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Under-diagnosis or delayed diagnosis of depression results in worse patient outcomes. Screening instruments help to address diagnosis but are underused in clinical practice. The use of different screening instruments by providers and by researchers makes it more difficult to assemble population-level data or interpret research findings in clinically useful ways. “Crosswalks” can be created that reliably allow the conversion of scores in one instrument to scores in another. The current report assessed the psychometric properties of the Patient Health Questionnaire – Adolescent (PHQ-A), 16-item self-reported Quick Inventory of Depressive Symptoms (QIDS-SR16), and its 5-item version, VQIDS-SR5, and established crosswalks between the measures. The three measures were found to be psychometrically sound in our sample, and each was sensitive to change over a one-month time period. Each measure could be reliably converted into the others. The 5-item VQIDS-SR5 holds promise as an effective tool for screening or repeated assessment due to its short length.

Nandy, K., Rush, A. J., Carmody, T., Kennard, B. D., Emslie, G. J., Slater, H., Mayes, T. L., DeFilippis, M., Garza, C., Storch, E. A., Wakefield, S. M., & Trivedi, M. H. (2023). A comparison of depressive symptom self-reported measures in the Texas Youth Depression and Suicide Research Network (TX-YDSRN). The Journal of Clinical Psychiatry, 85(1). https://doi.org/10.4088/jcp.23m14861

• Depression
• Measurement-Based Care

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There are multiple evidence-based therapy treatment options for youth with depression and/or suicidality, yet youth seeking treatment do not always receive these recommended treatments. Understanding the types of treatments received and patient understanding of their therapy experience is the first step to help track care in order to improve treatment received. To that end, TX-YDSRN assessed the validity of a new measure, the Depression Treatment Experiences Questionnaire (DTEQ), to better understand the youth experience with therapy. The measure showed promise as a useful tool for understanding therapy experiences, with two main domains identified by the measure. Lifestyle changes, such as changes to exercise and sleep, were found as a common addition to therapy. While almost half of participants reported receiving evidence-based therapy, the other half could not identify their therapy type, indicating a large gap in patient-provider communication.

Drummond, K. N., Guzick, A. G., Spencer, S. D., Pinciotti, C. M., Bivins, E. J., Minhajuddin, A., Slater, H., Gorman, A., Goodman, L. C., Walker, R. A., Wakefield, S. M., Wang, T., Chanoi, C., LaGrone, J. M., Soares, J. C., Smith, M., Lambie, F., Hughes, J. L., Snyder, S. A., Storch, E. A. (2025). Characterizing therapy experiences in youth with depression and suicide via the Depression Treatment Experiences Questionnaire. Clinical Psychology and Psychotherapy, 32(3). https://doi.org/10.1002/cpp.70088

• Measurement-Based Care
• Rating scales
• Depression

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One common obstacle to the effective treatment of mental health disorders is the fact that multiple people with identical diagnoses might experience different combinations of symptoms. This study set out to define subgroups of depressed youth using PROMIS, a self-report scale covering domains of physical function/mobility, anxiety, depressive symptoms, fatigue, peer relationships, interference of pain on one's life, and pain intensity. By using a statistical technique called latent class analysis, the authors were able to separate the participants into four subgroups: 1.) youth with less severe depression and higher physical functioning; 2.) youth with more severe depression, higher pain, and lower physical functioning; 3.) youth with more severe depression and higher pain, but with higher physical functioning; 4.) youth with more severe depression, lower pain, and lower physical functioning. Importantly, subgroup 3 demonstrated higher resilience compared to subgroup 2, possibly contributing to the higher functioning found in these youth. Identifying existing subgroups of patients with the same diagnoses may allow us to learn more about the variability found in depression and help find ways to promote better functioning in depressed youth.

Minhajuddin, A., Jha, M. K., Slater, H., Mayes, T. L., Storch, E. A., Shotwell, J., Soutullo, C., Wakefield, S. M., & Trivedi, M. H. (2024). Data-driven subgrouping of youths with depression reveals that resilience is associated with higher physical functioning despite high symptom burden in the Texas youth depression and suicide research network (TX-YDSRN). Journal of Affective Disorders, 348, 353–361. https://doi.org/10.1016/j.jad.2023.12.031

• Measurement-Based Care
• Depression

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Suicide is one of the leading causes of death in young people, so there is a critical need for valid, easy-to-administer, and easy-to-interpret assessments of suicidal risk. The 9-item Concise Health Risk Tracking – Self Report (CHRT-SR9) scale was developed by the CDRC to address this issue. This study used CHRT-SR9 scores from several large samples to identify clinically relevant categories of suicidal risk. Comparing percentile scores from CHRT-SR9 to response categories for Patient Health Questionnaire for Adolescents item 9 concerning suicide, ranges for four risk categories were identified. Our results demonstrate that CHRT-SR9 scores may be categorized as none (0-14), mild (15-21), moderate (22-26), and severe (27-36) suicidal risk. Placing CHRT-SR9 scores in context through identification of meaningful and clinically actionable categories will allow for increased understanding of suicidal risk and therefore aid suicide prevention efforts.

Nandy, K., Nandy, R. R., Rush, A. J., Mayes, T. L., & Trivedi, M. H. (2024). Evidence-based guidelines for the interpretation of the 9-item Concise Health Risk Tracking – Self-Report (CHRT-SR9) measure of suicidal risk. Journal of Psychopharmacology, 38(9), 784-788. https://journals.sagepub.com/doi/10.1177/02698811241268875

• Suicidality
• Measurement-Based Care
• CHRT-SR9
• Rating scales

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Hokelekli, F.O., Ayvaci, E.R., Minhajuddin, A., Walker, R.A., Goodman, L.C., Soares, J.C., Storch, E.A., Wakefield, S.M., & Trivedi, M.H. (in press). Examining Antidepressant Side Effect Burden in Youth: The FIBSER-C Scale in the Texas Youth Depression and Suicide Research Network Study. Journal of Child and Adolescent Psychopharmacology, 35(8), 463-470. https://doi.org/10.1089/cap.2025.0018

• Antidepressant
• Measurement-Based Care
• Rating scales
• Treatment
• Depression

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Many youth struggle with anxiety disorders, which are often debilitating and co-occurring with depression. To ensure accurate assessment of and intervention for youth anxiety, it is critical that clinicians have access to valid anxiety measurement tools. The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a frequently used measure to address anxiety, but its use has not been validated for diverse populations. To determine the validity of the SCARED for a wider range of youth, the measure was assessed in distinct groups based on age, sex, and ethnicity in TX-YDSRN youth. SCARED measurement performance was consistent across groups upon test. Younger children and females tended to endorse higher levels of anxiety compared to older children and males, respectively. These findings support the use of SCARED in more diverse populations of youth based on age, sex, and ethnicity, expanding clinicians' ability to measure youth anxiety.

Silva, T., Spencer, S. D., Higham, M., Castillo, A. A., Minhajuddin, A., Gorman, A., Goodman, L. C., Pinciotti, C. M, Hernandez, S., Slater, H., Soutullo, C. A., Hettema, J. M., Azhar, N. A., Goodman, W. K., Trivedi, M. H., & Storch, E. A. (2024). Measurement invariance of the Screen for Child Anxiety Related Emotional Disorders (SCARED) across ethnicity, age, and sex among youth with depression. Personalized Medicine in Psychiatry, 47-48, 100134. https://doi.org/10.1016/j.pmip.2024.100134

• Anxiety
• Measurement-Based Care
• Rating scales

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Irritability is a common characteristic of psychiatric disorders in children and adolescents but is often overlooked by scientific literature and screening tools. This study explores the psychometric value of the five-item irritability domain of the Concise Associated Symptom Tracking (CAST-IRR) scale for male and female youth. Adolescents completed the self-report version of the CAST-IRR, and the authors created an “informant” version of CAST-IRR, which was completed by a parent/guardian. Both versions of CAST-IRR had strong internal consistency and found similar associations for irritability with depression, anxiety, and functional impairment in males and females, indicating the appropriateness of use for both sexes. Similar to other studies where parent-child irritability was compared, there was poor agreement between self- and informant-report versions of CAST-IRR. Self-report CAST-IRR had a stronger association with self-report measures of depression and anxiety, while the informant-report CAST-IRR had a stronger association with informant-report measures of depression and anxiety. Given the ability to capture distinct features of irritability between the two versions, the results suggest that clinicians may consider using both self- and informant-report CAST-IRR scales to comprehensively assess irritability in male and female youth.

Jha, M.K., Minhajuddin, A., Baronia, R.B., Blader, J.C., Mayes, T.L., Petrosky, M.A., Slater, H.M., Wakefield, S.M., & Trivedi, M.H. (2025). Parent/Guardian- and Self-Report Versions of the Irritability Domain of the Concise Associated Symptom Tracking Scale: Evaluation of Psychometric Properties and Potential Clinical Utility in the Texas Youth Depression and Suicide Research Network. JAACAP Open. https://doi.org/10.1016/j.jaacop.2024.04.002 

• Measurement-Based Care
• Concise associated symptom tracking
• Irritability
• Rating scales

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Accurately measuring depression symptom severity is important for understanding patient trajectories and aiding treatment decisions. To provide increased awareness of depressive symptoms in youth, a particularly vulnerable population, it is helpful to survey both the youth themselves and a parent/guardian. Past research, however, has shown that parent-child agreement can vary widely depending on the survey used and may be influenced by demographic factors. Here, we studied TX-YDSRN parent-child agreement on the Patient Health Questionnaire-9 modified for adolescents (PHQ-A), a commonly used scale to assess severity of depression. Our results showed little agreement between PHQ-A scores reported by the youth and the youth’s parent/guardian on the youth’s depression severity. Agreement was not influenced by the youth’s age, sex, ethnicity, or parental depression history, but agreement was higher when youth were receiving psychotherapy treatment. Our findings highlight the importance of recognizing how reports of youth depression symptom severity may be influenced by who completes the assessment, and such discrepancies may need to be considered during assessment and subsequent treatment decisions.

Bivins, E.J., Buckland, E.K., Pinciotti, C.M., Riddle, D.B., Minhajuddin, A., Slater, H., Soutullo, C.A., Lambie, F., Saxena, K., Goodman, W.K., Onigu-Otite, E., Wakefield, S.M., Goodman, L.C., Trivedi, M.H., Guzick, A.G., & Storch, E.A. (2025). Parent-child agreement on depressive symptoms in depressed and suicidal youth. Journal of Child and Family Studies, 34, 2358-2368. https://doi.org/10.1007/s10826-025-03159-z

• Rating scales
• Depression

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The Concise Associated Symptom Tracking (CAST) is a 16-item scale that was developed over a decade ago to measure changes in depression-associated symptoms of irritability, anxiety, mania, panic, and insomnia. Despite being validated in adults, this study is the first attempt to assess its utility in youth and young adult populations. Confirmatory factor analysis supported a scale with 12 items in this population, dropping the mania items from the scale. Correlations to symptom-specific items on other validated instruments such as the PHQ-A, GAD-7, IDS-SR, CHRT, PROMIS, and SCARED showed the CAST-12 to be a valid scale for measuring these symptoms in those aged 8-20 years. Given that these symptoms may be associated with depression treatment outcomes, it is crucial to measure them throughout the treatment process, and the CAST-12 is one such tool for doing so.

Jha, M.K., Minhajuddin, A., Slater, H., Mayes, T.L., Blader, J.C., Brown, R., Garza, C., Kennard, B.D., Riddle, D., Storch, E.A., Shotwell, J., Soutullo, C.A., Wakefield, S.M., & Trivedi, M.H. (2023). Psychometric properties of Concise Associated Symptom Tracking (CAST) scale in youths and young adults: Findings from the Texas youth depression and suicide research network (TX-YDSRN). Journal of Psychiatric Research, 161, 179–187. https://doi.org/10.1016/j.jpsychires.2023.03.020

• Depression
• Anxiety
• Measurement-Based Care

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While risk factors for poor mental health often receive much attention, factors that protect or promote mental health deserve increased attention. Resilience, or the ability to adapt to life's challenges, has been identified as one protective factor, but there is a need for reliable and valid measures of resilience for research. In this study, we sought to test whether the CD-RISC-10, a brief measure of resilience, is appropriate for use within youth with depression and/or suicidal ideation. Results demonstrated that the CD-RISC-10 is valid and reliable, including over one-month follow up, for this youth population. This work will support future research efforts on understanding resilience and its impact on mental health by supporting the use this brief measure of resilience in at-risk youth.

Jeevarajan, J. R., Theodorou, A., Nandy, K., Guerra, M., Madia, N. D., Claassen, C., Goodman, L. C., Farmer, D., Wakefield, S. M., Minhajuddin, A., Slater, H., Mayes, T., Soutullo, C. A., Rosenberg, A., Ladd, S., Ahumada, N., Jackson, S., Rush, A. J., & Trivedi, M. H. (2025). Psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in adolescent and young adult psychiatric outpatients in the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Journal of Affective Disorders, 375, 155-164. https://doi.org/10.1016/j.jad.2025.01.091

• Rating scales
• Measurement-Based Care
• Depression
• Suicidality

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Anxiety disorders are the most common psychiatric comorbidity in youth with depression, with clinically significant anxiety occurring in half of all depressed youth. This combination is usually associated with more severe symptoms creating a need for clinically sound tools for measuring anxiety. This study assessed two such tools: Generalized Anxiety Disorder 7-item Scale (GAD-7) and the Patient-Reported Outcomes Measurement Information System (PROMIS)-Anxiety-4a. While both of these scales have been tested in adults and showed promise in adolescent populations, they have been minimally tested in large clinical samples and have not been studied specifically within depressed and/or suicidal youth. Statistical analyses showed that both the GAD-7 and PROMIS-Anxiety-4a had high internal consistency and good test-retest reliability. Additionally, when compared to other well-established measures of anxiety, they showed appropriate convergent and divergent validity. These findings indicate that either of these brief, freely available scales can be used to screen and monitor treatment response in research and clinical settings while working with depressed and suicidal youth.

Guzick, A., Storch, E. A., Smárason, O., Minhajuddin, A., Drummond, K., Riddle, D., Hettema, J. M., Mayes, T. L., Pitts, S., Dodd, C., & Trivedi, M. H. (2024). Psychometric Properties of the gad-7 and promis-anxiety-4a among youth with depression and suicidality: Results from the Texas Youth Depression and Suicide Research Network. Journal of Psychiatric Research, 170, 237–244. https://doi.org/10.1016/j.jpsychires.2023.12.033

• Measurement-Based Care
• Anxiety

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Suicide risk management protocols (SRMPs) are necessary for clinical research on subjects at risk for suicide, but few studies explicitly describe the steps taken to mitigate those risks and whether they have proven effective. In addition to that, there were previously no detailed published SRMPs for use with child and adolescent populations. This paper addresses this gap in the literature by detailing the process of arriving at the TX-YDSRN SRMP and describing the various tools used for data collection. The authors emphasize the importance of extensive training of clinical personnel, collaboration across care providers and institutions, and the dissemination of public suicide prevention resources to participants endorsing suicidal thoughts. Protocol documents were included in the publication.

Hughes, J. L., Trombello, J. M., Kennard, B. D., Slater, H., Rezaeizadeh, A., Claassen, C., Wakefield, S. M., & Trivedi, M. H. (2023). Suicide risk assessment and suicide risk management protocol for the Texas youth depression and suicide research network. Contemporary Clinical Trials Communications, 33, 101151. https://doi.org/10.1016/j.conctc.2023.101151

• Suicidality
• Measurement-Based Care

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