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Test and Measurements
Becks Depression Inventory II Test Review
Review of the Becks Depression Inventory II
Reviewer 1: Paul A. Arbisi,
Reviewer 2: Richard F. Farmer
1-Description of the test: The Test- cost, time to take the test,
theory behind the test, number of items, age appropriateness,
and any other information relevant to teaching me about the test
( Approximately one page double spaced)
2-Reviewer 1-Paul A. Arbisi: norm sample, practicality
and cultural fairness, validity, reliability, final comments ( At a
Minimum, one page double spaced) THIS INFO MUST BE
PART OF THIS……. “Generally the psychometric properties of
the BDI-II are quite sound. Coefficient alpha estimates of
reliability for the BDI-II with outpatients was .92 and was .93
for the nonclinical sample. Corrected item-total correlation for
the outpatient sample ranged from .39 (loss of interest in sex) to
.70 (loss of pleasure), for the nonclinical college sample the
lowest item-total correlation was .27 (loss of interest in sex)
and the highest (.74 (self-dislike). The test-retest reliability
coefficient across the period of a week was quite high at .93.”
VERY IMPORTANT TO ADDRESS THE RELIABILITY AND
THE RANG OF CORRELATIONS ETC..I CUT AND COPY
STRAIGHT FROM THE REVIEWER SO PLEASE PUT IT IN
YOUR OWN WORDS.
3- Reviewer 2- Richard F. Farmer: norm sample, practicality
and cultural fairness, validity, reliability, final comments ( At a
Minimum, one page double spaced) THIS INFO MUST BE
PART OF THIS….“Reliability of the BDI was evaluated with
multiple methods. Internal consistency was assessed using
corrected item-total correlations (ranges: .39 to .70 for
outpatients; .27 to .74 for students) and coefficient alpha (.92
for outpatients; .93 for students). Test-retest reliability was
assessed over a 1-week interval among a small subsample of 26
outpatients from one clinic site (r = .93).” VERY IMPORTANT
TO ADDRESS THE RELIABILITY AND THE RANG OF
CORRELATIONS ETC..I CUT AND COPY STRAIGHT FROM
THE REVIEWER SO PLEASE PUT IT IN YOUR OWN
WORDS.
4- Your thoughts on norm sample, practicality and cultural
fairness validity, reliability, final comments about using the
test. Why or why not. (At a Minimum, one page double
spaced). I want your thoughts based on specific information
and not just opinions such as “I don't like the GRE's” or "I don't
think it's fair to subject students to standardize testing.” I want
to know what you think about the norm sample, practicality and
cultural fairness validity, reliability based specifically on what
you learned from both reviewers and any other source.
Accession Number
14122148
Classification Code
Personality [12]
Database
Mental Measurements Yearbook
Mental Measurements Yearbook
The Fourteenth Mental Measurements Yearbook 2001
Title
Beck Depression Inventory-II.
Acronym
BDI-II.
Authors
Beck, Aaron T.; Steer, Robert A.; Brown, Gregory K.
Purpose
"Developed for the assessment of symptoms corresponding to
criteria for diagnosing depressive disorders listed in the ... DSM
IV".
Publisher
The Psychological Corporation, 555 Academic Court, San
Antonio, TX 78204-2498
Publisher Name
The Psychological Corporation
Date of Publication
1961-1996
Population
Ages 13 and over
Scores
Total score only.
Administration
Group or individual
Manual
Manual, 1996, 38 pages.
Price
1999 price data: $57 per complete kit including manual and 25
recording forms; $27 per manual; $29.50 per 25 recording
forms; $112 per 100 recording forms; $29.50 per 25 Spanish
recording forms; $112 per 100 Spanish recording forms.
Special Editions
Available in Spanish.
Cross References
See T5:272 (384 references); for reviews by Janet F. Carlson
and Niels G. Waller, see 13:31 (1026 references); see also
T4:268 (660 references); for reviews by Collie W. Conoley and
Norman D. Sundberg of an earlier edition, see 11:31 (286
references).
Time
(5-10) minutes.
Reviewers
Arbisi, Paul A. (University of Minnesota); Farmer, Richard F.
(Idaho State University).
Review Indicator
2 Reviews Available
Comments
Also available in Spanish; hand-scored or computer-based
administration, scoring, and interpretation available; "revision
of BDI based upon new information about depression."
Full Text
Review of the Beck Depression Inventory-II by PAUL A.
ARBISI, Minneapolis VA Medical Center, Assistant Professor
Department of Psychiatry and Assistant Clinical Professor
Department of Psychology, University of Minnesota,
Minneapolis, MN:
After over 35 years of nearly universal use, the Beck
Depression Inventory (BDI) has undergone a major revision.
The revised version of the Beck, the BDI-II, represents a
significant improvement over the original instrument across all
aspects of the instrument including content, psychometric
validity, and external validity. The BDI was an effective
measure of depressed mood that repeatedly demonstrated utility
as evidenced by its widespread use in the clinic as well as by
the frequent use of the BDI as a dependent measure in outcome
studies of psychotherapy and antidepressant treatment
(Piotrowski & Keller, 1989; Piotrowski & Lubin, 1990). The
BDI-II should supplant the BDI and readily gain acceptance by
surpassing its predecessor in use.
Despite the demonstrated utility of the Beck, times had changed
and the diagnostic context within which the instrument was
developed had altered considerably over the years (Beck, Ward,
Mendelson, Mock, & Erbaugh, 1961). Further,
psychometrically, the BDI had some problems with certain
items failing to discriminate adequately across the range of
depression and other items showing gender bias (Santor,
Ramsay, & Zuroff, 1994). Hence the time had come for a
conceptual reassessment and psychometrically informed
revision of the instrument. Indeed, a mid-course correction had
occurred in 1987 as evidenced by the BDI-IA, a version that
included rewording of 15 out of the 21 items (Beck & Steer,
1987). This version did not address the limited scope of
depressive symptoms of the BDI nor the failure of the BDI to
adhere to contemporary diagnostic criteria for depression as
codified in the DSM-III. Further, consumers appeared to vote
with their feet because, since the publication of the BDI-IA, the
original Beck had been cited far more frequently in the
literature than the BDI-IA. Therefore, the time had arrived for a
major overhaul of the classic BDI and a retooling of the content
to reflect diagnostic sensibilities of the 1990s.
In the main, the BDI-II accomplishes these goals and represents
a highly successful revamping of a reliable standard. The BDI-
II retains the 21-item format with four options under each item,
ranging from not present (0) to severe (3). Relative to the BDI-
IA, all but three items were altered in some way on the BDI-II.
Items dropped from the BDI include body image change, work
difficulty, weight loss, and somatic preoccupation. To replace
the four lost items, the BDI-II includes the following new items:
agitation, worthlessness, loss of energy, and concentration
difficulty. The current item content includes: (a) sadness, (b)
pessimism, (c) past failure, (d) loss of pleasure, (e) guilty
feelings, (f) punishment feelings, (g) self-dislike, (h) self-
criticalness, (i) suicidal thoughts or wishes, (j) crying, (k)
agitation, (l) loss of interest, (m) indecisiveness, (n)
worthlessness, (o) loss of energy, (p) changes in sleeping
pattern, (q) irritability, (r) changes in appetite, (s) concentration
difficulty, (t) tiredness or fatigue, and (u) loss of interest in sex.
To further reflect DSM-IV diagnostic criteria for depression,
both increases and decreases in appetite are assessed in the
same item and both hypersomnia and hyposomnia are assessed
in another item. And rather than the 1-week time period rated
on the BDI, the BDI-II, consistent with DSM-IV, asks for
ratings over the past 2 weeks.
The BDI-II retains the advantage of the BDI in its ease of
administration (5-10 minutes) and the rather straightforward
interpretive guidelines presented in the manual. At the same
time, the advantage of a self-report instrument such as the BDI-
II may also be a disadvantage. That is, there are no validity
indicators contained on the BDI or the BDI-II and the ease of
administration of a self-report lends itself to the deliberate
tailoring of self-report and distortion of the results. Those of us
engaged in clinical practice are often faced with clients who
alter their presentation to forward a personal agenda that may
not be shared with the clinician. The manual obliquely mentions
this problem in an ambivalent and somewhat avoidant fashion.
Under the heading, "Memory and Response Sets," the manual
blithely discounts the potential problem of a distorted response
set by attributing extreme elevation on the BDI-II to "extreme
negative thinking" which "may be a central cognitive symptom
of severe depression rather than a response set per se because
patients with milder depression should show variation in their
response ratings" (manual, p. 9). On the other hand, later in the
manual, we are told that, "In evaluating BDI-II scores,
practitioners should keep in mind that all self-report inventories
are subject to response bias" (p. 12). The latter is sound advice
and should be highlighted under the heading of response bias.
The manual is well written and provides the reader with
significant information regarding norms, factor structure, and
notably, nonparametric item-option characteristic curves for
each item. Indeed the latter inclusion incorporates the latest in
item response theory, which appears to have guided the
retention and deletion of items from the BDI (Santor et al.,
1994).
Generally the psychometric properties of the BDI-II are quite
sound. Coefficient alpha estimates of reliability for the BDI-II
with outpatients was .92 and was .93 for the nonclinical sample.
Corrected item-total correlation for the outpatient sample
ranged from .39 (loss of interest in sex) to .70 (loss of
pleasure), for the nonclinical college sample the lowest item-
total correlation was .27 (loss of interest in sex) and the highest
(.74 (self-dislike). The test-retest reliability coefficient across
the period of a week was quite high at .93. The inclusion in the
manual of item-option characteristic curves for each BDI-II
item is of noted significance. Examination of these curves
reveals that, for the most part, the ordinal position of the item
options is appropriately assigned for 17 of the 21 items.
However, the items addressing punishment feelings, suicidal
thought or wishes, agitation, and loss of interest in sex did not
display the anticipated rank order indicating ordinal increase in
severity of depression across item options. Additionally,
although improved over the BDI, Item 10 (crying) Option 3
does not clearly express a more severe level of depression than
Option 2 (see Santor et al., 1994). Over all, however, the option
choices within each item appear to function as intended across
the severity dimension of depression.
The suggested guidelines and cut scores for the interpretation of
the BDI-II and placement of individual scores into a range of
depression severity are purported to have good sensitivity and
moderate specificity, but test parameters such as positive and
negative predictive power are not reported (i.e., given score X
on the BDI-II, what is the probability that the individual meets
criteria for a Major Depressive Disorder, of moderate
severity?). According to the manual, the BDI-II was developed
as a screening instrument for major depression and,
accordingly, cut scores were derived through the use of receiver
operating characteristic curves to maximize sensitivity. Of the
127 outpatients used to derive the cut scores, 57 met criteria for
either single-episode or recurrent major depression. The
relatively high base rate (45%) for major depression is a bit
unrealistic for nonpsychiatric settings and will likely serve to
inflate the test parameters. Cross validation of the cut scores on
different samples with lower base rates of major depression is
warranted due to the fact that a different base rate of major
depression may result in a significant change in the proportion
of correct decisions based on the suggested cut score (Meehl &
Rosen, 1955). Consequently, until the suggested cut scores are
cross validated in those populations, caution should be
exercised when using the BDI-II as a screen in nonpsychiatric
populations where the base rate for major depression may be
substantially lower.
Concurrent validity evidence appears solid with the BDI-II
demonstrating a moderately high correlation with the Hamilton
Psychiatric Rating Scale for Depression-Revised (r = .71) in
psychiatric outpatients. Of importance to the discriminative
validity of the instrument was the relatively moderate
correlation between the BDI-II and the Hamilton Rating Scale
for Anxiety-Revised (r = .47). The manual reports mean BDI-II
scores for various groups of psychiatric outpatients by
diagnosis. As expected, outpatients had higher scores than
college students. Further, individuals with mood disorders had
higher scores than those individuals diagnosed with anxiety and
adjustment disorders.
The BDI-II is a stronger instrument than the BDI with respect to
its factor structure. A two-factor (Somatic-Affective and
Cognitive) solution accounted for the majority of the common
variance in both an outpatient psychiatric sample and a much
smaller nonclinical college sample. Factor Analysis of the BDI-
II in a larger nonclinical sample of college students resulted in
Cognitive-Affective and Somatic-Vegetative main factors
essentially replicating the findings presented in the manual and
providing strong evidence for the overall stability of the factor
structure across samples (Dozois, Dobson, & Ahnberg, 1998).
Unfortunately several of the items such as sadness and crying
shifted factor loadings depending upon the type of sample
(clinical vs. nonclinical).
SUMMARY. The BDI-II represents a highly successful revision
of an acknowledged standard in the measurement of depressed
mood. The revision has improved upon the original by updating
the items to reflect contemporary diagnostic criteria for
depression and utilizing state-of-the-art psychometric
techniques to improve the discriminative properties of the
instrument. This degree of improvement is no small feat and the
BDI-II deserves to replace the BDI as the single most widely
used clinically administered instrument for the assessment of
depression.
REVIEWER'S REFERENCES
Meehl, P. E., & Rosen, A. (1955). Antecedent probability and
the efficiency of psychometric signs, patterns, or cutting scores.
Psychological Bulletin, 52, 194-216.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh,
J. (1961). An inventory for measuring depression. Archives of
General Psychiatry, 4, 561-571.
Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory
manual. San Antonio, TX: The Psychological Corporation.
Piotrowski, C., & Keller, J. W. (1989). Psychological testing in
outpatient mental health facilities: A national study.
Professional Psychology: Research and Practice, 20, 423-425.
Piotrowski, C., & Lubin, B. (1990). Assessment practices of
health psychologists; Survey of APA Division 38 clinicians.
Professional Psychology: Research and Practice, 21, 99-106.
Santor, D. A., Ramsay, J. O., & Zuroff, D. C. (1994).
Nonparametric item analyses of the Beck Depression Inventory:
Evaluating gender item bias and response option weights.
Psychological Assessment, 6, 255-270.
Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A
psychometric evaluation of the Beck Depression Inventory-II.
Psychological Assessment, 10, 83-89.
Review of the Beck Depression Inventory-II by RICHARD F.
FARMER, Associate Professor of Psychology, Idaho State
University, Pocatello, ID:
The Beck Depression Inventory-II (BDI-II) is the most recent
version of a widely used self-report measure of depression
severity. Designed for persons 13 years of age and older, the
BDI-II represents a significant revision of the original
instrument published almost 40 years ago (BDI-I; Beck, Ward,
Mendelson, Mock, & Erbaugh, 1961) as well as the subsequent
amended version copyrighted in 1978 (BDI-IA; Beck, Rush,
Shaw, & Emery, 1979; Beck & Steer, 1987, 1993). Previous
editions of the BDI have considerable support for their
effectiveness as measures of depression (for reviews, see Beck
& Beamesderfer, 1974; Beck, Steer & Garbin, 1988; and Steer,
Beck, & Garrison, 1986).
Items found in these earlier versions, many of which were
retained in modified form for the BDI-II, were clinically
derived and neutral with respect to a particular theory of
depression. Like previous versions, the BDI-II contains 21
items, each of which assesses a different symptom or attitude by
asking the examinee to consider a group of graded statements
that are weighted from 0 to 3 based on intuitively derived levels
of severity. If the examinee feels that more than one statement
within a group applies, he or she is instructed to circle the
highest weighting among the applicable statements. A total
score is derived by summing weights corresponding to the
statements endorsed over the 21 items. The test authors provide
empirically informed cut scores (derived from receiver
operating characteristic [ROC] curve methodology) for indexing
the severity of depression based on responses from outpatients
with a diagnosed episode of major depression (cutoff scores to
index the severity of dysphoria for college samples are
suggested by Dozois, Dobson, & Ahnberg, 1998).
The BDI-II can usually be completed within 5 to 10 minutes. In
addition to providing guidelines for the oral administration of
the test, the manual cautions the user against using the BDI-II
as a diagnostic instrument and appropriately recommends that
interpretations of test scores should only be undertaken by
qualified professionals. Although the manual does not report the
reading level associated with the test items, previous research
on the BDI-IA suggested that items were written at about the
sixth-grade level (Berndt, Schwartz, & Kaiser, 1983).
A number of changes appear in the BDI-II, perhaps the most
significant of which is the modification of test directions and
item content to be more consistent with the major depressive
episode concept as defined in the Diagnostic and Statistical
Manual of Mental Disorders-Fourth Edition (DSM-IV;
American Psychiatric Association, 1994). Whereas the BDI-I
and BDI-IA assessed symptoms experienced at the present time
and during the past week, respectively, the BDI-II instructs the
examinee to respond in terms of how he or she has "been feeling
during the past two weeks, including today" (manual, p. 8,
emphasis in original) so as to be consistent with the DSM-IV
time period for the assessment of major depression. Similarly,
new items included in the BDI-II address psychomotor
agitation, concentration difficulties, sense of worthlessness, and
loss of energy so as to make the BDI-II item set more consistent
with DSM-IV criteria. Items that appeared in the BDI-I and
BDI-IA that were dropped in the second edition were those that
assessed weight loss, body image change, somatic
preoccupation, and work difficulty. All but three of the items
from the BDI-IA retained for inclusion in the BDI-II were
reworded in some way. Items that assess changes in sleep
patterns and appetite now address both increases and decreases
in these areas.
Two samples were retained to evaluate the psychometric
characteristics of the BDI-II: (a) a clinical sample (n = 500;
63% female; 91% White) who sought outpatient therapy at one
of four outpatient clinics on the U.S. east coast (two of which
were located in urban areas, two in suburban areas), and (b) a
convenience sample of Canadian college students (n = 120; 56%
women; described as "predominantly White"). The average ages
of the clinical and student samples were, respectively, 37.2 (SD
= 15.91; range = 13-86) and 19.58 (SD = 1.84).
Reliability of the BDI was evaluated with multiple methods.
Internal consistency was assessed using corrected item-total
correlations (ranges: .39 to .70 for outpatients; .27 to .74 for
students) and coefficient alpha (.92 for outpatients; .93 for
students). Test-retest reliability was assessed over a 1-week
interval among a small subsample of 26 outpatients from one
clinic site (r = .93). There was no significant change in scores
noted among this outpatient sample between the two testing
occasions, a finding that is different from those often obtained
with college students who, when tested repeatedly with earlier
versions of the BDI, were often observed to have lower scores
on subsequent testing occasions (e.g., Hatzenbuehler, Parpal, &
Matthews, 1983).
Following the method of Santor, Ramsay, and Zuroff (1994), the
test authors also examined the item-option characteristic curves
for each of the 21 BDI-II items as endorsed by the 500
outpatients. As noted in a previous review of the BDI (1993
Revised) by Waller (1998), the use of this method to evaluate
item performance represents a new standard in test revision.
Consistent with findings for depressed outpatients obtained by
Santor et al. (1994) on the BDI-IA, most of the BDI-II items
performed well as evidenced by the individual item-option
curves. All items were reported to display monotonic
relationships with the underlying dimension of depression
severity. A minority of items were somewhat problematic,
however, when the degree of correspondence between estimated
and a priori weights associated with item response options was
evaluated. For example, on Item 11 (agitation), the response
option weighted a value of 1 was more likely to be endorsed
than the option weighted 3 across all levels of depression,
including depression in the moderate and severe ranges. In
general, though, response option weights of the BDI-II items
did a good job of discriminating across estimated levels of
depression severity. Unfortunately, the manual does not provide
detailed discussion of item-option characteristic curves and
their interpretation.
The validity of the BDI-II was evaluated with outpatient
subsamples of various sizes. When administered on the same
occasion, the correlation between the BDI-II and BDI-IA was
quite high (n = 101, r = .93), suggesting that these measures
yield similar patterns of scores, even though the BDI-II, on
average, produced equated scores that were about 3 points
higher. In support of its convergent validity, the BDI-II
displayed moderately high correlations with the Beck
Hopelessness Scale (n = 158, r = .68) and the Revised Hamilton
Psychiatric Rating Scale for Depression (HRSD-R; n = 87, r =
.71). The correlation between the BDI-II and the Revised
Hamilton Anxiety Rating Scale (n = 87, r = .47) was
significantly less than that for the BDI-II and HRSD-R, which
was cited as evidence of the BDI-II's discriminant validity. The
BDI-II, however, did share a moderately high correlation with
the Beck Anxiety Inventory (n = 297; r = .60), a finding
consistent with past research on the strong association between
self-reported anxiety and depression (e.g., Kendall & Watson,
1989). Additional research published since the manual's release
(Steer, Ball, Ranieri, & Beck, 1997) also indicates that the BDI-
II shares higher correlations with the SCL-90-R Depression
subscale (r = .89) than with the SCL-90-R Anxiety subscale (r =
.71), although the latter correlation is still substantial. Other
data presented in the test manual indicated that of the 500
outpatients, those diagnosed with mood disorders (n = 264) had
higher BDI-II scores than those diagnosed with anxiety (n =
88), adjustment (n = 80), or other (n = 68) disorders. The test
authors also cite evidence of validity by separate factor analyses
performed on the BDI-II item set for outpatients and students.
However, findings from these analyses, which were different in
some significant respects, are questionable evidence of the
measure's validity as the test was apparently not developed to
assess specific dimensions of depression. Factor analytic studies
of the BDI have historically produced inconsistent findings
(Beck et al., 1988), and preliminary research on the BDI-II
suggests some variations in factor structure within both clinical
and student samples (Dozois et al., 1998; Steer & Clark, 1997;
Steer, Kumar, Ranieri, & Beck, 1998). Furthermore, one of the
authors of the BDI-II (Steer & Clark, 1997) has recently advised
that the measure not be scored as separate subscales.
SUMMARY. The BDI-II is presented as a user-friendly self-
report measure of depression severity. Strengths of the BDI-II
include the very strong empirical foundation on which it was
built, namely almost 40 years of research that demonstrates the
effectiveness of earlier versions. In the development of the
BDI-II, innovative methods were employed to determine
optimum cut scores (ROC curves) and evaluate item
performance and weighting (item-option curves). The present
edition demonstrates very good reliability and impressive test
item characteristics. Preliminary evidence of the BDI-II's
validity in clinical samples is also encouraging. Despite the
many impressive features of this measure, one may wonder why
the test developers were not even more thorough in their
presentation of the development of the BDI-II and more
rigorous in the evaluation of its effectiveness. The test manual
is too concise, and often omits important details involving the
test development process. The clinical sample used to generate
cut scores and evaluate the psychometric properties of the
measure seems unrepresentative in many respects (e.g., racial
make-up, patient setting, geographic distribution), and other
aspects of this sample (e.g., education level, family income) go
unmentioned. The student sample is relatively small and,
unfortunately, drawn from a single university. Opportunities to
address important questions regarding the measure were also
missed, such as whether the BDI-II effectively assesses or
screens the DSM-IV concept of major depression, and the extent
to which it may accomplish this better than earlier versions.
This seems to be a particularly important question given that the
BDI was originally developed as a measure of the depressive
syndrome, not as a screening measure for a nosologic category
(Kendall, Hollon, Beck, Hammen, & Ingram, 1987), a
distinction that appears to have become somewhat blurred in
this most recent edition. Also, not reported in the manual are
analyses to examine possible sex biases among the BDI-II item
set. Santor et al. (1994) reported that the BDI-IA items were
relatively free of sex bias, and given the omission of the most
sex-biased item in the BDI-IA (body image change) from the
BDI-II, it is possible that this most recent edition may contain
even less bias. Similarly absent in the manual is any report on
the item-option characteristic curves for nonclinical samples.
Santor et al. (1994) reported that for most of the BDI-IA items,
response option weights were less discriminating across the
range of depression severity among their college sample relative
to their clinical sample, an anticipated finding given that
students would be less likely to endorse response options
hypothesized to be consistent with more severe forms of
depression. Also, given that previous editions of the BDI have
shown inconsistent associations with social undesirability (e.g.,
Tanaka-Matsumi & Kameoka, 1986), an opportunity was missed
to evaluate the extent to which the BDI-II measures something
different than this response set. Despite these relative
weaknesses in the development and presentation of the BDI-II,
existent evidence suggests that the BDI-II is just as sound if not
more so than its earlier versions.
REVIEWER'S REFERENCES
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh,
J. (1961). An inventory for measuring depression. Archives of
General Psychiatry, 4, 561-571.
Beck, A. T., & Beamesderfer, A. (1974). Assessment of
depression: The Depression Inventory. In P. Pichot & R. Oliver-
Martin (Eds.), Psychological measurements in
psychopharmacology: Modern problems in pharmacopsychiatry
(vol. 7, pp. 151-169). Basel: Karger.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979).
Cognitive therapy of depression. New York: Guilford.
Berndt, D. J., Schwartz, S., & Kaiser, C. F. (1983). Readability
of self-report depression inventories. Journal of Consulting and
Clinical Psychology, 51, 627-628.
Hatzenbuehler, L. C., Parpal, M., & Matthews, L. (1983).
Classifying college students as depressed or nondepressed using
the Beck Depression Inventory: An empirical analysis. Journal
of Consulting and Clinical Psychology, 51, 360-366.
Steer, R. A., Beck, A. T., & Garrison, B. (1986). Applications
of the Beck Depression Inventory. In N. Sartorius & T. A. Ban
(Eds.), Assessment of depression (pp. 123-142). New York:
Springer-Verlag.
Tanaka-Matsumi, J., & Kameoka, V. A. (1986). Reliabilities
and concurrent validities of popular self-report measures of
depression, anxiety, and social desirability. Journal of
Consulting and Clinical Psychology, 54, 328-333.
Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory
manual. San Antonio, TX: The Psychological Corporation.
Kendall, P. C., Hollon, S. D., Beck, A. T., Hammen, C. L., &
Ingram, R. E. (1987). Issues and recommendations regarding the
use of the Beck Depression Inventory. Cognitive Therapy and
Research, 11, 289-299.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric
properties of the Beck Depression Inventory: Twenty-five years
of evaluation. Clinical Psychology Review, 8, 77-100.
Kendall, P. C., & Watson, D. (Eds.). (1989). Anxiety and
depression: Distinctive and overlapping features. San Diego,
CA: Academic Press.
Beck, A. T., & Steer, R. A. (1993). Beck Depression Inventory
manual. San Antonio, TX: Psychological Corporation.
American Psychiatric Association. (1994). Diagnostic and
statistical manual of mental disorders (4th ed.). Washington,
DC: Author.
Santor, D. A., Ramsay, J. O., & Zuroff, D. C. (1994).
Nonparametric item analyses of the Beck Depression Inventory:
Evaluating gender item bias and response option weights.
Psychological Assessment, 6, 255-270.
Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1997).
Further evidence for the construct validity of the Beck
Depression Inventory-II with psychiatric outpatients.
Psychological Reports, 80, 443-446.
Steer, R. A., & Clark, D. A. (1997). Psychometric
characteristics of the Beck Depression Inventory-II with college
students. Measurement and Evaluation in Counseling and
Development, 30, 128-136.
Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A
psychometric evaluation of the Beck Depression Inventory-II.
Psychological Assessment, 10, 83-89.
Steer, R. A., Kumar, G., Ranieri, W. F., & Beck, A. T. (1998).
Use of the Beck Depression Inventory-II with adolescent
psychiatric outpatients. Journal of Psychopathology and
Behavioral Assessment, 20, 127-137.
Waller, N. G. (1998). [Review of the Beck Depression
Inventory-1993 Revised]. In J. C. Impara & B. S. Plake (Eds.),
The thirteenth mental measurements yearbook (pp. 120-121).
Lincoln, NE: The Buros Institute of Mental Measurements.
Copyright
Copyright © 2011. The Board of Regents of the University of
Nebraska and the Buros Center for Testing. All rights reserved.
Any unauthorized use is strictly prohibited. Buros Center for
Testing, Buros Institute, Mental Measurements Yearbook, and
Tests in Print are all trademarks of the Board of Regents of the
University of Nebraska and may not be used without express
written consent.
Update Code
20140731
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Test and MeasurementsBecks Depression Inventory II Test Review.docx

  • 1. Test and Measurements Becks Depression Inventory II Test Review Review of the Becks Depression Inventory II Reviewer 1: Paul A. Arbisi, Reviewer 2: Richard F. Farmer 1-Description of the test: The Test- cost, time to take the test, theory behind the test, number of items, age appropriateness, and any other information relevant to teaching me about the test ( Approximately one page double spaced) 2-Reviewer 1-Paul A. Arbisi: norm sample, practicality and cultural fairness, validity, reliability, final comments ( At a Minimum, one page double spaced) THIS INFO MUST BE PART OF THIS……. “Generally the psychometric properties of the BDI-II are quite sound. Coefficient alpha estimates of reliability for the BDI-II with outpatients was .92 and was .93 for the nonclinical sample. Corrected item-total correlation for the outpatient sample ranged from .39 (loss of interest in sex) to .70 (loss of pleasure), for the nonclinical college sample the lowest item-total correlation was .27 (loss of interest in sex) and the highest (.74 (self-dislike). The test-retest reliability coefficient across the period of a week was quite high at .93.” VERY IMPORTANT TO ADDRESS THE RELIABILITY AND THE RANG OF CORRELATIONS ETC..I CUT AND COPY STRAIGHT FROM THE REVIEWER SO PLEASE PUT IT IN YOUR OWN WORDS. 3- Reviewer 2- Richard F. Farmer: norm sample, practicality and cultural fairness, validity, reliability, final comments ( At a Minimum, one page double spaced) THIS INFO MUST BE PART OF THIS….“Reliability of the BDI was evaluated with
  • 2. multiple methods. Internal consistency was assessed using corrected item-total correlations (ranges: .39 to .70 for outpatients; .27 to .74 for students) and coefficient alpha (.92 for outpatients; .93 for students). Test-retest reliability was assessed over a 1-week interval among a small subsample of 26 outpatients from one clinic site (r = .93).” VERY IMPORTANT TO ADDRESS THE RELIABILITY AND THE RANG OF CORRELATIONS ETC..I CUT AND COPY STRAIGHT FROM THE REVIEWER SO PLEASE PUT IT IN YOUR OWN WORDS. 4- Your thoughts on norm sample, practicality and cultural fairness validity, reliability, final comments about using the test. Why or why not. (At a Minimum, one page double spaced). I want your thoughts based on specific information and not just opinions such as “I don't like the GRE's” or "I don't think it's fair to subject students to standardize testing.” I want to know what you think about the norm sample, practicality and cultural fairness validity, reliability based specifically on what you learned from both reviewers and any other source. Accession Number 14122148 Classification Code Personality [12] Database Mental Measurements Yearbook Mental Measurements Yearbook The Fourteenth Mental Measurements Yearbook 2001 Title Beck Depression Inventory-II. Acronym BDI-II. Authors
  • 3. Beck, Aaron T.; Steer, Robert A.; Brown, Gregory K. Purpose "Developed for the assessment of symptoms corresponding to criteria for diagnosing depressive disorders listed in the ... DSM IV". Publisher The Psychological Corporation, 555 Academic Court, San Antonio, TX 78204-2498 Publisher Name The Psychological Corporation Date of Publication 1961-1996 Population Ages 13 and over Scores Total score only. Administration Group or individual Manual Manual, 1996, 38 pages. Price 1999 price data: $57 per complete kit including manual and 25 recording forms; $27 per manual; $29.50 per 25 recording forms; $112 per 100 recording forms; $29.50 per 25 Spanish recording forms; $112 per 100 Spanish recording forms. Special Editions Available in Spanish. Cross References See T5:272 (384 references); for reviews by Janet F. Carlson and Niels G. Waller, see 13:31 (1026 references); see also T4:268 (660 references); for reviews by Collie W. Conoley and Norman D. Sundberg of an earlier edition, see 11:31 (286 references). Time (5-10) minutes. Reviewers
  • 4. Arbisi, Paul A. (University of Minnesota); Farmer, Richard F. (Idaho State University). Review Indicator 2 Reviews Available Comments Also available in Spanish; hand-scored or computer-based administration, scoring, and interpretation available; "revision of BDI based upon new information about depression." Full Text Review of the Beck Depression Inventory-II by PAUL A. ARBISI, Minneapolis VA Medical Center, Assistant Professor Department of Psychiatry and Assistant Clinical Professor Department of Psychology, University of Minnesota, Minneapolis, MN: After over 35 years of nearly universal use, the Beck Depression Inventory (BDI) has undergone a major revision. The revised version of the Beck, the BDI-II, represents a significant improvement over the original instrument across all aspects of the instrument including content, psychometric validity, and external validity. The BDI was an effective measure of depressed mood that repeatedly demonstrated utility as evidenced by its widespread use in the clinic as well as by the frequent use of the BDI as a dependent measure in outcome studies of psychotherapy and antidepressant treatment (Piotrowski & Keller, 1989; Piotrowski & Lubin, 1990). The BDI-II should supplant the BDI and readily gain acceptance by surpassing its predecessor in use. Despite the demonstrated utility of the Beck, times had changed and the diagnostic context within which the instrument was developed had altered considerably over the years (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961). Further, psychometrically, the BDI had some problems with certain items failing to discriminate adequately across the range of depression and other items showing gender bias (Santor,
  • 5. Ramsay, & Zuroff, 1994). Hence the time had come for a conceptual reassessment and psychometrically informed revision of the instrument. Indeed, a mid-course correction had occurred in 1987 as evidenced by the BDI-IA, a version that included rewording of 15 out of the 21 items (Beck & Steer, 1987). This version did not address the limited scope of depressive symptoms of the BDI nor the failure of the BDI to adhere to contemporary diagnostic criteria for depression as codified in the DSM-III. Further, consumers appeared to vote with their feet because, since the publication of the BDI-IA, the original Beck had been cited far more frequently in the literature than the BDI-IA. Therefore, the time had arrived for a major overhaul of the classic BDI and a retooling of the content to reflect diagnostic sensibilities of the 1990s. In the main, the BDI-II accomplishes these goals and represents a highly successful revamping of a reliable standard. The BDI- II retains the 21-item format with four options under each item, ranging from not present (0) to severe (3). Relative to the BDI- IA, all but three items were altered in some way on the BDI-II. Items dropped from the BDI include body image change, work difficulty, weight loss, and somatic preoccupation. To replace the four lost items, the BDI-II includes the following new items: agitation, worthlessness, loss of energy, and concentration difficulty. The current item content includes: (a) sadness, (b) pessimism, (c) past failure, (d) loss of pleasure, (e) guilty feelings, (f) punishment feelings, (g) self-dislike, (h) self- criticalness, (i) suicidal thoughts or wishes, (j) crying, (k) agitation, (l) loss of interest, (m) indecisiveness, (n) worthlessness, (o) loss of energy, (p) changes in sleeping pattern, (q) irritability, (r) changes in appetite, (s) concentration difficulty, (t) tiredness or fatigue, and (u) loss of interest in sex. To further reflect DSM-IV diagnostic criteria for depression, both increases and decreases in appetite are assessed in the same item and both hypersomnia and hyposomnia are assessed in another item. And rather than the 1-week time period rated
  • 6. on the BDI, the BDI-II, consistent with DSM-IV, asks for ratings over the past 2 weeks. The BDI-II retains the advantage of the BDI in its ease of administration (5-10 minutes) and the rather straightforward interpretive guidelines presented in the manual. At the same time, the advantage of a self-report instrument such as the BDI- II may also be a disadvantage. That is, there are no validity indicators contained on the BDI or the BDI-II and the ease of administration of a self-report lends itself to the deliberate tailoring of self-report and distortion of the results. Those of us engaged in clinical practice are often faced with clients who alter their presentation to forward a personal agenda that may not be shared with the clinician. The manual obliquely mentions this problem in an ambivalent and somewhat avoidant fashion. Under the heading, "Memory and Response Sets," the manual blithely discounts the potential problem of a distorted response set by attributing extreme elevation on the BDI-II to "extreme negative thinking" which "may be a central cognitive symptom of severe depression rather than a response set per se because patients with milder depression should show variation in their response ratings" (manual, p. 9). On the other hand, later in the manual, we are told that, "In evaluating BDI-II scores, practitioners should keep in mind that all self-report inventories are subject to response bias" (p. 12). The latter is sound advice and should be highlighted under the heading of response bias. The manual is well written and provides the reader with significant information regarding norms, factor structure, and notably, nonparametric item-option characteristic curves for each item. Indeed the latter inclusion incorporates the latest in item response theory, which appears to have guided the retention and deletion of items from the BDI (Santor et al., 1994). Generally the psychometric properties of the BDI-II are quite
  • 7. sound. Coefficient alpha estimates of reliability for the BDI-II with outpatients was .92 and was .93 for the nonclinical sample. Corrected item-total correlation for the outpatient sample ranged from .39 (loss of interest in sex) to .70 (loss of pleasure), for the nonclinical college sample the lowest item- total correlation was .27 (loss of interest in sex) and the highest (.74 (self-dislike). The test-retest reliability coefficient across the period of a week was quite high at .93. The inclusion in the manual of item-option characteristic curves for each BDI-II item is of noted significance. Examination of these curves reveals that, for the most part, the ordinal position of the item options is appropriately assigned for 17 of the 21 items. However, the items addressing punishment feelings, suicidal thought or wishes, agitation, and loss of interest in sex did not display the anticipated rank order indicating ordinal increase in severity of depression across item options. Additionally, although improved over the BDI, Item 10 (crying) Option 3 does not clearly express a more severe level of depression than Option 2 (see Santor et al., 1994). Over all, however, the option choices within each item appear to function as intended across the severity dimension of depression. The suggested guidelines and cut scores for the interpretation of the BDI-II and placement of individual scores into a range of depression severity are purported to have good sensitivity and moderate specificity, but test parameters such as positive and negative predictive power are not reported (i.e., given score X on the BDI-II, what is the probability that the individual meets criteria for a Major Depressive Disorder, of moderate severity?). According to the manual, the BDI-II was developed as a screening instrument for major depression and, accordingly, cut scores were derived through the use of receiver operating characteristic curves to maximize sensitivity. Of the 127 outpatients used to derive the cut scores, 57 met criteria for either single-episode or recurrent major depression. The relatively high base rate (45%) for major depression is a bit
  • 8. unrealistic for nonpsychiatric settings and will likely serve to inflate the test parameters. Cross validation of the cut scores on different samples with lower base rates of major depression is warranted due to the fact that a different base rate of major depression may result in a significant change in the proportion of correct decisions based on the suggested cut score (Meehl & Rosen, 1955). Consequently, until the suggested cut scores are cross validated in those populations, caution should be exercised when using the BDI-II as a screen in nonpsychiatric populations where the base rate for major depression may be substantially lower. Concurrent validity evidence appears solid with the BDI-II demonstrating a moderately high correlation with the Hamilton Psychiatric Rating Scale for Depression-Revised (r = .71) in psychiatric outpatients. Of importance to the discriminative validity of the instrument was the relatively moderate correlation between the BDI-II and the Hamilton Rating Scale for Anxiety-Revised (r = .47). The manual reports mean BDI-II scores for various groups of psychiatric outpatients by diagnosis. As expected, outpatients had higher scores than college students. Further, individuals with mood disorders had higher scores than those individuals diagnosed with anxiety and adjustment disorders. The BDI-II is a stronger instrument than the BDI with respect to its factor structure. A two-factor (Somatic-Affective and Cognitive) solution accounted for the majority of the common variance in both an outpatient psychiatric sample and a much smaller nonclinical college sample. Factor Analysis of the BDI- II in a larger nonclinical sample of college students resulted in Cognitive-Affective and Somatic-Vegetative main factors essentially replicating the findings presented in the manual and providing strong evidence for the overall stability of the factor structure across samples (Dozois, Dobson, & Ahnberg, 1998). Unfortunately several of the items such as sadness and crying
  • 9. shifted factor loadings depending upon the type of sample (clinical vs. nonclinical). SUMMARY. The BDI-II represents a highly successful revision of an acknowledged standard in the measurement of depressed mood. The revision has improved upon the original by updating the items to reflect contemporary diagnostic criteria for depression and utilizing state-of-the-art psychometric techniques to improve the discriminative properties of the instrument. This degree of improvement is no small feat and the BDI-II deserves to replace the BDI as the single most widely used clinically administered instrument for the assessment of depression. REVIEWER'S REFERENCES Meehl, P. E., & Rosen, A. (1955). Antecedent probability and the efficiency of psychometric signs, patterns, or cutting scores. Psychological Bulletin, 52, 194-216. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory manual. San Antonio, TX: The Psychological Corporation. Piotrowski, C., & Keller, J. W. (1989). Psychological testing in outpatient mental health facilities: A national study. Professional Psychology: Research and Practice, 20, 423-425. Piotrowski, C., & Lubin, B. (1990). Assessment practices of health psychologists; Survey of APA Division 38 clinicians. Professional Psychology: Research and Practice, 21, 99-106. Santor, D. A., Ramsay, J. O., & Zuroff, D. C. (1994).
  • 10. Nonparametric item analyses of the Beck Depression Inventory: Evaluating gender item bias and response option weights. Psychological Assessment, 6, 255-270. Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck Depression Inventory-II. Psychological Assessment, 10, 83-89. Review of the Beck Depression Inventory-II by RICHARD F. FARMER, Associate Professor of Psychology, Idaho State University, Pocatello, ID: The Beck Depression Inventory-II (BDI-II) is the most recent version of a widely used self-report measure of depression severity. Designed for persons 13 years of age and older, the BDI-II represents a significant revision of the original instrument published almost 40 years ago (BDI-I; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) as well as the subsequent amended version copyrighted in 1978 (BDI-IA; Beck, Rush, Shaw, & Emery, 1979; Beck & Steer, 1987, 1993). Previous editions of the BDI have considerable support for their effectiveness as measures of depression (for reviews, see Beck & Beamesderfer, 1974; Beck, Steer & Garbin, 1988; and Steer, Beck, & Garrison, 1986). Items found in these earlier versions, many of which were retained in modified form for the BDI-II, were clinically derived and neutral with respect to a particular theory of depression. Like previous versions, the BDI-II contains 21 items, each of which assesses a different symptom or attitude by asking the examinee to consider a group of graded statements that are weighted from 0 to 3 based on intuitively derived levels of severity. If the examinee feels that more than one statement within a group applies, he or she is instructed to circle the highest weighting among the applicable statements. A total score is derived by summing weights corresponding to the
  • 11. statements endorsed over the 21 items. The test authors provide empirically informed cut scores (derived from receiver operating characteristic [ROC] curve methodology) for indexing the severity of depression based on responses from outpatients with a diagnosed episode of major depression (cutoff scores to index the severity of dysphoria for college samples are suggested by Dozois, Dobson, & Ahnberg, 1998). The BDI-II can usually be completed within 5 to 10 minutes. In addition to providing guidelines for the oral administration of the test, the manual cautions the user against using the BDI-II as a diagnostic instrument and appropriately recommends that interpretations of test scores should only be undertaken by qualified professionals. Although the manual does not report the reading level associated with the test items, previous research on the BDI-IA suggested that items were written at about the sixth-grade level (Berndt, Schwartz, & Kaiser, 1983). A number of changes appear in the BDI-II, perhaps the most significant of which is the modification of test directions and item content to be more consistent with the major depressive episode concept as defined in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994). Whereas the BDI-I and BDI-IA assessed symptoms experienced at the present time and during the past week, respectively, the BDI-II instructs the examinee to respond in terms of how he or she has "been feeling during the past two weeks, including today" (manual, p. 8, emphasis in original) so as to be consistent with the DSM-IV time period for the assessment of major depression. Similarly, new items included in the BDI-II address psychomotor agitation, concentration difficulties, sense of worthlessness, and loss of energy so as to make the BDI-II item set more consistent with DSM-IV criteria. Items that appeared in the BDI-I and BDI-IA that were dropped in the second edition were those that assessed weight loss, body image change, somatic
  • 12. preoccupation, and work difficulty. All but three of the items from the BDI-IA retained for inclusion in the BDI-II were reworded in some way. Items that assess changes in sleep patterns and appetite now address both increases and decreases in these areas. Two samples were retained to evaluate the psychometric characteristics of the BDI-II: (a) a clinical sample (n = 500; 63% female; 91% White) who sought outpatient therapy at one of four outpatient clinics on the U.S. east coast (two of which were located in urban areas, two in suburban areas), and (b) a convenience sample of Canadian college students (n = 120; 56% women; described as "predominantly White"). The average ages of the clinical and student samples were, respectively, 37.2 (SD = 15.91; range = 13-86) and 19.58 (SD = 1.84). Reliability of the BDI was evaluated with multiple methods. Internal consistency was assessed using corrected item-total correlations (ranges: .39 to .70 for outpatients; .27 to .74 for students) and coefficient alpha (.92 for outpatients; .93 for students). Test-retest reliability was assessed over a 1-week interval among a small subsample of 26 outpatients from one clinic site (r = .93). There was no significant change in scores noted among this outpatient sample between the two testing occasions, a finding that is different from those often obtained with college students who, when tested repeatedly with earlier versions of the BDI, were often observed to have lower scores on subsequent testing occasions (e.g., Hatzenbuehler, Parpal, & Matthews, 1983). Following the method of Santor, Ramsay, and Zuroff (1994), the test authors also examined the item-option characteristic curves for each of the 21 BDI-II items as endorsed by the 500 outpatients. As noted in a previous review of the BDI (1993 Revised) by Waller (1998), the use of this method to evaluate item performance represents a new standard in test revision.
  • 13. Consistent with findings for depressed outpatients obtained by Santor et al. (1994) on the BDI-IA, most of the BDI-II items performed well as evidenced by the individual item-option curves. All items were reported to display monotonic relationships with the underlying dimension of depression severity. A minority of items were somewhat problematic, however, when the degree of correspondence between estimated and a priori weights associated with item response options was evaluated. For example, on Item 11 (agitation), the response option weighted a value of 1 was more likely to be endorsed than the option weighted 3 across all levels of depression, including depression in the moderate and severe ranges. In general, though, response option weights of the BDI-II items did a good job of discriminating across estimated levels of depression severity. Unfortunately, the manual does not provide detailed discussion of item-option characteristic curves and their interpretation. The validity of the BDI-II was evaluated with outpatient subsamples of various sizes. When administered on the same occasion, the correlation between the BDI-II and BDI-IA was quite high (n = 101, r = .93), suggesting that these measures yield similar patterns of scores, even though the BDI-II, on average, produced equated scores that were about 3 points higher. In support of its convergent validity, the BDI-II displayed moderately high correlations with the Beck Hopelessness Scale (n = 158, r = .68) and the Revised Hamilton Psychiatric Rating Scale for Depression (HRSD-R; n = 87, r = .71). The correlation between the BDI-II and the Revised Hamilton Anxiety Rating Scale (n = 87, r = .47) was significantly less than that for the BDI-II and HRSD-R, which was cited as evidence of the BDI-II's discriminant validity. The BDI-II, however, did share a moderately high correlation with the Beck Anxiety Inventory (n = 297; r = .60), a finding consistent with past research on the strong association between self-reported anxiety and depression (e.g., Kendall & Watson,
  • 14. 1989). Additional research published since the manual's release (Steer, Ball, Ranieri, & Beck, 1997) also indicates that the BDI- II shares higher correlations with the SCL-90-R Depression subscale (r = .89) than with the SCL-90-R Anxiety subscale (r = .71), although the latter correlation is still substantial. Other data presented in the test manual indicated that of the 500 outpatients, those diagnosed with mood disorders (n = 264) had higher BDI-II scores than those diagnosed with anxiety (n = 88), adjustment (n = 80), or other (n = 68) disorders. The test authors also cite evidence of validity by separate factor analyses performed on the BDI-II item set for outpatients and students. However, findings from these analyses, which were different in some significant respects, are questionable evidence of the measure's validity as the test was apparently not developed to assess specific dimensions of depression. Factor analytic studies of the BDI have historically produced inconsistent findings (Beck et al., 1988), and preliminary research on the BDI-II suggests some variations in factor structure within both clinical and student samples (Dozois et al., 1998; Steer & Clark, 1997; Steer, Kumar, Ranieri, & Beck, 1998). Furthermore, one of the authors of the BDI-II (Steer & Clark, 1997) has recently advised that the measure not be scored as separate subscales. SUMMARY. The BDI-II is presented as a user-friendly self- report measure of depression severity. Strengths of the BDI-II include the very strong empirical foundation on which it was built, namely almost 40 years of research that demonstrates the effectiveness of earlier versions. In the development of the BDI-II, innovative methods were employed to determine optimum cut scores (ROC curves) and evaluate item performance and weighting (item-option curves). The present edition demonstrates very good reliability and impressive test item characteristics. Preliminary evidence of the BDI-II's validity in clinical samples is also encouraging. Despite the many impressive features of this measure, one may wonder why the test developers were not even more thorough in their
  • 15. presentation of the development of the BDI-II and more rigorous in the evaluation of its effectiveness. The test manual is too concise, and often omits important details involving the test development process. The clinical sample used to generate cut scores and evaluate the psychometric properties of the measure seems unrepresentative in many respects (e.g., racial make-up, patient setting, geographic distribution), and other aspects of this sample (e.g., education level, family income) go unmentioned. The student sample is relatively small and, unfortunately, drawn from a single university. Opportunities to address important questions regarding the measure were also missed, such as whether the BDI-II effectively assesses or screens the DSM-IV concept of major depression, and the extent to which it may accomplish this better than earlier versions. This seems to be a particularly important question given that the BDI was originally developed as a measure of the depressive syndrome, not as a screening measure for a nosologic category (Kendall, Hollon, Beck, Hammen, & Ingram, 1987), a distinction that appears to have become somewhat blurred in this most recent edition. Also, not reported in the manual are analyses to examine possible sex biases among the BDI-II item set. Santor et al. (1994) reported that the BDI-IA items were relatively free of sex bias, and given the omission of the most sex-biased item in the BDI-IA (body image change) from the BDI-II, it is possible that this most recent edition may contain even less bias. Similarly absent in the manual is any report on the item-option characteristic curves for nonclinical samples. Santor et al. (1994) reported that for most of the BDI-IA items, response option weights were less discriminating across the range of depression severity among their college sample relative to their clinical sample, an anticipated finding given that students would be less likely to endorse response options hypothesized to be consistent with more severe forms of depression. Also, given that previous editions of the BDI have shown inconsistent associations with social undesirability (e.g., Tanaka-Matsumi & Kameoka, 1986), an opportunity was missed
  • 16. to evaluate the extent to which the BDI-II measures something different than this response set. Despite these relative weaknesses in the development and presentation of the BDI-II, existent evidence suggests that the BDI-II is just as sound if not more so than its earlier versions. REVIEWER'S REFERENCES Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. Beck, A. T., & Beamesderfer, A. (1974). Assessment of depression: The Depression Inventory. In P. Pichot & R. Oliver- Martin (Eds.), Psychological measurements in psychopharmacology: Modern problems in pharmacopsychiatry (vol. 7, pp. 151-169). Basel: Karger. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford. Berndt, D. J., Schwartz, S., & Kaiser, C. F. (1983). Readability of self-report depression inventories. Journal of Consulting and Clinical Psychology, 51, 627-628. Hatzenbuehler, L. C., Parpal, M., & Matthews, L. (1983). Classifying college students as depressed or nondepressed using the Beck Depression Inventory: An empirical analysis. Journal of Consulting and Clinical Psychology, 51, 360-366. Steer, R. A., Beck, A. T., & Garrison, B. (1986). Applications of the Beck Depression Inventory. In N. Sartorius & T. A. Ban (Eds.), Assessment of depression (pp. 123-142). New York: Springer-Verlag. Tanaka-Matsumi, J., & Kameoka, V. A. (1986). Reliabilities
  • 17. and concurrent validities of popular self-report measures of depression, anxiety, and social desirability. Journal of Consulting and Clinical Psychology, 54, 328-333. Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory manual. San Antonio, TX: The Psychological Corporation. Kendall, P. C., Hollon, S. D., Beck, A. T., Hammen, C. L., & Ingram, R. E. (1987). Issues and recommendations regarding the use of the Beck Depression Inventory. Cognitive Therapy and Research, 11, 289-299. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100. Kendall, P. C., & Watson, D. (Eds.). (1989). Anxiety and depression: Distinctive and overlapping features. San Diego, CA: Academic Press. Beck, A. T., & Steer, R. A. (1993). Beck Depression Inventory manual. San Antonio, TX: Psychological Corporation. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Santor, D. A., Ramsay, J. O., & Zuroff, D. C. (1994). Nonparametric item analyses of the Beck Depression Inventory: Evaluating gender item bias and response option weights. Psychological Assessment, 6, 255-270. Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1997). Further evidence for the construct validity of the Beck Depression Inventory-II with psychiatric outpatients. Psychological Reports, 80, 443-446.
  • 18. Steer, R. A., & Clark, D. A. (1997). Psychometric characteristics of the Beck Depression Inventory-II with college students. Measurement and Evaluation in Counseling and Development, 30, 128-136. Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck Depression Inventory-II. Psychological Assessment, 10, 83-89. Steer, R. A., Kumar, G., Ranieri, W. F., & Beck, A. T. (1998). Use of the Beck Depression Inventory-II with adolescent psychiatric outpatients. Journal of Psychopathology and Behavioral Assessment, 20, 127-137. Waller, N. G. (1998). [Review of the Beck Depression Inventory-1993 Revised]. In J. C. Impara & B. S. Plake (Eds.), The thirteenth mental measurements yearbook (pp. 120-121). Lincoln, NE: The Buros Institute of Mental Measurements. Copyright Copyright © 2011. The Board of Regents of the University of Nebraska and the Buros Center for Testing. All rights reserved. Any unauthorized use is strictly prohibited. Buros Center for Testing, Buros Institute, Mental Measurements Yearbook, and Tests in Print are all trademarks of the Board of Regents of the University of Nebraska and may not be used without express written consent. Update Code 20140731 Annotation(s) My Projects