Childhood depression has become a recognized disorder and assessment of the disorder has become a topic among clinicians. Childhood Depression Inventory has been the most used assessment instrument among clinicians in diagnosing childhood depression. The purpose of this paper is to identify characteristics of the CDI and determine whether the CDI is an effective instrument in identifying childhood depression. Childhood Depression Facts. Three to five percent of children are affected by major depression (Bhatia & Bhatia, 2007).
There are numerous negative effects of depression in children including “growth and development, school performance, and peer or family relationships and may lead to suicide” (par. 1). Fifteen percent of children under the age of eighteen have symptoms of depression at any given time (2007). In the nine to seventeen year old age group five percent “meet the criteria for major depressive disorder and three percent of adolescents have dysthymic disorder” (Bhatia & Bhatia, par. 1, 2007).
Once children reach puberty the likelihood of the presence of depression increases significantly; and is more than twice as likely in females (Bhatia & Bhatia, 2007). There are risk factors, both biomedical and psychosocial, associated with depression. Family history and childhood abuse, chronic illness, female gender, chronic illness and stress can all lead to depression. While the diagnostic criteria of depression for children is almost identical to that of adults, it can be difficult to recognize symptoms of depression in children because they may have difficulty expressing their internal moods verbally.
It is for this reason that therapist use a variety of instruments to assess a child suspected of having depression. Childhood Depression Inventory. The Childhood Depression Inventory is the most widely used instrument for detecting the presence of child depression (Sitarenios & Kovacs, 1999). It was originally created in 1979 and made public in 1992 (1999). The CDI is useful, according to Sitarenios and Kovacs, (1999), in detecting signs of depression in children as well as monitoring treatment.
According to Bhatia and Bhatia (2007), “safe and effective treatment requires accurate diagnosis, suicide risk assessment, and use of evidence-based therapies” (par. 1). Sitarenios and Kovacs (1999) state that the CDI can “play a role in the diagnostic process”, it should not however be used alone as a diagnosis tool. The CDI originally originate from the Beck Depression Inventory, a self-rated twenty-one clinically based assessment for adults. The CDI, once created, was based on the adult scale because both children and adult depressive symptoms overlap (Sitarenios & Kovacs, 1999).
The CDI scale is constructed into four phases. The first and second phase were conducted with the input of children in patient settings. The third phase was a final draft that was reviewed by colleagues of Kovak and Beck (Sitarenios & Kovacs, 1999). After some rewording, and minor revisions the phase four version was ready. In phase four, score templates were developed and score values were eliminated. Currently a few additions have been made to the CDI (Sitarenios & Kovacs, 1999).
Based on psychometric analysis of the CDI, five factors were identified and added to the CDI manual, online administration of the test has been added since the inception of the internet. Now clinicians can score, report and evaluate CDI assessments online. The Children’s Depression Inventory is an instrument used specifically for children ages seven to seventeen. The self-reported assessment can identify and quantify a number of depressive symptoms, including; o Disturbed mood o Problems in hedonic and vegetative functions o Low self-evaluation
o Hopelessness o Difficulties in interpersonal behaviors Many of the items found on the CDI “pertain to the consequences of depression with respect to contexts that are specifically relavent to children”; for example school (Sitarenios & Kovacs, p. 270, 1999). The CDI is a multiple choice assessment with twenty-seven items and are categorized as zero for no symptom present, one meaning mild symptom and two meaning definite symptom present. In total, the scale score can range from zero to fifty-four (Sitarenios & Kovacs, 1999).
Additionally, the score on the CDI yields scores for five subscales (see Table 1 for definitions). These five subscales include; o Negative Mood o Interpersonal problems o Ineffectiveness o Anhedonia o Negative Self-esteem Definitions of these subscales have not been readily available until recently. Reliability. The reliability of the CDI is related to correct use and interpretation of the instrument. The determinants of reliability are internal consistency, test and retest reliability and standard error (Sitarenios & Kovacs, 1999).
Internal Consistency. The CDI measures the same dimension consistently (Sitarenios & Kovacs, 1999); i. e. internal consistency. Research studies have demonstrated that the CDI is reliable; satisfactory reliability is indicated with coefficients from . 60 and . 70. Good reliability is . 70 to . 80 and excellent reliability is . 80 to . 95 (1999). Sitarenios & Kovacs (1999) report that the majority of past studies reported a reliability of above . 70; the majority of those tests scored . 80 or higher. Table 1. Definition of Subscales