Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients.

This study evaluated the psychometric characteristics of the Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in a primary care medical setting. A principal-components analysis with Promax rotation indicated the presence of 2 correlated factors, Somatic-Affective and Cognitive, which explained 53.5% of the variance. A hierarchical, second-order analysis indicated that all items tap into a second-order construct of depression. Evidence for convergent validity was provided by predicted relationships with subscales from the Short-Form General Health Survey (SF-20; A. L. Stewart, R. D. Hayes, & J. E. Ware, 1988). A receiver operating characteristic analysis demonstrated criterion-related validity: BDI-II scores predicted a diagnosis of major depressive disorder (MDD), as determined by the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ). This study demonstrated that the BDI-II yields reliable, internally consistent, and valid scores in a primary care medical setting, suggesting that use of the BDI-II in this setting may improve detection and treatment of depression in these medical patients.     

The Patient–Doctor Relationship Questionnaire (PDRQ-9) in Primary Care: A Validity Study

This study assessed the validity of the Patient–Doctor Relationship Questionnaire-9 (PDRQ-9) in a primary care sample (N = 180). Convergent validity was assessed through a correlation between the patient-rated PDRQ-9 and the physician-rated Difficult Doctor Patient Relationship Questionnaire-10 (DDPRQ-10). Discriminant validity was assessed through correlations between the PDRQ-9 and patient age, patient- and physician-reported health and psychological distress. To determine if the PDRQ-9 could discriminate between groups, patient PDRQ-9 ratings were compared between patients who were treated by faculty physicians versus those who were treated by residents. An exploratory factor analysis confirmed that the PDRQ-9 was made up of a single factor. The PDRQ-9 scale was internally consistent (α = .96) and significantly and negatively correlated with the DDPRQ-10 (r = ?.22, p = .003) and was not significantly correlated with patient age, health, or psychological distress. PDRQ-9 ratings were statistically greater in patients who were treated by faculty physicians than those who were treated by residents (p = .01). This study provides additional support for the reliability and validity of the PDRQ-9 as a measure of the doctor–patient relationship in a primary care sample.     

Internet-Based Therapy for Mild to Moderate Depression in Swedish Primary Care: Short Term Results from the PRIM-NET Randomized Controlled Trial

Depression presents a serious condition for the individual and a major challenge to health care and society. Internet-based cognitive behavior therapy (ICBT) is a treatment option supported in several trials, but there is as yet a lack of effective studies of ICBT in “real world” primary care settings. We examined whether ICBT differed from treatment-as-usual (TAU) in reducing depressive symptoms after 3 months. TAU comprised of visits to general practitioner, registered nurse, antidepressant drugs, waiting list for, or psychotherapy, or combinations of these alternatives. Patients, aged ≥ 18 years, who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview. A total of 90 patients were randomized to either TAU or ICBT. The ICBT treatment included interactive elements online, a workbook, a CD with mindfulness and acceptance exercises, and minimal therapist contact. The treatment period lasted for 12 weeks after which both groups were assessed. The main outcome measure was Beck Depression Inventory-II (BDI-II). Additional measures were Montgomery Åsberg Depression Rating Scale – self rating version (MADRS-S) and Beck Anxiety Inventory (BAI). The analyses revealed no significant difference between the two groups at post treatment, neither on BDI-II, MADRS-S, nor BAI. Twenty patients (56%) in the ICBT treatment completed all seven modules. Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness, after 3 months, is at par with TAU.     

Validation of the Beck Depression Inventory-II in a low-income African American sample of medical outpatients

The psychometric properties of the Beck Depression Inventory-II (BDI-II) are well established with primarily Caucasian samples. However, little is known about its reliability and validity with minority groups. This study evaluated the psychometric properties of the BDI-II in a sample of low-income African American medical outpatients (N=220). Reliability was demonstrated with high internal consistency (.90) and good item-total intercorrelations. Criterion-related validity was demonstrated. A confirmatory factor analysis supported a hierarchical factor structure in which the BDI-II reflected 2 first-order factors (Cognitive and Somatic) that in turn reflected a second-order factor (Depression). These results are consistent with previous findings and thus support the use of the BDI-II in assessing depressive symptoms for African American patients in a medical setting.     

Validating the Beck Depression Inventory-II in Indonesia's general population and coronary heart disease patients

This study assesses the validity and determines the cut-off point for the Beck Depression Inventory-II (the BDI-II) among Indonesians. The Indonesian version of the BDI-II (the Indo BDI-II) was administered to 720 healthy individuals from the general population, 215 Coronary Heart Disease (CHD) patients, and 102 depressed patients. Confirmatory factor analysis indicated factorial similarity across the three samples. Significant correlations between the Indo BDI-II and other self-report measures related to depression demonstrated construct validity of the Indo BDI-II. Furthermore, there was a highly significant difference in the Indo BDI-II scores between depressed patients and non-depressed participants. Internal consistency and re-test reliability of the Indo BDI-II were acceptable. The receiver operating characteristic (ROC) curve indicated that the cut-off point of the Indo BDI-II for a mild severity of depression in Indonesian population should be 17. We conclude that the Indo BDI-II is a valid measure of depression, both in the Indonesian general population and in CHD patients.     

Psychometric Properties of the Beck Depression Inventory-II in a Clinically-Identified Sample of Mexican American Adolescents

We examined the internal consistency reliability, convergent and divergent validity, and factor structure of the Beck Depression Inventory-II (BDI-II) in a sample of 131 Mexican American youth. The BDI-II demonstrated excellent internal consistency reliability (α=.90) and solid convergent and divergent validity with various clinical scales of the Adolescent Psychopathology Scale. Two factors, Cognitive-Somatic and Affective, emerged from an exploratory factor analysis and suggested that depressive symptomology may manifest somewhat differently in Mexican American youth. In sum, results provide tentative support for the use of the BDI-II as a measure of depression for this sample.     

Criterion and construct validity of the Beck Depression Inventory (BDI-II) to measure depression in patients with cancer: The contribution of somatic items

Background/ObjectiveScreening for depression in patients with cancer can be difficult due to overlap between symptoms of depression and cancer. We assessed validity of the Beck Depression Inventory (BDI-II) in this population.MethodData was obtained in an outpatient neuropsychiatry unit treating patients with and without cancer. Psychometric properties of the BDI-II Portuguese version were assessed separately in 202 patients with cancer, and 376 outpatients with mental health complaints but without cancer.ResultsConfirmatory factor analysis suggested a three-factor structure model (cognitive, affective and somatic) provided best fit to data in both samples. Criterion validity was good for detecting depression in oncological patients, with an area under the ROC curve (AUC) of 0.85 (95% confidence interval [CI], 0.76–0.91). A cut-off score of 14 had sensitivity of 87% and specificity of 73%. Excluding somatic items did not significantly change the ROC curve for BDI-II (difference AUCs = 0.002, p=0.9). A good criterion validity for BDI-II was also obtained in the non-oncological population (AUC = 0.87; 95% CI 0.81–0.91), with a cut-off of 18 (sensitivity=84%; specificity=73%).ConclusionsThe BDI-II demonstrated good psychometric properties in patients with cancer, comparable to a population without cancer. Exclusion of somatic items did not affect screening accuracy.     

Factor Structure of the Beck Depression Inventory—II in a Medical Outpatient Sample

This study examined the factor structure of the Beck Depression Inventory—II (BDI-II) in a sample of 127 individuals referred by their primary care physicians. Using exploratory factor analysis with oblique rotation, a 2-factor model appeared to be the most parsimonious representation of the data. The rotated factors accounted for approximately 53% of the variance. Consistent with previous research, the first factor was interpreted as a somatic–affective dimension and the second factor reflected a cognitive dimension. The correlation between these 2 factors was .79. It appears possible to divide the BDI-II into subscales to facilitate interpretation in medical patients.     

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 Maternal Self-Efficacy Questionnaire in a Population of Iranian Mothers

Self-efficacy is an important indicator of a woman’s successful transition to her maternal role and an important predictor of a mother’s infant care behavior. This study aimed to evaluate the validity of the maternal self-efficacy scale in Iranian mothers. This cross-sectional study was conducted on 437 newly delivered mothers who were referred to health care centers in Bonab, Iran. A simple random sampling was performed. The research instrument included maternal self-efficacy. Translation validity was performed using the forward and backward translation method. Content validity was determined in qualitative (assessment of experts’ opinions) and quantitative areas using the content validity ratio (CVR) and Content Validity Index (CVI). Face validity was determined on 30 newly delivered mothers. To determine the construct validity, exploratory factor analysis was used. The reliability was determined in terms of reproducibility via Intra-class correlation coefficient (ICC) by test–retest and internal consistency (Cronbach’s alpha). CVI and CVR were 0.91 and 0.94 respectively. Further, the reliability was approved both in terms of reproducibility (ICC = 0.98) and internal consistency (α = 0.89). Construct validity was confirmed using exploratory factor analysis (KMO = 0.90, Bartlett’s test p < 0.001) for the scale. The findings supported the validity and reliability of the research instrument. Therefore, it is recommended that the instrument can be used in both clinical practice and research.     

Reliability and validity of the Beck depression inventory--II with adolescent psychiatric inpatients

This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess content validity. In Study 2, confirmatory factor analyses of several first-order solutions failed to provide adequate fit estimates to data for 205 boys, 203 girls, and the combined sample. Exploratory factor analyses identified new item-factor solutions. Reliability estimates were good (range =.72 to.91) for the BDI-II total and scale scores. In Study 3 (N=161 boys and 158 girls from Study 2), preliminary evidence for estimates of concurrent, convergent, and discriminant validity were established for the BDI-II.     

Primary Care and Clinical Psychology: Assessment Strategies in Medical Settings

There is ample evidence regarding medical-psychological comorbidity to consider clinical psychology as a viable component of health care services in medical settings. Psychologists can become valuable assets to primary care physicians who treat a high number of primary psychiatric cases as well as medical cases with secondary psychological symptoms. Psychologists who function in hospital-based clinics as well as affiliates with primary care (PC) offices can provide empirically supported assessment services that can make treatment more effective and efficient. Multiple studies indicate high prevalence rates of psychiatric patients in PC settings using various instruments. This paper reviews selected assessment tools that have established diagnostic validity and reliability that can be both strategic for patient care and useful to reinforce psychologist collaboration with primary care physicians (PCP).     

Measuring Latinos' perceptions of depression: a confirmatory factor analysis of the Illness Perception Questionnaire

This study examined the psychometric properties of the Revised Illness Perception Questionnaire adapted for a clinical sample of low-income Latinos suffering from depression. Participants (N = 339) were recruited from public primary care centers. Their average age was 49.73 years and the majority was foreign born females of either Mexican or Central American descent. Confirmatory factor analysis was used to test the factor structure of this measure. Construct and discriminant validity and internal consistency were evaluated. After the elimination of three items because of low factor loadings (< .40) and the specification of seven error covariances, a revised model composed of 24 items had adequate goodness-of-fit indices and factor loadings, supporting construct validity. Each of the subscales reported satisfactory internal consistency. Intercorrelations between the 5 illness perception factors provided initial support for the discriminant validity of these factors in the context of depression. The establishment of the psychometric properties of this adapted measure will pave the way for future studies examining the role illness perceptions play in the help seeking and management of depression among Latinos.     

A psychometric comparison of the Beck Depression Inventory-II in English and Spanish

The Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) is a widely used measure of depressive symptomatology originally authored in English and then translated to Spanish. However, there are very limited data available on the Spanish translation. This study compared the psychometric characteristics of the BDI-II in Spanish and English in a sample of 895 college students. The instrument was administered twice with a 1-week interval, either in the same language on both occasions or in a different language on each occasion. Results show strong internal consistency and good test-retest reliability in both languages. Confirmatory factor analysis demonstrated that the published English-language factor structure showed good fit with data from the Spanish instrument. Among bilingual participants who took the BDI-II in both languages, there was no significant language effect. These data provide initial evidence of comparable reliability and validity between the English and Spanish BDI-II in a nonclinical sample.     

Psychometric Properties of the Persian Version of Spiritual Well-Being Scale in Patients with Acute Myocardial Infarction

The purpose of this study was to assess the psychometric properties of the Persian version of Spiritual Well-Being Scale (SWBS) in patients with acute myocardial infarction. A multisite, cross-sectional survey was employed to determine the instrument’s reliability (Cronbach’s α and construct reliability) and validity (face, content, and construct). Using systematic sampling of adult outpatients at primary care clinic sites in the Qazvin City, Iran (N = 300), it was found that the Cronbach’s alpha and construct reliability of both factors associated with the SWBS were above 0.7. The construct validity of the scale was determined using exploratory factor analysis. The findings supported two factors: relation with God and relation with life. Further investigation through confirmatory factor analysis (eigenvalues of greater than one) confirmed a third factor construct associated with the SWBS. A total of 50.65 % of the variance were explained by these three factors. The overall findings of the study demonstrated that the SWBS is a valid and reliable instrument that has potential utility in future research and clinical practice settings.     

Convergent validity of the Beck depression inventory-II with the reynolds adolescent depression scale in psychiatric inpatients

The Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) and the Reynolds Adolescent Depression Scale (RADS; Reynolds, 1987) were administered to 56 female and 44 male psychiatric inpatients whose ages ranged from 12 to 17 years old. The Cronbach coefficient alpha(s) for the BDI-II and RADS were, respectively, .92 and .91 and indicated comparably high levels of internal consistency. The correlation between the BDI-II and RADS total scores was .84,p <.001. Binormal receiver-operating-characteristic analyses indicated that both instruments were comparably effective in differentiating inpatients who were and were not diagnosed with a major depressive disorder; the areas under the ROC curves for the BDI-II and RADS were, respectively, .78 and .76. The results (a) indicate that the BDI-II and the RADS have similar psychometric characteristics and (b) support the convergent validity of the BDI-II for assessing self-reported depression in adolescent inpatients.     

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.     

Norms for the Beck Depression Inventory (BDI-II) in a Large Dutch Community Sample

The Beck Depression Inventory (BDI-II) is a widely used instrument that provides information about the presence and severity of depressive symptoms. Although the BDI-II is a psychometrically sound instrument, relatively little is known about norm scores. This study aimed to develop reliable norms for the BDI-II in a Dutch community sample. Gender, age, and education were hypothesized to predict BDI-II scores. A total of 7,500 respondents from a community sample in The Netherlands completed the BDI-II. It was investigated by means of multiple regression analysis whether distinct norms for genders, education levels, and age group are appropriate. BDI-II scores depended on gender and education level, but not on age. BDI-II norms were computed based on the final regression model. These BDI-II norms can be used for diagnostic purposes, clinical decision making, or the evaluation of treatment effects.     

A psychometric evaluation of the Icelandic version of the WHO‐5

The psychometric properties of the Icelandic version of the World Health Organization five wellbeing index (WHO‐5) were evaluated using two samples, a randomly selected sample (N = 3,896) from the Icelandic National Registry and a convenience sample of primary care patients (N = 126). The factor structure of the scale was tested with confirmatory factor analysis (CFA). The correlation between the WHO‐5 and other measures of depression and anxiety were calculated to assess the scale's convergent and divergent validity. The discriminant validity of the WHO‐5 was explored with a receiver operating analysis compared to the Mini International Neuropsychiatric Interview. The CFA indicated that the factor structure of the WHO‐5 was one‐dimensional and factorial invariant between groups. The internal reliability of the WHO‐5 was adequate and the convergent, divergent and discriminant validity of the WHO‐5 was supported. It is concluded that the psychometric properties of the Icelandic version of the WHO‐5 are satisfactory.     

The Portuguese Version of the Psychological Adjustment to Separation Test-Part A (PAST-A): A Study with Recently and Non-recently Divorced Adults

Past research has demonstrated that divorced adults show more health problems and psychological distress than married adults. Considering the high prevalence rates of divorce among Western countries, new and robust measures should be developed to measure psychological distress after this specific transition in adulthood. The aim of this study was to adapt and validate a Portuguese version of the Psychological Adjustment to Separation Test-Part A (PAST-A; Sweeper and Halford in J Family Psychol 20(4):632–640, 2006). PAST-A is a self-report measure that assesses two key dimensions of separation adjustment problems: lonely-negativity and former partner attachment. Psychometric properties of the Portuguese version of PAST-A were assessed in terms of factor structure, internal consistency, and convergent and divergent validity, in an online convenience sample with divorced adults (N = 460). The PAST-A two-factor structure was confirmed by exploratory and confirmatory factor analyses, with each factor demonstrating very satisfactory internal consistency and good convergence. In terms of discriminant validity, the Portuguese PAST-A reveals a distinct factor from psychological growth after divorce. The results provided support for the use of the Portuguese PAST-A with divorced adults and also suggested that the explicative factors of the psychological adjustment to divorce may be cross-cultural stable. The non-existence of validated divorce-related well-being measures and its implications for divorce research are also discussed.