Depressive symptoms

Scale: Pediatric Depressive Symptoms – Short Form from the Patient-Reported Outcomes Measurement Information System (PROMIS)

What it measures:

  • A youth’s reported level of depressive symptoms.

Intended age range: 8- to 17-year-olds.

Brief description: This measure consists of 8 items. Youth are asked to consider their feelings over the past 7 days. Sample items include: “I felt sad”, “I felt lonely”, and “It was hard for me to have fun.” Response choices are Never, Almost never, Sometimes, Often, and Almost always.

Rationale: This scale was selected based on its relative brevity, appropriateness for use with a wide age range of youth, promising evidence of reliability and validity, and the availability of normative data that can be used to help gauge the severity of a responding youth’s depressive symptoms.

Cautions: This measure is not intended to assess the presence or absence of a depressive disorder. Therefore, care should be taken to describe and interpret resulting scores as referring to depressive symptoms rather than depression or a depressive disorder. In addition, although normative data are available to help with interpretation of scores, they may not apply fully to the youth served by a given mentoring program.

Special administration information: Provisions should be in place for appropriate follow-up and referral to mental health treatment for youth who report notably elevated levels of depressive symptoms (i.e., a T-score of 60 or higher per scoring procedures described below). Youth should be made aware of this possibility prior to completing the measure (i.e., that their responses will be reviewed to determine whether it may be appropriate to provide their parent or guardian with information about counseling or other resources).

How to score: Each item is scored on a 5-point scale from 0 (Never) to 4 (Almost always). A total score is computed by averaging across items.

How to interpret findings: Higher T-scores reflect greater levels of depressive symptoms. The corresponding T-score for a youth’s score, based on normative sample data, can be determined using a table in the scoring manual for the Pediatric PROMIS Profile Instruments (see the table titled, “Depressive Symptoms 8b” on p. 9). T-scores are constructed so that they have a standard deviation of 10 and an average of 50. For example, a T-score of 50 would represent a score equal to the average score for youth in the normative sample and a score of 60 would indicate a score that is one standard deviation higher than this average and thus an elevated level of depressive symptoms compared to the typical youth in the normative sample.

Access and permissions: This scale is available for non-commercial use with no charge and can be obtained here. A Spanish version is also available.

Alternatives: The Patient Health Questionnaire (PHQ-9) is the self-administered version of the depression portion of the PRIME-MD interview, which uses Diagnostic and Statistical Manual-IV criteria to screen for possible mental disorders in primary care settings. The measure and its documentation can be found here. Although originally developed for adults, validity evidence for use of this measure with adolescents is encouraging. It can be scored for evidence of a depressive disorder and to grade symptom severity via a continuous score. This measure may be a good alternative for programs interested in identifying youth who may be experiencing a depressive disorder. As with all survey-based measures, however, it does not provide a sufficient basis for making a clinical diagnosis of depression.

Citation: Irwin, D. E., Stucky, B. D., Langer, M. M., Thissen, D., DeWitt, E. M., Lai, J. S., . . . DeWalt, D. A. (2010). An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales. Quality of Life Research, 19, 595–607.

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