Tests and Measurements Achievement Test Review Revie.docx

Tests and Measurements
Achievement Test Review
Review of the Becker Work Adjustment Profile 2
Reviewer 1: James T. Austin & Stephanie D. Tischendorf
Reviewer 2: Pam Lindsey
Description: The Becker Work Adjustment Profile 2 was created
to measure the vocational
competency of people with disabilities in their work
environments. By assessing work habits,
attitudes, and skills of people with special needs, it aims to
target problem areas and assess the level of
supports needed. It is targeted for those ages 13 and older who
are disabled, including those who
are mentally retarded, physically disabled, emotionally
disturbed, learning disabled, and-or
economically disadvantaged. The instrument is completed by a
rater-observer who, according to
the user’s manual and test booklet, have "closely observed the
daily work behavior of the client and

has knowledge of the individual's work adjustment”. Austin &
Tischendorf describe the Becker
Work Adjustment Profile 2(BWAP:2) as a “restandardization of
the 1989 Work adjustment
profile (as the items have not changed).” They also offer
information about the test’s first version
from 1989, which was a revision of a rating scale developed as
part of a 1965 Federal grant.
Reviewer 2, Pam Lindsey, points out that vocational
competence is an element of rehabilitation
in those with disabilities, thus this test is useful for those
working with disabilities and helping
them to be successful in the workplace. By knowing a clients
vocational competence, we can
help address areas the client may be having problems in that
affect their job performance.
Types of Items:
The first page of the instrument is used to gather information
on the patients background
(name, sex, date, grade, date of birth, age in years, IQ, school-
facility, primary disability,
secondary disability, name, & title of evaluator). Pages 2
through 12 include 63 ratings that are

divided into four categories. Work habits and attitudes is the
first category, with 10 items or
ratings questions, Interpersonal relations is the second with 12
items, Cognitive skills is the third
with 19 items, and work performance skills is the last with 22
items. Page 13 and 14 provide
information on the results of the test and psychometric
information. The rater scores each
domain and enters the score at the end of each domain.
Vocational personnel familiar with daily
demands of the job and the individual being assessed complete
the questionnaire (Pam Lindsey).
Scoring Information:
The items are rated on a 0-4 rating, with 0 being a negative
score and 4 being a positive
score. Four domains and a total composite score (Broad Work
Adjustment) are used in creating
a profile of the client and work placement that can be linked to
work support needs. As stated
above, the rater scores each domain and enters the score at the
end of each domain. Raw scores
are translated to T scores and percentile ranks by disability
category. Again, this information can

be found on page 13 of the questionnaire booklet. Also found
on page 13 is raw scores,
percentiles, work placement and work support needs, and other
useful information for
interpreting the results of the questionnaire.
Technical Aspects/Psychometric Properties: A user’s manual is
included with the exam that
Austin & Tischendorf feel is quite “extensive”. The user’s
manual does 2 things. It defines the
four major methods of client work evaluation (work sample, job
analysis, standardized tests and
situational assessment), this test falling into the situational
assessment category. It also discusses
vocational competence and how it relates to work adjustment.
It provides information on
administering the test, scoring the test, and use of the test. It
also provides technical evidence of
reliability and validity.
The BWAP:2 was normed against 4,019 individuals with various
disabilities, although Austin &

Tischendorf felt it was weighted towards those with MR. The
norm group is categorized by
diagnostic category (disability) and gender, and the sample is
geographically diverse. All
normative data is found in Appendix A of the user’s manual.
Reliability: Different estimates of reliability of the BWAP:2 is
shown, derived from subsamples
based on diagnostic category. Internal Consistency estimates
for domain (.80 to .93) and for
BWA total score (.87 to .91), retest estimates of over 2-week
interval (range .82 to .96 across
domains), standard errors of measurement (.91 to 5.84) and
interrater reliability estimated by
pairs of raters for a sample of 117 adults in 3 sheltered
workshops (.82 to .89 across domains, .87
for Broad Work Adjustment). Both Austin & Tischendorf and
Pam Lindsey felt that these
numbers signified multiple estimates of reliability and normally
accepted values.
Validity: The user’s manual also provides information on
validity. Construct and criterion-
related validity data were stated to be sufficient. To measure
criterion-related validity, 167
people with MR had their scores on the BWAP:2 compared with

their scores on the AAMR
Adaptive Behavior scale. The AAMR Adaptive Behavior Scale
measures vocational adjustment
and adaptive behavior in its test takers. The evidence from this
comparison was used as proof
that the criterion-related validity was satisfactory. Internal
consistency, test-retest and interrater
reliability studies were conducted and all showed to be adequate
and/or stable. Pam Lindsey felt
that “Overall, technical data appear to support adequate
reliability and validity”. Austin &
Tischendorf, however, felt that really the task of comparing the
AAMR Adaptive Behavior Scale
and the BWAP:2 was showing convergent validity, as they felt
this did not show how the
instrument predicts success in some external outcome.
Possible Accommodations and modifications: Austin &
Tischendorf felt the test includes an
economically disadvantaged subgroup that they feel needs to be
better supported to be beneficial.
Another modification idea by Austin & Tischendorf was to
increase the length of the retest
period to more than 2 weeks in an attempt to strengthen the

reliability evidence of the test. They
also felt that the breakdown of the standardization sample or the
norm group was not broken
down enough. They wrote that it would be better if it were
additionally broken down into age,
ethnicity, and sex. Currently, it is broken down into mean age
by disadvantage. They also
thought statistically significant differences in regard to these
break downs (age/ethnicity/sex)
should also be included.
Practical Applications and Uses: As stated in the description,
the BWAP:2 was made to assess
work habits, attitudes, and skills of those with disabilities. By
doing this, we can assess the level
of support needed for these people with disabilities and help
them get the support that they need
to perform a job the best they can. It should be used as part of
a larger assessment process and
not solely used to assess one’s capabilities of performing or
holding a job. Instead, it should be
used to help find weak areas that need help or services.

Clinical recommendations and cautions for use: Austin &
Tischendorf caution that the
instrument is emphasizes mental retardation and may be dated
when compared with current
theories and approaches to learning disabilities. They also
recommend using modern test theory
and confirmatory factor analysis in analyzing data and in
appraising the construct validity of the
four different domains and the BWA composite score. They
also felt that it is important that the
vocational competence is standardized across all raters in order
to establish the validity of
observational data.
Summary of Reviewers:
In general, Pam Lindsey provides a less extensive review of the
BWAP: 2 than do James T.
Austin & Stephanie D. Tischendorf. Pam Lindsey seems to give
the basics needed to get a
picture of the BWAP:2. Pam Lindsey mentions the bias that
comes along with having an
observer who is observing the client or test taker and that

perceptions and prejudices can get in
the way. However, she feels that the instrument is valuable in
helping professionals try to
measure the vocational competence of persons with disabilities,
targeting areas that need special
attention, and assist them in building a rehabilitation plan that
will be appropriate for their
special needs. She feels that it is technically adequate or sound
and that scores could be
compared with other measures like adaptive behavior or
cognitive abilities. She also feels it is
not meant to be an assessment of an individual’s ability to work
or be successful on the job but
rather to be part of a bigger plan or process to help the
professional target areas that are strengths
and weaknesses to help them get support that they need.
Austin & Tischendorf offer a much more in depth and critical
review of the BWAP:2. While
Pam Lindsey felt that overall the data showed satisfactory
reliability and validity, Austin &
Tischendorf felt that comparing the AAMR Adaptive Behavior
Scale and the BWAP:2 did not
prove that the BWAP:2 could predict success in some external

outcome, which is basically the
definition of criterion related validity. Pam Lindsey also did
not offer many ideas in terms of
modifications or problems with the test. Austin& Tischendorf
felt the norm group was heavily
weighted towards those with MR, and the test is for those with
who are mentally retarded,
physically disabled, emotionally disturbed, learning disabled,
and-or economically
disadvantaged, and thus should have a norm group more equally
weighed between the different
disabilities. They felt that including an economically
disadvantaged should be better supported
to be beneficial, and that the test-retest period should be made
longer and should be compared
with week 2 re-test results in order to strengthen the reliability
evidence of the test. They also
called for a more extensive breakdown of
scores(age/ethnicity/sex) should be incorporated into
the BWAP:2. In terms of final thoughts about the BWAP:2,
Austin & Tischendorf felt the test
was easily administered and scored by raters, with “ample
opportunity to observe the focal
individual” (Austin & Tischendorf). They felt that several

improvements had been made from
its previous version. They left it by stating the following:
“Any issues that remain do not preclude a recommendation to
use the BWAP:2 but rather
suggest continuing to develop its knowledge base”(Austin &
Tischendorf).
My Opinion of the Instrument/Reviewers: Overall, I felt that
the Becker Work Adjustment
Profile 2 seems it could be a very useful tool for helping those
with disabilities be the best that
they can be. I agreed with both about the reliability being
adequate, however I sided with Austin
& Tischendorf when they discussed the issue of proving
evidence that the BWAP:2 has criterion
related validity. By comparing tests, I do not see how that
proves that BWAP:2 proves a client
would be successful in the future. I also agreed with Pam
Lindsey about the bias that can come
along with having an observer that is rating someone else, and
the interrater reliability that goes

along with this. However, I also agree with Pam Lindsey that
this comes with the territory of all
observational instruments, and I feel it should be kept in mind
when interpreting scores. Also,
the BWAP:2 does have adequate interrater reliability at .82 to
.89 across domains, and that I
think should put most those considering using the BWAP:2 at
ease.
I also feel that in terms of reliability and validity that it is
sufficient and is an advantage to using
this test. I think that the goals of this test also really make it
special or worth using, because it is
looking for strengths and weaknesses in the client’s vocational
skills, habits and attitudes. As a
rehabilitation counselor this is a huge goal. Having a way to try
to find these weaknesses and
helping a client work on them or receive help can help a client’s
job stability, self esteem, and
help them feel more socially accepted by others because they
are performing up to standards.
As Pam Lindsey mentioned, I think it is very important with all
tests to remember that it should

be used as part of a larger process which includes talking to and
learning about the client and
their experiences/what they might already know about
themselves, other tests or inventories, and
information about the disability. Tests should never be thought
of as a sort of as an
unquestionable source of information. It is also important to
look at how appropriate the test
might be for the client. From what I have read about the test, it
may not be the best test for
someone with learning disabilities due to seeming a little dated
in terms of learning disabilities,
however depending on the case maybe there is information to
gather that could be useful by
using the BWAP:2. Every situation is different and it is part of
the rehabilitation counselor’s job
to figure out if a test is appropriate for the user.
References:
Information from the reviews of James T. Austin & Stephanie
D. Tischendorf , and Pam Lindsey
The Becker Work Adjustment Profile 2
http://ovidsp.tx.ovid.com.gate.lib.buffalo.edu/spa/ovidweb.cgi

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.
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.
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.
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.
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.
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.
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