Another and adults. It’s highly important that the

Another advantage of the
BDI – II is that due to its standardized form, it’s easy to be understood by
the ones taking it, (as its guidelines are clear and concise), but also easy to
be administered. Also, I like that BDI-II can be administered to detect the
presence and the degree of depression in both adolescents and adults. It’s
highly important that the Beck Depression Inventory-II is especially useful in
rehabilitation and is considered one of the most reliable tools to screen
patients in alcohol and drug rehabilitation centers. The BDI can also be used
to track changes in the patient’s symptoms, so, in a way, the BDI can be used
to understand how effective the patient’s stay in the rehabilitation center has
been. After all it has been around for so long time and it is good reviewed.

After reviewing these two
assessments, I would most likely give preference to the BDI-II, because
compared to the Revised Hamilton Rating Scale for Depression, it gives the
patients the opportunity to better understand the aspects of their depression
and thus to approach the treatment from a more comprehensive level of active
involvement. I believe that is of great importance, because nowadays we, as
clinicians and therapists, should lead our patients to a more educational state
of approaching their illness, give them the chance to become more educated
about it and together, to work towards the best possible way of treatment. In
that sense, it brings significant improvements to the method of treatment as
well, because it facilitates the way for those responsible with the treatment
to provide the most suitable and personalized course of action in approaching
those depressive symptoms.

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To sum up the findings
concerning the two scales of assessment, I can state that if one is interested
in the disorder’s anxiety and somatic components, and implicitly in
understanding how different facets of the disorder are displayed by patients
and further change with treatment, they should use the Hamilton Rating Scale
for Depression; if, on the other hand, one is interested in evaluating the
amount of subjective distress and functional impairement caused by the
disorder, one should consider using the Beck Depression Inventory (Brown,
Schulberg, & Madonia, 1995). 

Beck et al. (1986) found a convergent validity
of the 14 clinical measures to be r = .72 when compared to the HAM-D r = .57. Kjærgaard
et al. (2014) produced convergent validity of the BDI-II when compared to the
SCID and found a low correlation (.40). This may be due to the fact that 20 of
the subject used when diagnosing major depressive disorder have an extremely
low BDI score. One explanation for this low validity could be because some
participants have atypical symptoms that are not included on the scale for a
short period of time (two weeks). Concurrent validity was found to be
moderately high (r = .71) for outpatients when compared to the Hamilton
Psychiatric Rating Scale for Depression Revised. The discriminative validity
had a moderate correlation (r = .47) when compared to the Hamilton Rating Scale
for Anxiety-Revised. This moderate correlation would be found because the
BDI-II is attempting to measure depression and not anxiety. Discriminative
validity was also determined when the BDI-II was found to be highly correlated
with the Beck Hopelessness Scale (n = 158, r = .68) and the Revised Hamilton
Psychiatric Rating Scale for Depression (n = 87, r = .71). These results
suggest that the BDI-II is examining participants for depression. The
researchers also found that outpatients had high scores than college students
and participants with mood disorders produced high scores than participants
with anxiety and adjustment disorders.

Researchers have found using coefficient alpha
that the reliability for the BDI-II has ranged from .92 for outpatients and .93
for the participants in the nonclinical sample. For the outpatient sample the item-total
correlation produces scores of .39 (loss of interest in sex) and .70 (loss of
pleasure). The nonclinical college sample that was used found the lowest
item-total correlation to be .27 (loss of interest in sex) and the highest
correlation was .74 (self-dislike). The researchers also used
test-retest reliability that had a spread of one week and the BDI-II produced a
high correlation of .93. The internal coefficient for the BDI scale was
determined using a meta-analysis to produce a Cronbach alpha score of .86 for
participants in the psychiatric sample and .81 for the participants in the
non-psychiatric sample (Beck, Steer, & Garbin, 1988). Kjærgaard et al.
(2014) found a reliability of .89 using Cronbach alpha, which would be
considered high. The results from these studies suggest that the reliability of
the BDI-II has sound reliability. 

Beck Depression Inventory -II (BDI-II) is
self-assessment of typical symptoms of depression and is one of most commonly used
instruments (Beck et al., 1961). It was developed to assess the degree of
depression symptoms in adults and adolescents older than 13 years with the
previously diagnosed depressive disorder. The original version included 21
items from different domains of symptoms that were used to examine mood
disorders: Loss of hope, feelings of rejection, inability to enjoy, feelings of
guilt, need for punishment, self-indulgence, self-sufficiency, suicidal risk,
plausibility, irritability, disorder in relation to other people, indecision,
negative self-image, reduced ability to work, sleep disorders, fatigue, lack of
appetite, weight loss, hypochondria and loss of sexual desire (Filip?i?,
2008).After the publication, DSM-IV also released the second version of this scale,
BDI-II. In this scale, the four new particles were added, and some old ones
have been thrown out so the new 21-item scale with four options under each
item, ranging from not present (0) to severe (3) better reflects new criteria
for a large diagnosis depressive disorder. Beck, Steer, and Brown (1996) also
have reformulated all the items to make it more clearly, the time frame in
which the person responded to the presence of symptoms increased with one for
the last two weeks, including the day of the test. The time it takes to
complete it is about 5 -10 minutes, the application is simple and customized to
the user, and the examiner can read the items and people with reading or
concentration difficulties.

Depression Inventory- II

Concerning the concurrent
validity of the (RHRSD) scale, it has been shown to be highly correlated with
scales such as BDI or MMPI Depression which were conducted by a clinician,
where the mean correlation for this studied was .67. The newer revision of this
scale has been established how the internal consistency coefficient of Cronbach
alpha ranges from .71 to .85 which can be considered as satisfactory
reliability. RHRSD and this research were also proclaimed (r = .84). The main
objections to this scale are: failure to include all the symptoms of a great
depression disorders (especially neurogenerative symptoms such as excessive
sleep or consumption food), the retention of items which have been shown to
measure different constructs (e.g., irritability and anxiety), giving unequal
weight to different symptoms (e.g. insomnia can be evaluated to six levels, and
tire to only two). To improve reliability amongst assessors, a structured
interview for RHRSD used in training was developed clinicians and clinical
investigations, and its use is associated with a better coefficient internal

The original version
included 21 clusters, but Hamilton emphasized that the last four items (daily
variations, depersonalization / derealization, paranoid symptoms and
obsessive-compulsive symptoms) should not be included in the total score
because such symptoms are rare or do not reflect the manifestation of depression
(Cusin, Yang, Yeung & Fava, 2009). From these conclusions came to light a
17-clusters version that became standard in clinical depression trials but
there are also versions of 23 and 26 clusters (Cusin, Yang,Yeung, & Fava,
2009). Research has shown how Cronbach alpha coefficients of internal
consistency of scale is ? = .83 and meta-analysis over 70 studies have shown
that clusters on the scale have satisfactory reliability (Bagby et al., 2004;
Cusin, Yang, Yeung & Fava, 2009). Test-retest reliability of this scale
proved to be high (r = .81), even when it was run with minimally trained
evaluators from different disciplines. It is a multidimensional scale on which
the identical result of two patients may have a different clinical
significance. This scale is also useful for monitoring changes depressive
symptoms during treatment (Abrabzdadeh-Bouchez & Lépine, 2003).

Revised Hamilton Rating
Scale for Depression (RHRSD) is one of the most widely used scales for
measuring and quantifying the severity of depression applicable to adults.
Clinicians perform it in a way to interview a person, and the purpose is to
evaluate the degree of depression in people with primary depression disease. It
additionally incorporates things to help clinicians affirm a finding of
depression and for assessing the effect of the disease on a client’s everyday
life. There are two RHRSD structures intended to be used for adults. The first
one is Clinician Rating Form which is completed during or after client’s
interview, and the 76-thing Self-Report Problem Inventory is completed by the
patient and it gives the clinician data parallel to that contained in the
clinician’s frame. There are 22 clusters of depressive symptoms for both
structures. Average duration of the implementation of this scale is 5-10
minutes, and it is designed for adults. The verification sample consisted of
202 depressed patients, 76% inpatients, 24% outpatients, and 69% females (Warren,
W. L. 1995). There was indicated moderate reliability for internal consistency
of .79 and .81 for the clinical and self-report.

Revised Hamilton Rating
Scale for Depression (RHRSD)

First, I’m going to
review the scale in which depressive symptoms are estimated by the researcher/psychotherapist.

I would like to provide a
review of two different depression assessment scales: Revised Hamilton Rating
Scale for Depression (Warren, W. L.,1994) and Beck Depression Inventory- II (Beck,
A. T., Steer, R. A., & Brown, G. K. 1961).These scales differ depending on
whether the researcher (structured interview) or the person himself/herself
completes a questionnaire whose total score is then compared to some standard
and, in that regard, determines to what extent depression symptoms are present
in the person. According to Brown,
Schulberg, & Madonia, (1995) the HRSD items are largely concerned with the
somatic and neurovegetative aspects of depression, while the BDI items tackle
the cognitive and affective dimensions of depression. Although they deal with different
aspects of the disorder, studies have shown that “when concordance of the two
instruments as outcome measures was examined in six randomized, controlled
psychotherapy trials, the correlation was .84” (AHCPR, 1993). Even more, it has
been shown through a meta-analysis of patient response to the psychotherapeutic
and pharmacologic treatments that the two scales produced similar rates of
recovery (AHCPR, 1993). However, these findings have varied along time, with
Edwards et al. (1984) and Lambert, Hatch, Kingston, & Edwards (1986), who
concluded after conducting another meta-analysis study, that the clinical
improvement with the HRSD is greater than the one with the BDI. As an
explanation to these differences, the authors of the article have come with two
possibilities: The first one is attributed to differences inherent in
observer-rating and self-report methods, and the second one is attributed to
the differences in the symptoms sampled by the two instruments (Brown,
Schulberg, & Madonia, 1995).  The two
assessment scales have also been evaluated from a factor – analysis perspective,
with the results stating that the BDI includes three to seven factors (Beck et
al., 1988). Why the variation the factor numbers? In this case, the method of
factor extraction seemed to cause the variation. The same factor – analysis
studies conducted on the HRSD have found three to six factors (Faravelli,
Albanesi, & Poli, 1986).

Many studies have focused
on self-assessment differences and clinical assessments. Diagnostic matching
was shown to be acceptable, but there were some differences; for example,
clinicians are trained to more accurately indicate the degree of depression
symptoms, so their diagnosis is more valid, but self-assessment of depression
is more sensitive when detecting changes in milder forms of depressive disorders
(Cusin, Yang, Yeung, & Fava, 2009).

According to Wall (2004),
formal assessments can be used to gather information for initial and continuous
evaluation without personal bias along with the information essential for
successful interventions. One of the roles of the assessment is to help
counselors evaluate their own effectiveness and how their intervention
influences the client (Wall, 2004).

developing various scales and questionnaires aimed at diagnosing depression
(clinical scale) or studying the degree to which it is present (research
scale), it is aimed to ensure a timely detection of symptoms and to assist the
endangered person. So, assessment in counseling gives the counselor data to
comprehend the client. Individuals are complex, and assessments can give the counselor
a more extensive and more precise point of view of the client.

The aim of the assessment of depression is
to measure the severity of depressive symptoms in terms of both the expression
of individual symptoms and the total number of depressive symptoms that were
present. Diagnosis is established using clinical scales, i.e. whether there is
a certain depressive disorder in the person or not, and the research scales
give an insight into the degree of depression symptoms (Abrabzdadeh-Bouchez
& Lépine, 2003).

Nowadays, depression has become the most
common mental illness the counselors /psychotherapists are dealing with.
Consequently, accurate assessment and diagnosis stand as first step in treating
depression. As the field of depression treatment gets wider, the number of
definitions and assessment of depression increases. Sometimes it is confusing
for counselors/psychotherapist to choose depression criteria, most reliable and
valid assessment devices which are of the most practical value in their practice.
An assessment of depression is completed by one of the following three
procedures: specific operational criteria and structured clinical/diagnostic interviews,
semi structured interviews and clinician rating scales and client self-report


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