Benedikte Timbremont

Assessing Depression in Youth: Relation Between the Children's Depression Inventory and a Structured Interview

This study examined the utility of the Childrens Depression Inventory (CDI) for predicting a diagnosis of a depressive disorder derived from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) Child Edition (KID-SCID). The participants were 80 referred children and adolescents with a mean age of 12.21 years (range = 8 to 18 years). A categorical approach by means of a receiver-operating characteristics (ROC) analysis was used to examine the adequacy of cutoff scores for screening purposes. The results indicated that for the suggested cutoff scores of 13 and 19, the CDI has satisfactory ROCs. A cutoff score of 16 showed an optimal relation between sensitivity and specificity. The results from logistic regression indicated that the CDI total score is predictive of a depressive disorder. The CDI also differentiated a depressive disorder from an anxiety disorder and a disruptive behavior disorder. Those results provide support for the usefulness of the CDI as a screening tool for detecting depressive disorders in children and adolescents.

Cognitive vulnerability in remitted depressed children and adolescents.

The cognitive model by Beck predicts that formerly depressed individuals remain vulnerable for future depressive episodes due to the existence of stable negative schemas. Activation of those schemas may explain high relapse rates in depression. The present study investigated cognitive vulnerability in remitted depressed children and adolescents. A sample of 44 in-patient youngsters was assigned to three groups after completing the CDI at two different times: a never depressed group, a currently depressed group and a remitted depressed group. All participants received a mood induction before they were given a self-referent encoding task. The results indicated that the currently and the remitted depressed groups rated more negative words as self-descriptive than the never depressed group. On the recall task, the never depressed group showed positive information processing compared to the currently depressed and the remitted depressed groups. The currently depressed group also showed a negative recall bias compared to the never depressed group. Implications and limitations of the findings are discussed.

Treating depressive symptoms in schoolchildren: A pilot study

Abstract.Although studies on sub-threshold depression in childhood and adolescence havedemonstrated an at risk profile that merits further attention, only few investigators examined the impact of therapy with these children. In this study, twenty elementary schoolchildren (aged 10–12) with moderate depressive symptoms were randomly assigned to an eighteen-session cognitive-behavioural treatment programme or to a waiting list (WL) control group (= Study 1). The key components of the programme ‘Taking Action’ used in the study were: affective education, problem-solving, cognitive restructuring and engaging in enjoyable activities. Child self-reports and parent reports were used to evaluate the outcome. Paired ttests comparing the 4-months follow-up results with baseline measurements, revealed a significant improvement on the Children Depression Inventory and on the Self-Perception Profile for Children, but only in the treatment group. Afterwards, the WL control group was treated as well. All children were followed in a long-term follow-up study (= Study 2). Analyses at the 12 month stage of the follow-up study showed a further improvement of the scores on the Self-Perception Profile. Moreover, a significant decrease was found on the Children Depression Inventory, the State-Trait Anxiety Inventory and the Child Behaviour Checklist parent measure. It was concluded that the protocol is suitable for European children. The most remarkable findings in this pilot study are discussed.

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 Childrens 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.

Identifying special educational needs: putting a new framework for graded Learning Support to the test

This paper reports a field test of a new system of Graded Learning Support Classification Matrix to determine special educational needs (SEN) in a more systemic way, proposed by the Belgian Ministry of Education (Flanders Region), to put a barrier to the trend of referrals to special education schools. It is not directly determined by a child’s medical diagnosis, but suggests SEN to be a product of the needed level of curricular adaptation and classroom support, and the child’s broad category (cluster) of functional difficulties. A sample of 8648 pupils (aged 2.5–18) from regular and special education was assigned into the new matrix by collaborators of all 73 Centres for Pupils’ Counselling (CPC), according to new criteria. Data were compared with current allocations. About 20% of children of primary school age have some kind of ‘special’ needs. 12.5 % of primary school aged children (8.9% of secondary school) have mild intellectual impairment and/or learning disability; and 3.3% (3.4%) have a diagnosed behavioural or autistic spectrum disorder. Using the new classification matrix, the number of children with SEN is much higher than before, but this reflects more the actual classroom reality and it allows a better estimation of true needs and resources, by the government as well as by the school. A matrix presentation of SEN as a ‘product’ of child characteristics and ‘levels of curricular adaptations’ seems to be a better answer to special needs than the present linear definition. We propose this broad matrix definition of SEN as an international standard in order to make figures across countries comparable. All staff will have to be trained to adopt a more needs‐based, dynamic, contextual assessment system, based on a more social model of disability, taking into account contextual factors such as family and school environment, rather than the currently widely used psychometric way.

Parental schemas in youngsters referred for antisocial behaviour problems demonstrating depressive symptoms

Abstract Based on schema theory, this study aimed to investigate parental schemas in a sample of depressed and non-depressed youngsters referred for antisocial behaviour problems and in a non-depressed non-referred control group. A sample of 82 children and adolescents (aged 8 – 18 years) filled out the Childrens Depression Inventory and the Young Parenting Inventory Mother (YPI-Mother) and Father (YPI-Father). On both the YPI-Mother and the YPI-Father, differences between groups were situated in the schema domain disconnection/rejection. On the YPI-Mother the referred depressed group scored higher than both non-depressed groups for the maladaptive schema defectiveness/shame. On the YPI-Father, the referred depressed group scored higher than both non-depressed groups for the maladaptive schemas abandonment/instability, emotional deprivation, and defectiveness/shame. Referred antisocial youngsters who demonstrate depressive symptoms perceive their parents as more cold, instable, unreliable, and unpredictable than do non-depressed controls. In treatment of antisocial youngsters the existence of a depressive subgroup characterized by specific parental schemas should be recognised.

Depression und Selbstwertgefühl bei adipösen Kindern und Jugendlichen

Zusammenfassung. Die vorliegende Studie untersucht, ob adipose Kinder und Jugendliche im Vergleich zu Normalgewichtigen eine negativere Selbstbewertung und mehr depressive Symptome aufweisen. Des Weiteren wird untersucht, ob sich eine depressive Symptomatik - sofern diese innerhalb der adiposen Gruppe nachgewiesen werden kann - durch ein negatives Selbstkonzept erklaren lasst. Bei insgesamt 151 Kindern und Jugendlichen im Alter von 9 bis 17 Jahren (75 adipose, 76 normalgewichtige Kinder) und deren Eltern wurden anhand verschiedener Fragebogen depressive Symptome sowie Selbst- und Fremdeinschatzungen zu Kompetenzen und Verhaltenstendenzen der Kinder zu verschiedenen (Lebens-) Bereichen erhoben. Die statistischen Analysen ergaben signifikant negativere Selbstbewertungen der adiposen Kinder und Jugendlichen in Bezug auf den athletischen Bereich als einer speziellen Komponente des Selbstkonzeptes. Fur den globalen Depressionswert fanden sich keine Unterschiede zwischen adiposen und normalgewichtigen Kindern u...

Depressie bij kinderen en adolescenten

SamenvattingDit artikel geeft een overzicht van de recente inzichten in depressie bij kinderen en adolescenten. Na een bespreking van het klinisch beeld, de prevalentie- en comorbiditeitscijfers wordt het ‘assessment’-proces toegelicht, met een beschrijving van de voorhanden zijnde instrumenten in het Nederlandstalige gebied. Ten slotte worden de meest onderzochte etiologische modellen beschreven. Recente inzichten omtrent informatieverwerkingsprocessen bij depressieve kinderen en jongeren krijgen hierbij speciale aandacht.