The Beck Depression Inventory A Formal Analysis Presented and Created By: Stacy Escobar, Kim Kubal, and Michael Williams

A Brief History and Overview Created by Aaron T. Beck; first published in 1961 Original version featured 21 questions/statements in regards to how the subject felt in the past week Included multiple statements/questions that indicated the same depression ranking/score; ‘(2a) I am blue or sad all the time and I can’t snap out of it’ + ‘(2b) I am so sad or unhappy that it is very painful’ The BDI-1A is introduced in the early 1970s and officially copyrighted in 1978 A and B statements removed Addressed only 6 of 9 DSM III criteria for depression diagnosis

History and Overview Continued… The BDI-II (the focus of this presentation) is introduced in 1996 Developed in response to the publication of the DSM IV Body image, hypochondriasis, and difficulty working questions/statements were replaced Sleep loss and appetite inquiries were modulated to assess for both increases and decreases All but three inquiries were reworded Participants are now asked about previous 2 weeks as opposed to just 1

Intended Use The BDI-II is intended to assess the severity of depression in psychiatrically diagnosed adults and adolescents 13 years of age and older Used with all groups, including various ethnic and cross-cultural groups Potential for Suicide Identification of irrational beliefs and relevant symptoms The BDI can be utilized both for short- term and longitudinal purposes; it is capable of measuring patient success rate in therapy and the status of the patient’s depression

Reliability/Validity High concurrent validity ratings between the BDI and other depression instruments such as the Minnesota Multiphasic Personality Inventory and the Hamilton Depression Scale One of the most widely used psychological metrics for depression testing 0.77-0.96 (on average) correlation rating compared with inventory and psychiatric ratings High construct validity; coefficient alpha rating of .92 for outpatients and .93 for college student samples High sensitivity/specificity scores; few false positives (high specificity) and high sensitivity (correctly identified depressive diagnosis; low false negatives) Not overly sensitive to daily (normal) variations in mood

Technical Data The BDI consists of 21 questions, each one scored on a scale value of 0-3 0-13: Minimal Depression 14-19: Mild Depression 20-28: Moderate Depression 29-63: Severe Depression Scores are determined by adding the values (0-3) that an individual scores on each statement/question Depression can be seen as exhibiting itself on two diagnosable levels – somatic and affective; the BDI reflects this notion and essentially tests for depression via two subscales

Technical Data Continued… Affective Subscale Pessimism Past Failures Guilty Feelings Punishment Feelings Low Self Regard Self Critical Suicidal Ideation Worthlessness

Technical Data Continued… Somatic Subscale Sadness Anhedonia Crying Agitation Loss Of Interest Indecisiveness Lethargy Change In Sleep Patterns Irritability Change In Appetite Difficulty Concentrating Loss Of Interest In Sex Both scales moderately correlated at 0.57, suggesting somatic and affective relation as opposed to distinction

Limitations Subject to the same issues as most other self-report assessments Can be exaggerated or minimized by subject Context matters; the presence of others while a subject takes the assessment can skew results Co-morbid physical illness can skew the somatic scale The BDI can be subject to ‘faking bad’ given that results are taken directly from the patient’s questionaire

Research Psychometric Properties of the Beck Depression Inventory-II in Low- Income, African American Suicide Attempters (J. Pers. Assess - Sep. 2008) Cross cultural examination – critical to determine effectiveness Most participants in previous studies have been white and middle-class Prior research has suggested that experiences of depression among medically ill patients (as opposed to psychiatric patients) are more likely to endorse somatic items and less likely to report affective issues Participants age 16 and older/English speaking; 133 African American in a total sample of 216; 71% reported incomes less than $12,000 Revised Hamilton Scale for Depression utilized

Research Continued… Results Evidence supported dimensionality, reliability, and validity of the BDI-II

References Groth-Marnat, G. (2009). Handbook of Psychological Assessment. Hoboken, N.J.: John Wiley & Sons, Inc. Joe, S., Woolley, M.E., Brown, G.K., Ghahramanlou-Holloway, M. Beck, A.T. (2008). Psychometric Properties of the Beck Depression Inventory-II in Low Income, African American Suicide Attempters. Journal of Personality Assessment, 90(5), 521-523. doi: 10.1080/00223890802248919. The Beck Depression Inventory. Retrieved from http://www.thepharmajournal.com/archives/2013/vol2issue1/ PartA/1.pdf (nd).