|
BECK DEPRESSION INVENTORY
The Beck Depression Inventory (BDI, BDI-II), created by Dr. Aaron T. Beck, is a 21-question multiple choice self-report inventory that is one of the most widely used instruments for measuring the severity of depression. The questionnaire is designed for adults age 17-80 and is composed of items relating to depression symptoms such as hopelessness and irritability, cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex. There are three versions of the BDI -- the original BDI, first published in 1961 and later revised in 1971 as the BDI-1A, and the BDI-II, published in 1996.
BDI
The original BDI, first published in 1961, consists of 21 questions about how the subject was feeling in the last week. Each set of at least four possible answer choices range in increasing intensity. Some items on the BDI have more than one statement marked with the same score. For instance, under the heading Mood there are two responses that score a 2, "2a, I am blue or sad all the time and I can't snap out of it," and "2b, I am so sad or unhappy that it is very painful." When the test is scored, a value of 0 to 3 is assigned for each answer and then the total score is compared to a key to determine the depression's severity. The standard cut-offs are as follows: 0-9 indicates that a person is not depressed, 10-18 indicates mild-moderate depression, 19-29 indicates moderate-severe depression and 30-63 signifies indicates severe depression. Higher total scores indicate more severe depressive symptoms.[1]
BDI-IA
The BDI-IA was published by Beck in 1971. It was meant to update the BDI, removing any -a and -b statements in the test for easier use and adding a statement asking for the patient to define if they felt any of the following within the past two weeks. Some researchers pointed out that the questions asked only addressed six out of the nine DSM-III criteria, one of the primary reasons for the development of the BDI-II. [2][3] The internal consistency for the BDI-IA was good, with a Cronbach's alpha coefficient of around 0.85. [4]
BDI-II
The BDI-II was a 1996 revision of the BDI, created to fall in line with the updated DSM-IV criteria for depression. [3] Items involving changes in body image, somatic preoccupation, and work difficulty were replaced. Also, sleep loss and appetite loss items were revised to assess both increases and decreases in sleep and appetite. All but three of the items were reworded; the items dealing with punishment feelings, suicidal thoughts or wishes, and interest in sex remain the same. Finally, participants are asked to rate how they have been feeling for the past two weeks, as opposed to the past week as in the original BDI.
Like the BDI, the BDI-II also contains 21 questions, each answer being scored on a scale value of 0 to 3. The cutoffs used differ from the original: 0-13 - minimal depression; 14-19 - mild depression; 20-28 -moderate depression; and 29-63 - severe depression. Higher total scores indicate more severe depressive symptoms.
The BDI-II is positively correlated with the Hamilton Depression Rating Scale with a Pearson r of .71. The test was also shown to have a high one-week test-retest reliability (Pearson r =.93). [5] The test also has high internal consistancy (α=.91).[3]
Subscales (Two-Factor Approach)
The BDI-II can be separated into two subscales. The purpose of the subscales is to determine the primary cause of a patient's depression; one subscale measures somatic symptoms, while the other measures cognitive symptoms.
The Cognitive Subscale contains eight items; pessimism, past failures, guilty feelings, punishment feelings, self-dislike, self-criticalness, and worthlessness. The Somatic-Affective Subscale consists of the other 13 items; sadness, loss of pleasure, crying, agitation, loss of interest, indecisiveness, loss of energy, change in sleep patterns, irratibility, change in appetite, concentration difficulties, tiredness and/or fatigue, and loss of interest in sex.
The two subscales were moderately correlated at .57. [6][7]
Limitations of the BDI
The BDI suffers from the same problems as other self-report inventories, in that scores can be easily exaggerated or minimized by the client. In addition, in participants with concomitant physical illness, it has been suggested that its reliance on physical symptoms such as fatigue might artificially inflate scores due to symptoms of the illness, rather than of depression.[8] Because of this, researchers and clinicians who work with medically ill populations might consider using the Center for Epidemiologic Studies - Depression Scale (CES-D) or the Hospital Anxiety and Depression Scale (HADS) as alternative measures.
See also
References
- ^ Beck, A.T. (1972) "Depression: Causes and Treatment" Philadelphia: University of Pennsylvania Press
- ^ Moran, P.W. & Lambert, M.J. (1983). "A review of current assessment tools for monitoring changes in depression." In M.S. Lambert, E.R. Christensen, & S. DeJulio (Eds.), The Assessment of Psychotherapy Outcomes. New York: Wiley.
- ^ a b c Beck, A.T., Steer, R.A., Ball, R., & Ranieri, W.F. (1996). "Comparison of Beck Depression Inventories -IA and -II in Psychiatric Outpatients." Journal of Personality, 67(3) 588-597.
- ^ Ambrosini P.J., Metz C., Bianchi M.D., Rabinovich H., Undie A. (1991). "Concurrent validity and psychometric properties of the Beck Depression Inventory in outpatient adolescents." J Am Acad Child Adolesc Psychiatry 30: 51-57.
- ^ Beck, A.T., Steer, R.A., & Brown, G.K. (1996) "Manual for the Beck Depression Inventory-II". San Antonio, TX: Psychological Corporation
- ^ Steer, R.A., Ball, R., Ranieri, W.F, & Beck, A.T. (1999). "Dimensions of the Beck Depression Inventory-II in Clinically Depressed Outpatients". Journal of Clinical Psychology. 55(1) 117-128.
- ^ Storch, E.A., Roberti, J.W., & Roth, D.A. (2001)."Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory-Second Edition in a sample of college students." Depression and Anxiety. 19(3), 187-189.
- ^ Moore M.J., Moore P.B., Shaw P.J. (1998) "Mood disturbances in motor neurone disease". Journal of the Neurological Sciences 160 Suppl 1: S53-S56
External links
|