What is the Children's Depression Inventory (CDI)?

Introduction

The Children’s Depression Inventory (CDI) was first developed in 1977 by Maria Kovacs. It was based on the Beck Depression Inventory, which is a self-report measure for depression for adults. The CDI was designed to assess depression in children and adolescents from the ages of seven to seventeen. The second edition of the CDI was published in 2011. The measure has twenty-seven items that ask children to report on their possible depressive experiences, such as feeling sad, crying a lot, not having fun anymore, being tired, not wanting to live, having trouble sleeping, experiencing low self-esteem, and having difficulties with friends.

The CDI is worded so that children and adolescents can read the questions themselves and write down their own answers. Each item offers three statements that signify varying levels of severity (from no problems to severe problems). Children and adolescents are asked to choose the statement that is most reflective of how they have been feeling within the past two weeks.

For example, one item gives children the following three options: I am sad once in a while; I am sad many times; I am sad all the time. Children are asked to put a mark by the sentence that describes their feelings. The first sentence (I am sad once in a while) is something that even people who are not depressed would be likely to endorse, whereas the third sentence (I am sad all the time) is more reflective of depression.

There is no specific item that confirms a diagnosis of depression. Instead, all of the items on the CDI are added together to provide an overall picture of how the child feels. The measure has been normed so that a child’s responses are compared against other children of that age and gender. The idea is that children’s answers should be compared with what is average or normative for that age and gender. Through this norming process, professionals can be sure not to diagnose a child who is just feeling normal amounts of distress. Overall, the CDI can help professionals gain a better understanding of children’s and adolescents’ feelings of depression and related concerns.

Strengths and Weaknesses

One of the primary strengths of the CDI is that it is very widely used throughout many countries. This commonality allows easy communication between professionals. The norms and standardization sample of the CDI allow professionals to have confidence in their interpretations of children’s and adolescents’ depressive symptoms. The strong psychometric properties suggest that the CDI is reliable (that is, stable) and valid (that is, meaningful). In addition, the CDI is practical to use because it is easy to administer and to score, and it is not expensive for professionals to purchase.

Even with these strengths, the CDI has some limitations. Although it was originally meant to assess depression only, there is now research to suggest that it assesses other problems as well as depression. For example, children who have difficulty with school or who have problems with peers because of excessive fighting might receive high scores on the CDI. Thus, it is important for professionals to assess many aspects of the child’s life rather than relying on the CDI alone to help diagnose depression.

Other Methods to Assess Childhood Depression

Even with a well-respected measure such as the CDI, it is standard practice for professionals to use a variety of measures before diagnosing depression in children and adolescents. In addition to using the CDI, professionals could conduct a structured diagnostic interview (such as the Diagnostic Interview Schedule for Children) with the child to assess for symptoms of depression and other psychological difficulties. Professionals may also want to observe the child (either in their office or in the classroom) to evaluate how the child interacts with others and to assess for depressive symptoms such as withdrawal or crying.

In addition to gathering information from the child directly, it is incumbent on professionals to use multiple informants (such as parents and teachers) to assess depression. The term “multiple informants” is used to suggest that other individuals in the child’s life can provide useful information about the child’s psychological symptoms. Structured diagnostic interviews can be conducted with parents about their child, and both parents and teachers can complete behavior checklists that might shed more light on the child’s psychological functioning. Many widely used behavior checklists (such as the Child Behavior Checklist and the Teacher Report Form, both developed by Tom Achenbach) can be used in conjunction with the CDI. Professionals should try to get an overall view of the child’s functioning and the family’s functioning, rather than using the CDI by itself to diagnose depression.

Bibliography

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