A model for the screening and identification of depressed children and adolescents in school settings.

Abstract

This article describes a procedure designed to screen and identify children and adolescents in school settings who manifest clinically relevant levels of depression. The multiple-stage procedure is designed to avoid identifying children and adolescents as clinically depressed when in fact their depression is of a transient and episodic nature. It also utilizes a multimethod assessment approach, thus dealing with the issue of method variance and increasing the validity of the identification procedure. The screening and identification procedure consists of three stages. The first stage involves school or grade-wide evaluation of students using selfreport measures of depression. The second stage consists of the reassessment of all students who have scored above a predetermined cutoff score on the first testing. Students who score above the cutoff on the second screening are administered an individual clinical interview for depression as the main component of the third stage. The application of this procedure in school settings is described, and suggestions of specific assessment measures of depression in children and adolescents are provided.Requests for reprints should be sent to William M. Reynolds, Western Psychological Services,

Adequate Screening of Youngsters for Depressive Characteristics

“…Especially in children it is important to investigate whether a single stressor or specific event is the cause of a transient mood fluctuation or if scores are the result of an ongoing disorder. A second screening moment can refine the screening process and eliminate children who either dissemble or exaggerate their reports of depressive symptoms, experience a transient depressed mood, or for other reasons score high on one measure moment but below the cut-off on a second one (Reynolds, 1986).…”

“…Still, also a multimethod procedure has been recommended where the administration of a self-report measure is followed by administration of a clinical interview at the end of this stage (Reynolds, 1986). Because of incomplete language development and immature cognitive processes in youngsters the reliability of self-reports is seen as a concern (Ollendick, Grills, & King, 2001;Zeman, Klimes-Dougan, Cassano, & Adrian, 2007).…”

Depression in Children and Adolescents: Identification, Assessment, and Treatment

“…Early identification of depressed children and adolescents in school settings is desirable, but Reynolds (1986a) recognized several factors that make this goal problematic:…”

“…Some parents deny that their child may be suffering from a mood disorder. On the basis of findings from prevalence studies of depression in children and adolescents and the lack of selfreferral, teacher referral, or parent referral, Reynolds (1986a) developed a three-stage screening program to identify depressed children and adolescents in school settings: (a) conducting large-group screening with self-report depression measures; (b) 3 to 6 weeks later retesting children who, on the basis of the large-group screening in Stage 1, meet cutoff score criteria for depression; and (c) conducting individual clinical interviews with children who manifest clinical levels of depression at both Stage 1 and Stage 2 evaluations.…”

“…Common self-report measures for children and adolescents are given in Table 4. Reynolds (1986a) has suggested that teachers avoid telling students they are being tested for depression because this information may induce lower levels of mood awareness. Instead, students can be informed that the school is interested in how they are feeling about themselves.…”