The use of the beck depression inventory with adolescents

Despite numerous theoretical and anecdotal reports of depression in adolescence, and the potential destructiveness of this disorder in this age group, little empirical work has been done. This study presents data on administration of the Beck Depression Inventory (BDI) to an adolescent sample (N= 568). Factor analysis and interitem and itemscale correlations of the BDI suggested that this questionnaire can be used with this population. The mean BDI score for the sample was slightly higher than that obtained in general population studies of younger children or adults. However, only 5% reported depression sufficiently high to be classified as severe, a figure similar to that of younger children but somewhat lower than that for adults. No significant differences across age were obtained, although significantly more females than males reported high depression scores.This article is based upon a doctoral dissertation submitted to the Department of Psychology at the University of Vermont. The author gratefully acknowledges the contributions of the members of her committee and those of her advisor, Harold Leitenberg, Ph.D.     

Properties of the beck depression inventory as a screening instrument for adolescent depression

The utility of the Beck Depression Inventory (BDI) for identifying Major Depressive Episode was assessed with two samples of adolescents, 65 psychiatric hospital inpatients and 49 secondary school students. Diagnoses based on the Child Assessment Schedule served as criteria. With the school sample, a BDI screening score of 16 resulted in 100% sensitivity and 93.2% specificity. For the inpatient sample, a cutoff of 11 yielded a sensitivity of 81.5% and specificity of 52.6%. There was evidence of the BDI's convergent and discriminant validity for both samples. The results were consistent with the assertion that Major Depressive Episode is a sufficiently distinct diagnostic category in adolescence to be detected by a screening measure such as the BDI.This research was supported by grants to the first author from the National Research Council, and to the second author from the Graduate Students Association of Arizona State University. The authors express their appreciation to Camelback Hospitals and to Judson School for their cooperation in arranging for subject participation.     

Diagnosing depression in patients with physical diseases using the beck depression inventory (BDI)

Abstract

Four-hundred-and-forty-three patients with a physical illness (355 with coronary heart disease and 88 with chronic pain), 150 unemployed persons and 623 subjects from the normal population in Jämtland, Sweden were tested using the BDI (Beck Depression Inventory). The aim of the study was to investigate whether scores on both the physical and non-physical components of the BDI differed between the patients and the other groups, or whether only the physical component was significantly higher in the patient group, and in such a case whether this could be interpreted as symptomatic of physical disease and not of depression. A cutoff score of ≥ 10 to determine mild depression and two different alternative physical and non-physical components were used. Forty-three percent of the patients with coronary heart disease and 50% of patients with chronic pain were categorized as being at least mildly depressed. Factor analyses indicated that a physical component comprising five items was the most meaningful and could best discriminate the physical symptoms. The patients' scores were significantly higher than those of the other two groups on the physical component but only higher than the normal population sample on the nun-physical component. This supports the idea that the items for physical symptoms in the BDI might be confounding when determining depression in patients with physical diseases. The non-physical component seems to be the best indicator of depression and is recommended as a complement to the total BDI scale when determining the degree of depression in patients suffering from a physical disease.     

The beck anxiety inventory: Psychometric properties in a community population

This study presents data on the norms and psychometric properties of the Beck Anxiety Inventory (BAI), using a sample of 225 community adult volunteers. Maximum-likelihood confirmatory factor analyses of previously published models of the BAI: a two-factor model and a five-factor model, showed that the fit of each model was unacceptable. Also, the fit of the single-factor model was poor. Exploratory principal-components analyses with varimax and oblique rotations suggested four BAI components within this sample. Satisfactory levels of reliability were established for the BAI subscales. Finally, the relations between the BAI total and subscale scores and a related measure of anxiety and with another self-report measure of psychological distress were examined.This paper was presented at the 27th Annual Convention of the Association for Advancement of Behavior Therapy, Atlanta, Georgia, November 1993.     

Assessing self-critical perfectionism in clinical depression

Several facets of perfectionism have been strongly associated with depression and anxiety. Dunkley and Blankstein (2000) combined these maladaptive traits with self-criticism to create a general construct labeled self-critical perfectionism. In this study, we employed confirmatory factor analysis to evaluate a model for assessing self-critical perfectionism in a clinically depressed sample using scales from 3 instruments. Participants were 356 depressed adult outpatients who completed 2 multidimensional measures of perfectionism and a measure of self-criticism. A confirmatory factor model that separated a self-critical perfectionism construct from a more adaptive, achievement-striving component of perfectionism was supported. A composite scale assessing self-critical perfectionism demonstrated much larger correlations with distress measures compared to a composite scale assessing achievement striving and also showed evidence of discriminant validity. In this study, we provided further support for the valid assessment of self-critical perfectionism and extended evidence for its assessment to a clinically depressed sample.     

The body in clinical cognitive theory: from beck to mindfulness

Working with the body in Mindfulness-Based Cognitive Therapy (MBCT) is often seen as a ‘means to an end’; that is, a vehicle for diverting attention from negative thought patterns, thereby fostering a detached metacognitive awareness of problematic thinking. The MBCT literature, however, accords the body a more central role. The literature expresses both the idea that the body is integral to a basic level of meaning creation experienced as a ‘bodily felt sense of something’ and that direct sensory or bodily awareness can contribute to a critical change in the felt sense of emotional difficulties. Tracing the development of the concept of the body in clinical cognitive theory, the paper concludes that these ideas of the body are anticipated in earlier revisions to Beck's schema theory. The paper concludes that research into the psychological mechanisms behind bodily awareness would be a fruitful supplement to the current research focus on metacognitive awareness.     

Factor structure and psychometric characteristics of the beck depression inventory-II

The present study evaluated the factor structure and psychometric properties of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in the nonclinical sample of 230 young adults. The BDI-II is a revised version of the BDI-IA. We evaluated the fit of three alternative models to the sample data, using confirmatory factor analysis. Results provided support for the fit of the oblique three-factor model. The BDI-II and factor scales had satisfactory coefficient alpha indices. We obtained gender differences on the BDI-II item, total, and factor scale scores. We examined the relations of the BDI-II with demographic variables and with other self-report measures of social desirability, anxiety, depression, stress, and self-esteem. We also examined the issue of whether specific self-report measures of anxiety and depression assess separate or different constructs. We discuss the limitations of the present study.     

Psychometric properties of the beck depression inventory-II with university students in Bahrain.

The Arabic version of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) was administered to 200 students enrolled at the University of Bahrain. Using exploratory and confirmatory factor analytic techniques, I obtained reasonable validity and reliability data for the BDI-II. Three oblique factors provided the most parsimonious and meaningful solution for students' responses. Findings of this study generally provide strong support for the psychometric soundness of the BDI-II as a measure of depression in college student populations even in Arabic culture, which differs dramatically from Western culture in both values and taboos.     

Clinical cutoffs for the beck Depression inventory and the Geriatric Depression scale with older adult psychiatric outpatients

The present study developed new clinical cutoffs for the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) with 59 older adult psychiatric outpatients. Maximum discrimination of a current major depressive episode resulted, with cutoff scores of 22 for the BDI and 16 for the GDS. Specifically, the following validity scores emerged for the BDI: sensitivity, 64%; specificity, 73%; positive predictive power, 75%; negative predictive power, 61%; and hit rate 68%. For the GDS the validity scores were as follows: sensitivity, 79%; specificity, 69%; positive predictive power, 77%; negative predictive power, 72%; and hit rate, 75%. Combined BDI and GDS scores did not result in improved prediction of a current major depressive episode as compared to the GDS alone. These results support the notion that the BDI and GDS are valid quick screening instruments in discriminating a current major depressive episode for older adult psychiatric outpatients.     

Assessing young adolescents' personality with the five-factor personality inventory

The Five-Factor Personality Inventory (FFPI) assesses a person's position on the (Dutch) psycholexically based Big Five factors: Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Autonomy. FFPI factor scores are reliable and valid if ratings are made by adults. The present study yields preliminary evidence of whether young adolescents provide reliable and valid self-ratings on this instrument or whether this depends on their cognitive ability level. The sample consisted of a large and representative cohort of youngsters with a mean age of 13 years. The adult structure of the FFPI was generally well replicated, across all ability levels represented in the study. The findings further suggest that young adolescents' factor scores are construct-valid and sufficiently reliable to be used in (group) research settings. However, for reports on individual profiles and decision making, an adolescent's cognitive ability level would need to be rather high. Even then, measuring Autonomy seems challenging.     

Normative and reliability data for the children's depression inventory

The present study was undertaken to examine some of the psychometric properties of the Children's Depression Inventory (CDI), a self-report inventory devised by Kovacs and Beck (1977) to measure depression in children and adolescents. Normative and reliability data were obtained from three independent samples taken from eight public schools in central Pennsylvania. Age- and gender-related differences in reported characteristics of depression were also investigated. The subjects were 594 males and 658 females whose ages ranged from 8 to 16 years and whose combined mean age was 11.67 years (SD=1.91). The CDI was group-administered to all 1,252 subjects; 155 fifth-grade subjects (77 males and 78 females) were retested after 3 weeks, and 107 seventh- and eight-grade subjects (45 males and 62 females) were retested after 1 year. The distribution statistics for the combined samples yielded an overall CDI mean of 9.09, a standard deviation of 7.04, and a cutoff score of 19 for the upper 10% of the distribution. Reliability assessed through coefficient alpha, item-total score product-moment correlations, and test-retest coefficients proved acceptable. Gender differences were obtained for several item-total score correlations and for test-retest reliability of CDI scores.     

The assessment of depression in children: The internal structure of the child depression inventory (CDI)

In the present report three separate studies of childhood depression were conducted. First, the internal structure of the Child Depression Inventory (CDI), with 216 children representing various ethnic groups with equal numbers of boys and girls, was evaluated through a factor analysis and by various internal-reliability measures (e.g. split-half reliabilities, Pearson correlations of each item to the total score). Four factors were established and internal reliability of the scale proved to be high. The relationship of the factor structure of the CDI to Kendell's Type A and B categorization of depression are discussed. In Study 2 the relationship of demographic variables to the CDI using the same group of children described for Study 1 was employed. Evaluating the characteristics of depression across age, sex and so on in children has not been frequently studied, and was deemed appropriate for the present investigation. Age proved to be a significant factor in depression scores although race and gender did not. With respect to age, older children tended to display more symptomatology. Comparisons of depressed children to nondepressed children also showed that age was a factor in the obtained scores, and range of severity in both groups. Depressed children differed from nondepressed children on all 27 items indicating that all the items on the CDI seem to be measuring a unitary concept. Study 3 compared CDI scores to a measure of social behavior, the Matson Evaluation of Social Skills with Youngster (MESSY). Seventy-six children (36 girls and 40 boys), ages 4–10 yrs $\text{(}\text{X}\text{?}\text{= 7)}$ were evaluated. Appropriate Social Skills was negatively correlated with childhood depression, and Inappropriate Impulsive/Assertiveness was positively correlated with depressive features described under the factor Guilt/Irritability. The implications of these data for further research on assessment, differential diagnosis and evaluation of treatment research are discussed.     

Assessing postpartum depression: Evidences for the need of multiple methods

IntroductionDifferent methods and instruments are frequently used to measure postpartum depression (PPD) in research, e.g. PPD-specific scales, DSM-based diagnostic interviews and rating scales assessing general depression. However, it is unsure whether these measures would lead to the same results, e.g. in the identification of “depressed” women or in their relations to third variables.Objective(s)We compared different measures of PPD and their relations with a third variable, namely the mothers’ marital satisfaction.MethodWe recruited 65 mothers to take part in a study about the impact of PPD on the development of early family relations. Maternal PPD was assessed with multiple methods (i) a PPD-specific scale, (ii) a DSM-based diagnostic interviews and (iii) a rating scale designed to assess the severity of depressive symptoms. We assessed mothers’ marital satisfaction with the Marital Adjustment Test (MAT).ResultsResults showed weak overlap between PPD-specific scale and DSM-based diagnosis of PPD, and modest correlations between the PPD-specific scale and the general depression rating scale. Only the score on the PPD-specific scale could predict marital satisfaction.ConclusionAs we found discrepancies between different measures of PPD, we suggest being cautious in the choice of measures and using multiple methods to measure PPD in a comprehensive way.     

Assessing depression with the MMPI and MMPI-2

The usefulness of the MMPI (Hathaway & McKinley, 1951 ) and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) for diagnosing and assessing symptomatic depression has been the subject of considerable debate for a number of years. In this article, we review the relative contributions of the MMPI and MMPI-2 clinical and content scales in predicting depression. Positive predictive power, negative predictive power, and overall classification rate were computed for Scale 2 (D) of the MMPI and MMPI-2 and the Depression content scale (DEP) of the MMPI-2. Scale 2 (D) of both the MMPI and MMPI-2 appears to be moderately accurate in predicting depression. Although some studies suggest that the content scale DEP provides incremental validity over Scale 2 (D) of the MMPI-2, the results of this review indicate that the content scale DEP of the MMPI-2 does not exceed the diagnostic efficiency of Scale 2 in predicting depression.     

Assessing problems of cancer patients: psychometric properties of the cancer inventory of problem situations

Evaluated the psychometric properties of the Cancer Inventory of Problem Situations (CIPS), a cancer-specific survey instrument designed to assess day-to-day problems and rehabilitation needs of cancer patients. A heterogeneous group of 479 cancer patients participated in the research. The substructure of the CIPS was investigated using factor-analytic techniques. The CIPS was factored into 31 clinically useful subscales. Further analyses led to five higher order factors representing the physical, psychosocial, medical interaction, marital, and sexual problem areas characteristic of cancer and its treatment. Internal consistency of all the scales was high (mean alpha = .81). The test-retest reliability and validity of the instrument were also studied in a sample of 120 patients. Analyses of items, subscales, higher order factors, and total CIPS scores suggest excellent reliability. The pattern of correlations of the CIPS with other measures (psychological distress; physical, marital, and sexual functioning; and quality of life) provided preliminary evidence of concurrent, discriminant, and convergent validity. The CIPS appears to have sound psychometric properties and fills an important gap in the assessment of cancer patients for both clinical and research purposes.     

Assessing personal work goals in the organizational setting: Development and evaluation of the work concerns inventory

This article reports on the development of an instrument for assessing the personal work goals of employees. The Work Concerns Inventory (WCI) combines idiographic and nomothetic methods to obtain a list of employee work goals and characterizations of those goals on behavior-relevant variables. The goal characteristics assessed on the WCI come from expectancy-value and behavioristic models of goal choice. The internal structure and validity of the WCI for predicting goal-directed behavior were examined in a field study involving 172 employees. The results indicated support for most hypotheses. The hypothesized relationships among the instrument's scales were supported. Goal characteristics predicted the frequency of goal-directed behavior, indicating that optimal prediction of behavior was achieved through the use of both cognitive and operant variables. The findings support the validity of the WCI and promote future research on how personal work goals influence organizational behavior.     

Women and vulnerability to depression: some personality and clinical factors

The purpose of this study is to explore the role of sex differences and personality in vulnerability to depression. Sex differences in personality and some clinical variables are described. We also assess the value of the variables that revealed significant sex differences as predictors of vulnerability to depression. In a group of adult participants (N = 112), 50% males and 50% females (mean age = 41.30; SD = 15.09; range 17-67), we studied sex differences in the three-factor personality model, using the Eysenck Personality Questionnaire, Form A (EPQ-A; Eysenck & Eysenck, 1975), and in the Five-Factor Personality Model, with the NEO Personality Inventory (NEO-PI; Costa & McCrae, 1985). The following clinical scales were used: the Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979), the Schizotypy Questionnaire (STQ; Claridge & Broks, 1984; Spanish version, Carrillo & Rojo, 1999), the THARL Scales (Dua, 1989, 1990; Spanish version, Dua & Carrillo, 1994) and the Adjustment Inventory (Bell, 1937; Spanish version, Cerdá, 1980). Subsequently, simple linear regression analysis, with BDI scores as criterion, were performed to estimate the value of the variables as predictors of vulnerability to depression. The results indicate that a series of personality variables cause women to be more vulnerable to depression than men and that these variables could be explained by a negative emotion main factor. Results are discussed within the framework of the psychological behaviorism theory of depression.     

Assessing the remedy: the case for contracts in clinical trials

Current orthodoxy in research ethics assumes that subjects of clinical trials reserve rights to withdraw at any time and without giving any reason. This view sees the right to withdraw as a simple extension of the right to refuse to participate all together. In this paper, however, I suggest that subjects should assume some responsibilities for the internal validity of the trial at consent and that these responsibilities should be captured by contract. This would allow the researcher to impose a penalty on the subject if he were to withdraw without good reason and on a whim. This proposal still leaves open the possibility of withdrawing without penalty when it is in the subject's best interests to do so. Giving researchers recourse to legal remedy may now be necessary to protect the science, as existing methods used to increase retention are inadequate for one reason or another.