IVON SAGITA

ST1013 8173

PSY 403

Make an Essay about the Topic Mentioned (1)

Answering 4 questions according to the case of client was diagnosed with

major depressive disorder (MDD) and intellectual disability.

Attempt (1)
 I. Introduction

Depression is often defined as feelings of sadness, disappointment, hopelessness,

lack of motivation, and loss of interest in life. When this feeling lasts for a moment,

it is called "the blues". However, when it lasts more than two weeks and affects

daily activities, it is called a depressive disorder. A person diagnosed with

depression has several symptoms including changes in appetite, weight gain,

changes in sleep and activity patterns, loss of energy, feelings of guilt, difficulty

thinking and making decisions, and thinking about death or suicide (Sadock BJ,

Sadock VA, Ruiz 2017).

Major Depressive Disorder (MDD) is a heterogeneous disease characterized by

feelings of depression, anhedonia, changes in cognitive function, changes in sleep,

changes in appetite, feelings of guilt that occur for two weeks, described as a loss

of interest or pleasure in activities that are usually done. (Kendler, Gatz, Gardner,

& Pedersen, 2006).

MDD diagnosis has five symptoms that are experienced for two weeks. The

symptoms are loss of interest, feelings of depression, appetite disorders, weight

loss, sleep disorders, psychomotor changes, loss of energy, worthlessness, guilt,

concentration problems, doubts and thoughts about death or suicide.. Mood swings

accompanied by loss of interest and feelings of worthlessness or guilt are a

prerequisite for diagnosing MDD (Maletic et al., 2007).

(MDD) and intellectual disability.

A. Personality assessment for measuring major depressive disorder (MDD)

One of the research measurement tools that are widely used in detecting

depression is a measurement tool made by Beck (1976), namely the Beck

Depression Inventory (BDI). BDI-II is a very popular measuring tool for

describing a person's depression (Beck, Steer & Brown, 1996). This measuring

instrument is made for use in individuals aged 13 years and over (Segal et.al.,

2008).

An example of a BDI revision , is that respondents are asked to respond to each

statement based on a time period of two weeks instead of one week like the

timeframe in BDI. The reason for this revision is to fit the depression criteria

on the DSM-IV which states that to diagnose depression, at least depressive

symptoms have been present for 2 consecutive weeks based on APA criteria.

Therefore, if the BDI respondents were asked to respond to questions based on

their feelings during the past week, then in BDI-II the respondents were asked

to respond to questions based on their feelings for the last two weeks. The BDI-

II consists of 21 items to assess the intensity of depression in both healthy and

physically ill people. Each item consists of four statements that indicate specific

depressive symptoms. These symptoms include sadness, pessimism, past

failures, loss of pleasure, feelings of guilt, feelings of punishment, self-dislike,

self-gravity, tthoughts of suicide, crying, agitation, loss of interest, doubt,

worthlessness, loss energy, changes in sleep patterns, irritability, changes in

2014).

B. Formal assesment tool to measure severity of MDD

The Hamilton Depression Rating Scale was developed by Dr. Max Hamilton

from the University of Leeds, England in 1960. Since then this scoring system

has been used widely in clinical practice and has become the standard in

pharmaceutical clinical trials, where this system has proven to be very useful in

determining the level of depression of a person before, during, and after

treatment. The HAM-D depression level assessment was based on the first 17

items, although the questionnaire contained 21 lists of statements. In general,

filling out this questionnaire takes 15-20 minutes. There are 8 items scored on

a 5 scale, from 0 = none to 4 = weight. While 9 items were scored with a value

of 0- 2. The interpretation of the HAM-D scoring system is to add the first 17

items with results 0-7 being normal, 8-13 mild depression, 14-18 moderate

depression, 19-22 major depression, and > 23 major depression (Hendlund and

Vieweg, 1979).

C. Specific measurement to assess adaptive and intellectual functioning

Standard instruments are needed to measure adaptive function with an increased

likelihood of better intellectual disability classification (Schachlock et al.,

2010). The research by (Jonker, et al., 2021) showed the result that ADAPT

(adaptive ability performance test) is a valid instrument to measure adaptive

skills in individuals with intellectual disabilities. The results of the assessment

intensity.

ADAPT is an instrument developed to measure three domain skills, namely

conceptual, social and practical adaptive behavior that occurs in adults. This

instrument has 65 items on a scale of 1 (not performing skills) to 5 (doing skills

completely and independently) based on actual client behavior. The total ADPT

score ranges are from 65 - 325. The examples of items from the ADPT include:

brushing teeth, using social media, thinking before acting, learning from

mistakes, washing and drying clothes, etc. (Jonker, et al., 2021).

D. Formal/informal assesment to Measure religoius inclination

The Spiritual Well-Being Scale (SWBS) is one of the assessment could be used

in measuring religious inclination. The research by Daaleman and Frey (2004)

showed the findings in correlation of religiosity with quality of life, health status

and depression than can be concluded SWBS is a valid and reliable instrument

in health-related quality-of-life studies using. The initial version of SWBS has

40 items consisting of 20 self-efficacy domains and 20 life-scheme domains and

could be used both adult and ternagers.

From the above explanation, it can be concluded that when treating clients

diagnosed with major depressive disorder (MDD) and intellectual disabilities, the

examiner can use several instruments such as the Beck Depression Inventory (BDI)

to detect depressive symptoms. Then use the Hamilton Depression Rating Scale

which has proven to be very useful in determining the level of depression of an

individual before, during, and after treatment. ADAPT (adaptive ability

performance test) is also a valid instrument to measure adaptive skills in individuals

with intellectual disabilities. And The Spiritual Well-Being Scale (SWBS) can be

used to measure the client's religiosity scale: so the results of all these instruments

can provide comprehensive assesments in order to plan the best treatments for the

client. Insha Allah.

Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck depression Inventory-II.

San Antonio, TX: Psychological Corporation.

Daaleman, T. P., & Frey, B. B. (2004). The Spirituality Index of Well-Being: a new instrument

for health-related quality-of-life research. Annals of family medicine, 2(5), 499–503.

https://doi.org/10.1370/afm.89

Hedlund, JL, Vieweg, BW. (1979) The Hamilton Rating Scale for Depression. J Operational

Psychiatry,; 10(2): 145-165.

Jonker, F. Et al. (2021). The ADaptive Ability Performance Test (ADAPT): A new instrument

for measuring adaptive skills in people with intellectual disabilities and borderline

intellectual functioning. Journal of applied research in intellectual disabilities.

https://doi.org/10.1111/jar.12876

Kendler, K. S., Hettema, J. M., Butera, F., Gardner, C. O., & Prescott, C. A. (2003). Life event

dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major

depresi and generalized anxiety. Arch Gen Psychiatry, 60(8), 789- 796. doi:

10.1001/archpsyc.60.8.789

Maletic, V., Robinson, M., Oakes, T., Iyengar, S., Ball, S. G., & Russell, J. (2007). Neurobiology

of depresi: an integrated view of key findings. Int J Clin Pract, 61(12), 2030-2040. doi:

10.1111/j.1742- 1241.2007.01602.x.

Sadock BJ, Sadock VA, Ruiz Pedro.2017. Kaplan & Sadock’s Concise Textbook of Clinical

Psychiatry 4th Edition. Philadelphia: Wolters Kluwe,pp. 324-457.

Schalock, et al. (2010). Intellectual Disability: Definition, Classification, and Systems of

Supports. AAIDD
Segal, D.L., Coolidge, F.L., Cahill, B.S. & O’Riley, A.A. (2008). Psychometric properties of the

BeckBDepression Inventory–II (BDI-II) Among Community-Dwelling Older

Adults.Behavior Modification, 32(1), 3-20.University of Colorado at Colorado Springs.

Sorayah (2014). Uji validitas konstruk Beck Depression Inventory-II.

http://journal.uinjkt.ac.id/index.php/jp3i/article/download/9259/pdf