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PSYD33H3 (9)

PSYD33 - Coyne Notes

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University of Toronto Scarborough
Michael Bagby

Self Reported DistressCOYNE 1994elevated scores on selfreport general psychopathologyis not accurate and shouldnt be used to describe inventoriesthese scores among college students represent distress that is minortransient careless use of the term entails confusion of normal unhappiness with pathology results of early factor analyses didnt provide decisive evidence against the use of distress in college students as an analog for clinical depression most students in a representative sample will not be distressed therefore they will fail to endorse most individual items and obtain low overall scores on inventories this lack of distress will be reflected in single factor solutionsMAIN ARGUMENTmeasures of selfreported distress arent adequate as proxy measures of depressiondepressive symptoms AND distressed college students are not an adequate substitute for persons meeting criteria for a diagnosisof depression on the basis of a structured interviewdiagnosable depression found within clinicalnonclinical populations is conceptually and empirically distinct from what is measured by selfreport questionnaires Does depression in college students represent an appropriate analog of research on depression in clinical patients we now have more sophisticated ways of explicating the relationship bw selfreported distress and diagnosable depression structured interviews allow for more reliable and valid identification of depression among psychiatric patientsDiagnosis of Depression methods used RDC DSMIII and its revision all require evidence of sustained mood disturbance but this can be met by apathy or loss of interestpleasure in almost all activities this primary symptom of depression isnt given enough weight in selfreport measures of distress and bc of respondents lack of comprehension it is difficult in obtaining reliable and valid assessments w selfreport measuresyet 1015 of severely depressed patients deny feelings of sadness and meet the mood criterion also a diagnosis of depression doesnt currently require that a person have sought help or be suffering marked impairment of functioningthis requirement was dropped from DSMIII bc it seemed superfluous reinstatement of the impairment criterion might improve predictive validity of diagnosis of major depression for DSMIV for diagnosis of MD DSMIIIR requires depressive symptoms in addition to either depressed mood or markedly diminished interestpleasure in activities for most of the day nearly every day for a minimum of 2 weeks clinical depression is associated w greater functional impairment than a variety of chronic medical conditions there have been developments of structured and semistructured assessment tools including SADS DIS SCIDSCID represents the state of the art in diagnostic research tools Vredenburg overlooked SCID and recommended DISwhich was initially designed to enable lay interviewers to obtain psychiatric diagnoses comparable to those in psychiatrist would obtain but performance of DIS falls short DIS relied heavily on respondents understanding of concepts and ability to judge their symptoms there is one treatment study that has initiated a 3stage selection processppl who score high on selfreport are administered DIS and then if they appear depressed a clinical interview by psychiatristEstimated Prevalencepossibility that DIS overdiagnoses depression highlights greater prevalence of depressive symtomsdifferences in prevalence of symptoms and diagnosable depression have imp implications
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