32 Diego et al. © 2001 WILEY-LISS, INC. DEPRESSION AND ANXIETY 13:32–37 (2001) DA 00008 CES-D DEPRESSION SCORES ARE CORRELATED WITH FRONTAL EEG ALPHA ASYMMETRY Miguel A. Diego, B.A., 1,2 Tiffany Field, Ph.D., 1 * and Maria Hernandez-Reif , Ph.D. 1 In order to evaluate the relationship between frontal EEG asymmetry and depressive symptomology, the Center for Epidemiological Studies Depression scale [CES-D; Radloff, 1977] was given to 163 women, and their EEG was recorded from the mid frontal (F3 and F4) and parietal (P3 and P4) regions during a 3 min baseline recording. As expected from previous research on de- pression, CES-D scores were negatively correlated with frontal EEG alpha asymmetry scores and positively correlated with left frontal EEG alpha power. Analyses of variance further revealed that mothers scoring above the cut-off for depression (CES-D³16) had significantly lower frontal EEG asymmetry scores than mothers with 0–2 and 3–12 CES-D scores but not lower scores than mothers with 13–15 CES-D scores. Depression and Anxiety 13:32– 37, 2001. © 2001 Wiley-Liss, Inc. Key words: frontal EEG asymmetry; depressive symptomology; CES-D INTRODUCTION Depression, the most common mental health illness affecting up to 17% of the U.S. population [Bland, 1997], is disproportionately more frequent in women (approximately a 2 to 1 female to male ratio), with the risk increasing during the pre- and post-partum peri- ods [Stuart et al., 1998; Yonkers, 1998]. Approximately 10% of pregnant women experience major depression during pregnancy [Hendrick et al., 1998], and up to 6 months after delivery, and anywhere from 26% to 85% percent of women experience mild depressive symptoms or postpartum blues [see Steiner, 1998 for review]. The depression of mothers, characterized by distress and impaired social functioning, negatively affects prenatal and postnatal development [Field, 1998; Stuart et al., 1998]. This highlights the impor- tance of identifying and treating depression in preg- nant women. Although treatment for depression in the general population has been highly effective, depressed preg- nant women are less likely to seek treatment [Bland, 1997; Yonkers, 1998]. Because they do not seek treat- ment, they are not identified, suggesting the need for perinatal screening. Although structured interviews such as the Diagnostic Interview Schedule (DIS) are the most reliable way of diagnosing depression [Cos- tello et al., 1984], self-report questionnaires including the Beck Depression Inventory (BDI) [Beck et al., 1979] and the Center for Epidemological Studies-De- pression Scale (CES-D) [Radloff, 1977] might be more effective screening instruments for use in prena- tal clinics. The length and complexity of structured interviews greatly limit their application. In contrast, the 20 item CES-D scale [Radloff, 1977] can be easily completed in approximately 5 min [Radloff, 1977]. The CES-D has been widely used with normal and psychiatric populations [see Radloff and Teri, 1986 for review], and has been correlated with diagnosed de- pression based on clinical evaluations [Radloff and Teri, 1986] and with well-established structured de- pression interviews, such as the DIS and depression scales, e.g., the BDI [Weissman et al., 1975; Wilcox et al., 1998]. Frontal EEG alpha asymmetry noted in depressed adults suggests a neurobiological basis for depression [Davidson, 1995; Henriques and Davidson, 1990]. In- dividual differences in EEG asymmetry reflect the dif- ference between alpha (8–13 Hz) power in a right hemisphere lead alpha power in a left hemisphere lead. Alpha power is inversely related to cortical acti- vation in adults [Shagass, 1972]; therefore, positive EEG asymmetry scores are thought to reflect greater left frontal cortical activation, whereas negative EEG 1 Touch Research Institutes, University of Miami School of Medicine, Miami, Florida 2 Florida Atlantic University, Department of Psychology, Boca Raton, Florida Contract grant sponsor: NIMH; Contract grant numbers: MH00331, MH46586); Contract grant sponsor: Johnson and Johnson. *Correspondence to: Dr. Tiffany Field, Touch Research Institutes, University of Miami School of Medicine, P.O. Box 016820, 1601 N.W. 12th Avenue, Miami, FL 33101. E-mail: tfield@med.miami.edu Received for publication 27 March 2000; Accepted 26 July 2000