DEPRESSION SELF-RATING SCALE FOR CHILDREN

(Birleson 1978)
Instructions:
This self-rating scale was developed for children between the ages of 8 and 14
years of age. lease e!plain to the child that the scale is a way of getting to
"now how children really feel abo#t things. $ive the scale to the child with the
directions below. %f children have diffic#lty in reading any of the ite&s' clinicians
&ay read o#t the state&ents in a ne#tral tone of voice that indicates no
preference in what they wish to hear.
Please read these stateents and tic! the ans"er that #est descri#es ho"
$ou ha%e &elt durin' the (ast "ee!) It is i(ortant to ans"er as honestl$ as
$ou can) The correct ans"er is to sa$ ho" $ou ha%e reall$ &elt)
*ostl$ Ne%er
Soeties
1. % loo" forward to things as &#ch as % #sed to.. ( ) ( ) ( ) ***
+. % sleep very well.............................,,.. ,, ( ) ( ) ( ) ***
-. % feel li"e crying.............................,,,,, ( ) ( ) ( ) ***
4. % li"e to go o#t to play......................,,.,, ( ) ( ) ( ) ***
.. % feel li"e r#nning away.....................,,,, ( ) ( ) ( ) ***
/. % get t#&&y aches...........................,.,,, ( ) ( ) ( ) ***
7. % have lots of energy........................,,,,. ( ) ( ) ( ) ***
8. % en0oy &y food..............................,,,,, ( ) ( ) ( ) ***
9. % can stic" #p for &yself...................,,,,. ( ) ( ) ( ) ***
11. % thin" life isn2t worth living...............,,,,. ( ) ( ) ( ) ***
11. % a& good at the things % do.................,,,. ( ) ( ) ( ) ***
1+. % en0oy the things % do as &#ch as % #sed to, ( ) ( ) ( ) ***
1-. % li"e tal"ing with &y fa&ily.................,,,.. ( ) ( ) ( ) ***
14. % have bad drea&s.......................,,,.. ( ) ( ) ( ) ***
1.. % feel very lonely............................,,,,, ( ) ( ) ( ) ***
1/. % a& easily cheered #p.......................,,,.. ( ) ( ) ( ) ***
17. % feel so sad % can hardly stand it...........,,.. ( ) ( ) ( ) ***
18. % feel very bored............................,,,,, ( ) ( ) ( ) ***
Than! $ou) Score ++++
0
DEPRESSION SELF-RATING SCALE FOR CHILDREN (DSRS-
C)
INTRODUCTION
The DSRS-C was developed in 1978 as part of a Masters of Philosophy
Thesis at the University of din!"r#h$ The s%ale was developed fro& a
lon#er inventory of '7 ite&s that were des%ri!ed in the literat"re in
asso%iation with depressive syndro&es in %hildhood$ These ite&s were
for&ed into positive and ne#ative state&ents( the order was rando&ised
and the )nal inventory was #iven to fo"r #ro"ps of %hildren a#ed !etween
7 and 1' years$
*$ * #ro"p of %hildren referred to a Child Psy%hiatry Clini% who &et an
operational de)nition of depressive disorder( were not intelle%t"ally
handi%apped and did not s"+er fro& s%hi,ophrenia or a"tis&
-./170$
1$ * %o&parison #ro"p of %hildren fro& a Child Psy%hiatry Clini%
pop"lation %ontrolled for se2( a#e and severity of dist"r!an%e
-./170$
C$ * #ro"p of %hildren fro& a s%hool for &alad3"sted p"pils who were
tho"#ht li4ely to !e de&orali,ed or have low self-estee& -./500$
D$ * %o&parison #ro"p of nor&al s%hool %hildren of &ean a#e 15$1
years -./190$
The operational de)nition of depressive disorder "sed the followin#
%lini%al %riteria6-
i0 viden%e of re%ent e2pressed "nhappiness( sadness( &isery or
%ryin#( with
ii0 7istory of !ehavio"r %han#e lastin# over 5 wee4s !"t less
than 1 year( with
iii0 viden%e of re%ent i&pair&ent in so%ial relationships and8or
de%line in s%hool perfor&an%e( with
iv0 The presen%e of two or &ore of the followin# sy&pto&s -
sleep dist"r!an%e( appetite dist"r!an%e( loss of "s"al ener#y
or interest( red"%ed a%tivity( e2pressed self-depre%atin# ideas(
s"i%idal threats or !ehavio"r( in%reased irrita!ility( new
so&ati% %o&plaints( wanderin# !ehavio"r( depressive
del"sions and hall"%inations$
* pilot st"dy esta!lished that "sin# a list of state&ents where the %hild
%o"ld a#ree or disa#ree was &ore relia!le and easier to "se than a
postin# !o2 for&at$ 9te&s were s%ored in the dire%tion of dist"r!an%e as 0
for :non-depressed: or nor&al responses( 1 for :so&eti&es: responses
and 5 for :depressed: or a!nor&al responses( i$e$ a %hild who slept well
:&ost of the ti&e: s%ored 0$ * %hild who felt lonely :&ost of the ti&e:
s%ored 5$
*n analysis of varian%e was "sed to deter&ine whi%h of the '7 self-ratin#
ite&s dis%ri&inated the depressed #ro"p fro& the other ' #ro"ps$ These
ite&s were ta4en to for& the DSRS-C$
The test-retest relia!ility of the S%ale on an independent sa&ple showed
satisfa%tory sta!ility -0$800$ 9ndivid"al ite&s had a relia!ility %oe;%ient of
0$<=-0$9=$ The S%ale>s %orre%ted split-half relia!ility was 0$8< showin#
#ood internal %onsisten%y$
1
The linearity of S%ale ite&s was assessed !y fa%tor analysis$ * rotated
&atri2 prod"%ed = fa%tors that to#ether shared <1? of the total varian%e$
These fa%tors were very si&ilar to those fo"nd in st"dies of ad"lts with
depressive disorders$
The S%ale had ade@"ate fa%e validity and fa%torial validity -1irleson
19810$ 9t was then tested for %lini%al validity on an independent
pop"lation of 1== %hildren a#ed !etween 8 and 1A years who were
attendin# a %hild psy%hiatry o"tpatient %lini%$
These %hildren were #ro"ped into a depressed pop"lation and :others:$
Children who s%ored 1= and a!ove on the DSRS-C were si#ni)%antly &ore
li4ely to !e #iven a psy%hiatri% dia#nosis of Ma3or Depression or
Dysthy&ia$ The predi%tive val"e of the total DSRS-C s%ore was al&ost as
#ood as the #lo!al s%ore of the history of depression and appearan%e of
depression eval"ated at interview !y Child Psy%hiatrists$
RESULTS
DSRS History &
Appearane o!
Depression
Sensiti"ity <<$7? <<$7?
Spei#ity 7<$7? 81$=?
$is%assi#ation Rate 5'$9? 59$A?
Positi"e Pre&ition 1=$0? 18$5?
Ne'ati"e Pre&ition 97$A? 97$=?
These )#"res have ass"&ed a prevalen%e of depressive disorder of =? in
a %lini% pop"lation$ Bhile those with a depression dia#nosis s%ored hi#hly(
it was noted that &any other %hildren with dysphori% &ood also s%ored
over 1=$ These %hildren presented with a ran#e of other psy%hiatri%
dia#noses in%l"din# %ond"%t disorder( &i2ed e&otional and %ond"%t
disorder and an2iety disorders( e$#$ s%hool ref"sal$
Many of these %hildren had isolated depressive sy&pto&s to#ether with a
Cat or irrita!le &ood at interview$ Most had histories of parental loss or
re3e%tion( and %a&e fro& dis%ordant or %onCi%ted fa&ily !a%4#ro"nds$
This is %onsistent with the o!servation that that depressive sy&pto&s
o%%"r %o&&only in %hildren in relation to psy%ho-so%ial stressors and that
depressive syndro&es o%%"r with a ran#e of severity( e2tent and d"ration$
Self-ratin# s%ales for depression( o!server-ratin# s%ales( %lini%al
appearan%e at interview( history fro& parents or tea%hers( history
o!tained fro& the %hild at interview and other infor&ation so"r%es are
!est "tili,ed to#ether( with infor&ation a!o"t the %onte2t of the pro!le&
!ehavio"r( to arrive at a well-%onsidered %lini%al dia#nosis$ .one of these
so"r%es alone %an ever !e re#arded as an ade@"ate and s";%ient
dia#nosti% tool$
The DSRS-C is si&ple to "se$ 9t is !rief and only ta4es a %hild a few
&in"tes to %o&plete$ Children with poor readin# s4ills or short-ter&
a"ditory &e&ory di;%"lties &ay re@"ire help in "nderstandin# the lon#er
ite&s( !"t the s%orin# patterns of yo"n#er %hildren have !een fo"nd to !e
very si&ilar to those of their elder peers -1irleson et al$ 19870$ Children
5
are "s"ally pleased to des%ri!e their e2perien%e thro"#h %o&pletin# the
s%ale and this %o&&"ni%ation or sense of !ein# "nderstood &ay fa%ilitate
a therape"ti% relationship$
The instr"&ent &ay !e "sed to#ether with other infor&ation fro&
parents( s%hool or other so"r%es to &a4e a %lini%al dia#nosis( to identify
%hildren with dysphori% &ood in response to environ&ental stress and to
&eas"re %han#e in e&otional stat"s$ 9t has !een widely "sed in the
U$S$*$( Canada( "rope( Dapan and China$ The DSRS-C &ay !e freely "sed
for %lini%al or resear%h p"rposes provided d"e a%4nowled#e&ent is &ade
a!o"t its ori#in$
AD$INISTRATION AND SCORING
Children are as4ed to %onsider their e2perien%e d"rin# the previo"s wee4
and to ti%4 how ea%h ite& has applied to the&$ 2plain that there is no
ri#ht or wron# answer and that the i&portant thin# is to say how they
have really felt$ They are as4ed to %hoose whether the state&ent applied
to the& :&ost of the ti&e:( :so&eti&es: or :never:$
9te& responses are si&ply s%ored in the dire%tion of dist"r!an%e( i$e$
depressive ite&s s%ore 5( :so&eti&es: ite&s s%ore 1( and non-depressive
ite&s s%ore 0$ Eor ite&s 1( 5( A( 7( 8( 9( 11( 15( 1' and 1< F&ostlyF s%ores
0( Fso&eti&esF s%ores 1 and FneverF s%ores 5$
Eor ite&s '( =( <( 10( 1A( 1=( 17 and 18 F&ostlyF s%ores 5( Fso&eti&esF s%ores 1
and Fnever s%ores 0$ The ite& s%ores are s"&&ed to #ive the total s%ore$
Re!erenes
1irleson P$ -19810 The Galidity of Depressive Disorder in Childhood and the
Develop&ent of a Self-Ratin# S%ale6 * Resear%h Report$ D$ Child
Psy%holo#y Psy%hiatry 55( 7'888$
1irleson P$ 7"dson 9( Hrey-1"%hanan D( Bol+ S$ -19870 Clini%al val"ation
of a Self-Ratin# S%ale for Depressive Disorder in Childhood -Depression
Self-Ratin# S%ale0$ D$ Child Psy%holo#y Psy%hiatry 58( A'8<0$
Idrsrinfo p! 15-10-199=( "pdated '1$15$5010J
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