Evaluate The Psychometric Properties Of A Psychological Assessment On DEPRESSION.

EBSCO Publishing Citation Format: APA (American Psychological Assoc.): NOTE: Review the instructions at http://support.ebsco.com.ezproxy.liberty.edu/help/? int=ehost&lang=&feature_id=APA and make any necessary corrections before using. Pay special attention to personal names, capitalization, and dates. Always consult your library resources for the exact formatting and punctuation guidelines.

References Reynolds, W. M., & Kobak, K. A. (1998). Reynolds Depression Screening Inventory. Retrieved from

http://ezproxy.liberty.edu/login?url=http://search.ebscohost.com/login.aspx? direct=true&db=mmt&AN=test.2135&site=ehost-live&scope=site

<!–Additional Information: Persistent link to this record (Permalink): http://ezproxy.liberty.edu/login? url=http://search.ebscohost.com/login.aspx?direct=true&db=mmt&AN=test.2135&site=ehost- live&scope=site End of citation–>

Reynolds Depression Screening Inventory Review of the Reynolds Depression Screening Inventory by MICHAEL H. CAMPBELL, Director of Residential Life, New College of University of South Florida at Sarasota, Sarasota, FL: TEST COVERAGE AND USE. The Reynolds Depression Screening Inventory (RDSI) is a paper- and-pencil self-report measure based on the well-known Hamilton Depression Inventory (HDI), which in turn was adapted from the classic Hamilton Depression Rating Scale. The test was designed to provide a brief, convenient, and cost-effective screening for the severity of depressive symptoms. Items for the RDSI were drawn from the 32-item HDI and selected to provide broad coverage of the DSM-IV criteria for Major Depressive Disorder, as well as to maximize scale homogeneity. The authors make clear that the RDSI is not intended to function as a diagnostic or predictive instrument; rather, the test provides quantitative and qualitative information on current levels of depressive symptomatology. The test is appropriate for use with adult outpatients, whether or not they meet DSM-IV criteria for diagnosis of a depressive disorder. NORMS AND TEST BIAS. The standardization sample for the RDSI consisted of 450 nonclient adults (ages 18-89) selected from a larger sample (n = 531) to provide balanced representation of gender and age groups. The authors also report norms from a psychiatric outpatient sample (n = 324), in which patients with Major Depressive Disorder (n = 150) were represented. Many of the analyses reported in the manual are based on the total development sample (n = 855). The manual provides comprehensive descriptions and analyses of sample demographics. There was a significant effect of gender on RDSI scores, consistent with previous research demonstrating a slight trend for women to report greater depressive symptomatology. There were no significant main effects for age or ethnicity, and no significant age X gender or ethnicity X gender interaction effects. However, as the authors prudently note, ethnic minorities, especially Asians and Hispanics, had relatively small sample sizes; therefore, statistical power may be insufficient to detect ethnicity-

related differences in scores. ADMINISTRATION AND SCORING. The RDSI is clearly and elegantly designed. The test is easily administered in both individual and group formats and is sufficiently straightforward to be used by a wide variety of mental health professionals with appropriate training. The manual provides clear instructions for administration and scoring, which is readily accomplished by hand. Additionally, the manual includes procedures for prorating incomplete protocols and describes some simple validity checks based on usual or inconsistent response patterns. The RDSI also contains six critical items that merit follow-up when scored in the keyed direction. The RDSI produces raw scores ranging from 0 to 63, although raw scores above 35 are rare. The manual provides tables for conversion of raw scores into T-scores and percentile ranks. Raw scores of 10 or below are not suggestive of clinical severity; scores from 11 to 15 suggest mild severity. A cutoff score of 16 identifies “a clinically relevant level of depressive symptoms” that warrants referral “for further evaluation and consideration of treatment” (professional manual, p. 15). The manual provides a detailed description of the cutoff score selection criteria: to maximize both hit rate and clinical sensitivity. In a study of the RDSI’s ability to differentiate between participants with an existing diagnosis of Major Depressive Disorder and nonpatient controls, a score of 16 correctly classified 94.9% of persons overall and 95.3% of those with an existing diagnosis of Major Depression. RELIABILITY. The reliability estimates of the RDSI appear excellent across a series of measures. Cronbach’s alpha estimates of internal consistency were .93 for the total sample and .89 for the psychiatric outpatient sample, with minimal differences between genders. Test-retest reliability computed at approximately one-week intervals (using a sample of 190 adults retested after the initial data collection) yielded an overall correlation of .94. The authors also report correlations between individual items and total scale score for the total development sample. Correlations ranged from .44 to .83 (all but two were above .50), suggesting substantial homogeneity of item content, even though the RDSI taps a diverse group of depressive symptoms. Finally, the standard error of measurement is less than 3 points for both men and women, indicating a stability of measure that supports clinical use. VALIDITY. The manual provides clear and comprehensive summaries of validational data. The descriptions of statistical and conceptual strategies for validation are very well written and well organized; the material should be broadly accessible, even to readers with relatively little training in quantitative methods. More importantly, the substance of these analyses is clear and convincing evidence of content, criterion-related, construct, and clinical validity. The item selection procedures for the RDSI provide important evidence of content validity. The selection process ensured that items reflected mood, cognitive, somatic, neurovegetative, psychomotor, and interpersonal areas of symptomatology. The RDSI item content is tied to the diagnostic criteria of the DSM-IV; the instrument is therefore atheoretical in that content parallels the DSM’s focus on symptom presentation rather than etiological explanation. Additionally, item validity can be implied from item homogeneity demonstrated by item-with-total-scale correlations, as noted above. The authors’ evaluation of criterion validity focuses on concurrent rather than predictive criteria, a choice defended on the grounds that the RDSI is designed to assess current levels of severity but not to predict the future course of depression. The manual presents strong evidence of concurrent validity based on correlations with a variety of criterion measures, including the Hamilton

Depression Rating Scale (.93), the Beck Depression Inventory (.94), the Beck Hopelessness Scale (.80), the Adult Suicidal Ideation Questionnaire (.67), the Beck Anxiety Inventory (.71), the Rosenberg Self-Esteem Scale (-.71), and the Marlowe-Crowne Social Desirability Scale–Short Form (-.37). This is an impressive array of correlations with well-validated criterion instruments. Moreover, the choice of criterion instruments provides strong evidence of convergent and discriminant construct validity. Further evidence of construct validity comes from factor analytic evaluation of the RDSI items. An initial principal components analysis using both orthogonal and oblique rotations yielded a consistent three-factor structure for the RDSI; the dimensions were depressed mood- demoralization, somatic complaints, and vegetative symptoms-fatigue. A second principal components analysis, restricted to data from psychiatric outpatients, yielded essentially the same factor structure. The manual includes an interesting discussion of clinical efficacy or clinical validity. In addition to a detailed discussion of the issues of hit rate and sensitivity noted earlier, the authors demonstrate statistically significant differences in RDSI score among nonreferred adults, persons with Major Depressive Disorder, and persons with other psychiatric diagnoses; the authors term this type of analysis “contrasted groups validity.” SUMMARY. The RDSI provides a reliable, valid, and convenient short screening for severity of depressive symptoms in psychiatric outpatients. The supporting materials are outstanding for their thorough documentation and clarity of expression, and the evidence of reliability and validity is compelling. Although the test probably does not provide much additional or qualitatively different clinical information relative to other instruments (e.g., Revised Hamilton Rating Scale for Depression [RHRSD], Beck Depression Inventory-II [BDI-II], or Minnesota Multiphasic Personality Inventory-2 [MMPI-2], the RDSI is an excellent choice for clinicians who desire an efficient screening focused on depressive symptoms.

Review of the Reynolds Depression Screening Inventory by ROSEMARY FLANAGAN, Adjunct Associate Professor of Psychology, St. John’s University, Jamaica, NY: The Reynolds Depression Screening Inventory (RDSI) is an instrument in a series (e.g., Reynolds, 1986) of depression inventories. The manual is well written and appears useful for both researchers and practitioners. Standardization procedures and psychometric properties are carefully explained; illustrative case examples are provided. To the credit of the authors, sufficient data are reported in the manual, permitting test users to arrive at their own judgments about the RDSI. A literature search did not yield further information; therefore, this review is based on material in the manual, and a recent conference presentation (Reynolds, Flament, Masango, & Steele, 1999). The authors appear to have realized their stated goal of developing a measure of depression consistent with the diagnostic criteria for Major Depressive Disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). Depression is a significant mental health problem in that surveys indicate (e.g., Kessler et al., 1994) prevalence rates as high as 10.3% for the general population. The RDSI is not intended for the diagnosis of depression, but rather, is to be used to provide an indication of the severity of the problem over the past 2 weeks. Items reflect the same domains that are covered on the Hamilton Depression Rating Scale (HDRS; Hamilton, 1960), with weighted response options for the items. The RDSI is similar in format to the Beck Depression Inventory (BDI; Beck, Steers, & Brown, 1987) in that each item is rated along a continuum, with higher scores indicative of greater depressive

symptomatology. There are three to five response options for each item, stated in specific behavioral terms, similar to a structured interview. Administration and hand scoring can be accomplished in 10-15 minutes; there is no computer-scoring format. Scoring involves summing the numerical values assigned to the response options, with data reported as linear T=scores (Mean = 50; SD = 10) and percentiles. Responses to six critical items are also reviewed. These items address the following and its extent: whether the respondent is feeling depressed, the respondent’s outlook, suicidal ideation, changes in interest and work performance, and general feelings about oneself. The RDSI is written at approximately a fifth-grade reading level, somewhat below the reading level of the BDI (eighth-grade). Similar to the BDI, this format is advantageous to practicing clinicians, as it can be administered and scored during an office visit, if necessary. Norms were derived from a sample of 450 individuals who were matched for gender and age. A concern is that the sample is geographically limited, having been drawn from the Midwestern and Western United States. The racial-ethnic composition of the sample is 89.1% Caucasian, 4.5% African-American, 2.0% Asian, 3.3% Hispanic, and 1.1% Other. Approximately 72% of the individuals were between 25 and 64 years of age, with 14% in both the 18-24- and 65-89-year cohorts; the mean age of the participants was 43. Socioeconomic status varied from professionals to the unemployed; dwelling areas were urban, suburban, and rural. Data were collected on several additional samples that were used in subsequent analyses. The psychiatric sample was composed of 324 individuals, 150 of whom were diagnosed as having major depression, 123 had anxiety disorders, and 51 were diagnosed with other psychopathology. The demographic characteristics of this group were generally similar to the standardization sample. The mean scores for each group were such that the groups were collapsed into two groups: those with major depression and those with other psychopathology. An additional sample referred to as the total development sample was used for some analyses; its composition is demographically similar to the other samples used. It was composed of 855 individuals, approximately 62% had no DSM-IV (American Psychiatric Association, 1994) diagnosis. The remaining 38% comprised a group with major depression and a group with other psychiatric problems. Coefficient alpha for the total sample and the psychiatric sample was .933 and .898, respectively. Test-retest reliability at a 1-week interval was .944. These values are adequate for clinical decision making and research (Kaplan & Saccuzzo, 1997; Nunnally & Bernstein, 1994). The instrument appears to assess a sole construct, with scores demonstrating adequate stability. Validity was examined in several ways: content, criterion-related, construct, and clinical (contrasted groups), and the efficiency, sensitivity, and diagnostic specificity of the RDSI cutoff score. Item-total correlations, reflecting content validity, are described as moderate to high, with approximately 25%-69% of the variance being explained for 16 of 19 items. Criterion-related validity was assessed by examining the sample correlation (r = .93) between an adapted version of the Hamilton Depression Rating Scale (HDRS; Reynolds & Kobak, 1995) and RDSI scores. The adapted form of the HDRS requires considerably less time to administer and is much less labor-intensive than the original HDRS (Hamilton, 1960), and is similar in format to the RDSI. Construct validity was evaluated by examining the relationship between the RDSI and several measures. Correlation with the Beck Depression Inventory (BDI; Beck, Steer, & Brown, 1987) was .94. Correlations with related constructs, such as suicide ideation, assessed by the Adult Suicidal Ideation Questionnaire (Reynolds, 1991) was .67. Correlation with the Rosenberg Self-Esteem Scale (Rosenberg, 1965) indicated an inverse relationship, as might be expected (-.71). Additional evidence of construct

validity was provided as part of the validation of the Physical Self-Concept Scale (Reynolds, Flament, Masango, & Steele, 1999). The measure evaluates physical aspects of appearance, ability/skills, intelligence, health, and self-efficacy related to these same domains. A moderate relationship with the RDSI was demonstrated, accounting for 21% of the variance for a sample of community-based college students and adults. Multiple regression analysis indicates that the RDSI measures depression as opposed to generalized psychological distress. This was substantiated in two analyses in which the beta weights for depression as assessed by the BDI and HDRS were .66 and .72, respectively. In contrast, beta weights ranged from -.22 to .18 for measures of hopelessness, suicide ideation, self- esteem, and anxiety. Factor analytic studies indicate that 58% of the variance in the total development sample is explained by a three-factor solution, corresponding to depressed mood, somatic complaints, and vegetative symptoms. The factors were extracted to provide evidence of validity, rather than to provide information about aspects of depression. It is made clear that the RDSI should not be the sole criterion used to diagnose depression, and that the factors should not be interpreted individually. This bears some similarity to the BDI. The most critical validity evidence is the efficacy of the RDSI cutoff scores. Analyses were conducted to determine the level at which the combination of sensitivity (correct identification of those with major depression), specificity (correct identifications of those who do not have major depression), positive and negative predictive value (correct identifications), and hit rate (proportions of correct identifications) were optimized. Data are also presented on the strength of association (chi square, kappa coefficient) and the quantified clinical validity of the cutoff scores (phi coefficient). The cutoff score that is expected to result in optimal decision making is 16, substantiated by tabled data indicating four (sensitivity, hit rate, chi square, phi coefficient) indices at their peak; the remaining indices are acceptably high. This corresponds to the 96th percentile, or T = .72. Should the score not be in the clinically significant range, the RDSI could be interpreted normatively. The item numbers of the six critical items are printed near the bottom of the front page of the protocol. Responses of “2” or higher on these items are clinically significant. Should an individual obtain scores of “3” or more on three critical items, further evaluation is indicated, irrespective of the total score. SUMMARY. The data in the manual suggest that the RDSI should live up to the authors’ claims. Psychometric properties are sound, despite a smaller norming sample than that used for the BDI. The level of detail in the manuals, particularly in the validity sections, exceeds that available in the BDI manual, and is an improvement. The RDSI is atheoretical; the BDI reflects Beck’s theory (e.g., Beck, 1973). The strength of the RDSI may be that it is a technical advance. Nevertheless, the uses and properties of the RDSI are similar to the BDI. The need for a new instrument to assess depression in a brief, time-sensitive format is debatable. Researchers and practitioners may be less likely to utilize a new measure, given the existing data and large literature supporting the BDI. It is reasonable to expect that additional research is needed for the RDSI to become a commonly accepted alternative to the BDI. REVIEWER’S REFERENCES Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56-62. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.

Beck, A. T. (1973). Depression; Causes and treatment. Philadelphia: University of Pennsylvania Press. Reynolds, W. M. (1986). Reynolds Adolescent Depression Scale. Odessa, FL: Psychological Assessment Resources. Beck, A. T., Steer, R. A., & Brown, G. K. (1987). Beck Depression Inventory-II manual. San Antonio, TX: Psychological Corporation. Reynolds, W. M. (1991). Adult Suicidal Ideation Questionnaire: Professional manual. Odessa, FL: Psychgological Assessment Resources. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., Wittchen, H., & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8- 19. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill. Reynolds, W. M., & Kobak, K. A. (1995). Reliability and validity of the Hamilton Depression Rating Inventory: A paper and pencil version of the Hamilton Depression Rating Scale clinical interview. Psychological Assessment, 7, 472-483. Kaplan, R. M., & Saccuzzo, D. (1997). Psychological testing (4th ed.). Pacific Grove, CA: Brooks- Cole. Reynolds, W. M., Flament, J., Masango, S., & Steele, B. (1999, April). Reliability and validity of the Physical Self-Concept Scale. Paper presented at the annual convention of the American Educational Association, Montreal, Canada.

*** Copyright © 2014. The Board of Regents of the University of Nebraska and the Buros Center for Testing. All rights reserved. Any unauthorized use is strictly prohibited. Buros Center for Testing, Buros Institute, Mental Measurements Yearbook, and Tests in Print are all trademarks of the Board of Regents of the University of Nebraska and may not be used without express written consent.