Laboratory and performance-based measures of depression in children and adolescents

Reviews laboratory and performance-based measures for the assessment of symptoms and correlates of depression in children and adolescents. First, we briefly review limitations of self-report and other report measures of depression. Next, we describe four laboratory methods, including social interaction tasks, information-processing tasks, measures of psychological deficits and laboratory analogue designs, and sleep studies. We then summarize the specific depressive symptoms measured by each of these methods. Finally, we discuss issues of the validity and utility of these methods.     

Malingering dissociative identity disorder: objective and projective assessment

Verification of dissociative identity disorder presents challenges given the complex nature of the illness. This study addressed the concern that this disorder can be successfully malingered on objective and projective psychological tests. 50 undergraduate women were assigned to a Malingering or a Control condition, then completed the Rorschach Inkblot Test and the Dissociative Experiences Scale II. The Malingering group were asked to simulate dissociative identity disorder; controls received instructions to answer all materials honestly. Analysis indicated that malingerers were significantly more likely to endorse dissociative experiences on the Dissociative Experiences Scale II in the range common to patients with diagnosed dissociative identity disorder. However, on the Rorschach there were no significant differences between the two groups. Results suggest that the assessment of dissociative identity disorder requires a multifaceted approach with both objective and projective assessment tools. Research is needed to assess these issues in clinical populations.     

A test of interpersonal theory of depression in children and adolescents using a projective technique

Using a projective technique among child and adolescent psychiatric inpatients, we tested several hypotheses derived from Coyne's (1976b) interpersonal theory of depression. First, we predicted that depression would be associated with rejection, even controlling for the effects of aggression. Depression and rejection were associated only when aggression effects were covaried. Second, we hypothesized that the depression-rejection relation would display symptom specificity. Consistent with this hypothesis, we found that depression, but not anxiety, was related to rejection. Third, we assessed whether an index of interpersonal style—reliance on others—moderated the depression-rejection relation. Results suggested that depression and overreliance were both associated with high rejection scores, whereas the combination of low depression and low reliance on others was associated with low rejection scores. We found that results held across age groups. The implications of our findings for the interpersonal theory of depression in youngsters are discussed.     

A comparison of projective and objective fear-of-success and sex-role orientation measures as predictors of women's performance on masculine and feminine tasks

This study compared projective and objective measures of fear of success (FOS) with each other and with a measure of sex-role orientation as alternative predictors of 309 college women's achievement behavior on masculine and feminine tasks. Neither the sex role nor the FOS measures predicted substantial performance differences on the masculine or feminine tasks, although the objective FOS scales and the Bem Sex Role Inventory did predict subjects' stated investment in the task and attributions for success in a manner generally consistent with FOS theory. In addition, the objective FOS scales showed strong relationships with achievement motivation and sex-role orientation, while TAT (Thematic Apperception Test) FOS was unrelated to either of these variables. The results provide partial support that objective FOS scales tap actual avoidance tendencies characteristic of traditionally feminine women, while the TAT measure reflects, at most, an ambivalence over success which may be equally characteristic of high achieving, nontraditional women and low achieving, traditional women.The research reported here was supported by Grant 1 R03 MH 28835-01 from the U.S. Department of Health, Education and Welfare.     

Two objective measures of self-esteem

Two scales were constructed to assess self-esteem, conceptualized as reflecting (a) feelings of competence and efficacy, and (b) perceived positive appraisal from significant others. To control for response bias a paired choice format was chosen for the items constructed. A buffer scale designed to measure social assertiveness was also included. Data were collected on three samples of high school boys. The item intercorrelations were subjected to principal component analyses followed by Varimax rotations. In each of the three analyses factors of Confidence, Popularity (Social Approval), and Social Assertiveness emerged. The revised self-esteem scales, each defined by 11 items, have been shown to have acceptable reliability and some concurrent validity based on correlations with the well-known Rosenberg Self-Esteem Scale.     

Anorexia and depression: depressive comorbidity in anorexic adolescents

Frequently, depression is a concomitant pathology in anorexia nervosa. To verify this, we carried out a comparative case/control study with 50 anorexic patients, restricting-type (ANP), 50 depressed patients (DP) and 50 non-patients (NP), aged between 13 and 16. We used the Rorschach Test and the Minnesota Multiphasic Personality Inventory (MMPI) and compared the results to parent's observations collected from the Achenbach Child Behavior Checklist (CBCL). Results showed two clearly different groups among participants: ANP with depression (36%) and ANP without depression (64%). This seems to indicate that depression is not a core element in anorexic disorders. However, we also observed a significant increase in the MMPI scale 2, which was probably related to starvation and weight loss. We confirmed the absence of general anxiety in the ANP group and obtained differences between depressive symptoms and those derived from coping deficit disorders. The discussion emphasizes the importance of using several tests to reduce bias in results and conclusions.     

Predictors of depression in female adolescents

Depression during adolescence has been associated with a number of factors, including failure to individuate (Blos, 1968), insecure attachments (Armsden, McCauley, Greenberg, Burke, & Mitchell, 1990), negative parental representations, and object relations that lack self-other differentiation (Blatt, Wein, Chevron, & Quinlan, 1979). The present study examined factors associated with symptoms of depression in 59 nonclinical female adolescents. Specifically, the relationship between a number of theoretically related measures-separation-individuation, interpersonal concerns, self-critical concerns, attachment style, parental representations-and symptoms of depression was investigated. The model developed was able to explain the interrelationships of the variables involved in the psychological process of adolescence, and their demonstrated ability to predict symptoms of depression in normal female adolescents.     

Relationships among projective and direct verbal measures of achievement motivation

The present study was undertaken to explore ways projective arid nonprojective verbal measures of achievement motivation elicit comparable and dissimilar responses in a "Third World" sample of entrepreneurs as a test of McClelland's theory of economic growth. Results were generally consistent with the theory of achievement motivation, and suggested that high scores on n Ach were associated with high rates of industrial and agricultural output; low scores were associated with static or declining business. TAT measurement was the best predictor in that it correlated 0.68 and 0.48 with agricultural and industrial production. Results further lend support to past findings: namely, that Various achievement measures appear to be measuring dissimilar constructs.     

Undesirable life-events and depression in young adolescents

We compared the relationship between individual undesirable life-events and comprehensive life-event factors, as well as major depression in adolescents. Students in four public suburban middle schools were screened for depressive symptomatology and life-events by a self-administered questionnaire. Seven of 21 individual events (parents' divorce, parental job loss, problems between parents, problems between the adolescent and his/her parents, failing a grade in school, school suspension, death of a close friend) and three of six life-event factors (conflict/disappointment, marital discord, maladjustment) were significantly related to depression in univariate models. A multivariate examination of the individual events was difficult to interpret, but examination of the event factors found maladjustment and conflict/disappointment significant. Analyses using the undesirable life-event factors provided a clearer picture of the relationships investigated by grouping related events into a more manageable number of independent categories. Specific combinations of life-events suggest stronger associations with adolescent depression than others. Clinicians may identify youths at risk for depression when specific combinations of undesirable life-events occur.     

Defensive style and performance on objective personality measures

Two studies on the relations between various styles of defense and the power or validity of self-reports on objective personality questionnaires. The power of individual items on the Rotter Internal-External Locus of Control scale to discriminate between subjects defined as internals or externals by a median-cut procedure using the total score was not affected by the presence Or absence of a projective defensive style. However, the presence of repressive tendencies did appear to restrict item power. Prediction from two achievement scales taken from Gough's California Psychological Inventory was not influenced by level of repression, was affected somewhat adversely by a projective style, and was most clearly contaminated by a rationalizing defense. It was proposed that the differential effects of defensive styles upon the validity of personality tests depended upon the convergence or divergence of the cognitive operations involved in the type of defense and in the type of personality measure.     

Psychosocial treatment of depression and suicidality in adolescents

Depression is a common disorder among adolescents and is associated with a high risk of suicide. Suicide is the third leading cause of death among adolescents in the United States. Currently, there are only two evidence-based psychotherapies for adolescence depression: cognitive-behavioral therapy and interpersonal psychotherapy. Furthermore, psychosocial interventions that specifically target suicidal behavior in adolescents are even fewer in number than treatments for depression. This article will review the psychosocial interventions for depression and suicidality in adolescents and will describe a recently developed treatment that is under study for depressed suicidal adolescents.     

Community recognition of objective and subjective characteristics of depression

Assessed knowledge of depression in a random sample of 527 community-living adults. Vignettes were presented which described a young or old protagonist with depressive symptoms. Respondents were asked to identify potential problems and possible solutions. A depression information measure followed. Results indicated that community residents were aware of many objective features of depression although they identified less information about treatment issues. Older respondents were least informed. Although there were no gender differences in objective knowledge, men were less likely to mention depression with regard to the vignettes. Suggestions for implementing more effective community interventions are discussed.     

Cognitive and projective measures of differentiation and their relationship to empathy

The present investigation compared cognitive and projective methods of assessing “differentiation,” Witkin's Embedded Figures Test (EFT) and Blatt's Concept of the Object Scale (COS), and reexamined expectations concerning the relationship between level of differentiation and capacity for empathy. Whether lesser or greater differentiation would promote empathy was of specific interest. Two forms of empathy were investigated, an “affective” form assessed by the Mehrabian Empathy Scale and a “cognitive” form assessed by the Hogan Empathy Scale. Expected sex differences in differentiation and empathy were also investigated. Results demonstrated consonance between COS and EFT measures of differentiation within the male sample only (p < .05). Individuals classified by EFT as relatively less differentiated (“field dependent”) produced more part object responses (p < .02) and those classified as more differentiated (“field independent”) showed a trend toward more whole object responses (p < .10) on the COS. Associations between measures of differentiation and empathy reached significance or showed trends in the male group only. Men with relatively lesser differentiation on the EFT (“field dependent”) showed greater “affective empathy” (p < .10) and men with greater differentiation on the COS showed greater “cognitive” empathy (p < .05). Women demonstrated higher levels of “affective” empathy than men (p < .001).