Self Report Severity Scales

Self-report scales are valuable indices of change, as well as supplemental indices of severity, in working with depressed teenagers. Some adolescents are more comfortable acknowledging distress in the relative privacy of a self-rating situation than in the interactive interview, although the reverse pattern also occurs. We recommend, at a minimum, administering self-report scales at the beginning, midpoint, and endpoint of acute intervention. Many cognitive-behavioral therapists administer a self-report scale prior to each session as a way to monitor changes in the patient's mood over the course of treatment. Repeated use of the same scale, however, can threaten the validity of the self-report, because some adolescents adopt an all-or-none approach to the items on relatively long self-report scales. For this reason, we suggest informally assessing mood on a weekly basis, always inquiring about suicidal thoughts or behavior, and administering formal scales intermittently over the course of treatment.

An example of a psychometrically strong measure of adolescent depression is the Reynolds Adolescent Depression Scale (RADS). Although it has recently been revised, the original RADS (Reynolds, 1987) is a 17-item self-report instrument. In the TADS study (TADS Team, 2004) the pattern of results based on the RADS was very similar to that on the CDRS-R, suggesting that the RADS may be a reliable and valid measure with clinically depressed youth (Reynolds & Mazza, 1998).

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