PhD Oral Exam - Alyssa Herzig, Psychology

When studying for a doctoral degree (PhD), candidates submit a thesis that provides a critical review of the current state of knowledge of the thesis subject as well as the student’s own contributions to the subject. The distinguishing criterion of doctoral graduate research is a significant and original contribution to knowledge.

Once accepted, the candidate presents the thesis orally. This oral exam is open to the public.

Abstract

Background: National stroke guidelines recommend that all stroke survivors be screened for depression multiple times following stroke. However, compliance with screening guidelines is poor and persons with post stroke depression (PSD) remain under diagnosed and undertreated. Ultra-short PSD screening tools are recommended to increase feasibility of routine screening. Existing ultra-short depression screening tools were developed for primary care and have not shown sufficient sensitivity for screening PSD relative to gold-standard reference tests. Objectives: The principle objective was to determine what brief combinations of self-report mood questions can be used in ultra-short screening measures to accurately and feasibly screen for depression in stroke survivors, relative to a gold standard reference test for depression at different times post stroke. Method: This prospective study included a sample of 121 adults recruited from consecutive hospital admissions. At five time points within the first year following a stroke, participants were administered the current Major Depressive Episode diagnostic interview of the SCID-I/NP and completed questionnaires containing items assessing mood state, including The Stroke Specific Geriatric Depression Scale, The Mental Health Index, The Stroke Impact Scale version 3.0, and The EuroQOL five dimensions questionnaire. This author developed and followed a novel protocol for systematically comparing single items and two-item combinations for their abilities to accurately detect diagnoses of major, minor, and any depression according to the SCID-I/NP gold-standard measure. Results and conclusions: Results indicate that two-item screening tools containing items assessing mood state can accurately screen for depressive disorders and that the accuracy of ultra-short index tests for PSD are time-dependent. Results are consistent with previous studies suggesting that different screening questions are required at different time points following stroke. This study concludes that continued development of screening tools can contribute to minimizing the substantial negative impacts and costs of PSD through closing the gap between actual practice and best practice in PSD screening.