (familiar examiner and unfamiliar examiner). In the Intervention manipulation, subjects were shown either a videotape prompting the child that self-disclosure was appropriate or a tape of a cartoon (control condition). In the Examiner manipulation, subjects were administered the experimental measures by either a familiar (parent) or unfamiliar (research assistant) examiner. Dependent variables were the Children's Depression Inventory (CDI; Kovacs, 1981), the Depression scale of the Roberts Apperception Test for Children (RATC; McArthur & Roberts, 1982), and a depression measure taken from the Child Behavior Checklist (CBCL; Achenbach & Edelbrock, 1983). As hypothesized, the Examiner x Intervention interaction revealed that children who did not view the disclosure videotape and who were tested by an unfamiliar examiner gave significantly lower self-reports of depression on the CDI than children in the other conditions. However, parent and child projective reports of depression did not vary as a function of experimental condition. The results are interpreted as selective responding on the part of pediatric patients. Limitations of assessing internal psychological states in children are discussed.     

Age,gender, race,socioeconomic status,and birth cohort differences on the children's depression inventory: a meta-analysis

A within-scale meta-analysis was performed on 310 samples of children (ages 8-16; N = 61,424) responding to the Children's Depression Inventory (CDI). Girls' depression scores stayed steady from ages 8 to 11 and then increased between ages 12 and 16. Boys' CDI scores were stable from ages 8 to 16 except for a high CDI score at age 12. Girls' scores were slightly lower than boys' during childhood, but girls scored higher beginning at age 13. There were no socioeconomic status effects and no differences between White and Black samples. However, Hispanic samples scored significantly higher on the CDI. Analyses for birth cohort showed a slight decrease in boys' CDI scores over time and no change for girls. Longitudinal studies demonstrated a marked testing effect.     

Selective Responsiveness of Chronically Ill Children to Assessments of Depression

Many investigators have noted that depression is a common symptom among pediatric cancer patients. However, prevalence rates vary widely across studies This variation in prevalence rates may be due, in part, to selective reporting of patients based on measure, used and environmental cues. In this study, we evaluated 50 chronically ill pediatric patients (19 cancer and 31 diabetic patients) for their use of selective reporting of depression. Factors in the 2 x 2 design were Intervention (disclosure videotape and cartoon videotape) and Examiner (familiar examiner and unfamiliar examiner). In the intervention manipulation, subjects were shown either a videotape prompting the child that self-disclosure was appropriate or a tape of a cartoon (control condition). In the Examiner manipulation, subjects were administered the experimental measures by either a familiar (parent) or unfamiliar (research assistant) examiner. Dependent variables were the Children's Depression inventory (CDI; Kovacs, 1981), the Depression scale of the Roberts Apperception Test for Children (RATC; McArthur & Roberts, 1982), and a depression measure taken from the Child Behavior Checktist (CBCL; Achenbach & Edelbrock, 1983). As hypothesized, the Examiner x intervention interaction revealed that children who did not view the disclosure videotape and who were tested by an unfamiliar examiner gave significantly lower self-reports of depression on the CDI than children in the other conditions. However, parent and child projective reports of depression did not vary as a function of experimental condition. The results are interpreted as selective responding on the part of pediatric patients. Limitations of assessing internal psychological states in children are discussed.     

Parent-completed and adolescent-completed CDIs: Relationship to adolescent social and cognitive functioning

The purpose of this study was to examine the relationship of both young adolescents' scores on the Children's Depression Inventory (CDI) and their mothers' ratings of the adolescents' depression (parent-completed CDI) to indices of their social and cognitive functioning obtained from a source outside the home. Subjects consisted of a nonclinic sample of 85 young adolescents (11–15 years of age), their mothers, and their social studies teachers. Recent school grades and teacher-completed measures served as the indices of adolescent social and cognitive competence. The results indicated that both adolescents' and mothers' CDI scores were significantly and negatively correlated with measures of adolescent cognitive and social functioning. Multiple regression analyses, utilizing adolescent- and parent-completed CDI scores as predictors, indicated that both predictor variables entered into the equations for cognitive functioning while only the mother-completed CDI entered into those for social functioning. When maternal depression was also entered into the multiple regressions, the findings regarding mother- and adolescent-completed CDI scores were not altered. The relationship of these findings to other somewhat disparate findings concerning the utility of mother and child reports of child depression is discussed.This research was supported, in part, by the William T. Grant Foundation and the University of Georgia's Institute for Behavioral Research.     

The assessment of depression in children: The internal structure of the child depression inventory (CDI)

In the present report three separate studies of childhood depression were conducted. First, the internal structure of the Child Depression Inventory (CDI), with 216 children representing various ethnic groups with equal numbers of boys and girls, was evaluated through a factor analysis and by various internal-reliability measures (e.g. split-half reliabilities, Pearson correlations of each item to the total score). Four factors were established and internal reliability of the scale proved to be high. The relationship of the factor structure of the CDI to Kendell's Type A and B categorization of depression are discussed. In Study 2 the relationship of demographic variables to the CDI using the same group of children described for Study 1 was employed. Evaluating the characteristics of depression across age, sex and so on in children has not been frequently studied, and was deemed appropriate for the present investigation. Age proved to be a significant factor in depression scores although race and gender did not. With respect to age, older children tended to display more symptomatology. Comparisons of depressed children to nondepressed children also showed that age was a factor in the obtained scores, and range of severity in both groups. Depressed children differed from nondepressed children on all 27 items indicating that all the items on the CDI seem to be measuring a unitary concept. Study 3 compared CDI scores to a measure of social behavior, the Matson Evaluation of Social Skills with Youngster (MESSY). Seventy-six children (36 girls and 40 boys), ages 4–10 yrs $\text{(}\text{X}\text{?}\text{= 7)}$ were evaluated. Appropriate Social Skills was negatively correlated with childhood depression, and Inappropriate Impulsive/Assertiveness was positively correlated with depressive features described under the factor Guilt/Irritability. The implications of these data for further research on assessment, differential diagnosis and evaluation of treatment research are discussed.     

Depression in Latino adolescents: a cultural discrepancy perspective

Latino adolescents report high levels of depression compared to other youth, yet little is known about how culture-specific factors contribute to risk (Blazer, Kessler, McGonagle, & Swartz, 1994; Roberts, Roberts, & Chen, 1997; Roberts & Sobhan, 1992; Twenge & Nolen-Hoeksema, 2002). In this study we evaluated the link between cultural discrepancy (i.e., perceived acculturation and gender role disparity between children and their parents) and depression among children of Latino immigrants. Compared to boys, Latina adolescents reported greater differences in traditional gender role beliefs between themselves and their parents and higher levels of depression. Gender role discrepancy was associated with higher youth depression, with this relationship mediated by increases in family dysfunction. Moreover, a moderator analysis suggested that gender role discrepancy effects may be most pronounced for Latina adolescents. Gender role discrepancy was associated with poorer family functioning for girls but not for boys, although the interaction effect was only marginally significant. These preliminary results point to the importance of considering cultural discrepancy as a contributing factor to youth depression.     

Cognitive and Behavioral Contributions to Depression Severity,Quality of Life,and Functioning Among People Living With HIV in South Africa

Cognitive-behavioral treatments for depression typically address both behavioral (e.g., activation) and cognitive (e.g., rumination) components, and consequently improve quality of life (QOL) and function in high-resource settings. However, little is known about the cross-cultural applicability and relative contribution of these components to depression symptom severity, QOL, and functional impairment in South Africa and other resource-limited global settings with high HIV prevalence rates.Persons with HIV (N = 274) from a peri-urban community outside Cape Town, South Africa, were administered multiple measures of depression (Hamilton Depression Scale, Centre for Epidemiological Studies Depression Scale, South African Depression Scale), cognitive and behavioral components related to depression (Ruminative Response Scale, Behavioral Activation for Depression Scale), and measures of QOL and functioning (Sheehan Disability Scale, Quality of Life Enjoyment and Satisfaction Scale—Short Form). Multiple linear regression models were fit to assess the relative contribution of behavioral and cognitive components to depression severity, QOL, and functional impairment in this population.Models accounting for age and sex revealed that lower levels of behavioral activation (BA) were significantly associated with all measures of depression, as well as with QOL and functional impairment (all ps < .01). Rumination was associated with all measures of depression (all ps < .01), but not with QOL or functional impairment.The consistent and unique association of BA with depression, QOL, and functional impairment bolsters its importance as a treatment target for this population.     

Sex differences in social support, loneliness, and depression among Korean college students

This study examined the sex differences in reports of social support (network size and satisfaction), loneliness, and depression among Korean college students and examined whether measures of social support and loneliness predicted depression scores. In the sample were 452 college students enrolled in four universities in Korea. The women reported a larger social support network size and being less satisfied with their support than the men. Women reported higher scores on the Revised UCLA Loneliness Scale and the Beck Depression Inventory than men. Social support satisfaction scores and network size on the Social Support Questionnaire-6 and scores on the Loneliness Scale predicted scores on Depression in both the groups. Loneliness was the largest predictor of Depression for either sex. The amount of variance in Depression accounted for by Loneliness was 35% for women and 24% for men.     

Depression symptoms among Omani children: age and sex differences

The present study explored the existence of depressive symptoms among Omani children according to sex and age. The Arabic translated version of the Multidimensional Child and Adolescent Depression Scale was administered to 1,749 children (828 boys, 921 girls) ranging in age from 10 to 18 years old (M= 13.9, SD = 2.3) from 10 schools representing different areas of Muscat, Oman. The results showed no differences in the total mean scores on depression between boys and girls, although differences were observed on 4 of the 8 subscales. Boys had significantly higher scores on Weak concentration and Loneliness, while girls scored higher for Sleep problems and Anhedonia. Significant differences across ages also were exhibited for the total score as well as four subscales (Pessimism, Weak concentration, Anhedonia, and Fatigue), suggesting higher rates of depression among 15- to 18-year-olds.     

Measurement of depression: Comparison between self-reports and clinical assessments of depressed outpatients

Agreement among several depression scales was investigated as regard the relative influences of administration mode (self-rating or clinical rating) and scale content. The Beck Depression Inventory (BDI), the Self-Rating Depression Scale (SDS), the Hamilton Rating Scale for Depression (HRSD), and three corresponding scales with identical structure and content but the alternative administration mode were administered to 47 outpatients with diagnoses of DSM-III major depression disorders. Correlations between the total scores and the degrees of association between corresponding items of different scales were calculated. The results suggest that differences in content contribute more to inter-scale discrepancy than differences in administration mode. The implications for the evaluation of outpatients with major depression are discussed.     

Specificity of Depressive Symptoms and Suicidality in a Juvenile Delinquent Population

Research which has related scores on the Children's Depression Inventory (CDI) to suicidality have generally neglected to examine the possibility that specific depressive factors within the CDI may be more predictive of suicidality than the full scale score. Knowledge of such factors would help to explain the relationship between depression and suicidality and improve the prediction of suicidal behavior. The current study examined the relationship of depressive factors to suicidality in a sample of 200 incarcerated juvenile delinquents. The published factor structure for the CDI and one derived from the delinquent population were compared. Results revealed two factors from the derived solution, hopelessness and low self-esteem, to be more powerful predictors of suicidal ideation than the full-scale CDI score. These results suggest that symptoms such as low self-esteem and hopelessness may be responsible for the well-documented relationship between depression and suicidality. Furthermore, it appears that the prediction of suicidality may be improved by examining specific depressive factors in suicide research as opposed to full-scale scores from depression inventories such as the CDI.     

Self-esteem, depression, and alcohol dependency among high school students

123 high school students completed the short form of the Coopersmith Self-esteem Inventory-School Form and its Lie scale, Beck's Depression Inventory, and an Alcohol Dependency Scale. Analyses of variance (2 x 4) showed boys had higher mean Lie scores than girls, and freshmen had lower mean alcohol dependency scores than sophomores, juniors, and seniors. Correlations between self-esteem scores and depression scores were significant and negative, but values were significant and positive between self-esteem and lie scores and between depression and alcohol dependency scores. Much work is required to understand better the relations among depression, self-esteem, and drug and alcohol dependency in high school students if interventions are to focus upon prevention.     

Social skills and depression in adolescent suicide attempters

The relationship among depression, social skills, and suicidal behavior was examined in a sample of 41 adolescents hospitalized in a general medical setting following a suicide attempt. These subjects were compared to 40 nonsuicidal psychiatrically hospitalized adolescents. Level of depression, assessed using the Children's Depression Inventory (CDI), and social skills, assessed via the Matson Evaluation of Social Skills with Youngsters (MESSY), were evaluated for all subjects. The suicide attempters and psychiatrically hospitalized patients were not found to differ on either the CDI or MESSY. However, multiple regression analyses revealed the factor scores of the MESSY to be related to depression in both patient groups. The data provide support for the relationship between social skills and depression. Results are also discussed in terms of the similarities between adolescent suicide attempters and nonsuicidal psychiatrically disturbed adolescents.     

Evaluation of subclinical depression in children using self-, peer-, and teacher-report measures

This study reports on several classification issues utilizing the Children's Depression Inventory (CDI), the Child Behavior Checklist-Teacher Form (CBCL-T), and the Peer Nomination Inventory of Depression (PNID). The first sample contained 752 public school children in grades 5, 6, and 9. A second sample of 142 fifth-graders was included to have an additional PNID comparison group. Results revealed moderate correlations between the CDI and the CBCL-T and PNID. Use of multiple criteria for selecting children as depressed was discussed, and selection rates using multiple measures with either strict or lenient cutoff scores were given. Normative data on the PNID were evaluated, and it was suggested that norms for the PNID may not be generalizable to other samples. Finally, race and gender analyses showed that CDI scores for females were significantly higher than for males, whereas CDI scores for Hispanics were significantly higher than for non-Hispanic whites. However, Omega-squared analyses for these two variables showed this to be of little practical significance.     

Depression and self-esteem in academically gifted and nongifted children: A comparison study

The present investigation examined depression and self-esteem in a sample of 145 gifted and nongifted fourth and fifth grade children. Self-esteem was assessed by the Coopersmith Self-Esteem Inventory. Depression was measured by Kovacs' Children's Depression Inventory, the Reynolds' Child Depression Scale, and teachers' global ratings of depression. As a group, gifted children did not differ on levels of self-esteem or depression from their nongifted peers. However, when grade and gender differences were examined, it was found that gifted boys tended to report lower levels of self-esteem and more depression than gifted girls. Teachers also judged boys to be more depressed than girls. Furthermore, fifth-graders were rated by teachers to be more depressed than fourth-graders. Overall, this investigation did not find major differences in affective characteristics between gifted and nongifted children.     

Norms and screening utility of the Dutch version of the Children's Depression Inventory in clinical and nonclinical youths

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to DSM-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals.