¶ … Beck Depression Inventory-II (BDI-II) is a 21-item clinician administered and scored scale that is designed to measure a person's mood and symptoms related to depression. The BDI-II was designed to conform to the DSM-IV depression diagnostic criteria and represents a substantial improvement over its predecessor, the original Beck Depression Inventory. The BDI-II has been used both as a research measure (its primary intended use) and to assist with the clinical diagnosis of depression. The BDI-II has been subject to numerous empirical studies designed to measure its internal consistency, convergent and discriminant validity, criterion validity, and construct validity and the test demonstrates acceptable psychometric qualities, but there have been some concerns with its use. This paper reviews the development of the BDI-II, its psychometric properties, uses, strengths, and weaknesses. Advantages and disadvantages of using the BDI-II and recommendations for future research regarding its use are also discussed.
Title of paper
The psychiatric diagnosis of major depressive disorder characteristically begins with the identification of symptoms of which the presence and/or severity that occur over a specific span of time are evaluated. Standardized measures of depression that can be used to measure and document mood, somatic, vegetative, and other depressive symptoms can be useful in the diagnosis of depression and also to determine the severity of the symptoms in the person. The Beck Depression Inventory (BDI) is a 21-item clinician administered and scored scale designed to measure mood and symptoms related to depression that although developed originally for research purposes in 1961, also enjoyed widespread clinical use (Arbisi, 2001). Following nearly 35 years of clinical and research use the BDI underwent a major revision. The revised version of the Beck, the BDI-II was developed in 1996. This paper reviews the development of the BDI-II, its psychometric properties, uses, strengths, and weaknesses.
Basic Description and Test Development
Compared to the original BDI, the BDI-II added items covering such aspects of depression as agitation, worthlessness, concentration difficulties, and loss of energy. Consequently, items were dropped or revised regarding the domains of weight loss, body image change, somatic preoccupation, and work difficulty while still retaining the BDI's 21-item format. The revision was substantial as all but three of the original items were change (Arbisi, 2001). (Grothe et al., 2005) reports that the revisions of the BDI to the BDI-II were undertaken to make the test correspond more closely to the diagnostic criteria for mood disorders in the DSM-IV by, designing it to correspond to the items of the SCID (Structured Clinical Interview for DSM Disorders) for the DSM-III-R. Furthermore some items on the original BDI had some issues with clinically failing to differentiate across the range of depression (e.g., mild, moderate, and severe presentations of depression) and several other items were found to display a gender bias (Arbisi, 2001). In fact, a revision of the original BDI had been developed in 1987 (the BDI-IA) that reworded 15 of the original items 21 items but yet this version still did not address some of the aforementioned issues with the original BDI such as its limited range of depressive symptoms nor its failure to be consistent with DSM diagnostic standards and criteria for mood disorders (Arbisi, 2001).
The BDI-II consists of 21 items read by the subject (or alternatively they can be read to the subject by the administrator). Each item is followed by four options (statements) that the respondent is required to endorse as they are related to their feelings over the prior two weeks including the day of the assessment. The options are scored zero to three, with higher scores reflecting more severe levels of depressive symptomatology. The items reflect different dimensions of depression ranging from sadness to loss of energy to loss of interest in activities such as sex. A test question example is provided below (Beck, Steer, & Brown, 1996):
1. Sadness
0. I do not feel sad.
1. I feel sad much of the time.
2. I am sad all the time.
3. I am so sad or unhappy that I can't stand it.
The time to administer the test typically ranges from five to ten minutes (Arbisi, 2001). The test is designed for and can be administered to individuals 13-86 years of age, provided they are not illiterate (in which case the test can be read aloud to the subject). However it has been used for younger and older subjects as well (Arbisi, 1996). Following completion of the test the administrator sums up the individual item totals and compares them to standardized cut scores to determine the severity of depression in the individual.
The cut scores for the BDI-II were originally...
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