Naïve Observers’ Perceptions of Hospitalized and Community Adolescents’ Depressive Symptoms

Adolescent depression significantly impacts long-term functioning and well-being, often going undetected and untreated, highlighting the need for innovative detection methods. This study examined whether unfamiliar, naïve observers could detect depressive symptoms in adolescents, relying solely on behavioral residue (language transcribed from a clinical interview). Identifying whether naïve observers, untrained in detecting psychological symptoms, can utilize verbal output to accurately detect depressive symptoms yields scientific insight that could be expanded upon to support prevention efforts. The study involved 200 adolescent participants (100 hospitalized, 100 community; M_age = 15.31, henceforth referred to as targets). They reported on their depressive symptoms and completed the Child Attachment Interview (CAI; Shmueli-Goetz et al., 2008). Naïve observers (N = 52 college students split in two rounds), unaware of all other information about targets, read transcripts of targets' CAI interviews; using solely that information, they rated targets' depressive symptoms. Observers also assessed their confidence in their evaluation of targets' symptoms. Results showed a positive association between observers' ratings and targets' self-reported depressive symptoms (Round 1 Cohen's d = 1.25, Round 2 Cohen's d = 1.42) and this association remained significant controlling for linguistic categories connected to depression detected by computer analysis. Observers' ratings discriminated between hospitalized and community adolescents (Round 1 Cohen's d = 1.43, Round 2 Cohen's d = 1.37), though confidence in their ratings was not associated with targets' ratings or group (community or hospitalized). Observers can reliably and accurately identify depressive symptoms in adolescents using attachment interviews, over and above computer analysis alone. This work suggests that naïve observers contribute unique insight into the detection of adolescent depressive symptoms.