Analyzing the Use and Validity of the Hamilton Depression Scale for Psychological Evaluation

Abstract * There are various psychological measures which are used to evaluate conditions such as depression in children and adults and even insomnia. The articles Revised Hamilton Rating Scale for Depression and also Antidepressants and the Sound of One Hand Clapping discuss the use of the Hamilton Depression Scale. These articles also compare and contrast the measurements which were discovered by using this scale. Within the contents of this paper is an explanation as to who is qualified to administer and interpret the measure as well as the settings in which it would deem proper to use the measure.

Finally, validity of the Hamilton Depression Scale is reviewed within this paper. Psychological Measure The Hamilton Depression Scale or normally known as HAM-D is a test that was developed by Max Hamilton around 1960 (Warren, 1994). The test has been revised in the years of 1966, 1967, 1969, and finally in 1980. It is a questionnaire that is filled out by the patient and professional after the patient’s initial interview. The main goal of the test is not to help diagnose the person’s depression, but to test the severity of the depression.

Max Hamilton was also clear that the test he created should not be used to diagnose patients, but simply to test the levels of severity. Summary of Articles The articles analyzed were, Revised Hamilton Rating Scale for Depression, written by W. L. Warren and Antidepressants and the Sound of One Hand Clapping written by Ronald W. Pies, MD from the Psychiatric Times. HAM-D looks at the level of severity of the different symptoms that are found in patients that have depressions. The symptoms of mood, insomnia, agitation, anxiety and weight loss are some the characteristics that are addressed in the questionnaire.

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In other words, it tests people that have already been diagnosed with clinical depression to find, if any, changes that may have come from treatment, or symptoms that have worsened due to daily struggles. This test is used by psychologists on children, teenagers, and adults (Warren, 1994). A great example of its many uses is trying to find the effect of placebos on patients. The placebo, also known as a sugar pill, is known to have no true physical effect on the human body except in the psychological belief of its healing power by the patient (Pies, 2011). The article written by W.

Warren explored more on the clinical therapy that is achieved from the test, while Ronald W. Pies MD’s article focus more on the experimenting research benefits of the test. They both agree on the purpose of the test, but have slightly different goals or focus of its use in the psychological community. HAM-D Administration The majority of psychological testing for antidepressants is done through the HAM-D test (Pies, 2011). In Warren’s article, he explained that the reliability of internal tests done with the HAM-D comes around 81% with a fair sample reaching the general representation of the demographics of clinical depress patients.

The validity was also to be found in a mean around 61% as being correlated by other depression tests such as the BMI (Warren, 2011). There are seven items that Hamilton felt were necessary to consider when administering the HAM-D. The first would be the severity and longevity of the symptoms. The second is that the test should cover the last week or two weeks. It is not meant to cover just a day since it is difficult to monitor lack of sleep, or weight loss in one day.

The third item is that each item in the scale must be evaluated separately. Just because a person rates high in one area does not mean that they will rate high in another area. The fourth item that Hamilton covered was that the scale is based on a change from the norm in the patient. This scale is used to rate the depressed mood symptoms not the personality of the person. The fifth item is that each week should be looked at separately. The researcher should not look at one week, or ask about the previous week when doing the new test.

The sixth item, which is rarely done now, is that the person administering the test should look at all sources of information, such as listening to what family members have to say. The last item that Hamilton felt necessary was to caution the clinician to use their own judgment when evaluating a person. For example, if a person says they have lost a lot of weight, but in reality it is only a few pounds, the clinician must be able to evaluate this information for what it really may be, such as dieting, or eating special foods due to a holiday (Hersen, 2004).

Hamilton never did set a specific set of standards for who should be allowed to administer the test. He did feel that the person who was administering the test should have certain skills and knowledge. Hamilton is quoted as saying, “The value of the scale depends entirely on the skill of the interviewer in eliciting the necessary information (Hersen, 2004)”. Hamilton felt that the clinician should have a varied background with dealing with people with all different degrees of severity in their depression. The rater should have didactic training as well as a background in psychology especially with affective disorders.

The person doing the rating should have good interviewing skills, this would include knowing when to ask certain questions as well as how to phrase the questions that are to be asked (Hersen, 2004). Validity It is difficult to say that the Hamilton Depression Scale in general is either valid or invalid without considering a few factors. Researchers have analyzed content, convergent, discriminant, factorial and predictive validity which are found within this scale. Content validity refers to the reflection of the scale items in correspondence to known factors of depression.

Convergent validity correlates with other depression’s other measures. Discriminant validity involves distinguishing between groups which suffer from depression and those groups that do not. Factorial validity stems from factor examination of the data-based structure of the scale, determining whether each item focuses on the designed factor. Finally, predictive validity occurs in predicting change in the severity of symptoms which are associated with treatment (Bender, 2005). Validity within the Hamilton Depression Scale varies depending on what is being examined.

Testing for information regarding older adults may be more or less valid than testing to see if the condition of the economy influences depression. Validity studies which examine scaling and item content concluded that several items failed at measuring single symptoms or containing response options that correlate with the degrees of severity (Bender, 2005). However, as previously mentioned, when this scale was used to measure antidepressants as they relate to depression, it proved 61% valid in comparison to other tests which are administered to produce information which pertains to depression.

These two discoveries assist in concluding that the validity of this measure varies based on different factors such as what it actually being tested and possibly the whom is person or persons responsible for administering the test due to interpretation and biasness. Conclusion Various measures evaluate the factors which correlate with depression, but the Hamilton Depression Scale is one of the most widely used in terms of depression. This measure is not used to diagnose depression, but rather to produce information about the level of severity.

Although there is no definitive answer about who should be administering this test, the administrator should take seven factors into consideration during this process. As with any other testing measure, validity has to be taken into consideration when determining if the test should continue to be used in the future. However, validity is not cut and dry, but rather complex as it concerns what is being measured. Overall, this widely used measure, has revealed useful results in the past concerning depression and will continue to do so in the future. References Bender, K. (2005).

Throwing Out the Gold? Reconsidering the HAM-D. Psychiatric Times Retrieved from http://www. psychiatrictimes. com/blog/couchincrisis/content/article/10168/1968125 Hersen, M. , Hilsenroth, M. J. , & Segal, D. L. (2004). Comprehensive handbook of psychological assessment . Hoboken, NJ: John Wiley & Sons, Inc.. Pies, R. W. (2011) Antidepressants and the Sound of One Hand Clapping. Psychiatric Times Retrieved from http://www. psychiatrictimes. com/blog/couchincrisis/content/article/10168/196812 Warren, W. (1994). Revised Hamilton Rating Scale for Depression. Retrieved from EBSCOhost.

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