Components that are measured on depression

Question 1

Components of Depression on CDI

Answer 1

Negative Mood
Interpersonal Problems
Ineffectiveness
Adedonia (people lose interest in what they like)
Negative Self-Esteem

Question 2

Tests to Measure Depression

Answer 2

Connor’s Depression Inventory (CDI)

Yields T-scores and what areas affect most of them

Question 3

Assessment of Depression (DSM-V)

Answer 3

Disruptive Mood Dysregulation Disorder
To address overdiagnosis of bipolar disorder
Children who have persistent irritability and frequent episodes of extreme behavioral dyscontrol
Major Depressive Disorders
Persistent Depressive Disorders (Dysthymia)
Depressive Disorders due to other medical conditions
Unspecified Depressive Disorder

Prevalence rate of
Pre-adolescent children is less than 3%
Adolescence is 15%

Dysphoric mood
Suicide attempts
Sleeping too much
Adolescent girls have more somatic complaints
Those who have depression; one third of relatives are depressed
Earlier the onset (before age of 15) and recurs afterward = worse than after the age of 15; the earlier depression starts, the worse

Question 4

Assessing Depression and Anxiety

Answer 4

Should not just be based on DSM-V

1. All children should be screened
   BASC is a screening tool because its multi-dimensional
   The fact that a child scores high on depression doesn’t mean that they have depression; need further evaluation (interview, etc)
   Structured interview
   When do the symptoms start and is there a family resemblance
2. Look at the classifications
   Look at DSM-V and see if child fills the criteria
   Cause clinical and significant distress in social, occupational, etc. functioning (and how much it impairs in different environments)
3. Comorbid disabilities
   Not attributable to substance or other medical condition; rule-out, but also understand that if someone is on hard drugs you have to ask if the person is self-medicating
   a. Learning Disabilities
   Not always but sometimes there is a learning disability and this can be primary
   b. Eating Disorders
   c. Oppositional Defiant Disorder
   d. Conduct Disorder
4. Classifying
   Must rule out logical reasons for depression such as a recent death
5. Treatment
   Must look at maladaptive cognitions (distortions, taking things to extremes, etc) and beliefs
   Must look at chronic stressors (divorced parents, parenting style)
   Must look at parent depression
   Evaluate parental style or are they authoritarian
   Evaluate the response to previous interventions

Question 5

Anxiety

Answer 5

Forming anxiety - maximizing the danger, minimizing the coping skill
For treatment, do opposite
Generalized (or trait) anxiety - not anxious about just a test or closed spaces, it generalizes into the person’s personality
Trait Anxiety
Permeates the person
Treated by guided imagery.
Maximize the danger, minimize the coping ability; want to increase coping ability
State anxiety
Means you’re in a state of anxiety and we’re going to treat it; ex) what are you anxious about?, “snakes”
Specific anxiety - snakes, closed spaces, etc; exposure therapy as treatment

For both anxiety and depression, affects perception
Things you look at influenced by anxiety and depression which have reinforcing loops
Treatment includes guiding imagery so you can break this loop

Question 6

Screening

Answer 6

1. Identify scale you can use
   Revised children manifest anxiety scale
2. Look at the DSM-5 criteria and use a specific diagnostic scale and look to see if the symptoms come and go or are they stable
3. Comorbidity
   Depression
4. Look for externalizing problems
5. Determine influence of anxiety on school performance and being absent
6. Social relationships between peers
7. Alternative causes
   Rule out out psychopathology, medical problems, stressful life events
8. Treatment considerations - assess for maladaptive cognitions (i’m going crazy, i’m going to die, i’ll never get better); CBT, DBT (dialectical behavioral therapy)
9. Assess if parents have depression, parenting style
10. Look at effects of previous interventions including counseling and including medication

Has to be medical history, developmental history, stressful life events