Identifying depression in children: a comparison of alternative selection criteria

This study evaluated commonly used methods of identifying "depressed" children and examined the extent to which the conclusions about correlates of dysfunction vary among different selection criteria. Child psychiatric patients (N = 231, ages 7-12) and their parents participated and completed measures to permit identification of "depressed" children on the basis of three separate criteria, including self-report scores on the Children's Depression Inventory, parent-reported scores for the same measure, and a DSM-III diagnosis of major depression. The study examined whether depressed and nondepressed children, defined separately by the different criteria, differed in a variety of depression-related symptoms, cognitive processes, and social activity. The results indicated little overlap in the persons identified as "depressed" on the basis of child- or parent-completed CDI scores or DSM-III diagnosis. Depressed and nondepressed children tended to differ across all domains (depression-related symptoms, cognitive processes, and social activity) for each selection criterion. However, significant differences were evident in these domains only when the selection criterion and other domains were assessed with the same informant (e.g., self-report) and hence shared a common method (rater) component. The findings underscore the potential influence that method factors may have in influencing the conclusions that are drawn regarding the correlates of childhood depression.