Beck Depression Inventory vs. Hamilton Depression Scale Beck

Beck Depression Inventory vs. Hamilton Depression Scale Beck The revised Beck Depression Inventory (BDI-II), published in 1996 was authored by Aaron Beck, Robert A. Steer, and Gregory K. Brown. Similar to its predecessor, it consists of 21multiple choice questions that assist in determining the severity of depression. Each item consists of four statements arranged in order to ascertain the severity of a certain symptom of depression. BDI-II conforms to the DSM-IV criteria for depression. Clients who are presented with the BDI-II are asked to answer each question based upon the way they have felt for the past two weeks in order to accurately conform to the DSM-IV criteria. The BDI-II is intended for adolescents and adults and should not be administered to those under the age of thirteen. Scoring The BDI-II consists of twenty one questions, all of which correspond to a particular symptom of depression. Each item consists of a four point scale ranging from 0-3. Items 16 and 18 consist of seven items which are used to indicate an increase or decrease in both sleep patterns and appetite. A total score of 0-13 is considered minimal range, 14- 19 is considered mild, 20-28 is considered moderate, while 20-63 is considered to be severe (Beck, Steer and Brown, 1961). The BDI-II may be scored by hand or by using a software program such as Q Local, where the scores may be recorded and monitored by the clinician. The test may be administered frequently, as it is intended to monitor symptoms that have occurred within a two week range. Reliability Becks Depression Inventory II has been used for many years with great success. Its reliability is still questioned by some. Sprinkle, Lurie, Insko, Atkinson, Jones, Logan and Bassada (2002) state that Although the BDI-II manual (Beck, Steer, Brown, 1996) and various other reports (e.g., Dozois et al., 1998, and Steer, Kumar, Ranieri, Beck, 1998) have offered substantial evidence for the instruments commendable split-half internal consistency (with reported coefficient alphas of .91 and slightly higher), there are only two published reports to date on the instruments test- retest reliability (par.6). Sprinkle et al., (2002) further report Beck, Steer, and Brown (1996) reported on 26 outpatients (no diagnostic information is offered) who were administered the BDI-II at the times of their first and second therapy sessions (approximately one week apart), producing a test-retest correlation of .93 (par 6). Validity Validity of the BDI-II appears to be favorable. A study conducted by Storch, Roberti and Roth (2002) examined the psychometric properties of the BDI-II. 414 students from two separate universities participated in the study. Their results supported BDI-II two-factor structure measuring cognitive-affective and somatic depressive symptoms (par.1). They concluded that the validity of the BDI-II was supported by favorable results with self-report measures of depression and anxiety (par.1). The results of this study duplicate past research of a college sample which supported the reliability and validity of the BDI-II. Arnau, Meager, Norris, and Bramson (2001) also conducted a psychometric evaluation of the BDI-II using primary care patients. The study consisted of 340 primary care patients (7 of which were eliminated due to incomplete responses). 68.8% of the participants were female and the age group tested ranged from ages 18-54(M = 36.5, SD = 10.1, Arnau et al., 2001). The average score from the participants was 8.4 (SD = 9.7). They reported that scores of 14 or higher, suggesting at least a mild level of depression (Beck et al., 1996 as cited in Arnau et al., 2001) were observed in 23.2% of the sample (p.3). Arnau et al., (2001) also found an alpha coefficient of .94, which they considered to be excellent internal consistency. They concluded that the BDI-II yielded strong evidence for the factorial validity of the BDI-II in a primary care setting (p.6). They found that the BDI-II could easily be implemented into the primary care setting without disrupting patient flow. BDI-II Reviews Arbisi and Farmer, reviewers of BDI-II indicate that the BDI-II is easy to administer and requires approximately five to ten minutes to complete. Arbisi states concern however, that there are no validity indicators contained on the BDI or the BDI-II and the ease of administration of a self-report lends itself to the deliberate tailoring of self-report and distortion of the results (Beck, Steeler Brown, 1961 par. 5). Arbisi and Farmer concur that the manual BDI-II was well written and provides a multitude of supportive information regarding norms, factor structure, and notably, nonparametric item-option characteristic curves for each item (Beck, Steer Brown, 1961 par. 4). They contend that the BDI-II has improved upon the original by updating the items to reflect contemporary diagnostic criteria for depression and utilizing state-of-the-art psychometric techniques to improve the discriminative properties of the instrument (Beck, Steer Brown, 1961 par. 10). Although the reviewers have noted their concern regarding the lack of room for diversity, Arbisi and Farmer appear to approve of its use as a depression assessment tool. Hamilton Depression Scale The Hamilton Depression Scale (abbreviated as HDS, HAMD or HAD) is used to measure the severity of symptoms of depression. For many years it was considered to be the gold standard. It was developed by Max Hamilton in the late 1950s and was used to evaluate the performance of the first antidepressants. It was released in 1960. Upon its release, Hamilton acknowledged that it had room for improvement (p. 56). He revised the HDS in 1967. The HDS consists of 21 multiple choice questions. The first 17 questions determine the severity of the depression symptoms, while the additional four questions address the areas of paranoia and obsession and their relation to depression .The HDS can be administered to both children and adults. It is considered to be easy to read and interpret; it is recommended that the HDS be administered only by a licensed professional. Scoring The HDS was intended to be administered by an experienced clinician by conducting a clinical interview.   Scoring and administrating the scale may be considered cumbersome as Hamilton did not provide structured guidelines for this purpose. No standardized probe questions were provided to elicit information from patients and no behaviorally specific guidelines were developed for determining each items rating (Health Care Technology Systems, 2010). Seventeen items are rated on a 5-point (0-4) or a 3-point (0-2) scale. Overall scores of 0-6 are considered normal. Scores from 7-17 are indicative of mild depression. Scores from 18-24 represent moderate depression. Scores that are greater than 24 are representative of severe depression. Reliability Bagby, Ryder, Schuller, and Marshall (2004) state that Clinician-rated instruments should demonstrate three types of reliability: 1) internal reliability, 2) retest reliability, and 3) interrater reliability (par.4). They contend that the internal reliability of the HDS estimates ranged from 0.46 to 0.97, and 10 studies reported estimates 0.70 (par.5). They further contend that the majority of items contained in the HDS indicate sufficient reliability .Per their testing, the following items were met in each sample: (Guilt, middle insomnia, psychic anxiety, somatic anxiety, gastrointestinal, general somatic) and an additional five items met the criteria in all but one sample (depressed mood, suicide, early insomnia, late insomnia, work and interests, hypochondriasis) (par.6). A potential problem was suggested with loss of insight, as it had the greatest number of variables. Interrater reliability was considered to be poor. Cicchetti and Prusoff (1983, as cited in Reynolds and Kobak, 1 995) state in a study of interrater reliability of a 22-item version of the HDRS found low levels of reliability for individual items, with 14 of the 22 items demonstrating intraclass correlation coefficients of less than .40 (par. 4). Retest Reliability Scores for the retest reliability of the HDS ranged from 0.81 to 0.98. Williams (1998 at cited in Bagby et al., 2004) argued in favor of using structured interview guides to boost item and total scale reliability and developed the Structured Interview Guide for the Hamilton Depression Rating Scale (par.8). Doing so increased the retest reliability to 0.54 in spite of the fact that only four items met the necessary criteria for reliability; i.e.: depressed mood, early insomnia, psychic anxiety, and loss of libido (par.8). Validity The Hamilton Depression Scale is comprised of 1) Content, 2) Convergent, 3) Discriminant, 4 Factorial, and 5) Predicative Validity. Content validity is determined by examining scale items to determine correspondence with known features of a syndrome (Bagby et al., 2004 par. 9). Convergent validity is sufficient when a scale indicates Pearsons r values of a minimum of 0.50 in conjunction with measures of the same syndrome. Discriminant validity is determined by indicating that groups that differ in diagnostic status may be separated through the use of the scale. Predictive validity of symptom severity measures such as the Hamilton depression scale is determined by a statistically significant (p HDS Reviews Bernard Carroll wrote a letter to the editor of the American Journal of Psychiatry in December, 2005 entitled: Why the Hamilton Depression Scale Endures. He offers three reasons why the HDS remains the gold standard. First of all, he contends that Hamiltons HDS focused on patients burden of illness (par.1). He suggests that this is the reason why the HDS contains examples of anxiety that are present in depressive episodes, but are not part of the diagnosis for depression. He further contends that Hamilton intended the use of this scale for clients that are well known by the clinician. In this light, the HDS displays a range from mild to extreme illness (par. 1). Second, Carroll contends that the demand for a revised scale based upon modern criteria of major depression is not realistic. Carroll believes that Current definitions of major depression, instantiated in DSM-IV, for instance, are deliberately atheoretical nominalist conventions that lack unifying constructs, predictive validity, and explanatory power (par.2). He believes that this is the reason why those who are diagnosed with DSM-IV criteria for major depression are so contrasting. He adds: In the future, we might add biomarkers or endophenotypes to clinical symptoms in assessing depression, but that day is not here (par.2). Third, Carroll does not believe that the HDS has been outmatched in performance. He does not believe that the HDS is insensitive to changes in the severity of depression symptoms. When compared to the Montgomery-Asberg Depression Rating Scale, he believes that the Hamilton Depression Scale is superior in its sensitivity to change and in detecting early change with treatment while having the advantage of far more comprehensive symptom coverage (par.3). Carroll concludes his letter by stating The endurance of the Hamilton depression scale is remarkable, considering how many unauthorized, nonvalidated, mutant versions now circulate (Hamiltons original 17 items have expanded to 28 at my last count). This is not progress, however, because the text versions and procedural use in many contemporary treatment trials are corrupted (par 4). Paul C Burnett, a reviewer of the HDS contends that the manual is extensive and comprehensive (par.2). The instructions for administering the test are clear and contain examples of the scoring process. All of the symptoms contained in the test are described and provide examples to be used in the interviewing process. He believes that the symptoms contained in the test conform to the criteria listed in the DSM-IV. The manual, which contains a sample of 202 depressed patients, is comprised of 76% inpatients, 24% outpatients, and 69% female (par.3). The manual contends that the demographics are fair, despite the fact that no data is provided to support this. He contends that the manual did not include data to support the procedure that was utilized to select this demographic. Burnett states that Internal consistency estimates were found to be .79 and .81 for the clinical and self-report forms respectively, indicating moderate reliability (par. 4). Other studies suggest that the internal consistency range from .45 to .95, which is stated in the manual as consistent with the results from the verification sample (par.4). Burnett does not consider a range of .45 to .81 as acceptable internal consistency. Burnett concludes that the HDS consists of a well written and concise manual, which clearly describes the administration and scoring process. He finds that the two scales have moderate internal consistency, sound concurrent validity, and relatively consistent and stable factor structures (par. 7). His only complaint is that the verification sample is minimal and does not sufficiently describe the manner in which it was selected. The Stronger Assessment Tool Both Aaron Beck and Max Hamilton have created an assessment tool to determine the severity of the symptoms of depression. While Hamiltons Depression Scale was considered to be the gold standard, and may be administered to both children and adults, one would have to conclude that Becks Depression Inventory-II is the stronger of the two assessments. It appears that the BDI-II can be administered with ease and does not require an interviewing process. The BDI-II has been revised to monitor the severity of symptoms of depression for the last two weeks, while Hamiltons HDS does not state such strict guidelines. It also appears as though the BDI-II contains a stronger internal consistency with an alpha coefficient of .95 as opposed to the HDS internal coefficiency of .79 and .81. Another reason for this conclusion was the original intention of use of the scales. Hamiltons HDS was developed to evaluate the performance of the first generation of antidepressants, while Becks Depression Inventory was developed to determine the nature of the severity of symptoms of depression without the use of medication. Becks BDI-II appears to have surpassed the HDS as reviewers have considered this assessment tool as utilizing state-of-the-art psychometric techniques to improve the discriminative properties of the instrument (Beck, Steer Brown, 1961 par. 10). It appears as though Becks BDI-II is the preferred choice among todays clinicians.

Sound on the Web :: Websites Internet Technology Computers Essays

Sound on the Web Transcript Using sound on the internet can greatly benefit and enhance a webpage (Teachernet). Sounds, rather they be background, core content, or music, create mood, theme, and help define the usefulness of the site (Farkas 94). Sounds can serve as core content. Sound can be used to introduce a site; either by music or a narrated welcome (Farkas 95). Narration can also serve as the content, like this site, or to help the viewer navigate the site and help the user make choices once viewing the site (Teachernet). Sounds can also be background noises. Rather these sounds be music, sound effects, or narration, background noise can help the user by reinforcing the website’s content (Teachernet). Narration is a very common way of adding sound to a webpage. As stated before, it can be used to welcome or introduce users to the website and can also give directions about how to use the website or inform or teach (Teachernet). But beware, using narration can be tricky. When using narration, one must be aware of the quality of sound that is being produced. As Farkas and Farkas state, â€Å"There are great differences in voice quality.† Some people may have a good speaking voice, but when recorded, it may not be clear, sound correct, or even be audible. Farkas and Farkas suggest that when using narration find a â€Å"trained† narrator, a drama, or communications student to narrate. Typically, these people have been coached on how to speak clearly and how to use techniques to record content well (Farkas 95). However, in some situations this may not be the case. If you or a certain person is required to do the narration, be sure to practice and work on the content to fit your or their particular speaking and recording style (Farkas 95). Supplemented sounds are typically background noises. These noises can be used to reinforce ideas, reward users, provide context or help explain ideas (Teachernet). By providing sound to accompany graphics, the user is able link a graphic with the context it is presented in. Using sound in this manner would either help explain the graphic or the function of the graphic within the website (Teachernet). If sound is used in a navigational sense, the sound could alert the user as to where to go on the page or what they have already chosen to do. Also, sounds can help explain ideas or teach concepts (Teachernet).

Best practices in project quality management/leadership for IT Essay

1. 0 Introduction Most people simply accept low quality from many information technology (IT) products. So what if ones laptop crashes a couple of times a week? Just ensure there is back up for data. So what if one cannot log in to the business intranet or the internet right now? Just attempt a little later when it is less busy. So what if the latest version of word-processing software was shipped with several bugs? One may like the software’s new features, and all new software has bugs. Is quality a real problem with information technology projects? Yes, it is! IT is not just a luxury available in some offices, homes, or schools. Firms throughout the world provide employees with access to computers. The majority of people in the US use the internet, and usage in other countries continues to expand rapidly. It took only six years for 60 million people to use the internet compared to 20 years for 60 million to use cell phones (Kathy, 2008, p. 292). Many issues of individual and or group lives depend on high-quality IT products. Food is produced and distributed with the help of computers; vehicles have computer chips to monitor performance; students use computers to aid them learn in school; organizations depend on technology for many business functions; and millions of people depend on technology for entertainment and individual communications (Kathy, 2008). Many IT projects develop mission-critical systems that are utilized in life-and-death circumstances. Such as navigation systems on aircraft and computer components built into medical equipment. Financial institutions and their clients also depend on high-quality information systems. Clients get very upset when systems present inaccurate data or display information to unauthorized people that could result to identity theft. When any of these systems fails, it is much more than a mere inconvenience (Taguchi, 2004). 1. 1 Definitions Before one can enhance the quality of IT projects, it is good to understand the fundamental concepts of project quality management. Indeed, it is hard to define project quality management. According to the international organization for standardization (ISO) quality can be defined as the totality of features of an organization that bear on its ability to satisfy stated or implied requirements (Kathy, 2008). It can also be defined as the extent to which a set of inherent features fulfils needs (ISO9000). Other professionals define quality based on adherence to needs and fitness for use. Adherence to needs means project’s products and processes meet laid down specifications. Fitness for use implies a product can be used as it was intended. The purpose of project quality management is to make sure that the project will fulfill the requirements for which it was undertaken. Project management involves among others things meeting or surpassing stakeholder requirements and anticipations. The project group must initiate good relationships with core stakeholders, especially the primary client for the project, to comprehend what quality implies to them. Many technical projects fail because the project management group aims only at meeting the written requirements for the project (Juran and Frank, 2002). Quality, therefore, must be on an equal basis with project scope, cost, and time. If the project’s stakeholders are dissatisfied with the quality of the project management or the end products of the project, the management group will require adjusting time, cost, and scope to fulfill stakeholder needs. In which case meeting only documented requirements for time, cost, and scope is not sufficient. To attain stakeholder fulfillment, the project group must come up with a good working relationship with all stakeholders and comprehend their implied or stated requirements. Best practices: over the years, organizations have become mesmerized with the term-best practice-but after continued use, experts began scrutinizing the expression and now better definitions exist. A best practice starts simply with an idea. Knowing that there is a process, tool, activity, or method that can deliver results effectively than any other method and provides one with the desired results with less barriers and predictable complexities is a welcome. As a result, one apparently ends up with an efficient way of completing a task by use of a repeatable procedure that has stood the test of time for quite a large number of IT projects (Kathy, 2008). As project quality management evolved, so did the meanings of best practices. Some definitions of best practices are complicated while others are somehow simple. Yet, they both address the same aim of encouraging project quality management throughout the organization. Firms must decide on the depth and extent of their best practices. Must it be at high level and generic or at a low level and detailed? A generic best practice may not attain the desired efficiencies whereas a detailed one may not have unlimited applicability. Basically, any firm can decide to have own definition of best practices and there might even be company quality requirements on the definition of such best practices. For example, a best practice can be defined as something that: works, works well, works well on a repetitive basis, leads to a competitive advantage, can be identified in quest to improve business, and prevents the firm from problems.

Days of the Week in Italian Vocabulary

What day does the market come to town? What day does the post office close early? What day of the week do you want to go to Chianti? To organize your daily life, figure out when to go to events, and schedule time to hang out with friends while you are in Italy, youll need to know how to tell time and be familiar with the days of the week—la settimana. Days of the Week: I Giorni della Settimana Monday: lunedà ¬Tuesday: martedà ¬Wednesday: mercoledà ¬Thursday: giovedà ¬Friday: venerdà ¬Saturday: sabatoSunday: domenicathe week: la settimana (from the number sette)the weekend: il fine settimana or il weekend. (Pronunciation note: Notice the grave accent mark () on the words for lunedà ¬ through venerdà ¬. That accent mark lets you know where to put the stress in the word so, in this case, the stress falls on the last syllable.) Note also that in Italian the days of the week and the names of months and seasons are all lowercase. Che giorno à ¨ oggi? What day is it today?Oggi à ¨ mercoledà ¬. Today is Wednesday.Ieri era martedà ¬. Yesterday was Tuesday.Domani à ¨ giovedà ¬. Tomorrow is Thursday.Il mio compleanno à ¨ sabato. My birthday is Saturday. Days of the Week: Article or Not? As shown above, days of the week are used without definite article (la, il, lo) when talking about an immediately upcoming day of the week—in other words, the upcoming Sunday or Monday or the past Sunday or Monday. Sunday I am going to the beach. Domenica vado al mare.Tuesday I dont have school. Martedà ¬ non ho scuola.Wednesday morning I am not working. Mercoledà ¬ mattina non lavoro. This past Sunday I went to visit a friend. Domenica scorsa sono andata a trovare unamica.Next Wednesday I am going to Prague. Mercoledà ¬ prossimo vado a Praga. You use a definite article when you mean every Sunday or Monday. Days of the week are all masculine except for domenica. On Sundays I go to the beach. La domenica vado al mare. On Tuesdays I dont have school. Il martedà ¬ non ho scuola.On Wednesday mornings I dont work. Il mercoledà ¬ mattina non lavoro. Note that in Italian you do not need a preposition before the day of the week so there is no on Sunday). Also note that if you add mattina or sera to your day of the week, it does not alter the gender of the day of the week, which stays masculine. Plural or Singular? Like all other accented nouns in Italian, lunedà ¬, martedà ¬, mercoledà ¬, giovedà ¬, e venerdà ¬ are invariable, so they don’t change in their plural form, but if you use an article, that must be plural (i giovedà ¬). Sabato e domenica have regular plural forms when needed—i sabati e le domeniche. Sundays in summer are fabulous. Le domeniche in estate sono favolose.I love Saturdays in June. Amo i sabati a giugno.Mondays are busy days. I lunedà ¬ sono giorni impegnativi. To speak about something that happens regularly every Monday or every Sunday, in addition to using the definite article as mentioned above, you have a couple of options with the adjectives ogni (always singular) and tutte/tutti: I take my dance class every Monday. Vado a danza tutti i lunedà ¬. I study every Sunday. Studio ogni domenica. Also note, if you want to take a few days off—lets say from Tuesday to Friday—you use da...a: Il negozio à ¨ aperto dal lunedà ¬ pomeriggio al giovedà ¬ incluso. The store is open from Monday afternoon through Thursday.Faccio festa da martedà ¬ a venerdà ¬. I am taking off from Monday to Friday. (Yes, fare festa means to take days off!) Other Examples Il weekend il mercato à ¨ aperto. The market is open on the weekends.Parto per l’Italia sabato. I’m leaving for Italy on Saturday.Perchà © non vieni venerdà ¬? Why dont you come on Friday?Sono libero venerdà ¬ sera. Ti va di andare al cinema? I’m free Friday evening. Want to go to the movies?Martedà ¬ mattina vado dal dottore. Tuesday morning I am going to see the doctor.Andiamo al mare da giovedà ¬ a domenica? Do you want to go to the beach from Wednesday to Sunday?Di solito il venerdà ¬ lavoro sempre, ma questo venerdà ¬ non lavoro. Usually I work on Fridays, but not this Friday.Il giorno pià ¹ bello della settimana à ¨ lunedà ¬ perchà © à ¨ l’inizio di una nuova settimana. The nicest day of the week is Monday because it’s the start of a new week. Note that stores in Italy usually have half a weekday off—grocery stores usually on Wednesday afternoons and other stores such as clothing stores on Mondays. It is called the giorno di chiusura or giorno di riposo. Qual à ¨ il vostro giorno di riposo (di chiusura)? When is your day off?Siamo chiusi tutte le domeniche mattine or Siamo chiusi la domenica mattina. Our day off is every Sunday morning.I negozi di alimentari sono chiusi il mercoledà ¬ pomeriggio. Grocery stores are closed on Wednesday afternoons. A Long Weekend: Il Ponte and Other Curiosities If you are struggling to remember the names of the days of the week, it might help to remember whence they came—all from the Romans, pre-Christianity, and mostly from the names of the planets: lunedà ¬ from the moon (lunae dies, the day of the Moon), martedà ¬ from Mars (Martis dies, the day of Mars), mercoledà ¬ from Mercury (Mercuri dies), giovedà ¬ from Giove (Iovis dies, the day of Jupiter), venerdà ¬ from Venere (Veneris dies, of the day of Venus), and sabato from Saturno (Saturni dies, the day of Saturn). Domenica was added later as Dominica, the day of the Lord. When a religious festival or holiday such as the Festa della Repubblica or Ognissanti falls on a Tuesday (martedà ¬) or a Thursday (giovedà ¬), Italians often do something called fare il ponte, which literally means to make a bridge, and figuratively means to take a four-day holiday. That means they take off the intervening Monday or Friday. In Italy the week starts on Monday; most activities, including schools, are open on Saturdays, at least in the morning. A few uses of the word la settimana: la settimana bianca (a winter vacation, skiing, mostly), la settimana santa (Holy Week, for Easter), la settimana lavorativa (the work week), la settimana corta (a short work week, Monday through Friday), and la settimana lunga (a long work week, including Saturday).