Establishing the measurement precision of the patient health questionnaire in an adolescent sample.

BACKGROUND: Technically sound measures are necessary for accurately identifying youth at risk for depression, but many studies rely on classical test theory metrics or adult samples to evaluate measures. This study examined the use of the PHQ-8, a common and freely available pediatric depression screener, in an adolescent sample using item response theory (IRT). METHODS: Secondary analyses were conducted on data from a study conducted in Midwestern middle schools in which 1224 youth completed the PHQ-8 as part of a battery of surveys. Polytomous IRT analyses (a Graded Response Model) were used to evaluate the PHQ-8. Items were examined for their ability to distinguish between respondents of different latent depression severity and for differential item functioning (DIF) across demographic categories. RESULTS: All PHQ-8 items had adequate discriminative abilities. Items measuring anhedonia and psychomotor disturbances performed relatively poorly, and items measuring somatic symptoms (appetite and sleep) were most informative when respondents endorsed extreme response options ("not at all" or "nearly every day"). No DIF was found across grade level or race, but several items were flagged for DIF by gender and student income level. LIMITATIONS: These results might not be generalizable to a broader youth population due to administration setting and the unique demographic characteristics of this sample (76.0 % African American). CONCLUSIONS: Tools such as the PHQ-8 are appropriate to quickly screen for depression in adolescents, but further scrutiny of adolescent response patterns is warranted. Future research should examine items measuring anhedonia and psychomotor and somatic disturbances in adolescents.

Does Child Likeability Mediate the Link Between Academic Competence and Depressive Symptoms in Early Elementary School?

The present study investigated the role of teacher-rated likeability as a mediator of the relation between low academic competence and depressive symptoms in elementary-aged children. Analyses focused on a sample of children at risk for child maltreatment living in Hawaii (n = 380). Structural equation modeling supported the hypothesized negative relations between academic competence in first grade and depressive symptoms in third grade controlling for correlated constructs (e.g., baseline social avoidance, parenting stress, externalizing problems, and internalizing symptoms). Teacher-rated likeability in second grade negatively mediated the effect of academic competence on depressive symptoms. Implications for understanding the role of early academic skill deficits and social judgments on risk for depressive symptoms as well as recommendations for interventions and prevention strategies are discussed.