Child Depression Inventory
Introduction
Depression does not only occur on adults, there have been many studies that show that children also are prone to depression. Depression is associated with different mood disorders that can cause children to be lonely, alarming, irritating, heart wrenching as well as devastating (Fristad 2004, p. ix). Due to the said reason, there have been many diagnostic tools that have been introduced in order to assess as well as measure the pediatric depression. This paper will tackle to Child Depression Inventory as a tool for assessing the behavior of children with regards to depression, together with its advantages and disadvantages.
Child Depression Inventory
Child Depression Inventory of CDI has been reported as the most thoroughly researched as well as widely used measure of depression in children (cited in Barkley 1987, p. 88). It is a symptom-oriented instrument that is use in assessing depression in children between the ages of 7 and 17 years old (Frey 2003), other authors stated that the CDI is highly proposed for children who are between the ages of 8 and 13 (cited in Barkley 1987, p. 88), while other said that the said test is used for children ages between 6 to 17 years (Kovacs 2008).. The CDI is a 27-item self-report questionnaire that is designed as a downward extension of the Beck Depression Inventory or the BDI (cited in Barkley 1987, p. 88). The CDI requires and will take 10-15 minutes in order to be completed (Barkley 1987, p. 88).
In 1992, Maria Kovacs published CDI for the first time. Later on, it was developed due to fact that depression among young children are, more often than not, hard to diagnose. Another thing is that depression has been regarded as an adult disorder, not until the 1970s, past studies concluded that the nervous systems of children were not adequately mature to manifest the changes of neurochemical in the brain function that is related to depression (Frey 2003). The said test is being used by the clinicians and counselors in order to help: evaluate the self-reported symptoms of depression like the feeling of unimportance and loss of concentration in activities of a child; maintain diagnosis and treatment planning; and perform a clinical research (Frey 2003).
The CDI can also be administered to the patient repeatedly to measure different changes in their depression condition in different time, which will help to assess the results of the treatment and behavior for their depressive disorders (Frey 2003).
Child Depression Inventory Process
Like what have stated in the first part of the paper, CDI is a self-rated measuring tool for depression. It means that the child or the adolescent who is being evaluated will be going to record their answers to the questions that are stated on the test sheet, it is different from other depression measurement tool that uses different verbal answers to the questions that are used to analyze and then recorded by the respective examiner (Frey 2003). It is somewhat related to the BDI and the Weinberg Screening Affective Scale or WSAS that are considered as self-rated instruments that are used for assessing the depression in children (Frey 2003).
Each of the questions that are included in the CDI is made up of three different possible responses. The children or adolescent who are being evaluated will select the answer that can describe him or her condition over the preceding two weeks (Frey 2003; cited in Barkley 1998, p. 88).
The CDI is intended to formulate and construct a quantitative measurement of different warning signs of depression such as: moods conflict; dejected self-evaluation; turmoil in behavior to other people; capability for pleasure and satisfaction; and vegetative symptoms that is consist of low energy or e, oversleeping, having difficulties with different activities that require effort and energy, as well as other symptoms of submissiveness or immobility (Frey 2003). It is also used in order to distinguish as well as appraise the different symptoms of a major depressive disorder or dysthymic disorder in children as well as adolescents. It can also help to differentiate the difference between those children who are suffering from those said disorders and those children who are suffering from other mental conditions (Frey 2003).
The system of the scoring will be based on the three-point scale or zero to 2, of the increasing strictness. The score for all of the given items will be summed or accumulated in order to provide the total score. The accumulated score will be interpreted in order to relate or reflect to the rigorousness of the depression (cited in Barkley 1987, p. 88).
Critical Evaluation of the Children Depression Inventory
There have been many tests that had already developed in order to cater to the different demands of different mental and behavioral disorder of children with regards to the depression. The CDI is one of them, and it has been widely used since it’s first published.
Advantages of CDI
CDI is considered as a test that uses printed instruments as a tool for assessing the emotional assessment of children. The most important advantage of the printed instrument is that it offer predetermined nature and linked and connected possibility of the objective standards. Another thing is that, it offers accessibility for the empirical investigation of dependability and legality (House 2002, p. 93).
In terms of reliability, there have been reviews by several investigators that show that the internal efficiency and consistency of CDI have ranged from .80 to .94, while the stability had been estimated to range from .50 to .87 for the psychiatric patients, and .38 to .84 for those non-psychiatric subjects (Barkley 1987, p. 88). Also the test-retest reliability of the different correlation had appeared to be satisfactory (Center for Psychological Studies n.d.).
There are also different research studies that have supported the CDI as an significant test that can be used both for descriptive and prognostic uses for distinguishing different indications of depression in children as well as adolescents. Studies of discriminant strength found out that important dissimilarities of Negative Mood factor scores (p < .05) but no important dissimilarities for total CDI scores between a model of 134 children and adolescents with different depressive disorders.
Another thing is that CDI’s content is valid for the Major Depressive Disorder. The said fact had been found out from the investigation that compares the CDI scores with the various measures of depression. The correlations have been generally varies from .40 to .90. The said result also shows the important connection of the CDI to the adolescent-completed indices of parent-child disagreement (cited in Barkley 1987, p. 89).
Another important advantage of the test is that it enables to distinguish and differentiate clinical from the non-referred control samples such as: depressed from non-depressed psychiatric patients; psychiatric from non-psychiatric remedial patients; as well as severely suicidal psychiatric inpatients from other psychiatric inpatients (cited in Barkley 1987, p. 89).
Disadvantage of CDI
Although there have been many advantages that are associated with the CDI, it also has its own share of flaws and disadvantages. Like any other self-report measures that are used in children, CDI also shares the same weakness, and that is the fact that children do not have the equal level of capability like the adults in order for them to appreciate and comprehend as well as report their strong internal emotions. In addition to that, children also has the equal capability like the adults to alter or amend their answers on the CDI, to imitate what they think are the preferred answers rather than what they really feel. The said phenomenon is called the faking good or faking bad. It is based and depends on the bias of the modified answers (Frey 2003).
With the connection to the unequal ability of the children to understand and appreciate the test, another important issue is the reading and comprehension capability of the children. It tackles to the ability of the children to express and verbalize their different feelings and emotions. Due to the fact that each and every individual is unique, the CDI might not be appropriate in every case of child and adolescent depression because there are some who has impaired reading ability (Chrissy & Company 2007). Due to the fact that there are some children who are not yet that good in reading and understanding, the said factor might affect the credibility and efficiency of the result of the study.
CDI is also somewhat demanding, due to the fact that, the result of the said test can only be assessed and appraised by a trained professional psychologist or psychiatrist and not by parents, tutors or school nurse (Frey 2003). The said test also recommends retesting for those children who have gained a positive score on the CDI, within a 2 to 4 week interval between the test and the retest. The complete investigative assessment by a licensed mental health professional also follows, after the fist said process. The assessment is consisted of several interviews with the child or adolescent, together with the parents and other people who are connected to him or her (Frey 2003).
References
Barkley, R 1987, Defiant Children: A Clinician’s Manual for Parent Training, Guilford Press
Children’s Depression Inventory (CID), Center for Psychological Studies, viewed 7 March 2008, < http://www.cps.nova.edu/~cpphelp/CDI.html >
Chrissy & Company 2007, Child Depression Inventory: Assessment Tool for Adolescent Depression, Associated Content, viewed 7 March 2008, <http://www.associat edcontent.com/article/293151/child_depression_inventory_assessment.html>
Frey, R 2003, Child Depression Inventory, Gale Encyclopedia of Mental Disorder, findarticles.com, viewed 7 March 2008, <http://findarticles.com/p/articles/mi_gx5197/is_2003/ai _n19119252 >
Fristad, M & Goldberg Arnold, J 2004, Raising a Moody Child: How to Cope with Depression and Bipolar, Guilford Press
Goldman, A, Hain, R & Liben, S 2006, Oxford Textbook of Palliative Care for Children, Oxford University Press
House, A 2002, The First Session with Children and Adolescents: Conducting a Mental Health Evaluation, Guilford Press
Kovacs, M 2008, The Children’s Depression Inventory, Pearson, viewed 7 March 2008, < http://www.pearsonassessments.com/tests/cdi.htm >
Appendices
Appendix A The Internal Structure of the Child Depression Inventory in Russian and UK Schoolchildren
Factors Structure for Total Russian Sample
Factor 1: Pessimism/Sense of Failure 16.9%
CDI 3: I do everything wrong .74
CDI 13: I cannot make up my mind about things .65
CDI 20: I feel alone all the time .58
CDI 23: I do very badly in subjects I used to be good in .51
CDI 24: I can never be as good as other kids .44
CDI 19: I worry about aches .37
Factor 2: Sadness 9.2%
CDI 26: I never do what I am told .75
CDI 6: I am sure that terrible things will happen to me .67
CDI 25: Nobody really loves me .66
CDI 16: I have trouble sleeping every night .56
CDI 10: I feel like crying every day .47
CDI 9: I want to kill myself .39
Factor 3: Irritability/Oppositional Behavior 7.4%
CDI 17: I am tired all the time .67
CDI 11: Things bother me all the time .63
CDI 27: I get into fights all the time .62
CDI 5: I am bad all the time .53
CDI 4: Nothing is fun at all .51
Factor 4: Negative Self-Image 6.2%
CDI 14: I look ugly .69
CDI 7: I hate myself .65
CDI 2: Nothing will ever work out for me .58
CDI 22: I do not have any friends .58
Factor 5: Lethargy/Struggle with School 5.1%
CDI 21: I never have fun at school .57
CDI 18: Most days I do not feel like eating .55
CDI 15: I have to push myself all .48
the time to do my schoolwork
CDI 12: I do not want to be with people at all .47
CDI 1: I am sad all the time .35
Factor Structure for Total UK Sample
Factor 1: Sadness/Somatic Worries 22.9%
CDI 1: I am sad all the time .69
CDI 10: I feel like crying every day .66
CDI 20: I feel alone all the time .63
CDI 6: I am sure that terrible things will happen to me .62
CDI 19: I worry about aches and pains all the time .54
CDI 17: I am tired all the time .45
CDI 16: I have trouble sleeping every night .41
Factor 2: Lethargy/Struggle with School 6.7%
CDI 23: I do very badly in subjects I used to be good in .69
CDI 3: I do everything wrong .67
CDI 11: Things bother me all the time .53
CDI 12: I do not want to be with people at all .51
CDI 13: I cannot make up my mind about things .43
CDI 2: Nothing will ever work out for me .41
CDI 15: I have to push myself all the time to do my .39
schoolwork
Factor 3: Isolation 5.9%
CDI 25: Nobody really loves me .70
CDI 21: I never have fun at school .60
CDI 24: I can never be as good as other kids .58
CDI 22: I do not have any friends .52
CDI 18: Most days I do not feel like eating .40
Factor 4: Oppositional Behavior 5.7%
CDI 26: I never do what I am told .58
CDI 5: I am bad all the time .57
CDI 9: I want to kill myself .54
CDI 27: I get into fights all the time .43
Factor 5: Negative Self-Image 4.9%
CDI 14: I look ugly .73
CDI 8: All bad things are my fault .64
CDI 4: Nothing is fun at all .46
CDI 7: I hate myself .39
Factor Structure for Total Boys Sample
Factor 1: Negative Self-Image/Pessimism 17.0%
CDI 25: Nobody really loves me .68
CDI 24: I can never be as good as other kids .60
CDI 18: Most days I do not not feel like eating .60
CDI 9: I want to kill myself .59
CDI 6: I am sure that terrible things will happen to me .48
CDI 21: I never have fun at school .47
CDI 7: I hate myself .42
CDI 11: Things bother me all the time .41
CDI 14: I look ugly .39
Factor 2: Isolation/Sadness 9.1%
CDI 10: I feel like crying every day .83
CDI 16: I have trouble sleeping every night .66
CDI 20: I feel alone all the time .66
Factor 3: Lethargy 7.7%
CDI 15: I have to push myself all the time to do my schoolwork .71
CDI 13: I cannot make up my mind about things .67
CDI 2: Nothing will ever work out for me .57
CDI 5: I am bad all the time .53
Factor 4: Oppositional Behavior 6.9%
CDI 27: I get into fights all the time .73
CDI 22: I do not have any friends .68
CDI 26: I never do what I am told .57
CDI 3: I do everything wrong .41
Factor 5: Self Blame 5.6%
CDI 12: I do not want to be with people at all .70
CDI 23: I do very badly in subjects I used to be good in .60
CDI 8: All bad things are my fault .56
CDI 1: I am sad all the time .56
Factor 6: Somatic Worries 5.2%
CDI 17: I am tired all the time .70
CDI 4: Nothing is fun at all .50
CDI 19: I worry about aches and pains all the time .48
Factor Structure for Total Girls Sample
Factor 1: Sadness/Lonelines 22.7%
CDI 10: I feel like crying every .84
day
CDI 1: I am sad all the time .74
CDI 11: Things bother me all the .56
time
CDI 20: I feel alone all the time .52
CDI 19: I worry about aches and .51
pains all the time
CDI 13: I cannot make up my mind .44
about things
CDI 5: I am bad all the time .43
Factor 2: Lethargy/Isolation 8.2%
CDI 25: Nobody really loves me .66
CDI 21: I never have fun at school .61
CDI 22: I do not have any friends .60
CDI 24: I can never be as good as .57
other kids
CDI 16: I have trouble sleeping .57
every night
CDI 6: I am sure that terrible .42
things will happen to me to do
my schoolwork
CDI 18: Most days I do not feel .39
like eating
CDI 9: I want to kill myself .37
CDI 4: Nothing is fun at all .33
Factor 3: Oppositional Behavior 6.7%
CDI 27: I get into fights all the .74
time
CDI 26: I never do what I am told .70
CDI 3: I do everything wrong .67
CDI 23: I do very badly in subject .59
I used to be good in
CDI 8: All bad things are my fault .58
CDI 12: I do not want to be with .46
people at all
CDI 17: I am tired all the time .35
Factor 4: Negative Self-Image 5.5%
CDI 14: I look ugly .76
CDI 7: I hate myself .73
CDI 2: Nothing will ever work Out .51
for me
Source: (Charman, T & Pervova, I 2001, ‘The Internal Structure of the Child Depression Inventory in Russian and UK Schoolchildren’, Journal of Youth and Adolescence, vol. 30, no. 1, pp. 41 – 50)
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