Assessment of overt behavior and childhood depression among psychiatrically disturbed children.

Abstract

The present investigation examined the relation of direct observations of overt behavior to depression among 62 child psychiatric inpatients (ages 8-13 years old). Childhood depression was assessed by self-report and interview measures administered separately to children and their mothers. Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 1980) diagnoses were also obtained from direct interviews and were supplemented with clinical information. Direct observations of the children were obtained during free-time periods over several days. Multiple behaviors were observed and coded into one of three categories: social activity (e.g., talking with others and playing games), solitary behavior (e.g., working alone on a task and playing alone), and affect-related expression (e.g., smiling and frowning). Depressed children engaged in significantly less social activity and exhibited less affect-related expression than did their nondepressed peers. Overt behavioral measures were consistently related to parent-completed but not to child-completed measures of depression. The present findings suggest that depressive symptoms are reflected in diverse behaviors in everyday life. Finer grained analyses of behavior are needed to follow up these results.Research on childhood depression has increased considerably in recent years (see Cantwell & Carlson, 1983;Petti, 1983). Advances can be attributed in part to the emergence of a large number of assessment techniques. Most of the measures currently available consist of questionnaires and interviews administered to children or their parents (Kazdin & Petti, 1982;Kovacs, 1981). Although these measures have been useful in identifying depression and its correlates, they represent a relatively restricted range of assessment techniques. Also, self-and parentreport measures raise interpretive problems

Issues in the treatment of depressed children

“…Depressed children are less popular (Jacobsen, Lahey, & Strauss, 1983;Lefkowitz & Tesiny, 1985;Strauss, Forehand, Frame, & Smith, 1984), less liked (Blechman, et aI., 1986;Faust, Baum, & Forehand, 1985;Peterson, Mullins, & Ridley-Johnson, 1985), and are rejected by peers (Kennedy, Spence, & Hensley, 1989). Perhaps this is sensed by depressed youths and accounts for findings indicating that depressed youngsters engage in less social interaction (Kazdin, Esveldt-Dawson, Sherick, & Colbus, 1985). Consistent with Coyne's hypothesis, depressed children elicit negative reactions from adults (Mullins, Peterson, Wonderlick, & Reaven, 1986) and peers (Kennedy et aI., 1989).…”

“…This rejection in turn leads to the development of a sense of self, which is composed of a poorly developed positive self-scbema and a more active negative self-schema (Prieto et aI., 1992) and negative world schemata (Kaslow et al, 1992). In addition, it may lead to withdrawal (Kazdin et al, 1985), which insulates the young-steT from corrective learning experiences. As the youngster matures and faces new stressors, he or she does not have the family or peer social support (Blechman et aI., 1986;Jacobsen et aI., 1983;Kennedy et al, 1989;Peterson et al, 1985) necessary to help buffer their impact, and the impact is further heightened througb negative distortions in information processing (Kendall et aI., 1990) and a possible deficit in coping skills.…”

Bipolar disorder and depression in childhood and adolescence

“…Elas podem apresentar várias características, como anedonia, baixa auto-estima, isolamento e pobre interação social. Os pais que abusam fisicamente dos filhos induzem-nas a um aprendizado de desesperança [40][41][42][43][44] . Os estudos mostram que crianças sexualmente abusadas apresentam ansiedade, culpa, vergonha, agressão e sintomas depressivos ou de outros transtornos psiquiátricos.…”

Clinical Dysfunction and Psychosocial Interventions: The Interplay of Research, Methods, and Conceptualization of Challenges

“…Measures completed by the same rater correlated more highly with each other when rating different constructs than did measures completed by different raters when evaluating the same construct (e.g., Kazdin et al 1983c,d). The evaluation of different raters on standardized checklists raised broader assessment issues we studied including the correspondence of checklist data, observed performance, and psychiatric diagnoses (Kazdin & Heidish 1984;Kazdin et al 1983aKazdin et al , 1985a. We also gave some attention to child ratings of clinical dysfunction and how they evaluated different disorders and their causes, outcomes, and remedies .…”

“…We completed several studies that evaluated cognitive and emotional features, overt behavior (e.g., social activity, affect-related facial expressions) in naturalistic observations, and nonverbal behavior (during interviews and storytelling), and that addressed diagnostic issues and challenges (e.g., Kazdin, 1989Kazdin, , 1990Kazdin et al 1983dKazdin et al , 1985aKazdin et al , 1986b. We also evaluated depression and its relation to early child experiences (e.g., child abuse) and to other disorders (e.g., anxiety disorders, developmental disabilities) (e.g., Kazdin et al 1985b, Matson et al 1983).…”