Depression is common among adolescents, affecting between 7% and 33% depending on its definition, assessment, and severity (Petersen, Compas, Brooks-Gunn, Stemmler, Ey, & Grant, 1993). Radloff (1991) found a dramatic increase in depression between the ages of 13 and 15, leveling off at approximately 17-18. Childbirth seems to increase the risk of depression, with Colletta (1983) reporting a rate of 59% for mothers aged 15 to 19.
Early pregnancy is also common. In a study on postpartum depression, age was made a covariate because of the disproportionate number of adolescents in the random sample of depressed mothers (Field, Healy, Goldstein, Perry, Bendell, Schanberg, Zimmerman, & Kuhn, 1988).
Identifying depression in adolescent mothers is crucial for their own well-being as well as that of their infants. Teenage mothers are noted to have less realistic developmental expectations and less desirable child-rearing practices (Field, Widmayer, Stringer, & Iganoff, 1980). Moreover, infants of adolescent mothers are more likely to have cognitive, emotional, and physical problems (Field et al., 1980). However, an understanding of adolescent depression has been hampered by a lack of well-established techniques for identifying this population (Roberts, Lewinsohn, & Seeley, 1991).
Two of the most commonly used instruments for detecting depression among adolescents are the Beck Depression Inventory (BDI) and the Center for Epidemiologic Studies Depression Scale (CES-D). The Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) has been used in over 200 studies on psychiatrically diagnosed patients (Piotrowski, Sherry, & Keller, 1985) and normal populations (Steer, Beck, & Garrison, 1986). The BDI has also been widely used to detect depression in normal adolescent samples (Barrera & Garrison-Jones, 1988; Gibbs, 1985; Kaplan, Hong, & Weinhold, 1984; Teri, 1982), in psychiatrically hospitalized adolescents (Strober, Green, & Carlson, 1981), and adolescent mothers (Colletta, 1983; Field et al., 1980; Steer, Scholl, & Beck, 1990).
The Center for Epidemiologic Studies Depression Scale was developed as part of a National Institute of Mental Health study to measure depressive symptoms among adults (Radloff, 1977). The CES-D has been used less frequently with adolescents than has the BDI. However, it has been validated with adolescents (Radloff, 1991) and adolescent mothers (Colletta, 1983; McKenry, Browne, Kotch, & Symons, 1990).
A correlation of .70 between the CES-D and the BDI has been reported for a sample of high school students (Roberts et al., 1991), indicating that they are comparable but different. Thus, the CES-D and BDI may be measuring different facets of depression. For example, the BDI has been shown to differentiate nondepressed, moderately depressed, and severely depressed individuals (Beck et al., 1961; Beck, 1967), concentrating more on somatic symptoms than does the CES-D (Campbell & Cohn, 1991). The CES-D primarily focuses on cognitive and affective symptomatology, with an emphasis on depressed mood (Radloff, 1977). Another difference is that the CES-D does not have an item on suicide, but does include four reverse-scored positive affect items (e.g., the degree to which one feels happy, hopeful, enjoys life, or feels good about oneself).
Nevertheless, items on the CES-D were originally taken from the BDI and other validated measures (Weissman, Scholomskas, Pottenger, Prusoff, & Locke, 1977), making at least some of the elements comparable. A number of studies have used the BDI and CES-D interchangeably to define depressed experimental groups, considering them to be equally useful screening instruments with good psychometric properties (Kendall, Hollon, Beck, Hammen, & Ingram, 1987; Radloft & Locke, 1986; Radloff & Teri, 1986). A study by Gotlib and Cane (1989), which compared eight widely used self-report measures of depression using DSM-III criteria, concluded that the BDI and CESD should be the scales of choice. …