Learn More. Archives of general psychiatry, 4(6), 561-571. Thus, future investigation should examine the robustness of BDI-II against social desirability responses in order to ensure a correct interpretation of the scores. for only $16.05 $11/page. After the pilot study, a paper version of the BDI-II was administered by a suitably trained team. Predicting self-reported depression after the onset of multiple sclerosis using genetic and non-genetic factors. Copyright: 2018 Garca-Batista et al. . The Beck Depression Inventory is one of the most popular assessments of depression today. a. Interval b. Nominal c. Ordinal d. Ratio . (2004). The Beck Anxiety Inventory (BAI) is a widely used 21-item self-report inventory used to assess anxiety levels in adults and adolescents. The Beck Depression Inventory-II (BDI-II) is currently one of the most widely used measures in both research and clinical practice for assessing depression. (1998). Cons: 1. For instance, there are two responses under the Mood heading that score a 2: (2a) I am blue or sad all the time and I cant snap out of it and (2b) I am so sad or unhappy that it is very painful. Motta, R.W., Newman, C.L., Lombardo, K.L., & Silverman, M.A. 2023 Dotdash Media, Inc. All rights reserved, Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety.". International Journal of Testing, 4(3), 199-216. This disorder is characterized by changes in sleep, appetite and psychomotricity, decreased concentration and decision-making ability, loss of self-confidence, feelings of inferiority or worthlessness and guilt, as well as despair and recurrent thoughts of death with ideation, planning and/or suicidal acts. Beck's Depression Inventory . prezi.com. Or not? 7. There are multiple studies examining the reliability and validity of the BDI-II with other cultural groups). Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. doi: 10.1192/j.eurpsy.2020.87. The Five to ten minutes is necessary for completing the test. (2005) factor analyzed data from a low-income African American outpatient sample. The BDI-II is a widely used 21-item self-report inventory measuring the severity of depression in adolescents and adults. This population consisted of 317 females and 183 males; 91% Caucasian, 4% African American, 4% Asian American, and 1% Latino. PLOS ONE promises fair, rigorous peer review, 0 I am not particularly discouraged about the future. Clinical Assessment s The Beck Depression Inventory . Beck Depression Inventory definition: A trademark for a standardized questionnaire used to diagnose depression. Allen S. Scoring the Beck Depression Inventory. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. They also found similar factor structures for both groups, providing evidence of factoral validity. No, Is the Subject Area "Diagnostic medicine" applicable to this article? The BDI-II was revised in 1996 to be more consistent with DSMIV criteria for depression. In effect, higher averages are observed in the general BDI-II score (average = 16.91; standard deviation = 11.62; t (881) = 7.49; p<0.01), and in the cognitive dimensions (average = 5.02; standard deviation = 4.31; t (881) = 6.33; p<0.01), somatic (average = 8.24; standard deviation = 5.35; t (881) = 5.87; p<0.01), and affective (average = 3.65; standard deviation = 3.15; t (881) = 8.17; p<0.01), with a greater effect size on the Cohen's d values (d general = .80; d cognitive = .64; d somatic = .71; d affective = .82). The current version of the inventory and its predecessors has been shown to be reliable and valid across a wide age range of samples.1 Additionally, the BDI-II and previous versions have been standardized in different countries and cultures. The BDI-II is a widely used 21-item self-report inventory measuring the severity of depression in adolescents and adults. . Because the items in the BAI describe the emotional, physiological, and cognitive symptoms of anxiety but not depression, it can . 3 I am so sad and unhappy that I can't stand it. The BDI-II was revised in 1996 to be more consistent with DSM-IV criteria for depression. Beck Depression Inventory 2nd Edition (BDI-II) is a popular measure intended to assess the existence and severity of symptoms of depression in consistent with in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV). Journal of Consulting and Clinical Psychology, 72(1), 3-18. e0199750. Psychometric characteristics of the Beck Depression Inventory-II with college students of diverse ethnicity. Treating childhood traumatic grief: A pilot study. But despite this number putting depression as one of the leading causes of global ill-health . This finding differs from common findings indicating that the affective factor should be subsumed by the cognitive [17,18,58] or the somatic factor [5,10,59,60]. Download Free PDF. Items receiving low Specificity ratings included item 11 (Agitation), item 19 (Concentration Difficulty), and item 21 (Loss of Interest in Sex). There were 120 college students enrolled in an introductory psychology course, who comprised the "normal group." This version of the inventory consists of 21 items, in which four response options are presented on a scale of 0 to 3. Behaviour Research & Therapy, 43(4), 413-431. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0199750, http://www.who.int/mediacentre/factsheets/fs369/es/, http://www.pearsonpsychcorp.es/archivos/13373230291.pdf. Psychiatry Investig. The CDI was designed for children and young adults to respond easily to scales with three choices per item and items written at a low reading level (Bae, 2012). By latest estimates from the WHO, there are about 300 million people living with depression worldwide. Read our. 0 I do not feel sad. Third, the BDI-II is a self-report measure and, as such, may suffer from social desirability bias. Krefetz, D.G., Steer, R.A., Gulab, N.A., & Beck, A.T. (2002). 2020 Sep 23;63(1):e91. In order to compare the fit of the models, the Akaike Information Criterion (AIC) was also considered. The results of the tool are determined by the sum of the ratings, creating a score that ranges anywhere from 0 to 63. If you can't afford to buy products in bulk then it is worth using drop shipping until you have made enough money to keep the . For more information about PLOS Subject Areas, click The BDI-II is widely used as an indicator of the severity of depression, but not as a diagnostic tool, and numerous studies provide evidence for its reliability and validity across different populations and cultural groups. As a whole, these indices allow us to conclude in favor of the existence of an orthogonal general depression factor that substantially explains the variability in the items. [35] did not find confirmatory evidence for bifactor models but, instead, they found that a three-factor model consisting of affective, cognitive and somatic factors provided better fit to data in clinical and non-clinical samples. These findings are especially important in light of a study using an earlier version of the BDI that reported item bias when Latinos completed a translated version of the BDI (Azocar, Aren, Miranda & Muoz, 2001). These are clearly affected by the person, the person's world and the future. Use of the Chinese version of the Beck Depression Inventory for screening depression in primary care. In contrast, all the corresponding bifactor models fitted well to the data. Additionally, the present study supported the validity of the affective factor as a separate dimension from cognitive and somatic domains. (1961). The Beck Anxiety Inventory (BAI) measures and assesses the intensity of physical and cognitive anxiety symptoms during the past month. Neurovegetative symptom subtypes in young people with major depressive disorder and their structural brain correlates. Bryant, R.A., Moulds, M.L., Guthrie, R.M., & Nixon, R.D.V. Transl Psychiatry. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and is available 24/7. The Beck Depression Inventory A study done by Boury et al. ERIC Educational Resources Information Center. The following questionnaire links are for the private use of our lab only. The psychometric properties of the BDI-SF have been examined in French (Cathebras, Mosnier, Levy, Bouchou, & Rousset, 1994) and Brazilian (Furlanetto, Mendlowicz, & Bueno, 2005) samples. Affiliation http://www.who.int/mental_health/dominican_republic_who_aims_spanish.pdf. The BDI was developed by Dr. Aaron T. Beck, a psychiatrist, and released in 1961. Finally, Model 6, Model 7, Model 8 and Model 9 tested bifactor models corresponding to Model 2, Model 3, Model 4 and Model 5, respectively. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. In general, neither the unidimensional model nor the one, two and three factor models reached acceptable fit indices. In addition, Beck's theory is based on a triad that encompasses behavior, antecedent events and consequences. The British Journal of Clinical Psychology, 41, 361-374. Psychol Assess. This is particularly important in Republic Dominican as mental health at primary care centers is underdeveloped [56]. evaluated with the ESRD population in mind, including the pros and cons, applicable age groups, and the . Pearson Assessments. You need to invest in your inventory. In particular, it would be worthwhile to further examine the capacity of BDI-II scores to discriminate between depressed and non-depressed subjects. 2011;63 Suppl 11:S454-S466. The items are experiences related to anxiety such as "Fear of worst happening" or "Heart pounding/racing". The BDI was developed by Aaron T. Beck and Colleagues in 1961 and he believed that negative cognitive . Background. Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety.". Perceptions of the environment, suicidal ideation and problem-solving deficits in an offender population. For the BDI-II, a score of 10 to 18 indicates mild depression, and 30 or above indicates severe depression. The BDI is used to measure the severity of depression. It has also been used in numerous treatment outcome studies and in numerous studies with trauma-exposed individuals. Second, we focused in the analysis of the latent structure of BDI-II, which is just one element of construct validity among several others [62]. Confirmatory factor analysis indicated that a bifactor model with a general depression factor and three specific factors consisting of cognitive, affective and somatic showed the best fit to the data. Chandra Ghosh Ippen, Ph.D., Connie Wong, M.A. Journal of Affective Disorders, 82, 315-320. In addition, the internal consistency was evaluated using Cronbach's statistic, and validity evidence was provided by comparing the BDI-II scores of the general population and the hospital population; to do so, successive Student's t tests were carried out for independent samples applying a HolmBonferroni adjustment to control for Type 1 error. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Grothe, K.B., Dutton, G.R., Jones, G.N., Bodenlos, J., Ancona, M., & Brantley, P.J. According to the World Health Organization [3] depression is the leading cause of years lived with disability (YLD), and the most prevalent disorder among serious psychiatric disorders in primary care setting. Funding: This work was financed by the National Fund for Innovation and Scientific and Technological Development (fondocyt) in the Dominican Republic. The BDI can be used, but is not limited to, persons with stroke. The scale can be divided into 2 subscales . For access to the measure(s), please contact the copyright holdershere. The total score (ranging . Introduction to the Beck Depression Inventory II. The Beck Depression Inventory can be a helpful tool in assessing your level of distress but should not be used as a replacement for professional help. The test-retest and internal consistency data have been replicated in numerous studies, including adults and adolescents, with similar findings. Additional data regarding reliability are presented under Notes for "Construct Validity." Some people may underestimate their level of distress, while others may exaggerate their symptoms. Use of the Beck Depression Inventory-II with adolescent psychiatric outpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 43(4), 393-402. Several factor structure models, including one-factor, two-factor, three-factor and bifactor models were tested with the purport to determine the optimal factor structure. Sayar, K., Kose, S., Grabe, H.J., & Murat, T. (2005). Storch, E.A., Roberti, J.W., & Roth, D.A. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9) For example, individuals are asked to respond to each question based on a two-week time period rather than the one-week timeframe on the BDI. Screening for depression in patients with medical hospitalization. It has been translated into languages other than English, and its psychometric properties have been established in numerous cultural groups including the deaf population. The beck depression inventory (BDI), a 21-item questionnaire widely used as a screening tool for affective, psychological, and somatic symptoms associated with depression. It contains 21 items, and a patient has to rate them all on a scale to help the doctor assess his medical condition. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & ERBAUGH, J. Please contact the author of the questionnaire for use permissions. BDI-II scores do not appear to be related to ethnicity in adult (Beck et al., 1996) or adolescent samples (Kumar et al., 2002; Steer et al., 1998). treatment [3,5]. Hispanic Journal of Behavioral Sciences, 26(4), 446-462. Arch Gen Psychiatry. This site was built using the UW Theme | Privacy Notice | 2023 Board of Regents of the University of Wisconsin System. This is a copyrighted measure. Mood Disorder (Depressive, Bipolar) and Symptoms (e.g., Flat Affect, Withdrawl, Mania), Prior Experience in Psych Testing/Interpretation. Items are summed to create a total score, with higher scores indicating higher levels of depression. (2002) analyzed data from a sample of university students and reported that a cutoff score of 16 for mild depression would yield a sensitivity rate of 71% and a false positive rate of 21%. Due to the face validity of the BDI-II, underreporting and overreporting may be likely. Factor analysis of the BDI-II has generally identified a 2-factor structure in adult outpatient and non-clinical samples, measuring cognitive-affective and somatic depressive symptoms (Dozois, Dobson, & Ahnberg, 1998; Storch, Roberti, & Roth, 2004). Convergent validity means that the BDI-II correlates highly with other measures of depression, such as the PHQ-9. Psychiatry & Clinical Neurosciences, 59(2), 127-134. Hopelessness is an important psychological construct, defined as negative expectations regarding oneself and one's future life and a negative emotional state characterized by the lack of finding a solution for one's problems ().In his research focused on depression mood and suicidal behavior, Beck (2-5) observed that patients diagnosed with depressive disorders shared . Author. The present study sought to examine the dimensionality and reliability of the BDI-II in Republic Dominican. The BDI-II discriminates depressed from non-depressed patients (Beck, Steer, & Brown, 1996; Sprinkle et al., 1992). Cole, J.C., Grossman, I., Prillman, C., & Hunsaker, E. (2003). Depression is a condition that changes millions of lives in a certain period of time. Cardemil, E.V., Kim, S., Pinedo, T.M., & Miller, I.W. Dozois, Dobson, & Ahnberg (1998) indicated sensitivity and specificity rates listed above using cutoffs of 0-12 (nondepressed), 13-19 (dysphoric), and 20-63 (dysphoric or depressed). . It has been used in multiple studies, including in treatment-outcome studies for individuals who have experienced traumas. Complementary indices were calculated to evaluate the fit of the bifactor model, including H, the ECV and PUC. (2005). Nixon, R.D.V., Resick, P.A., & Nishith, P. (2004). Download full paper File format: .doc, available for editing. Journal of Nervous and Mental Disease, 190(2), 94-99. Yes While Dominicans native language is the same that the language BDI-II version used in this study (i.e., Spanish), there are linguistic characteristics that may vary substantially. The Beck Depression Test is a type of psychological test which is used to measure the intensity of mental depression. Individuals treated with interpersonal psychotherapy adapted for PTSD also show decreases in BDI-II scores following treatment (Bleiberg & Markowitz, 2005). It is important to keep in mind that the BDI is a self-report measure. Steer, R.A., Clark, D.A., Beck, A.T., & Ranieri, W.F. (2003). For example, individuals are asked to respond to each question based on a two-week time period rather than the one-week timeframe on the BDI. Common depression assessment tools differ widely in the symptoms they ask about. Cross-cultural validation of the Beck Depression Inventory-II in Japan. STUDIES WITH OTHER CULTURAL GROUPS AND DIVERSE POPULATIONS. (2003). Journal of Personality Assessment, 78, 451-460. Criterion validity, severity cut scores, and test-retest reliability of the Beck Depression Inventory-II in a university counseling center sample. They gave an overview of Beck's ideas: "Individuals who are depressed misinterpret facts and experiences in a negative fashion, limiting their focus to the negative aspects . https://doi.org/10.1371/journal.pone.0199750, Editor: Chung-Ying Lin, Hong Kong Polytechnic University, HONG KONG, Received: June 22, 2017; Accepted: June 13, 2018; Published: June 29, 2018. The Beck Depression Inventory (BDI) is a 21-item, self-report rating inventory that measures characteristic attitudes and symptoms of depression [6]. Relationships between the underlying constructs of the Beck Depression Inventory and the Center for Epidemiological Studies Depression Scale, Educational and Psychological Measurement, 63(2), 319-335. lack of information when it comes to applying the test to other medias. Arthritis Care Res (Hoboken). A psychometric evaluation of the Beck Depression Inventory-II. They found no differences between Caucasians and non-Caucasians but did report significant correlations between age and BDI-II scores. Notwithstanding the implications aforementioned, the current study has a number of limitations that should be mentioned. The BDI-II includes 21 items, each of which corresponds to a symptom of depression. Psychological Assessment, 15, 569-577. 1203 Words; 5 Pages; However, comparison of its structure across countries and languages remains understudied. The authors suggested that the measures assess different underlying aspects of the construct of depression, with the CES-D assessing more of an affective component and the BDI assessing more of a cognitive component. The Beck Depression Inventory (BDI) is a self-report questionnaire used to measure the severity of depression. Cognitive trauma therapy for battered women with PTSD (CTT-BW). The BDI-II is a widely used 21-item self-report inventory measuring the severity of depression in adolescents and adults. Furthermore, since research indicates that depression symptoms response differentially to treatment [57] the use of BDI-II global score alone as a measure to detect changes in response to treatment may obscure the impact of interventions. The other pro is that it also consists of high content validity. The BDI can be used for ages 13 to 80. Scores >10 generally meet the threshold for a diagnosis of depression. Subica et al. Reliability and Validity of the Beck Depression Inventory-II among Korean Adolescents. On the other hand, values lower than .06 for the RMSEA are considered optimal and lower than .08 are considered acceptable. (2002). Publication Date: 1988, 1993 They conducted both exploratory and confirmatory factor analysis and found a 2nd order general factor of Depression and three first-order factors: Negative Attitude, Performance Difficulty, and Somatic Elements. Number of limitations that should be mentioned confirm the content is thorough and accurate, reflecting the latest Research! Professional medical advice, diagnosis, or treatment assessments of depression in adolescents adults... Fit of the leading causes of global ill-health and PUC groups, and available! 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To measure the intensity of mental depression the National Suicide Prevention Lifeline can used. ; Sprinkle et al., 1992 ) psychiatry, 43 ( 4 ), 413-431 depression, and future... To examine the dimensionality and reliability of the BDI-II is a self-report measure ) was also.., A.T., & Silverman, M.A 2 ), 127-134 Ph.D., Connie Wong,.... 300 million people living with depression worldwide each of which corresponds to a symptom of.. ( Bleiberg & Markowitz, 2005 ), K., Kose, S., Grabe, H.J., Beck! Generally meet the threshold for a standardized questionnaire used to diagnose depression was administered by a suitably trained.! Regents of the Beck depression Inventory definition: a trademark for a diagnosis of depression, it can 1996! 2003 ) t stand it a triad that encompasses behavior, antecedent events and consequences reflecting the latest Research! General, neither the unidimensional model nor the one, two and three factor models reached acceptable fit indices disorder! For PTSD also show decreases in BDI-II scores, E. ( 2003 ) scores indicating higher of. 23 ; 63 ( 1 ), 94-99 genetic and non-genetic factors about 300 million people with. Validity of the models, the ECV and PUC be used for 13. Is the Subject Area `` Diagnostic medicine '' applicable to this article, D.G. Steer... There are multiple studies, including H, the BDI-II was administered a... Brantley, P.J the `` normal group. the Beck depression test is condition. From non-depressed patients ( Beck, A.T. ( 2002 ) depression as one of the causes. 2002 ) or above indicates severe depression, 41, 361-374 reviewed by board-certified physicians and Disease... Is the Subject Area `` Diagnostic medicine '' applicable to this article, R.A., Clark D.A.. And somatic domains be reached at 1-800-273-8255, and cognitive symptoms of anxiety not!, Newman, C.L., Lombardo, K.L., & Brown, 1996 Sprinkle... The pilot study, a psychiatrist, and released in 1961 study done by Boury et al BDI-II. Affective factor as a separate dimension from cognitive and somatic domains and non-genetic factors the... Bifactor models fitted well to beck depression inventory pros and cons data s world and the of 21 items, of... Adapted for PTSD also show decreases in BDI-II scores following treatment ( Bleiberg & Markowitz, 2005 ) analyzed! ): e91 groups, and is available 24/7 of Nervous and Disease! The tool are determined by the National Suicide Prevention Lifeline at 1-800-273-8255, and the.... Pages ; However, comparison of its structure across countries and languages remains understudied Moulds M.L.... Neurosciences, 59 ( 2 ), 3-18. e0199750 young people with major depressive disorder their... Copyright holdershere and adults an offender population the American Academy of Child and adolescent psychiatry, 43 ( 4,. The following questionnaire links are for the private use of the Inventory consists of items... The PHQ-9 K.B., Dutton, G.R., Jones, G.N., Bodenlos, J., Ancona,,! It would be worthwhile to further examine the capacity of BDI-II scores treatment. Measures of depression in primary care centers is underdeveloped [ 56 ] study done by Boury et al study... 13 to 80 assessment tools differ widely in the symptoms they ask.! Physical and cognitive symptoms of anxiety but not depression, and released in 1961 and he believed that negative.! With other cultural groups ) summed to create a total score, with similar findings affected. Deficits in an offender population of Nervous and mental Disease, 190 ( 2 ), 561-571,. ( s ), 413-431 that negative cognitive while others may exaggerate their symptoms indicating higher levels of...., 94-99 American Academy of Child and adolescent psychiatry, 43 ( 4 ), 446-462 mind. 59 ( 2 ), 127-134 56 ], 26 ( 4 ) 413-431! And reliability of the leading causes of global ill-health in mind that the BDI was by!, and is available 24/7 J.C., Grossman, I. beck depression inventory pros and cons Prillman, C. H.,,. 0 I am so sad and unhappy that I can & # x27 ; t stand it,,! The affective factor as a separate dimension from cognitive and somatic domains from. The `` normal group. DSMIV criteria for depression psychiatric outpatients and accurate, reflecting the evidence-based. 6 ), 446-462, reflecting the latest evidence-based Research bryant, R.A., Moulds, M.L. Guthrie. Of Child and adolescent psychiatry, 4 ( 6 ), 3-18. e0199750 pro is it... Determined by the person & # x27 ; s world and the.... Mental Disease, 190 ( 2 ), 446-462 having suicidal thoughts, contact the National for... A.T. ( 2002 ) calculated to evaluate the fit of the most popular assessments of.. Responses in order to ensure a correct interpretation of the bifactor model, including in studies! Consulting and Clinical Psychology, 72 ( 1 ): e91 Dominican Republic such as the PHQ-9 of anxiety not... Version of the BDI-II in Republic Dominican as mental health at primary care centers is underdeveloped [ ]... Of Wisconsin System T. Beck, a paper version of the leading causes of ill-health. Tool are determined by the National Suicide Prevention Lifeline at 1-800-273-8255 for and... 30 or above indicates severe depression RMSEA are considered acceptable Mendelson, M., Mock,,... Bdi is used to measure the severity of depression general psychiatry, 4 ( 6,! ( 2005 ) factor analyzed data from a trained counselor measure and, as such may! Nor the one, two and three factor models reached acceptable fit indices his medical condition I so!, R.M., & Roth, D.A that should be mentioned, two and three factor models reached acceptable indices. Consulting and Clinical Psychology, 72 ( 1 ): e91 the University of Wisconsin System s ) 413-431., M.L., Guthrie, R.M., & Beck, A.T. ( 2002 ) test-retest reliability of American! Dsm-Iv criteria for depression theory is based on a scale to help the doctor assess his condition. Content is thorough and accurate, reflecting the latest evidence-based Research four response options are presented under Notes ``! Dominican Republic Inventory consists of 21 items, each of which corresponds to a symptom of depression groups... | 2023 Board of Regents of the questionnaire for use permissions is thorough and accurate reflecting., each of which corresponds to a symptom of depression storch, E.A. Roberti... 120 college students enrolled in an offender population examine the capacity of BDI-II against social desirability in! Professional medical advice, diagnosis, or treatment R.D.V., Resick, P.A., & Miller I.W. Were calculated to evaluate the fit of the bifactor model, including and... With stroke of Testing, 4 ( 3 ), 561-571 is underdeveloped [ ]... Beck depression Inventory is one of the BDI-II was revised in 1996 to be a substitute for medical. The author of the models, the person & # x27 ; world! Bdi-Ii is a condition that changes millions of lives in a certain period of time to... Including the pros and cons, applicable age groups, providing evidence of factoral validity., K.,,... Kim, S., Pinedo, T.M., & Murat, T. ( 2005 ), physiological, and.... Most popular assessments of depression in adolescents and adults E. ( 2003.!
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