Author

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(No Transcript)
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Author

• Bruce A. Bracken, PhD
• Professor
• The College of William Mary
• School of Education
• P.O. Box 8795
• Williamsburg, VA 23187-8795
• [phone]
• babrac_at_wm.edu
• www.itc2004.com
• www.psychoeducational.com

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Author

• Karen K. Howell, PhD
• Senior Research Scientist
• Emory University School of Medicine
• Department of Psychiatry and Behavioral Sciences
• Maternal Substance Abuse and Child Development
  Project
• 1256 Briarcliff Road N.E., Suite 324W
• Atlanta, GA 30306
• Phone [phone]
• Fax [phone]
• Email khowell_at_emory.edu

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Multifaceted Natureof Adjustment

• Multidimensional, context-dependent model of
  adjustment, with six primary life domains
• Three intra-personal domains
• Affect
• Competence
• Physical
• Three interpersonal domains
• Social
• Academic
• Family

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Developmental Natureof Adjustment

• Adjustmentbecomesincreasingly
  differentiatedwith age
• Life domains differentiateas a functionof
  exposure to different contexts

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TriangulationMulti-source, MultipleContext
Assessment
Other Sources- Direct Observation -
Indirect Approaches (e.g., Projective
Techniques) - Background Information
- Self Statements

Psychosocial Adjustment
Third-Party Report - Clinical Assessment of
Behavior (CAB) - DSMD - BASC
Self-Report - CAD - RADS - BDI
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Constructing the CADA Multidimensional,Multi-St
ep, Multi-Year Process
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Depression

• Approximately 2.5 percent of children and 8
  percent of adolescents in the U.S. have
  depression.
• An NIMH-sponsored study of 9 to 17-year-olds,
  more than 6 percent in a 6-month period were
  depressed and 4.9 percent having major
  depression.
• Research indicates that depression onset is
  occurring earlier in life today than in past.
• National Institute of Mental Health

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ContentIdentification
Identification of relevant content was
accomplished through

• A review of the literature pertaining to child,
  adolescent, and adult development and depression
• A review of item content from existing
  instruments
• An examination of current diagnostic criteria
  based on the DSM-IV
• Consideration of item content to reflect
  depressed mood among individuals across a wide
  age range
• Suggestions from colleagues
• Wrote 175 items across 16 content domains based
  on literature and DSM diagnostic criteria

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Features

• Uses a Four-point Item response format
• Strongly Agree
• Agree
• Disagree
• Strongly Disagree
• Comes with CAD-SP that scores, profiles, reports
  data, and facilitates interpretation
• Standard scores (T-scores)
• Percentile ranks
• Confidence intervals
• Qualitative classifications
• Graphical profile display

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Features

• Single form appropriate for ages 8 to 79 years
• Easily administered 50 item scale
• Ten minute completion time
• Multidimensional view of depressions - Four
  Symptom Scales - Twelve Major Depressive
  Symptoms - Six Clinical Clusters - Three
  Veracity Scales
• Easily hand scored or optional software scoring
  system
• Based on DSM-IV diagnostic criteria and clinical
  literature

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Features

• Critical Item clusters identify risk factors for
  potential self-harm
• Exceptional psychometric qualities
• Large, diverse, national normative sample
• Content appropriate, children, and adolescents
  without sacrificing face validity

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Normative Sample
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Normative Sample
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Normative Sample
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Normative Sample
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Scale Variance and Demographics
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Four Clinical Scales

• Depressed Mood (DM)
• 23 items - - feelings of extreme unhappiness,
  sadness, loneliness, lack of personal
  significance, poor self-concept, and discouraged
  outlook on life.
• Anxiety/Worry (AW)
• 11 items - - increased anxiety, worry, fear,
  and related symptoms

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Four Clinical Scales

• 3. Diminished Interest (DI)
• 6 items - - loss of interest in activities
  that previously were enjoyable, diminished
  excitement, lack of enjoyment, and not wanting to
  participate in daily routines
• 4. Cognitive and Physical Fatigue (CPF)
• 10 items - - somatic issues, fatigue,
  sleeplessness, insufficient energy, lack of
  mental of physical clarity, clumsiness or
  slowness, and inability to complete tasks

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Six Critical Item Clusters

• 1. Hopelessness
• 5 items - - sense that current conditions are
  permanent and with no promise for improvement,
  extreme unhappiness, having given up on the
  future, and inability to continue the current
  level of suffering
• 2. Self-Devaluation
• 5 items - - sense of self-loathing, failure,
  extreme loneliness, and loss of personal meaning
• 3. Sleep/Fatigue
• 3 items - - feelings of fatigue, lack of
  energy, and desire to do little other than sleep

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Six Critical Item Clusters

• 4. Failure
• 3 items - - sense of limited personal
  competence or an overwhelming sense of failure
• 5. Worry
• 3 items - - feelings of generalized worry and
  worry that bad things may happen
• 6. Nervous
• 3 items - - feelings of anxiety, nervousness,
  and limited ability to relax

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CADTheoretical Structure
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Internal Consistency by Age
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Internal Consistency by Age
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Internal Consistency by Age
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Internal Consistency by Age
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Internal Consistencyby Gender
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Internal Consistencyby Race/Ethnicity
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Internal Consistencyby Race/Ethnicity
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Internal Consistencyby Race/Ethnicity
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Internal Consistencyby Race/Ethnicity
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Internal ConsistencyClinical Sample
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Test-Retest Stability
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Test-Retest Stability
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Test-Retest Stability
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CAD, BDI-II and RADSConcurrent Validity
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CAD, BDI-II and RADSConcurrent Validity
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Disordered Youth andAdults Corresponding Scales
Groups of disordered youth and adults perform in
mild critical range on appropriate scales Major
Depression n 48 Dysthymia n 33 Mixed
Clinical n 108
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Dysthymia
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Mixed Clinical
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CAD four-factor CFAconceptual model
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CAD two-factor CFAconceptual model
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CAD two-factor CFAFactor loadings for the8-
17-year-old sample
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CAD two-factor CFAFactor loadings for the18-
79-year-old sample
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Summary of Goodness-of-FitStatistics for CFA
Models by Age
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Summary of Goodness-of-FitStatistics for CFA
Models by Age
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Summary of Goodness-of-FitStatistics for CFA
Models by Age
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Administrationand Scoring
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Test Materials

• Test Kit Includes
• Comprehensive Professional Manual
• CAD Rating Form
• CAD Profile Form/Score Form
• CAD Scoring Program Software and Users Manual

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AppropriatePopulations

• Normed, standardized, and validated foruse with
  children through adults
• ages 8 to 79 years
• both genders
• all racial/ethnic backgrounds
• all geographical regions and residential
  communities
• all socio-economic strata
• all disability subgroups
• all linguistic or cultural backgrounds

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ProfessionalRequirements

• Individuals with adequate training may administer
  and score the CAD with supervision
• CAD interpretation requires formal training
  and/or graduate degree in
• clinical psychology
• school psychology
• counseling psychology
• developmental/behavioral pediatrics
• or a related behavioral field

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Scoring

• The CAD can be hand-scored or scored using the
  computerized CAD-SP
• Hand-scoring is accomplished using a carbonless
  form
• Skipped Items and missing responses
• CAD-SP prorates scores when at least 90 of items
  on a scale are completed
• If more than 10 of the items on a scale are
  omitted, CAD-SP treats scale as invalid

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Score Report

• Obtaining the Score Report
• Administer CAD Rating Form
• Open CAD Scoring Program (CAD-SP) on computer
• Enter basic demographic data
• Enter item responses
• CAD-SP automatically calculates and provides
• T-Scores
• Percentile ranks
• Confidence intervals
• Clinical classifications
• Graphical display of results

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CAD ScoreSummary Report
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CAD ScoreSummary Report
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CAD ScoreSummary Report
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CAD ScoreSummary Report
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Clinical Interpretation

• Quantitative and Qualitative Interpretation
  Process
• 5-Step Interpretation Process
• Interpret CAD Total Scale (CAD TS)
• Interpret CAD Symptom Scales, Validity Scales and
  Critical Item Clusters
• Interpret CAD Individual Items
• Interpreting the follow-up Clinical Interview
• Compare performance on the CAD in light of other
  test and background information

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CAD Total Score(CAD TS)

• The CAD TS is best measure of General
  Affectivity
• T Score Metric (i.e., Mean 50, SD 10)
• Percentile Ranks
• Confidence Intervals
• Qualitative Classifications 59 Normal
  Range60-69 Mild Clinical Risk70-79 Significa
  nt Clinical Risk 80 Very Significant Clinical
  Risk