RE: SOCW6111 – Assessment of Depression – Response to 2 students

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Humanities

Respond to at least two colleagues with two or three strategies your colleague might apply in treating Miranda’s depression.

Please be detailed in response and include 2 peer reviewed references

Response to Michael

Post the depression scale you located, summarize how it is used, and describe the target population.

The depression scale I located is the “Beck Depression Inventory—II” (BDI—II) (Beck, Steer, & Brown, 1961). According to Congress (2013), the BDI—II is the “most widely used measurement for assessing depressive symptoms in adults” (pg. 137). This is a self-report assessment, and although the test psychometric properties show “excellent reliability,” self-reporting methods are subject to response bias (Congress, 2013). The BDI-II is a 21-item format with four options under each item, ranging from not present (0) to severe (3) (Likert scale). According to Congress (2013), a score of 0-13 indicates normal levels of depression; 14 to 19, mild to moderate levels; 20 to 28, moderate to severe; and 29 to 63, extremely severe level of depression (pg. 137).

Describe how you might apply this assessment to the course-specific case study of Miranda and include any additional questions you would ask Miranda to assess her level of depression.

The case scenario does not say how long or even if Miranda grew up in Scotland, so instead of using the “culturagram,” I would use the genogram in conjunction with the BDI—II and the cognitive processing theory. Using the genogram aids me in the origins of Miranda problems by diagramming her family over at least the last three generations. Using the BDI—II gives me a quick and efficient interpretation that “can” “provide others sources of data” that might not be gained in a client interview. Both the assessment and the scale can provide information in the utility of the cognitive processing theory. Two additional questions I would ask are: does Miranda feel guilty about not helping her mother in her abusive relationship, or does she feel vengeful towards her mother for not speaking up for her?

Then, identify the red flags that might cause concern and/or indicate significant depression.

According to the American Psychiatric Association (2013), Miranda must meet 5 of the 9 criteria to have the diagnosis for major depression. Miranda expresses that she is depressed, has lost pleasure in doing leisure activities, increase appetite, insomnia, feeling of worthlessness, and recurrent thoughts of death (American Psychiatric Association, 2013, pg. 94-95).

Finally, identify a scale that can be used to assess risk for suicide.

According to Beck & Steer (1978), “the Beck Hopelessness Scale or BHS is a 20-item self-report instrument for assessing hopelessness, particularly in relation to the risk of suicide” (para. 1). I like this scale because of it derivated from the BDI. Also, what makes this scale interesting is that “when vegetative and other symptoms of depression are controlled for, hopelessness remains a significant predictor of suicidality; conversely, when hopelessness is partialled out, depression does not correlate with suicidality. This is what makes the BHS unique and valuable as a complement to measures of depression” (para. 1). I thought this was interesting because on one side of the coin, if you rule out depression, but the person remains hopeless, they still have a chance of committing suicide, but not the other way around.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Beck, A. T., Steer, R. A., & Brown, G. K. (1961). Beck Depression Inventory–II.

Beck, A. T., & Steer, R. A. (1978). Beck Hopelessness Scale [Revised].

Congress, E. (2013). Assessment of adults. In M. Holosko, C. Dulmus, & K. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 125–145). Hoboken, NJ: Wiley.

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Response to Anthony

Correa-Barrick Depression Scale

The Correa-Barrick Depression Scale is a self-report measure used to asses levels of depression. This scale, while not to be used solely as a diagnostic tool, is to be used to measure the severity of symptoms. This scale may be used in a group setting or on an individual basis in numerous locations to include “private practices, hospitals, universities and colleges, health departments, clinics, government/military and other agencies”( Barrick & Correa, 2015) The CBDS is geared towards adults 18 and older, and as stated earlier can be used within any population.. A great asset to using the Correa-Barrick Depression Scale is that it may also be used to evaluate client changes in depression over time. The CBDS has high internal consistency reliability, with an alpha coefficient of .91. Administration of the CBDS consist of a pen and paper questionnaire of 20 item. The CBDS assess four areas of depression: “cognitive-emotional disturbance (e.g., worry, restlessness), general outlook (e.g., looking forward to fun things, future outlook), physiological symptoms (e.g., sleep problems, body feels heavy) and sensory/perceptual disturbance (e.g., appetite change)” (Barrick & Correa, 2015). In addition, the CBDS is the first assessment scale to include a color sensitivity item based on modest findings from researcher that highlight an association between depression severity and color sensitivity.

Applying the Correa-Barrick Depression Scale to the Case Study of Miranda

The use of the CBDS in Miranda’s case would allow me as her Social Worker to continue to evaluate they severity of her symptoms over time. The use of this scale over the course of time allows us to observe any changes that may be required in treatment for Miranda, while also helping to establish patterns. For example, does Miranda score higher on the scale during a certain time or during a life event? If a change was noted in the scale, follow up questions could be provided to explore possible influencers.

In addition, I would use the Perceived Stress Scale (PSS). The PSS was first published in 1983, and is frequently used for measuring perceived stress. The scale can be used with individuals with at least a junior high school education, and can be administered with groups or individuals. The scale is a 10 item questionnaire utilizing a Likert scale response, with 0 representing never and 4 representing very often. The questions all start out with “in the last month”, therefore allowing a large time table for the scale to be conducted. (Cohen et. Al., 1983).

Red Flags that indicate Significant Depression

There are several red flags of mental illness that Social Workers, educators, and overall the general public should be aware off according to the American Psychiatric Association (2015). While experiencing one or two of these symptoms may not be conclusive of mental illness, having several of them is alarming. In either case, if any clients or individuals experience the following, professional help should be consulted:

Recent Withdrawal and loss of interest in others, Drops in function levels at school work, or social activities, problems with concentration or memory, increased sensitivity to senses or avoidance to over stimulation, experiencing apathy, feelings of disconnect, sudden changes in mood, sleep, appetite, or hygiene changes, and illogical thinking.

Assessment Scales to identify risk of Suicidal Ideation

“Suicide assessment and prevention is an important part of any comprehensive assessment process.”(Congress, 2013). Individuals suffering from depression carry higher risk for Suicide than those who don’t, 25 times greater. (Friedman & Leon, 2007). To properly conduct an assessment, a useful scale to use would be the Scale of Suicide Ideation- Current. The SSI-C is a 19 item instrument designed to assess for SI. The scale has high internal consistency and high correlations with ratings of Suicidal risk and measures of self-harm. In addition, it is found to be sensitive to the levels of depression over time. (Beck et. al., 1979).

References

Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47(2), 343-352.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.

Congress, E. (2013). Assessment of adults. In M. Holosko, C. Dulmus, & K. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 125–145). Hoboken, NJ: Wiley.

Friedman, R.A. & Leon, A.C. (2007). NEJM — Expanding the Black Box — Depression, Antidepressants, and the Risk of Suicide. New England Journal of Medicine, 356:2343-2346.

Warning Signs of Mental Illness. (n.d.). Retrieved from https://www.psychiatry.org/patients-families/warni…

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