Clinical Assessment of Depression

The Clinical Assessment of Depression (CAD) is a comprehensive assessment of children's, adolescents', and adults' depressive symptoms. CAD content was developed from a review of the literature pertaining to child, adolescent, and adult development and depression and was closely aligned with current diagnostic criteria of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.).

Notably, the CAD employs a single 50-item form as an overall measure of general affectivity. This comprehensive set of depressive symptoms was employed in part to test previous assumptions that the nature of depression varies across the age span. Multidimensionality was added to the instrument through the inclusion of symptom scales and critical item clusters sensitive to specific dimensions of depression. The CAD produces a total scale score and standard scores for each of four symptom scales and six clusters. The CAD critical item clusters (e.g., Hopelessness, Self-Devaluation) include item content that is especially sensitive to individuals who may be at risk for harming themselves. Table 1 shows the full range of affective symptoms assessed on the CAD and its symptom scales.

The CAD was normed on a sample of 1,900 children, adolescents, and adults aged 8 through 79 years. The normative sample included individuals from a wide range of racial and ethnic backgrounds, geographical [Page 149]regions of the United States, and residential communities (urban, suburban, and rural). Table 1 also presents the instrument's total sample symptom scale and total scale internal consistency estimates; CAD total scale reliabilities range from .96 to .97 across the entire age range. Less than 1% of the total scale variability is associated with examinees' age, gender, race/ethnicity, or socioeconomic status. Overall, data from CAD reliability and validity studies suggest that depressive symptoms are common and behave similarly, regardless of the demographic characteristics of the examinee.

The CAD has multiple applications, with broad uses in clinical, educational, and research settings. Although it is very comprehensive as a measure of depressive symptomatology, the CAD is appropriately brief (10 minutes) for use with depressed clients and is easily administered. Because the CAD is a self-report instrument requiring only a fourth-grade reading level, it can be completed by most clients, regardless of age, without help from an examiner. Maximizing scoring and interpretation efficiency, the CAD can be scored either by hand or by computer by individuals with little psychometric training, and resulting data can be collated, profiled, and reported for professional interpretation and use.