Assessment Of Depression With Lgb Women And

Patient verbal self-report and written self-report measures are standard in clinical practice. Although standard self-report measures are useful, clinicians need to review their customary forms for heterosexist content. For example some questionnaires ask about social anxiety around people of the opposite sex. The assumption is that heterosocial anxiety will complicate the individual's establishing intimate relationships. However, simply rephrasing the question to ask whether the patient experiences anxiety around someone he/she finds romantically attractive assesses the same problem and includes same-sex attractions.

Standard measures of depression tend to be gender-neutral and are useful with LGB patients. Conducting an interview with the Hamilton Rating

Scale for Depression (HRSD; Hamilton, 1960) provides the best place to start in assessing the patient's depression. Given the high rate of overlap between depression and anxiety, therapists should also assess for anxiety with either the Hamilton Scales ofAnxiety or a measure such as the Anxiety Disorders Interview Schedule for the DSM-IV (ADIS-IV; Brown, Di Nardo, & Barlow, 1994). Clinicians should keep in mind the literature suggesting that gay men are more likely than heterosexual men to meet criteria for major depressive disorder (MDD), whereas lesbian and bisexual women are more likely to meet criteria for generalized anxiety disorder (GAD; Cochran et al., 2003). Although generalizations from the literature are of limited value to the individual case, this research suggests initial, testable hypotheses given the gender of the patient coming to therapy. The Beck Depression Inventory—II (BDI-II; Beck, Steer, & Brown, 1996) and the Beck Hopelessness Scale (BHS;Beck & Steer, 1988) are good measures to use from session to session as a brief assessment of improvement during treatment. Adolescent versions of these scales can be used when working with LGB youth.

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