The Children's Depression Inventory: Error in cutoff scores for screening purposes.

The Children's Depression Inventory (CDI) is used to screen for depression in school-age children. Such screening uses the manual's reported information on suggested cutoff scores. These cutoff scores are based on an erroneous base-rate calculation and an inadequate methodology. Data are provided showing that for the suggested cutoff scores of 13 or 20, the CDI has poor receiver-operating characteristics. Indeed, for the cutoff score of 20, suggested as being suitable for screening in the general population (e.g., schools), clinicians will miss 86% of depressed children. In conclusion, it is recommended that the CDI is better suited as a continuous measure of mood and that cutoff scores should not be used to screen for the likely presence or absence of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Four-year predictive value of the Children's Depression Inventory.

Predictive value for the Children's Depression Inventory (CDI) was demonstrated through a 4-year follow-up study of 105 children who entered a private residential school for children who had lost one or both natural parents through death, divorce, or separation. At baseline, depressed and nondepressed groups were defined with the CDI. They were then reevaluated at the end of 1, 2, and 4 yrs. On the CDI, the Revised Children's Manifest Anxiety Scale, and the Internalizing scale of the Child Behavior Checklist, the original depressed group who remained at school all 4 years showed scores that were significantly higher than those of the nondepressed group after 1 and 2 years, and were also greater after the 4th year. They further showed significantly poorer academic performance, received significantly more counseling, and more often separated from the school under negative circumstances. The most pathological scores overall were demonstrated by the children in the original depressed group who separated from the school during the 4 years under negative circumstances. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Children's Depression Inventory: A systematic evaluation of psychometric properties.

Determined the psychometric properties of the Children's Depression Inventory (CDI) by administering it to 294 schoolchildren (aged 7 yrs to 13 yrs 4 mo) and to 269 psychiatric inpatients (aged 7 yrs 1 mo to 16 yrs 4 mo). Results show good internal consistency in both groups, but test–retest data were variable across populations and test–retest intervals. Validity analysis showed that the CDI distinguished Ss with general emotional distress from normal schoolchildren. However, differences between CDI scores of depressed (DSM-III) and nondepressed Ss were not significant. There was a good correspondence between the CDI and self-report measures of self-concept. It is suggested that the CDI measures a multidimensional construct that overlaps with other childhood disorders (particularly anxiety). Although the CDI may be the best researched instrument available to measure depression from the child's viewpoint, more work is needed before it can be interpreted with confidence in clinical and research settings. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor analysis of the Children's Depression Inventory in a community sample.

The factor structure of the Children's Depression Inventory (CDI; M. Kovacs, 1992) was evaluated in a large community sample of 1,777 children and 924 adolescents. There were 5 first-order factors (Externalizing, Dysphoria, Self-Deprecation, School Problems, and Social Problems) for the child group; the adolescent group yielded the same 5 factors plus a 6th factor (Biological Dysregulation). Confirmatory factor analyses supported the stability and replicability of the obtained factor structures. Both samples yielded 2 higher order factors—Internalizing and Externalizing. The factors were compared with previous CDI factors identified for clinical (B. Weiss et al., 1991) and community (M. Kovacs, 1992) samples. Other notable findings included more boys reporting high scores (17 and above) on the CDI among the child sample, whereas, among adolescents more girls reported high scores (17 and above) on the total CDI as well as higher scores on the biological dysregulation factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of Children's Depression Inventory factors to major depression among adolescents.

This study examined the relationship between the Children"s Depression Inventory (CDI) scores and major depression, conduct disorder, and anxiety disorder diagnoses. Participants were 107 (58 male, 49 female) psychiatric inpatients, aged 12–18 years (M?=?15.4, SD?=?1.5). Definite major depression participants (n?=?26) reported higher scores than nondepressed participants (absence of any depression diagnosis, n?=?81) on all 5 CDI factor scores and the total CDI score. Conduct disorder participants scored higher on the externalizing factor; no other significant main or interaction effects were obtained for conduct disorder or anxiety. A discriminant function model using the 5 CDI factor scores classified participants as depressed versus nondepressed with a high degree of accuracy; a model using only the CDI total score yielded comparable discriminatory accuracy. The CDI total score was recommended as the most practical measure for classifying participants as depressed or not depressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Longitudinal Structure of the Children's Depression Inventory: Testing a Latent Trait-State Model.

In a 6-wave longitudinal study, children (Grades 4-6, n=648), adolescents (Grades 7-9, n=1,489), and their parents completed child-adolescent or parent versions of the Children's Depression Inventory (CDI; M. Kovacs, 1981). Using structural equation modeling, the authors conducted latent trait-state analyses to distinguish between a stable trait dimension of depression (in which individual differences are stable over time) and an autoregressive dimension (in which individual differences are less stable over time). Children's CDIs reflected the autoregressive dimension more than a stable trait dimension, whereas parents' CDIs reflected a stable trait dimension more than an autoregressive dimension. Reports from adolescents and their parents reflected a stable trait dimension more than an autoregressive dimension of depressive symptoms. Results suggest that the longitudinal structure of the CDI varies considerably depending on the age of the target and the type of informant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's Depression Inventory: Construct and discriminant validity across clinical and nonreferred (control) populations.

[Correction Notice: An erratum for this article was reported in Vol 55(6) of Journal of Consulting and Clinical Psychology (see record 2008-10746-001). An error occurred in Table 3. Specifically, for the three-factor solutions, the coefficient of congruence between the first factor of the combined sample and the first (rather than the second) factor of the nonreferred sample should read "93."] The construct and discriminant validity of the Children's Depression Inventory (CDI) was evaluated for a large child and adolescent sample of clinical inpatients (n&=&153) and demographically comparable nonreferred subjects (n&=&153). Principal component analyses of the overall sample, using separate groups of clinical and nonreferred samples, found two- and three-factor models with optimal simple structure and clinical meaningfulness. These factors characterized Depressive Affect, Oppositional Behavior, and Personal Adjustment. The first two factors exhibited adequate internal consistency and correspondence across samples, whereas the third factor was strongest for nonreferred subjects. All three factor scores entered a significant discriminant function and correctly classified most nonreferred and clinical subjects. However, only Depressive Affect and Oppositional Behavior entered into the discriminant function that distinguished depressive and conduct-disorder subjects from nonreferred subjects. The percentage of nonreferred subjects who were correctly categorized ranged from 70.4 to 71.6, whereas the percentage of correctly classified clinical subjects ranged from 25 to 60. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief Symptom Inventory norms for spinal cord injury.

Investigated the effects of spinal cord injury (SCI) upon a person's response to the Brief Symptom Inventory (BSI) by analyzing differences across item-response distributions from 225 Ss with SCI (aged 17–68 yrs) vs a nonpatient normative sample of 719 Ss. The study also developed more appropriate BSI normative data for persons with SCI. Because Ss' time since injury varied at time of BSI administration, normative scores were provided within 3 groupings: at discharge from the hospital; 0–24 mo post-discharge; and beyond 24 mo. Results show that SCI Ss had higher BSI scores when compared with Ss in the normative sample. These differences were particularly significant across 8 BSI items that reflected actual SCI physical and psychosocial symptoms. SCI Ss reported more distress during the period immediately following discharge to 24 mo. Overall, BSI scores tended to be lower at discharge and after 24 mo post-discharge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in the expression of depressive responses on the Beck Depression Inventory.

Suggests that although epidemiological data have documented sex differences in depression, the nature and origins of the differences are unclear. Depression in 972 male and 1,300 female unmarried college students was measured by the Beck Depression Inventory. No sex differences were found in the degree of depression, and yet, discriminant function analysis of the responses of the most depressed scorers yielded a significant and interpretable sex difference in the patterns of symptom expression. Depressed males were more likely to report an inability to cry, loss of social interest, a sense of failure, and somatic complaints. Females were characterized by indecisiveness and self-dislike. These patterns were not the same as sex-role-stereotyped responding in the total, predominantly nondepressed, sample. Speculations are made about the consequences of sex differences in depressive responses, including hypotheses about sex differences in experience with help-seeking and labeling. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in subclinical depression: Administration of the Beck Depression Inventory in public and private disclosure situations.

To test the idea that the preponderance of female depressives is due to a masculine tendency to avoid negative social consequences by reporting fewer depressive symptoms, the Beck Depression Inventory (BDI) was administered to 106 male and 104 female undergraduates under conditions of public and private disclosure. It was hypothesized that males would score lower on the BDI than females in the public disclosure condition but not males in the private disclosure condition. Results of both studies fail to support the experimental hypothesis. However, ANOVA revealed a significant interaction between sex of S and sex of examiner. Results are discussed in terms of a willingness to admit more symptoms to a same-sex person due to fear of rejection by the opposite sex and in terms of gender-specific patterns of self-disclosure in first-encounter heterosexual situations. Results also suggest that BDI scores of college students can be interpreted without regard to type of administration. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Applicability of Cognitive Mediational and Moderational Models to Explain Children's Depression Inventory Factor Scores in Urban Youth.

This investigation examined whether cognition serves as a direct factor, mediates, or moderates the relationship between stressful life events and Children's Depression Inventory (CDI; Kovacs, 1992) factor scores in urban, ethnic minority youth. Ninety-eight middle school students completed measures of stressful life events, cognition (cognitive triad and locus of control), and depressive symptoms. Results provided support for both mediating and moderating models of depression. Specifically, the cognitive triad mediated the relationship between stressful life events and depressive symptom categories of negative mood, ineffectiveness, and anhedonia, while it interacted with stressful life events to predict negative self-esteem. In addition, locus of control was found to interact with stressful life events to predict anhedonia. Finally, the diathesis-stress model was not supported when predicting the CDI Interpersonal Problems factor score, which taps externalizing behaviors. Implications for school psychology research and practice include the importance of including measures of stressful life events and cognitive styles in assessment of children's social-emotional functioning. In addition, results highlight the need to target children's perceptions for intervention since they appear to play a significant role in psychological reactions to stressors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Assessment of depression in mentally retarded adults: reliability and validity of the Children's Depression Inventory (CDI)

The applicability of the Children's Depression Inventory (CDI) in the informant-rating version to mentally retarded adults (> 19 years of age) of all degrees of severity is researched here for the first time. The sample (N = 798) consisted of residents in community-based group homes (56.9%) and residents of a variety of institutions (43.1%). On average, 23 of the 24 CDI items were to be assessed. Internal consistency, interrater reliability, and the item-total score correlations were adequate. The three factors derived from factor analysis were open to clear interpretation. The CDI score proved to be independent of age, sex, and degree of mental retardation. Persons with behavior problems, psychotropic drug treatment, non-Down syndrome status, as well as the residents of a psychiatric clinic, all returned a higher CDI score. Among those having a CDI score > or = 17 (n = 54), there were 57% with DSM-III-R depressive disorders. These results suggest that the CDI in an informant-rating version is suitable as a diagnostic and screening instrument for mentally retarded adults.     

Depression in children: Prevalence and correlates.

Assessed the prevalence of severe depression in 3,020 3rd–5th graders according to the risk variables of sex, age, intellectual functioning, and family income. Also investigated was a set of variables theoretically associated with the construct of childhood depression. Data were gathered by means of peer nominations, self-ratings, teachers' observations, and pupil personnel records. Data from 508 of the children's mothers were also obtained from an individually administered, precoded interview. The overall prevalence rate of depression for Ss, based on peer nominations, was 5.2%. Of the 38 variables hypothesized to be in the domain of childhood depression, 18 correlated significantly with the peer nomination measure. Ss nominated on depressive symptoms by their peers were also nominated as unhappy and unpopular. These Ss also rated themselves as depressed. (54 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Children's Depression Scale: assessment of factor structure with data from a normal adolescent population

This study investigated the reliability and construct validity of the Children's Depression Scale. Data were gathered from an Australian sample of male and female students with a mean age of 14.9 years (N = 202). Factor analysis using principal components was conducted to develop a revised version of the scale. Four factors met the stipulated criteria and accounted for 54% of the variance. The revised subscales, three with five items and one with four items, were shown to have strong construct and face validity and high reliability. Further work on this measure is necessary to refine it for future research.     

Children's development of alcohol use norms: Contributions of parent and sibling norms, children's temperaments, and parent–child discussions.

This study explored the unique contributions of children's temperaments, parents' and siblings' alcohol use norms, and parent–child discussions to 10- to 12-year-old children's alcohol use norms. Independent assessments of each family member's alcohol use norms, mother- and father-reported child temperament assessments, and child reports of the frequency and nature of parent–child discussions were obtained for 171 families. Hierarchical multiple regression analyses revealed a moderational effect: Children whose temperaments placed them at greater risk for alcohol problems in adolescence and early adulthood reported alcohol use norms that became more liberal as other family members' norms became liberal. Frequent and bidirectional parent–child discussions were linked with less liberal alcohol use norms. The results support a transactional model of norm development that features interplay among children's temperaments and family processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment depression in primary care practice with the Beck Depression Inventory and the Hamilton Rating Scale for Depression.

Individuals suffering from depression seek help as frequently in the primary care setting as in psychiatric facilities. As primary care physicians increasingly provide such treatments, they will need to assess a patient's clinical status before, during, and after treatment. The authors evaluated the concordance and factor structures of 2 widely used depression inventories, the Beck Depression Inventory and the Hamilton Rating Scale for Depression, in a sample of primary care patients participating in a randomized, control trial of treatments for major depression. The 2 scales were significantly correlated and assessed similar rates of improvement at multiple assessment points. Factor analyses indicated that despite their equivalent assessment of severity of depression, the 2 instruments emphasize different dimensions of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's early approaches to learning and academic trajectories through fifth grade.

Children's early approaches to learning (ATL) enhance their adaptation to the demands they experience with the start of formal schooling. The current study uses individual growth modeling to investigate whether children's early ATL, which includes persistence, emotion regulation, and attentiveness, explain individual differences in their academic trajectories during elementary school. Using data from the Early Childhood Longitudinal Study – Kindergarten Cohort (ECLS-K), the present investigation examined the association between ATL at kindergarten entry and trajectories of reading and math achievement across 6 waves of data from kindergarten, 1st, 3rd, and 5th grade (n = 10,666). The current study found a positive link between early ATL and individual trajectories of reading and math performance. Overall, children's early ATL was equally beneficial for children regardless of their race/ethnicity and dimensions of their socioeconomic background. However, links between early ATL and academic trajectories differed by their gender and initial levels of math and reading achievement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)