Assessment and Treatment of Depression in Children and Adolescents

269 Pages·2000·3.14 MB·English

DOCUMENT RESUME
ED 375 371
CG 025 824
AUTHOR
Clarizio, Harvey F.
TITLE
Assessment and Treatment of Depression in Children
and Adolescents. Second Edition.
REPORT NO
ISBN-0-88422-103-2
PUB DATE
94
NOTE
269p.
PUB TYPE
Books (010)
EDRS PRICE
MF01/PC11 Plus Postage.
DESCRIPTORS
*Adolescents; Affective M,-sures; Child Health;
*Children; Clinical Diagnosis; *Depression
(Psychology); Elementary Secondary Education;
Emotional Problems; Loneliness; Mental Disorders;
Mental Health; Psychopathology; Self Destructive
Behavior; *Suicide; Therapy
ABSTRACT
Despite signs of increasing agreement among mental
health professionals, controversy continues over developmental,
diagnostic, and intervention issues surrounding childhood depression.
This introductory text is written for practitioners as well as for
advanced undergraduates or graduate students who are preparing to
become psychologists, social workers, counselors, or special
education teachers working with affectively disturbed children and
youth. No attempt is made to present a consistent theoretical
framework. Instead, the book concentrates on those viewpoints
currently popular among mental-health specialists. Although the text
addresses the influence of biological and social forces on affective
disorders, the emphasis is on psychological factors thought to be
operative in depression and suicide among young people. The book's
most distinctive features include its research base, its
developmental orientation, and its emphasis on the practitioner.
Other important aspects of the book include: some research positions
on childhood depression; information on the development of this
illness; guidelines for diagnosis, assessment, and treatment of
childhood depression; and a separate chapter dealing with suicide in
school-aged youth. Each chapter contains a summary of its content and
a list of references. Twenty-seven tables present diagnostic
criteria, depression checklists, therapeutic approaches, strategies
for dealing with suicidal youth, and other information. (RJM)
***********************************************************************
Reproductions supplied by EDRS are the best that can be made
from the original document.
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SECOND EDITION
riz
ASSESSMENT
AND
TREATMENT
OF
PRESS'S
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OERI position or policy
CHILDREN
AND
ADOLESCENTS
HARVEY F. CLARIZIO
2
BEST COPY AVAILABLE
-A
ASSESSMENT AND
TREATMENT OF
DEPRESSION N
CHILDREN AND
ADOLESCENTS
3
ASSESSMENT AND
TREATMENT OF
DEPRESSION IN
CHILDREN AND
ADOLESCENTS
(Second Edition)
Harvey F. Clarizio
Michigan State University
CPPC
CLINICAL PSYCHOLOGY PUBLISHING CO., INC.
4 CONANT SQUARE
BRANDON, VT 05733
4
Copyright © 1989, 1994 by Clinical Psychology Publishing Company,
Inc., Brandon, Vermont. Second edition 1994.
All rights reserved. No portion of this book may be reproduced in any
form, by photostat, microfilm, retrieval system, or by any means now
known or later devised, without prior written permission of the publisher.
Permission is not necessary for brief passages embodied in critical reviews
and articles.
Library of Congress Catalog Card Number: 93-71833
ISBN: 0-88422-103-2
Square
CPPC i
Cnant
4Brandon,
Cover design: Sue Thomas
Printed in the United States of America.
TABLE OF CONTENTS
Preface
ix
Introduction
1.
1
Definitional Issues: Five Schools of Thought
2
Differentiation from Normality
7
Differentiation from Related Diagnoses
8
Classification Systems
16
Prevalence
28
Etiology
31
Summary
39
A Developmental Approach
2.
49
Normal Development and Childhood Depression
50
Developmental Trends in Depressive Symptcmatology
54
Age Trends in Prevalence Figures
58
Gender Differences
60
Continuity
63
Summary
78
Diagnosis and Assessment
3.
85
Levels of Diagnosis
85
Assessment Techniques
87
Multistage Model
117
Additional Diagnostic Concerns
119
Guidelines for Assessment
125
Summary
127
6
CONTENTS
vi
Treatment of Childhood Depression
135
4.
Psychoanalytic Approaches
137
Behavioral and Social Skills Approaches
138
150
Cognitive Approaches
Drug Therapy
170
176
Family Therapy
Multimodal Therapy
179
Implications for Practice
181
184
Summary
Suicide in School-Aged Youth
195
5.
197
Prevalence
Identification and Prediction of Youth at Risk
200
Assessing the Suicidal Adolescent
.211
213
Treatment
223
Strategies for Prevention
239
Summary
K.
LIST OF TABLES
Differentiation of Childhood Depression from Related
1.1
Conlitions
9
Differentiating Features of Anxiety and Depression
1.2
14
DSM-11I-R Classification of Mood Disorder
1.3
17
DSM-III-R Criteria for Major Depressive Episode
1.4
18
DSM-111-R Criteria for Dysthymia
1.5
20
Weinberg Criteria for Childhood Depression
1.6
24
2.1
Developmental Changes in Depressive Symptomatology
59
2.2
Advantages and Disadvantages of Research Designs Used
in Continuity Studies
65
CBCL-NUR items
3.1
98
3.2
Symptoms Checklist for Major Depressive Disorders
105
3.3
Characteristics and Content oi Interviews
112
The Children's Reinforcement Survey Schedule:
4.1
Sample Items
141
4.2
Adolescent Activities Checklist: Sample Items
142
4.3
Sequencing of Treatment Program
147
4.4
The Cognitive Triad Inventory for Children
153
4.5
Using RET with Depressed Children
161
4.6
Self-Control Therapy
168
4.7
Common Psychopharmacologic Medications Used with
Depressed Children or Adolescents
172
4.8
Strategies for Dealing with Depressive Behaviors
185
8
r
LIST OF TABLES
viii
Indicators of Suicidal Risk
201
5.1
Selected Characteristics of Suicide Completers Versus
5.2
202
Attempters
214
Interview Questions for Children and Parents
5.3
216
Ground Rules for Family Meetings
5.4
Phases, Goals, and Selected Interventions in Individual
5.5
218
Psychotherapy with Suicidal Youth
220
Components of Crisis Intervention for Suicide Attempters
5.6
4
222
No-Suicide Contract
5.7
229
Preventive Steps
5.8
9
O
PREFACE
The topic of childhood depression has undergone rapid and significant
changes in the course of a few decades. Mental health specialists initially
overlooked this condition, later argued against its existence, then recom-
mended universal acceptance of it as a separate clinical entity very similar in
nature to adult depression. Most recently they have expressed concern over
the impact of the child's cognitive, linguistic, and socioemotional develop-
ment capabilities on depressive symptomatology and treatment. Despite signs
of increasing agreement among mental health professionals, controversy con-
tinues unabated over developmental, diagnostic, and intervention issues. Al-
though the research base is indeed sketchy, the number of empirical studies is
expanding appreciably, and answers to many of the currently perplexing ques-
tions should be forthcoming in the next decade.
This introductory text is written for practitioners as well as for advanced
undergraduates or graduate students who are preparing to become psychol-
ogists, social workers, counselors, or special education teachers working
with affectively disturbed children and youth. No attempt has been made to
present a consistent theoretical framework. Instead, major attention has been
devoted to those promising viewpoints currently popular among mental
health specialists. Although examining the interactional contributions of bi-
ological and social forces to affective disorders, the focus is clearly on psy-
chological factors thought to be operative in depression and suicide among
young people. The most distinctive features of the book are its research base,
its developmental orientation, and its practitioner emphasis.
10