Introduction
Beck Depression Inventory II is multi-choice self-report inventory with 21 questions that is used to measure levels of depression. The Beck Depression Inventory II (BDI-II) was created in 1996 as an improvement over the Beck Depression Inventory I (BDI-I). BDI-II is used to evaluate the occurrence and magnitude of depression in adolescents and adults. The changes to BD-II were initiated because of the new guidelines for diagnostic criteria redefined by the American Psychiatric Association’s publication. BD-II follows the criteria outlined in the Diagnostic and Statistical manual of Mental Disorders. BD-II is not used as a definite diagnosis of depression. In BD-II unlike BD-I, people are expected to report their feelings for a period of two weeks and not one as was applied in BD-I.
The questions in BD-II have are rated on a scale of 0 to 3 depending on the level of severity except for items 16 and 18. The scale in questions 16 and 18 contains 0, 1a, 1b, 2a, 2b, 3a and 3c. Question 16 examines variations in sleep patterns whereas question 18 examines changed in appetite. The sum of scores for depressive symptoms from the inventory is clinically interpreted. The criterion-referenced procedure utilizes three ranges: 0 – 13 minimal depression; 14 – 19 mild depression; 20 – 28 moderate depression; 29 – 63 indicating severe depression BDI-II uses primary comprehensible language for clarity. The instructions for the BDI-II are straightforward and concise. Little to no training is required to dispense or score the test. The interpretation of the scores requires an expert with clinical training and experience. The BDI-II test is positively connected with the Hamilton Depression rating Scale and the Scale for Suicide Ideation
Literature Review on Beck Depression Inventory II
Different professionals in the areas of depression and psychology have written about the BDI-II analyzing the history of the inventory; effectiveness, validity and reliability of the inventory; and the use of the inventory among different demographics. In the study, we examine the content of 6 articles focusing on BDI-II.
Test Review: Beck Depression Inventory – II
The article was written by Catherine Smith and Bradley Erford of the Loyola College in Maryland for the Association of Assessment in Counselling. The article defines the BDI-II as a test for indicating the existence and extent of the symptoms of depression. BDI-II grades the symptoms of depression such as irritability, hopelessness, fatigue, weight loss, sleep patterns and feelings of guilt. The test is carried out on adolescents starting from 13 years and all adult age groups. The BDI-II test kit contains a manual and 25 recorded forms. They state that the BDI-II cannot be stored electronically and that all scoring has to be done by hand. Clients are given approximately 5 – 10 minutes to complete the test. However, the BDI-II is not designed to be used as an actual tool for diagnosing depression. They determined the wording to be an improvement over the previous BDI-I. The language used is understandable to people with a minimum education level of grade 5. Administering and training for the test can be administered by medical para-professionals .
The BDI-II test has been validated against other criteria. BDI-II test scores have been correlated with scores on other psychological tests. The BDI-II has been positively correlated with the Scale for Suicide Ideation with a score of r = 0.37 and n = 158. The BDI-II positively correlates with the Beck Hopelessness Scale with a rating of r = 0.68 and n = 158. BDI-II positively relates to the Hamilton Psychiatric Rating Scale for Depression with scores of r = 0.71 and n = 87. The BDI-II also relates to the Hamilton rating Scale for Anxiety with a rating of r = 0.47 and n = 87. A diagnostic efficiency sample of 127 students produced a 93% true positive rate and an 18% false positive rating. The authors commented that the BDI-II was a flexible instrument that could be used in a clinical or non-clinical setting .
Beck Depression Inventory
The article was written by Aaron Beck, Robert Steer and Gregory Brown for the Department of Family Medicine of the Medical University of South Carolina. The article defines BDI-II as a self-report instrument of 21-item intended to evaluate the presence and severity of indications of depression as listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 4th Edition. This new adjusted BDI-II replaced the BDI and the BDI-1A, and included items aiming to index symptoms of depression, which would necessitate hospitalization. Things are changed to indicate to patterns of sleep and appetite. Indicators such working difficulty, loss of weight and somatic anxiety were replaced. The new items are labeled irritability, concentration deficiency and loss of energy. Different statements in the BDI-II were re-worded ensuing in a significant revision over both BDI and BDI-1A.
The article states that there are four scores to summarize an individual symptom of depression. Questions 16 and 18 have seven options to indicate changes in sleep patterns and appetite. Cut score rules for the BDI-II are reported with the recommendation that bases be adjusted based on the features of the sample, and the reason for use of the BDI-II. For the BDI-II the coefficient alphas (0.92 for outpatients and 0.93 for the college students) were greater than those for BDI- 1A (0.86). The connections for the corrected item-total were substantial at 0.05 level (with a Bonferroni modification), for both the outpatients and the college students. A correlation ratio of 0.93 was achieved for test-retest reliability using the responses of 26 outpatients who were tested at initial and second therapy sessions that were carried out one week apart. One of the main objectives of BDI-II was to have it follow the diagnostic criteria for depression. Items were inserted, removed and re-worded expressly to assess the symptoms of depression DSM-IV criteria and thus improve the content validity of the BDI-II measure. Factorial Validity has been proven by the correlations of the 21 points evaluated from the sample responses. The authors advise against the use of BDI-II as a sole diagnostic instrument because depressive symptoms can be part of other necessary diagnostic disorders .
Psychometric Evaluation BDI-II with Primary Care Medical Patients
The article was written by Randolf C. Arnau, Mary W. Meagher, Margaret P. Norris, and Rachel Bramson. It outlines BDI-II as a measure of depression that used physical and psychological factors to understand the extent of depression. The study examined the psychometric attributes of the BDI-II instrument in gauging depression in primary care medical setting. The study found that BDI-II closely relates to the Hamilton Psychiatric Rating Scale for Depression and the Hamilton rating Scale for Anxiety. A classified, second-order examination designated that all items use a second-order construct of depression. Confirmation of convergent validity was stipulated by foreseen relationships with subscales. BDI-II scores projected an identification of major depressive disorder, as clarified by the Primary Care Evaluation of Mental Disorders. This study established that the BDI-II produces consistent, internally reliable and valid scores in primary care medical setting. It proposes that the use of BDI-II in the primary care setting may improve exposure and management of depression in these medical patients .
Dimensions of the Beck Depression Inventory-II in Clinically Depressed Outpatients
The article was written by Steer, Robert A., Roberta Ball, William F. Ranieri, and Aaron T. Beck. The study’s aim was to ascertain the dimensions of BDI-II in clinically depressed patients. The article states that BDI-II was carried out in patients of between 13 years and 80 years. BDI-II can be used for testing, diagnosing, and monitoring of therapeutic development in both inpatients and outpatients. The article found the BDI-II to be a significant improvement over the BDI-I. Depression can be understood to have two parts: the effective factor and the physical component. Effective components include emotions, attitudes, and moods. Physical components include change in sleep patterns, loss of appetite and weight loss. BDI-II has been separated to contain two subscales .
The affective subscale included past disappointments, pessimism, feelings of guilt, self-loathe, self-criticism, suicidal thoughts, and feelings of worthlessness. The somatic subscale included unhappiness, loss of pleasure, anxiety, loss of interest, and indecisiveness. It also entailed loss of energy, loss of interest in sex, change in sleep pattern, loss of appetite, irritability, and exhaustion. The subscales were relatively correlated at 0.57, signifying that the somatic and psychological aspects of depression are connected rather than being entirely distinct. The study was done on outpatients of ages 25 and above. The study indicated that differences between men and women could exist regarding incidence and severity of the manifestation of depressive symptoms. A sequential confirmatory factor analysis displayed a model in BDI-II. The model replicated one fundamental second-order element of self-reported depression consisting of two first-order factors demonstrating cognitive and non-cognitive symptoms.
Psychometric Characteristics of the Beck Depression Inventory–II with College Students
The article is written by Steer Robert and David Clark. The objective of the article was to examine the psychometric characteristics of the BDI-II, a demographic of college students. The writers indicate that the BDI-II is a revision of the BDI-I and was best suited to measure levels of depression. It has 21 questions with scores of 0 to 3 except questions 16 and 18. 140 college students of ages 23 and above formed the sample for the study. The study examined the convergent and discriminant validities of the BDI-II with regards to other psychosomatic instruments and determined that the symptom dimensions of the BDI-II described were comparable to those found in other samples of college students. The coefficient alpha for BDI-II was established at 0.91. Results indicated that internal reliability of the BDI-II is high among college students and exhibits convergent validity with relation to the personality attributes of Sociotropy and Solitude as established by the Sociotropy and Autonomy scales. The affective and physical dimensions of self-reported depression were determined. The authors propose that the results of the BDI=II were generalizable across various genders and cultures among college students. The authors recommended developing local norms when using the test with new college student samples .
Psychometric Properties of the Beck Depression Inventory-II: A Comprehensive Review
The article was written by Yuan-Pang and Clarice Goldstein. The article reviews the psychometric properties of the BDI-II as a self-report mechanism of depression occurring in different settings and demographics. The study determined that BDI-II was a relevant psychiatric instrument that had reliability and improvement over BDI-I and BDI-IA. BDI-II has the capability of discerning between depressed and non-depressed patients, improved coexisting, content, and operational validity. Based on available psychometric statistics, the BDI-II was determined to be a cost-effective instrument for measuring the degree of depression, with broad applicability in research and clinical practice. Studies of BDI-II were done on data from three groups: non-clinical, psychiatric and medical samples. The inner consistency was estimated to be around 0.9, and the retest consistency stretched from 0.73 to 0.96. The relation between BDI-II and the BDI-I was high and substantial overlap with procedures of depression and nervousness was reported. BDI-II was an efficient method for determining depression among clients .
Conclusion
Beck Depression Inventory II is multi-choice self-report inventory with 21 questions that is used to screen, diagnose, and monitor levels of depression. BDI-II is an improvement over the BDI-I. BDI-II evaluates both affective and somatic factors. BDI-II is correlated with other psychological tests. BDI-II is an effective and flexible instrument for measuring depression among all populations. One major limitation with BDI-II is that the patients can exaggerate or downplay the scores to various questions in the inventory. Patients also give different answers depending on the social environment they are while taking off the BDI-II. The research was well done and extensive and provided broader understanding of BDI-II. BDI-II is highly recommended for use in both medical and non-medical settings.
References
Arnau, R. C., Meagher, M. W., Norris, M. P., & Bramson., R. (2001). Psychometric Evaluation of the Beck Depression Inventory-II with Primary Care Medical Patients. Health Psychology.
Beck, A. T., Steer, R. A., & Brown, G. K. (2012). Beck Depression Inventory. Charleston: Medical university of South Carolina.
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 Assessment .
Smith, C., & Erford, B. T. (2001). Test Review: Beck Depression Inventory - II. Association for Assessment in Counselling and Education.
Steer, R., & Clark, D. A. (1997). Psychometric Characteristics of the Beck Depression Inventory–II with College Students. Measurement and Evaluation in Counseling and Development .
Wang, Y.-P., & Gorenstein, C. (2013). Psychometric Properties of the Beck Depression Inventory-II: a Comprehensive Review. Association of Psychiatry Brazil.
