| Objectives1.To assess the validity and reliability of the Chinese version of the elev-en-item Kutcher Adolescent Depression Scale(KADS-11)in Chinese ado-lescents,calculate its optimal Cut-Off value and the sensitivity and speci-ficity,and explore the possibility of providing a useful tool to assess the severity of adolescent depressive symptoms.2.To establish the GCBT therapist maunal for adolescent depression,test the therapy efficacy preliminarily,and verify the responsiveness of the KADS-11.Methods1.Totally 3180 students aged 11-17 years were selected from schools in 6 provinces and Shanghai.All of them were asked to complete the KADS-11 and Children Depression Inventory(CDI),Students whose CDI scores were above 19(including 19)were diagnosed with the DSM-IV criteria of depressive disorder,73 students from Shanghai sample were assessed with KADS-11 and CD Ito analyze the test-retest reliability 1month later.2.To establish the GCBTtherapist manual for adolescent depression ac-cording to a series of theory and practice study,and conduct an eight-sessions GCBT therapy for 17 depressive adolescents(GCBT group),and the control group(15 depressive adolescents)only received the regular psychological education.The GCBT group and control group were evaluat-ed by KADS-11,SDQ,SCARED at the baseline,the end of 4weeks/8weeks,and three-months follow-up.Results1.Part one(1)Validity:Exploratory factor analysis showed that KADS-11 had 2 fac-tors,and confirmatory factor analysis tested proved the 2-factor model fit better than the one-factor model.The KADS-11 total scores were posi-tively correlated with CDI total scores(r=0.74,P<0.01),and the KADS-11 scoreswere higher in depressive group than those in non-depressive group.(2)Reliability:The Cronbach's alpha coefficient of the KADS-11 was 0.84,the spilt-half reliability coefficient was 0.71(P<0.01),and the test-retest coefficient was 0.77(P<0.01).(3)ROC:The mean area under the curve(AUC)of KADS-11was 0.94,the optimal cut-off point of KADS-11 was total score?9,sensitivity and speci-ficity were 89%and 90%respectively.2.Part two(1)At the three-months follow-up,the scores of SDQ total difficulties and the factor "hyperactivity/inattention",SCARED total scores,scores of the factor "Panic Disorder or significant Somatic Symptoms","Generalized Anxiety Disorder",and "School Avoidance" in the GCBT group weresig-nificantly lower than the scores at the baseline(P<0.05).(2)The KADS-11,SDQ,SCARED total scores between the GCBT group and control group were not significantly different from each other at the evaluation time(baseline,the end of 8weeks,3-months follow-up).The GCBT group showed thetendency of decreasing steadily from the baseline to the follow-up,however,the symptom severity of the control group in-creased at the 3-months follow-up.(3)At the 3-months follow-up,KADS-11 revealed large sensitivity to change,with the value of ES(Cohen's d=0.6)lower than SDQ(Cohen's d=0.8).Conclusions1.The KADS-11 is appropriate for Chinese adolescents because of its good validity,reliability,diagnosis accuracy and sensitivity to change,it could be used to assess depressive symptoms for adolescents.2.The results of this pilot study showed a reduction in the depression symptoms,anxiety symptoms and behavior problems in depressive adoles-cents following participation in a manualized CBT group therapy program.3.The GCBT manual in this study has good properties for adolescent de-pression,and the findings support the feasibility of extending the treatment in the school psychological treatment and clinical practice. |
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