Birleson Depression Self-Rating Scale for Children (DSRS-C)

Peter Birleson first developed a self-rating scale for depression in childhood (DSRS-C) in 1978 as part of a Masters of Philosophy Thesis at the University of Edinburgh (Birleson, 1978, 1981). The now 18-item self-rating scale emerged from a longer 37-item inventory associated with major depressive syndromes in childhood (Birleson, Hudson, Buchanan, & Wolff, 1987). The DSRS-C tool is based on the operational definition of depressive disorder, implying a duration of a specific affective behaviour pattern where there is impairment in a child’s or adolescent’s ability to effectively function in his/her environment (Birleson, 1981).

The DSRS-C measures the direction of disturbances felt in the past week by children and adolescents aged between 8 to 14 years of age. Subjects are asked to select one of the following options; “Most of the time,” “Sometimes,” or “Never.” The scores for the scale are 2, 1, or 0. Responses to items are simply scored in the direction of disturbance. For example; depressive items are scored 2 (i.e. “I feel so sad I can hardly stand it”), “sometimes” items are scored 1 (i.e. “I get tummy aches”), and non-depressive items score 0 (i.e. “I look forward to things as much as I used to”) (Birleson, et al. 1987). The 18 scores are then summed to give the total score. For items 1, 2, 4, 7, 8, 9, 11, 12, 13 and 16 ‘mostly’ scores 0, ‘sometimes’ scores 1 and ‘never’ scores 2. For items 3, 5, 6, 10, 14, 15, 17 and 18 ‘mostly’ scores 2, ‘sometimes’ scores 1 and ‘never scores 0. Higher scores indicate stronger depressive tendencies and the maximum score is 36 (Denda, Kako, Kitagaea, & Koyama, 2006).

In terms of psychometric properties in determining a valid and reliable psychometric test, 18 of the original 37 items were found to separate depressed groups from others in a statistically significant way, thus 18 items were retained and now comprise the current DSRS-C (Birleson, 1981; Birleson, et al. 1987). The DSRS-C has shown sound psychometric properties in clinical samples (Birleson, et al. 1987) and community samples (Kaplan, Hong, & Weingold, 1984). Reliability and validity of the self-rating scale was found to be satisfactory (Birleson, 1981). Individual items for the DSRS-C had correlations of between .65 and .95. Test-retest reliability of the DSRS-C for the maladjustment group was .80, thus showing a highly satisfactory degree of stability (Birleson, 1981). Furthermore, internal consistency estimated by split-half reliability coefficient, was found to be .86 (Birleson, 1981). The English version of the DSRS-C has been translated into 11 languages, including Arabic, Arabic (Syria), Chinese, Dari, Hindi, Italian, Japanese, Khmer, Norwegian, Pashto and Russian. Not all of the translated versions however have been psychometrically evaluated.

In regard to its limitations, given that the DSRS-C is a self-rating scale, it is possible to establish rapport whilst interviewing children/adolescents, thus consequently increasing the validity of response (Birleson, et al. 1987). Furthermore, whilst the DSRS-C is easy to administer, shorter scales are less robust in eliminating error due to misunderstanding items or response set (Birleson, et al. 1987). Moreover, self-evaluation is dependent on the individual’s mood at that particular time, thus meaning there are a number of external factors that could potentially influence response to items. It is also important to note that young children may experience difficulty in reporting their depression, as age increases the expression of depressive symptoms, thus children/adolescents may tend to underestimate or overestimate their feelings (Birleson, et al. 1987; Kaplan, Hong, & Weingold, 1984).

The DSRS-C is a freely available tool to the public and can be accessed through multiple sources on the internet. It is important to note that the DSRS-C was never intended to be used as a diagnostic tool for depression in children and adolescents, but rather to measure moderate to severe depression in childhood This is because the instrument does not include; the assessment of other symptoms, the developmental status of a child, the history of disturbances or its context (Birleson, 1978, 1981). Health professionals may however use the tool as a quick and cost-effective screener for depression before administering costly diagnostic measures (Denda, et al. 2006).

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