Beck Depression Inventory
Beck Depression Inventory
Definition
The Beck Depression Inventory (BDI) is a series of 21 self-reported questions developed to measure the intensity, severity, and depth of depressive symptoms in patients aged 13-80. A shorter form is composed of seven questions and is designed for administration by primary care providers.
Purpose
The BDI was first developed by Aaron T. Beck, a pioneer in cognitive therapy. Its purpose is to detect, assess, and monitor changes in depressive symptoms among people in a mental health care setting.
Precautions
The BDI is designed for use by trained professionals. It should be administered by a knowledgeable mental health professional who is trained in its use and interpretation.
Description
The BDI was developed in 1961, adapted in 1969, and copyrighted in 1979. A second version of the inventory (BDI-II) was developed and published in 1996 to reflect revisions in the fourth edition, text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a handbook that mental health professionals use to diagnose mental disorders.
The long form of the BDI is composed of 21 questions or items, each with four possible responses. Each response is assigned a score ranging from zero to three, indicating the severity of the symptom that the patient has experienced over the past two weeks. A version designed for use by primary care providers (BDI-PC) is composed of seven self-reported items.
Individual questions of the BDI assess mood, pessimism, sense of failure, self-dissatisfaction, guilt, punishment, self-dislike, self-accusation, suicidal ideas, crying, irritability, social withdrawal, body image, work difficulties, insomnia, fatigue, appetite, weight loss, bodily preoccupation, and loss of libido. The first 13 items assess symptoms that are psychological in nature, while items 14 to 21 assess more physical symptoms.
The BDI is also used to detect depressive symptoms in a primary care setting. The BDI usually takes between five and ten minutes to complete as part of a psychological or medical examination.
Results
The sum of all BDI item scores indicates the severity of depression. The test is scored differently for the general population and for individuals who have been clinically diagnosed with depression. For the general population, a score of 21 or over represents depression. For people who have been clinically diagnosed, scores from 0 to 9 represent minimal depressive symptoms, scores of 10 to 16 indicate mild depression, scores of 17 to 29 indicate moderate depression, and scores of 30 to 63 indicate severe depression. The BDI can distinguish between different subtypes of depressive disorders, such as major depression and dysthymia (a less severe form of depression).
The BDI has been extensively tested for content validity, concurrent validity, and construct validity. The BDI has content validity (the extent to which items of a test are representative of that which is to be measured) because it was constructed from a consensus among clinicians about depressive symptoms displayed by psychiatric patients. Concurrent validity is a measure of the extent to which a test concurs with already existing standards; at least 35 studies have shown concurrent validity between the BDI and such measures of depression as the Hamilton Depression Rating Scale and the Minnesota Multiphasic Personality Inventory-D. Tests for construct validity (the degree to which a test
KEY TERMS
Reliability —The ability of a test to yield consistent, repeatable results.
Validity —The ability of a test to measure accurately what it claims to measure.
measures an internal construct or variable) have shown the BDI to be related to medical symptoms, anxiety, stress, loneliness, sleep patterns, alcoholism, suicidal behaviors, and adjustment among youth.
Factor analysis, a statistical method used to determine underlying relationships between variables, has also supported the validity of the BDI. The BDI can be interpreted as one syndrome (depression) composed of three factors: negative attitudes toward self, performance impairment, and somatic (bodily) disturbance.
The BDI has also been extensively tested for reliability, following established standards for psychological tests published in 1985. Internal consistency has been successfully estimated by over 25 studies in many populations. The BDI has been shown to be valid and reliable, with results corresponding to clinician ratings of depression in more than 90% of all cases.
Higher BDI scores have been shown in a few studies to be inversely related to educational attainment; the BDI, however, does not consistently correlate with sex, race, or age.
See alsoCognitive-behavioral therapy.
Resources
BOOKS
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text rev. Washington, D.C.: American Psychiatric Association, 2000.
Clark, David A., Aaron T. Beck, and Brad A. Alford. Scientific Foundations of Cognitive Theory and Therapy of Depression. New York: John Wiley & Sons, 2003.
Nezu, Arthur, George F. Ronan, and Elizabeth A. Meadows, eds. Practitioner’s Guide to Empirically Based Measures of Depression. New York: Springer Publishing Company, 2006.
Tolman, Anton O. Depression In Adults: The Latest Assessment And Treatment Strategies. Kansas City, MO: Compact Clinicals, 2005.
VandenBos, Gary R., ed. APA Dictionary of Psychology. Washington, D.C.: American Psychological Association, 2006.
PERIODICALS
Carlbring, Per, and others. “Internet vs. Paper and Pencil Administration of Questionnaires Commonly Used in Panic/Agoraphobia Research.” Computers in Human Behavior 23.3 (May 2007): 1421–34.
Mehl, Matthias R. “The Lay Assessment of Subclinical Depression in Daily Life.” Psychological Assessment 18.3 (September 2006): 340–45.
Poole, Helen, Ros Bramwell, and Peter Murphy. “Factor Structure of the Beck Depression Inventory-II Patients with Chronic Pain.” Clinical Journal of Pain 22.9 (November-December 2006): 790–98.
Snijders, A. H., M. M. Robertson, and M. Orth. “Beck Depression Inventory Is a Useful Screening Tool for Major Depressive Disorder in Gilles de la Tourette Syndrome.” Journal of Neurology, Neurosurgery & Psychiatry 77.6 (June 2006): 787–89.
Solomon, Ari, and others. “Taxometric Investigation of Unipolar Depression in a Large Community Sample.” Psychological Medicine 36.7 (July 2006): 973–85.
ORGANIZATIONS
American Psychiatric Association. 1400 K Street NW, Washington, DC 20005. <http://www.psych.org>.
The Center for Mental Health Services Knowledge Exchange Network (KEN). U.S. Department of Health and Human Services. Telephone: (800) 789-2647. <http://www.mentalhealth.org>.
National Alliance for the Mentally Ill (NAMI). Colonial Place 3, 2107 Wilson Boulevard, Suite 300, Arlington VA 22201-3042. Telephone: (703) 524-7600 or (800) 950-6264. <http://www.nami.org>.
National Depressive and Manic Depressive Association (NDMDA). 730 N. Franklin Street, Suite 501, Chicago IL 60601-3526. Telephone: (314) 642-0049 or (800) 826-3632. <http://www.ndmda.org>.
National Institute of Mental Health. 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. Telephone: (301) 443-4513. <http://www.nimh.nih.gov>.
Substance Abuse and Mental Health Services Administration (SAMHSA). Center for Mental Health Services (CMHS), Department of Health and Human Services. 5600 Fishers Lane, Rockville MD 20857. <http://www.samhsa.org>.
Michael Polgar, PhD
Ruth A. Wienclaw, PhD
Beck Depression Inventory
Beck Depression Inventory
Definition
The Beck Depression Inventory (BDI) is a series of questions developed to measure the intensity, severity, and depth of depression in patients with psychiatric diagnoses. Its long form is composed of 21 questions, each designed to assess a specific symptom common among people with depression. A shorter form is composed of seven questions and is designed for administration by primary care providers. Aaron T. Beck, a pioneer in cognitive therapy, first designed the BDI.
Purpose
The BDI was originally developed to detect, assess, and monitor changes in depressive symptoms among people in a mental health care setting. It is also used to detect depressive symptoms in a primary care setting. The BDI usually takes between five and ten minutes to complete as part of a psychological or medical examination.
Precautions
The BDI is designed for use by trained professionals. While it should be administered by a knowledgeable mental health professional who is trained in its use and interpretation, it is often self-administered.
Description
The BDI was developed in 1961, adapted in 1969, and copyrighted in 1979. A second version of the inventory (BDI-II) was developed to reflect revisions in the Fourth Edition Text Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, a handbook that mental health professionals use to diagnose mental disorders).
The long form of the BDI is composed of 21 questions or items, each with four possible responses. Each response is assigned a score ranging from zero to three, indicating the severity of the symptom. A version designed for use by primary care providers (BDI-PC) is composed of seven self-reported items, each correlating to a symptom of major depressive disorder experienced over the preceding two weeks.
Individual questions of the BDI assess mood, pessimism, sense of failure, self-dissatisfaction, guilt, punishment, self-dislike, self-accusation, suicidal ideas, crying, irritability, social withdrawal, body image, work difficulties, insomnia , fatigue , appetite, weight loss, bodily preoccupation, and loss of libido. Items 1 to 13 assess symptoms that are psychological in nature, while items 14 to 21 assess more physical symptoms.
Results
The sum of all BDI item scores indicates the severity of depression. The test is scored differently for the general population and for individuals who have been clinically diagnosed with depression. For the general population, a score of 21 or over represents depression. For people who have been clinically diagnosed, scores from 0 to 9 represent minimal depressive symptoms, scores of 10 to 16 indicate mild depression, scores of 17 to 29 indicate moderate depression, and scores of 30 to 63 indicate severe depression. The BDI can distinguish between different subtypes of depressive disorders, such as major depression and dysthymia (a less severe form of depression).
The BDI has been extensively tested for content validity, concurrent validity, and construct validity. The BDI has content validity (the extent to which items of a test are representative of that which is to be measured) because it was constructed from a consensus among clinicians about depressive symptoms displayed by psychiatric patients. Concurrent validity is a measure of the extent to which a test concurs with already existing standards; at least 35 studies have shown concurrent validity between the BDI and such measures of depression as the Hamilton Depression Scale and the Minnesota Multiphasic Personality Inventory-D . Following a range of biological factors, attitudes, and behaviors, tests for construct validity (the degree to which a test measures an internal construct or variable) have shown the BDI to be related to medical symptoms, anxiety, stress , loneliness, sleep patterns, alcoholism, suicidal behaviors, and adjustment among youth.
Factor analysis, a statistical method used to determine underlying relationships between variables, has also supported the validity of the BDI. The BDI can be interpreted as one syndrome (depression) composed of three factors: negative attitudes toward self, performance impairment, and somatic (bodily) disturbance.
The BDI has also been extensively tested for reliability, following established standards for psychological tests published in 1985. Internal consistency has been successfully estimated by over 25 studies in many populations. The BDI has been shown to be valid and reliable, with results corresponding to clinician ratings of depression in more than 90% of all cases.
Higher BDI scores have been shown in a few studies to be inversely related to educational attainment; the BDI, however, does not consistently correlate with sex, race, or age.
Resources
BOOKS
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revised. Washington, D.C.: American Psychiatric Association, 2000.
Beck, A. T., A. J. Rush, B. F. Shaw, and D. Emery. Cognitive therapy of depression. New York: Guilford Press, 1979.
PERIODICALS
Beck, A. T., and R. A. Steer. "Internal consistencies of the original and revised Beck Depression Inventory." Journal of Clinical Psychology 40 (1984): 1365-1367.
Beck, A. T., R. A. Steer, and G. M. Garbin. "Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation." Clinical Psychology Review, 8 (1988): 77-100.
Beck, A. T., D. Guthy, R. A. Steer, and R. Ball. "Internal consistencies of the original and revised Beck Depression Inventory." Journal of Clinical Psychology, 40 (1984): 1365-1367.
ORGANIZATIONS
American Psychiatric Association. 1400 K Street NW, Washington D.C. 20005. <http://www.psych.org>.
The Center for Mental Health Services Knowledge Exchange Network (KEN). U.S. Department of Health and Human Services. (800) 789-2647. <http://www.mentalhealth.org>.
National Alliance for the Mentally Ill (NAMI). Colonial Place 3, 2107 Wilson Blvd, Suite 300, Arlington VA, 22201-3042. (703) 524-7600 or (800) 950-6264. <http://www. nami.org>.
National Depressive and Manic Depressive Association (NDMDA). 730 N. Franklin St, Suite 501, Chicago IL 60601-3526. (314) 642-0049 or (800) 826-3632. <http://www.ndmda.org>.
National Institute of Mental Health. 6001 Executive Boulevard, Rm. 8184, MSC 9663, Bethesda, MD 20892-9663. (301) 443-4513. <http://www.nimh.nih.gov>.
Substance Abuse and Mental Health Services Administration (SAMHSA). Center for Mental Health Services (CMHS), Department of Health and Human Services, 5600 Fishers Lane, Rockville MD 20857. <http://www.samhsa.org>.
Michael Polgar, Ph.D.