Convergent Validity of a Single Question with Multiple Classification Options for Depression Screening in Medical Settings

Abstract

Keywords-convergent validity; depression screening; single question; BDI-II; severity level I. INTRODUCTIONDepression is one of the most common mental illnesses globally in both medical and non-medical populations. The World Health Organization noted that in 17 countries 1 in 20 people reported having an episode of depression in the past year [1]. In the United States, the Centers for Disease Control and Prevention reported a 9.1% prevalence rate of current depression in the general population [2]. Reference [3] observed a lifetime prevalence of 16.6% for major depression with a lifetime morbid risk of 29.9% for persons 13 years of age and older. The prevalence of depression in medically ill persons has been reported to be significantly higher than healthy persons, with rates ranging from 20% to 40% [4]. As staggering as these rates may seem, in an examination of the existing literature, categorical prevalence rates of depression in patients with comorbid medical illnesses as high as 75% have been reported [5]. The importance of considering prevalence rates in medically ill persons lies in the finding that 47.6% of psychologists in the United States work in medical settings [6,7]. It is therefore essential that frontline healthcare professionals working in medical settings be able to quickly and effectively evaluate and screen for depressive symptomology.Depression is assessed through self-report questionnaires or a structured clinical interview (e.g., SCID-CV) [8]. With regard to psychometric options, the BDI-II [9] is one of the most commonly used [10,11]. The BDI-II measures a patient's severity level of depression: none/minimal, mild, moderate, or severe. An evaluation of the psychometric properties of the BDI-II has demonstrated that this instrument yields reliable, internally consistent, and valid assessments of depression in medical care settings [12].Due to the time-limited nature of assessment often observed in medical settings, efforts should be made to develop screening procedures that are valid, yet brief enough to be administered to medically ill persons. Previous studies have investigated the effectiveness of a one or two question format as a means of screening for depression in medical settings. A single depression question format entails comparing patient responses to a depression question (e.g., "Are you depressed?") to a clinical interview. In a two question format, the depression question is combined with a loss of interest question (e.g., "Have you experienced loss of interest in things or activities that you would normally enjoy?"). Patient responses are again typically compared to a diagnosis from a structured clinical interview.Results are presented in terms of sensitivity and specificity. Sensitivity refers to the true positive rate; the degree of agreement between patients who describe themselves as depressed and a finding of depression on the secondary measure (typically a clinical interview). Specificity is the true negative rate; the degree of agreement between those who identify them...

Effect of observer’s cultural background and masking condition of target face on facial expression recognition

“…2C). These results indicated that 20-30% of judgments differed based on race, supporting the results of previous studies 9,10,11,12 . Our experiment revealed that "fear" perceived on target faces by Westerners tended to be perceived as "surprise" by East Asians.…”

“…Previous studies on the racial differences of observers 9,10,11 reported that the precision of FER (percentage of estimated labels that correctly matched the label of the facial images) differed depending on the race of the observer. Additionally, the study of Fouty et al 12 revealed statistically signi cant differences in precision between observers of different races. However, there is still uncertainty regarding which emotions are confused across different races.…”