The instrument is considered a clinician-rating scale as opposed to self-reported instrument. When assessing for the depression in children that takes a specific tool created specifically for that population and construct. All assessment instruments have a purpose and there are technical considerations an assessor must consider when using it. The assessor must be familiar with the tool, understand the purpose for which it is used, how reliable and valid it is, the way it is scored and items needed for assessment, whether the measure has generalizable results, and something about the population on which the instrument was normalized. The Children’s Depression Rating Scale, Revised (CDRS-R) is used to assess depression in children and adolescents ages 6-18 using 17 different areas of assessment. This paper will present a detailed overview of this instrument.

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Test Review:
Children’s Depression Rating Scale, Revised (CDRS-R)
Sidney Gaskins
Walden University
1

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Abstract
The Children’s Depression Rating Scale, Revised (CDRS-R) was modeled after the Hamilton
Rating Scale for Depression. The instrument is considered a clinician-rating scale as opposed to
self-reported instrument. When assessing for the depression in children that takes a specific tool
created specifically for that population and construct. All assessment instruments have a purpose
and there are technical considerations an assessor must consider when using it. The assessor
must be familiar with the tool, understand the purpose for which it is used, how reliable and valid
it is, the way it is scored and items needed for assessment, whether the measure has generalizable
results, and something about the population on which the instrument was normalized. The
Children’s Depression Rating Scale, Revised (CDRS-R) is used to assess depression in children
and adolescents ages 6-18 using 17 different areas of assessment. This paper will present a
detailed overview of this instrument.

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Test Review:
Children’s Depression Rating Scale, Revised (CDRS-R)
The Children’s Depression Rating Scale, Revised (CDRS-R) has been developed to
assess depression using 17 categories or areas of assessment. Assessing for depression in
children and adolescents can be difficult. Differentiating between anxiety and depression
requires tools able to separate the different symptoms and allow for appropriate care to be given.
Stark, Kaslow, and Laurent (1993) found that in a group of children depressed, anxious, and
comorbid depressed and anxious there was little differentiation between their responses on given
measures. The Children’s Depression Rating Scale, Revised (CDRS-R) is able to those 17
categories to narrow the diagnosis. However, to understand whether the instrument is appropriate
for a practitioner’s clientele they must conduct research to gather general information,
understand the purpose and nature of the instrument, know the technical considerations involved
in its use, and evaluate qualifications of users and understand the scoring system used. This
paper presents each of the aforementioned as a review of the Children’s Depression Rating
Scale, Revised (CDRS-R).
I. General Information
A. Title: Children’s Depression Rating Scale, Revised (CDRS-R)
B. Author: Elva O. Poznanski and Hartmut Mokros
C. Publisher: Western Psychological Services, 12031 Wilshire Blvd., Los Angeles, CA 900251251
D. Forms, groups to which applicable: Specifically used to assess depression in children ages 6
to 18 this assessment tool also monitors treatment responses. It can be applied in nonclinical
setting such as schools and pediatric clinics (Western Psychological Services, n.d.). This
assessment allows the interviewer to rate 17 symptoms: (1) Impaired Schoolwork, (2) Difficulty

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Having Fun, (3) Social Withdrawal, (4) Appetite Disturbance, (5) Sleep Disturbance, (6)
Excessive Fatigue, (7) Physical Complaints, (8) Irritablilty, (9) Excessive Guilt, (10) Low SelfEsteem, (11) Depressed Feelings, (12) Morbid Ideation, (13) Suicidal Ideation, (14) Excessive
Weeping, (15) Depressed Facial Affect, (16) Listless Speech, and (17) Hypoactivity. (Western
Psychological Services, n.d.). The CDRS-R has been successfully translated into German and
Hebrew (Keller, Grieb, Ernst, Spröber, Fegert, & Kölch, 2011, Zalsman, Misgav, Sommerfeld,
Kohn, Brinstein-Klomek, Diller, Sher, Schwartz, Ben-Dor, Wolovik, & Oquendo, 2005).
E. Practical features: A nonclinical sample of children was used to derive norms. These children
were directly interviewed. Though many self-report measures diagnose, the direct interview
process gives the interviewer the opportunity to engage with the child, interact with them in a
positive manner, and have treatment evaluation be immediate (Western Psychological Services,
n.d.). Due to the client being young this instrument takes into consideration their sensitivity
allowing for a semi-structured interview process. The interviewer is provided with a useful guide
to conduct the interview with both the child and the parent(s) of the child.
F. General type: The CDRS-R, is a diagnostic tool used to assess childhood depression of those
aged six to twelve years old and monitor the treatment response.
G. Date of publication: The CDRS-R was last revised and published in 1996.
H. Costs, booklets, answer sheets, scoring: The CDRS-R price data for the materials necessary
are: $99 per the kit including 25 administration booklets and 1 manual; $44 per 25 administration
booklet; $60 per manual; and $22 per continuing education questionnaire and evaluation form
(Western Psychological Services). Each area assessed is rated on a 7-point scale which makes it
easy to observe symptoms. On the scale 7 represents severe clinical difficulties while 1 indicates
the lack of difficulties. The assessment also integrates information from other sources such as

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parents and school personnel.
I. Time required to administer: The time needed to administer this assessment is between 15-30
minutes. This estimate includes both administration and scoring of the interview. Though there
are no stated training requirements the detail required to administer and to score the instrument
appropriately does call for an appropriately trained mental health professional (Nezu, Ronan,
Meadows, & McClure, 2000).
J. Purpose for which evaluated: For use with youth ages 6-18 years old who are placed in the
custody of the department of children services or involved with juvenile justice and are in need
of mental health services.
II. Purpose and Nature of the Instrument
A. Stated purpose: The Children’s Depression Rating Scale was modeled after the Hamilton
Rating Scale for Depression and is used specifically to screen for and diagnose depression and as
a way to monitor treatment responses in youth ages six to twelve years old. It can also detect
slight, notable changes in and severity of symptoms (Western Psychological Services, n.d.;
Wolfe, & Mash, 2006).
B. Description of test, items, and scoring: The CDRS-R is a multi-report instrument. It has selfreport, parental interview, and teacher interview instruments to gain a well-rounded view of the
youth. There are 17 symptom areas that are assessed 14 of which are rated on a 7-point scale and
three rated on a 5-point scale. Those rated on a 7-point scale, a 2 indicates that there may be a
problem but it is not clinically significant, ratings between 3-7 indicate clinically significant
problems in the assessed area (Nezu, et al., 2000). Within the instrument, a clinician can add
comments about the rated symptom below each item. All 17 items produce the Summary Score
for this instrument. T-scores between 55-64 indicate further evaluation, any score > 65 indicates

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a likely depressive disorder (Lam, Michalak, & Swinson, 2005).
C. Use in counseling: The use of CDRS-R as a screening and diagnostic instrument is only one
aspect of how it can be used for counseling. While it is a self-report instrument, the nature of the
instrument is that the assessor interviews the client that allows for direct interaction and
engagement. This can add to the development of the therapeutic alliance and provide positive
interaction for a child who may be withdrawn (Western Psychological Services, n.d.). There is a
manual and rating form available, each copy of the rating form contains information about
scoring and interpretation, and the manual provides a guide for parent interviews (Verhulst &
van der Ende, 2006).
III. Technical Considerations
A. Normative sample: Two hundred thirty-three school children were used to standardize the
ratings for the CDRS-R. The T-scores for this derived from the Summary Score being converted
(Verhulst & van der Ende, 2006). For the clinical sample, the mean T-score for depressive
disorders as 71, the nonclinical sample was 53. Children who did not report suicidality, in the
nonclinical sample, the range was from 1.2 (SD = 0.6) to 2.1 (SD = 1.0), and from 1.6 (SD = 0.9)
to 3.2 (SD = 1.3). Disturbances in appetite were the least severe, and morbid ideation, the most.
Child interviews in the sample of symptom area means ranged from 1/5 (SD = 1.0; appetite
disturbance) to 3.7 (SD = 1.7; low self-esteem). The German translation was tested on 60
inpatients (26 female, 34 male) between the ages of 7.5 to 17.9 (M = 13.9, SD = 2.9) (Keller et
al., 2011).
B. Reliability: Verhulst and van der Ende (2006) reports that in a 2-week interval, test-retest for
the Summary Scores there is .80, that in a group of school age that the instrument Summary
score has a Cronbach’s alpha of .85, and between two clinician was .92. According to Nezu, et

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al. (2000). In the clinical sample item-total correlations ranged from .28 (impaired schoolwork)
to .78 (depressed feelings), and the range was from .26 (appetite disturbance) to .71 (depressed
facial affect) in the nonclinical sample. Four psychiatrists who specialize in working with
children conducted the initial interviews, two psychiatrists corated each interview. A clinical
sample of children (N = 25) was used to establish interrater reliability. Interrater reliability was
shown to be superior (r = .92).
Test-retest reliability was established over a 2-week period and proved stability over that time (r
= .80). Based on intake and 2-week postintake interviews done by two separate clinicians,
clinical sample (N = 52) test-retest reliability was established. The second rater conducted their
interviews blind to the initial ratings.
C. Validity: Clinician-reported ratings of depression on the CDRS-R Summary score correlated .
87 and .48. The Summary Score on the CDRS-R and that of the Dexamethasone Suppression
Test were significantly associated (Verhulst & van der Ende, 2006).
D. Generalizability: This author was unable to find information directly pertaining to the
generalizability of the instrument. It has been widely used and found to be reliable with children
in schools, adolescents with depression, and when translated into German and Hebrew (Keller et
al., 2011; Mayes, et al., 2010, Zalsman, et al., 2005)
IV. Practical Evaluation
A. Qualifications of examiners: Examiners using this tool are recommended to be a clinician
educated at an accredited university, having completed a considerable amount of graduate or
post-graduate coursework in test interpretation, psychometrics, measurement theory, educational
statistics or a closely related area (Australian Council for Educational Research, 2011; Ontario
Centre of Excellence for Child and Youth Mental Health, 2011). According to Australian

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Council for Educational Research (2011) examiners should be involved with organizations that
require experience in the “ethical and competent use of psychological tests”.
B. Scoring provisions: There are 17 symptom areas that are assessed 14 of which are rates on a
7-point scale and three rated on a 5-point scale (Gaskins, 2012). Scoring for this instrument
requires that all 17 scores are used to produce a Summary Score, which is a T-score. The score
ranges between 17-119, scores between 55-64 indicate the need for further evaluation, those
scores > 65 indicate the possibility of depressive disorder (Australian Council for Educational
Research, 2012; Lam et al., 2005). If the examiner finds it useful scores from alternative sources
such as parents interviews can be compared for each of the 17 areas Specific instructions about
how the instrument is scored and interpreted is available in the instrument manual produced by
the publisher.
V. Evaluation
A. Comments of reviewers: Dowd and Stovall (2001) consider the CDRS-R to be an instrument
that is well-designed, reliable, and valid due to the studies conducted using the instrument. The
use of multiple resources such as parent and teacher input is noted as a strength. In this review
the fact that it is a semi-structured instrument was of concern, which as addressed through
suggesting that standardize format be followed. Dowd and Stovall (2001) questioned the
exclusion of Asian and Native American children from the sample population, caution
practitioners working with these populations against its use, and consider this lack of national
standardization a weakness. Overholser, Brinkman, Lehnert, and Ricciardi (1995) found that
there are a number of symptoms of which can be identified in the interviewing and scoring
process that are not specific to depression and proposed the development of a short form. The
creation of a short form should include only those symptoms specific to a diagnosis of

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depression. Both of these assessments suggest that there is a need to investigate and improve the
norm sample to reflect the population and to address only those symptoms specific to depression
in the assessment of a client.
B. General evaluation: The CDRS-R is a comprehensive, easily administered instrument that
allows the assessor to begin the therapeutic process during the assessment. The ability to interact
with a client who is possibly isolated and withdrawn is a unique feature that supports the
development of a therapeutic alliance immediately. Interviewing is not an exact science therefore
this semi-structured instrument demands an interviewer who is trained, experienced in using this
instrument, and is able to systematically follow the instructions outlined in the manual to elicit
necessary participation by the client. Though it is considered a reliable and valid instrument in
assessing depression in children, was norm sampled with two hundred thirty-three school
children, the concern with this instrument is the relatively small norm sample and whether or not
this sample was demographically representative of the U.S. population. To answer this question
further investigation is necessary. Overall, CDRS-R is an efficient and useful instrument to
engage children ages 6-18 in an assessment of the severity of their depression.

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VI. References
Australian Council for Educational Research. (2012). Children’s Depression Rating Scale –
Revised (CDRS-R). In ACER Shop Online. Retrieved January 13, 2012, from
https://shop.acer.edu.au/acershop/group/CDR/28;jsessionid=3B9EE0AB5DA3C63632CE871D95C77C55.
Dowd, E. T., Stovall, D. E. (2001). [Review of the Children’s Depression Rating Scale,
Revised]. In The fourteenth mental measurements yearbook available from
http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/detail?
vid=3&hid=25&sid=37adb9bc-c1d6-4268-b256-06c609f0b2bd
%40sessionmgr4&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=loh&AN
=17073337
Gaskins, S. (2012). Assessing Depression in Youth: Researching the Children’s Depression
Rating Scale, Revised (CDRS-R).
Keller, F., Grieb, J., Ernst, M., Spröber, N., Fegert, J. M., Kölch, M. (2011). Children's
Depression Rating Scale-Revised (CDRS-R): development of a German version and
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39(3),179-85
Lam, R. W., Michalak, E. E., Swinson, R. P. (2005). Assessment scales in depression, mania and
anxiety. Abingdon, Oxfordshire, OX, UK: Taylor & Francis. Retrieved from
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&ei=aI0IT626Jea42wXp1Mm3Aw&ved=0CFwQ6AEwAw#v=onepage&q=children's
%20depression%20rating%20scale&f=false

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Mayes, T. L., Bernstein, I. H., Haley, C. L., Kennard, B. D., & Emslie, G. J. (2010).
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adolescents. Journal of Children and Adolescent Psychopharmacology. 20(6), 513-516.
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recordnumber=609&vio_name=vioeval.
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Psychology, 24(4), 443-452.
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we assessing depression or the broad-band construct of negative affectivity?. Journal Of
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Verhulst, F. C., van der Ende, J. (2006). Assessment scales in child and adolescent psychiatry.
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Wolfe, D. A., & Mash, E. J. (2006). Behavioral and emotional disorders in adolescents: Nature,
assessment, and treatment. New York, NY: Guilford Press. Retrieved from
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urpose%20and%20nature%20of%20children's%20depression%20rating
%20scale&f=false
Western Psychological Services. (n.d.). Children's Depression Rating Scale, Revised (CDRS-R).
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Schwartz, G. S., Ben-Dor, D. H., Wolovik, L., & Oquendo, M. (2005). Children's
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depression-inventory-cdi-childrens-depression-rating-scalerevised-cdrsr-reliabilityhebrew-version/.
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_pageid=53%2C69676&_dad=portal&_schema=PORTAL.