Assessment and treatment of depression among early adolescents

This project consisted of two phases designed to assess the prevalence of depressive symptomatology and the efficacy of treatment among middle school students. Phase 1 employed a multistage-multimethod assessment model to screen an entire middle school of 1,293 sixth-, seventh-, and eighth-grade students on two self-report measures of depression--the Children's Depression Inventory (CDI) and the Reynolds Adolescent Depression Scale (RADS). In order to eliminate students with situational or transitory mood disorders, a second screening followed the initial screening by 1 month. The second screening (Stage 2) entailed a reevaluation of all students who had previously scored above criterion on both the CDI and the RADS. Stage 3 involved the administration of the Bellevue Index of Depression (BID), a structured clinical interview, among all students who met depression criteria at both Stage 1 and Stage 2 assessments. Students scoring above criterion for depression at this final assessment were then targeted for participation in the treatment phase.;Phase 2 of this investigation consisted of a treatment study comparing the efficacy of three short-term, structured, school-based treatments with a waitlist control condition (n = 17 per group). Treatments consisted of a cognitive-behavioral therapy condition, a relaxation therapy condition, and a self-modeling treatment condition. One-fourth of the treatments for each condition were observed in person and rated for reliability. Posttesting and a 1-month follow-up were implemented employing identical dependent measures utilized in Phase 1. Approximately one-half (44%) of posttest clinical interviews were conducted by raters blind to treatment/control condition.;Phase 1 results revealed 6.2% of subjects to meet depression criteria according to this assessment model. Phase 2 treatment data indicated that all active treatment conditions, relative to the waitlist-control, produced a significant decrease in depression and an increase in self-esteem at posttest and 1-month follow-up. Qualitative analysis parent-report data, consumer satisfaction data, and data from treated control subjects further support the integrity of the independent variable. These findings are presented within the framework of providing effective assessment and intervention strategies designed to diagnose and treat adolescent depression.