Diagnostic Efficiency of the Child and Adolescent Symptom Inventory (CASI-4R) Depression Subscale for Identifying Youth Mood Disorders

Abstract

This study examined the diagnostic and clinical utility of the Child and Adolescent Symptom Inventory-4R (CASI-4R) depressive and dysthymia subscale for detecting mood disorders in youth (ages 6-12; M = 9.37) visiting outpatient mental health clinics. Secondary analyses (N=700) utilized baseline data from the Longitudinal Assessment of Manic Symptoms (LAMS) study. Semi-structured interviews with youth participants and their caregivers determined psychiatric diagnoses. Caregivers and teachers completed the CASI-4R. CASI-4R depressive symptom severity and symptom count scores each predicted mood disorder diagnoses. Both caregiver versions of the CASI-4R subscale significantly identified youth mood disorders (areas under the curve [AUCs] = .78 - .79, ps<.001). The symptom severity version showed a small but significant advantage. Teacher symptom severity report did not significantly predict mood disorder diagnosis (AUC = .56, p > .05), whereas the teacher symptom count report corresponded to a small effect size (AUC = .61, p < .05). The CASI-4R depression scale showed strong incrememental validity even controlling for the other CASI-4R scales. Caregiver subscale cutoff scores were calculated to assist in ruling in (diagnostic likelihood ratio [DLR] = 3.73) or ruling out (DLR = 0.18) presence of a mood disorder. The CASI-4R depressive subscale caregiver report can help identify youth mood disorders and using DLRs may help improve diagnostic accuracy.

Hooked on a thought: Associations between rumination and neural responses to social rejection in adolescent girls

“…Self-reported depressive symptom severity was obtained using the Adult Self-Report Inventory-4 ( Gadow et al, 2004 ). The inventory assesses 10 symptoms of major depressive disorder (MDD) defined by DSM-IV (e.g., depressed mood, loss of interest in doing any activity, a sense of worthlessness), which has high validity, reliability, and clinical utility ( Salcedo et al, 2018 ). Participants rated each item as 0 ( never ), 1 ( sometimes ), 2 ( often ), or 3 ( very often ).…”

Girls' brain structural connectivity in late adolescence relates to history of depression symptoms

“…Self‐reported depressive symptoms were collected using the Child, Adolescent, and Adult Symptom Inventories – 4th Edition beginning when the girls were age 10 and continuing annually through age 19 (Gadow, 2015). All 9 symptoms of DSM‐IV major depressive disorder were assessed with these inventories, which demonstrate high validity, reliability, and clinical utility (Salcedo et al, 2017). Symptom severity, a dimensional measure, provides a significant advantage in identifying youth with mood disorders (Salcedo et al, 2017).…”

“…All 9 symptoms of DSM‐IV major depressive disorder were assessed with these inventories, which demonstrate high validity, reliability, and clinical utility (Salcedo et al, 2017). Symptom severity, a dimensional measure, provides a significant advantage in identifying youth with mood disorders (Salcedo et al, 2017). Items were rated 0 ( never ), 1 ( sometimes ), 2 ( often ), or 3 ( very often ) and summed; yes or no items (e.g., change in appetite) were recoded ( yes = 2.5, no = 0.5) following the scoring criteria.…”

Is the Finding Too Good to Be True? Moving from “More Is Better” to Thinking in Terms of Simple Predictions and Credibility

“…Authors can also be clear when doing effectiveness work or selecting more conservative and generalizable models. It is legitimate to suggest that the reader apply a different rule of thumb-for example, "Because we are using clinically realistic comparison groups, we believe an AUC of .80 (or d = 1.2) is a good target, rather than a .90 that usually has only been achieved by studies with distilled cohorts in this content area" (e.g., Salcedo et al, 2017). This is not the same thing as lazily using convenience samples and whatever variables are laying around.…”