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Introduction
Issues of quality of goods and services in psychological science and practice have gained particular popularity in recent years. TV shows, specialized magazines, and journalistic articles devoted to the issues of the quality of psychological services are in great demand among people of different ages. Along with this, problems with the quality of psychological testing materials are no less relevant and trending. This is because testing is one of the most widespread psychological diagnostics methods due to several significant advantages. Individuals experiencing symptoms of anxiety disorders often try to make a diagnosis on their own.
The problem of the abundance of psychological tests leads to the need to compare multiple testing options for indicators of their purpose, features, and interpretations of the evaluation and validity. As objects of research are chosen tests aimed at detecting depression, which is one of the most significant problems nowadays. Thus, the Beck, Hamilton, and Montgomery-Asberg scales will be analyzed and compared as some of the most frequently used instruments for detecting depressive disorders.
Discussion
The A.T. Beck Hopelessness Scale is among the widespread techniques offered for work with suicidal and depressive personal behavior. The method is presented in numerous methodical manuals and is accessible to multiple users due to its prevalence on thematic sites on the Internet. However, as several authors fairly point out, amateurism and unprofessional use of diagnostic tools can lead to the most unpredictable consequences for the person being tested and the diagnostician (Balsamo et al., 2020). The test’s purpose is to predict the possibility of suicide based on thoughts about the future and the expectations placed on the individual. It consists of 20 statements reflecting feelings, states, and attitudes about the future and the past (Sueki, 2022). The field of application of the methodology and its results in the sources are not specified.
Still, based on the analysis of the focus of the manuals, it is possible to determine the social sphere of human activity or social practice in which this methodology and the data obtained with its help will be in demand. First, these are medical, educational, and social service institutions for solving the issues related to the diagnosis, prevention, and correction of suicide risk. The method is precious as an indirect indicator of suicide risk in depressed individuals and in people who have previously attempted suicide.
Age boundaries and characteristics of the target group, and its correspondence to the sample population, which the technique is focused on, are not specified in most manuals. The information on the age range of applicability of the “hopelessness” scale offered in the “Dictionary of Psychodiagnostic Guidelines” indicates a boundary of 17-80 years (Balsamo et al., 2020). Still, this publication also lacks a reference to the primary source.
None of the authorities in question provides information about components of the diagnostic process, such as the approximate time taken to perform the diagnostic procedure and the testing conditions. The results are processed by comparing the data obtained with the methodology’s key (Kilem et al., 2018). The number of coincidences of the answer options with the key is counted, the sum of which is compared to the range of the interpreter scores, based on which the degree of hopelessness of the option is revealed.
The Hamilton Depression Rating Scale for Depression is a clinical aid developed to quantify patients with depressive disorders before, during, and after treatment. It is the standard for determining the effectiveness of medications in treating depressive disorders. Unlike the previous test, it has a broader application. The scale allows quantitative evaluation of the dynamics of depressive manifestations and is well suited for monitoring the effectiveness of treatment in patients over 18 years of age. Testing is performed by a doctor and most often includes 17 or 21 items (Jia et al., 2019). The questions on the scale relate to the patient’s condition during the last few days or the previous week.
The number of direct questions should be kept to a minimum and asked in various ways, combining options with affirmative or negative answers. During retesting, the researcher should not see the results of previous measurements and only fill out a blank scale form. If possible, questions about changes in the patient’s condition since the last examination should be avoided. The response option that most accurately describes the patient’s condition should be chosen for evaluation. The first 17 items provide a measure of the severity of depression. Four items (18-21) provide information about ancillary symptoms that may require special treatment (Vindbjerg et al., 2019). Normative data vary slightly, depending on the literature sources. The following gradations are often considered:
- 0 to 6 points, regular;
- 7 to 16, mild depressive disorder;
- 17 to 24, moderate depressive disorder;
- More than 24 severe depressive disorder.
The Hamilton Depression Scale is a professional tool for diagnosing depression, allowing a comprehensive assessment of a client’s condition by indicating the most pronounced symptoms. The Montgomery and Asberg Depression Rating Scale (MADRS), proposed in 1979, is considered equivalent to the HAM-D in reliability (Obeid et al., 2018). The main requirements for the scale used in studying the effectiveness of antidepressant therapy are:
- Shortness and easiness of use.
- Reliability of depression assessment.
- Sufficient sensitivity and accuracy in assessing the dynamics of the condition.
Therefore, the main goal of S.A. Montgomery and M. Asberg in developing the scale for assessing depressive illness was to ensure sensitivity and accuracy in determining changes in status for each instrument item. The authors also reduced the total number of items on the scale (Hengathner et al., 2020). A large number of items in a small sample size can cause or increase random calculation errors. More importantly, the measurement procedure would become unnecessarily cumbersome and time-consuming, and an inexperienced researcher may not be able to complete all items during a single examination.
The Montgomery-Asberg Depression Rating Scale (MADRS) is fully fit for purpose. The MADRS has fewer items than the HDRS, the most commonly used depression scale (10 versus 21) (Hieronymus et al., 2019). The MADRS captures all significant symptoms of depression, although some prominent symptoms are not included in the hierarchy. The main disadvantage is that it does not assess motor retardation, although the MADRS is equivalent to the HDRS in reliability. At the same time, MADRS seems to register the dynamics of the condition more accurately than HDRS. Consequently, significant differences between the therapies can be recorded in a smaller sample size, which is ethically a considerable advantage in clinical trials (Rabinowitz, 2022). Assessment should be based on a clinical interview in which questions are asked first in more general terms.
Conclusion
The degree of symptom severity is specified in detail according to the criteria of the scale. The researcher should decide whether the severity of symptoms conforms to the primary rating scale definitions (0, 2, 4, 6) or their intermediate values (1, 3, 5) (Hieronymus et al., 2019). It should be remembered that, for depressed patients, cases in which a correct assessment based on an interview is complex. Comparing the two tests allows one to conclude that the Hamilton and Montgomery-Asberg scales are similar, with the latter being more effective. The Beck test has other features and is the only sample with a marked century category. However, it should be understood that all tests require the involvement of a specialist and cannot be used for private purposes.
References
Balsamo, M., Carlucci, L., Innamorati, M., Lester, D., & Pompili, M. (2020). Further insights into the beck hopelessness scale (BHS): Unidimensionality among psychiatric inpatients. Frontiers in psychiatry, 11, 727. Web.
Hengartner, M. P., Jakobsen, J. C., Sørensen, A., & Plöderl, M. (2020). Efficacy of new-generation antidepressants assessed with the Montgomery-Asberg Depression Rating Scale, the gold standard clinician rating scale: A meta-analysis of randomised placebo-controlled trials. PLoS One, 15(2), 81. Web.
Hieronymus, F., Lisinski, A., & Eriksson, E. (2022). The response pattern to SSRIs as assessed by the Montgomery‐Åsberg Depression Rating Scale: a patient‐level meta‐analysis. World Psychiatry, 21(3), 472. Web.
Jia, Y., Liu, L., Sheng, C., Cheng, Z., Cui, L., Li, M., & Chen, L. (2019). Increased serum levels of cortisol and inflammatory cytokines in people with depression. The Journal of nervous and mental disease, 207(4), 271-276. Web.
Kliem, S., Lohmann, A., Mößle, T., & Brähler, E. (2018). Psychometric properties and measurement invariance of the Beck hopelessness scale (BHS): Results from a German representative population sample. BMC psychiatry, 18(1), 1-11. Web.
Obeid, S., Hallit, C. A. E., Haddad, C., Hany, Z., & Hallit, S. (2018). Validation of the Hamilton Depression Rating Scale (HDRS) and sociodemographic factors associated with Lebanese depressed patients. L’encephale, 44(5), 397-402. Web.
Rabinowitz, J. (2022). Outlier-response pattern checks to improve measurement with the Montgomery-Asberg depression rating scale (MADRS). Journal of Affective Disorders, 299, 444-448. Web.
Sueki, H. (2022). Relationship between Beck Hopelessness Scale and suicidal ideation: A short-term longitudinal study. Death studies, 46(2), 467-472. Web.
Vindbjerg, E., Makransky, G., Mortensen, E. L., & Carlsson, J. (2019). Cross-cultural psychometric properties of the Hamilton Depression Rating Scale. The Canadian Journal of Psychiatry, 64(1), 39-46. Web.
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