Beck Depression Inventory-II

Beck Depression Inventory-II (BDI-II)

Brief history: The Beck Depression Inventory (BDI) has gone through multiple revisions. The original BDI instrument developed in 1961 (BDI). Revision began in 1971 to improve the wording of items, with the final revised instrument published in 1979 (BDI-IA). A technical manual for the BDI-IA published in 1987 and revised in 1993. The beck depression inventory second edition (BDI-II) is a 21-item self-report questionnaire to assess the existence and severity of symptoms of depression as listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 1994).

Purpose:  The Beck Depression Inventory second edition designed to determine the presence and severity of symptoms of depression.

Population: Adolescents and adults (ages ≥13 years).

Score: Produces single score indicating the intensity of the depressive symptoms.

Time:  5-10 minutes, longer for patients with severe depression or obsessional disorders.

Author: Aaron T. Beck, Robert A. Steer, and Gregory K. Brown.

Publisher: The Psychological Corporation.

Description: The Beck Depression Inventory (BDI) has gone through multiple revisions. The original BDI instrument developed in 1961 (BDI). Revision began in 1971 to improve the wording of items, with the final revised instrument published in 1979 (BDI-IA). A technical manual for the BDI-IA published in 1987 and revised in 1993.

The BDI-II, published in 1996, contains a substantial revision of the original and revised BDI-IA, and omits items relating to weight loss, body image, hypochondria, and working difficulty so that the assessment of symptoms corresponds to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria.

The beck depression inventory second edition (BDI-II) is a 21-item self-report questionnaire that assesses the existence and severity of symptoms of depression as listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 1994). The BDI-II timeframe extends for 2 weeks to correspond with the DSM-IV criteria for major depressive disorder.

The individidual felt depressed.

The BDI-II developed to correspond to DSM-IV criteria for diagnosing depressive disorders and includes items measuring cognitive, affective, somatic, and vegetative symptoms of depression.

Scoring:  Each of the 21 items corresponding to a symptom of depression summed to give a single score for the BDI-II.  There is a 4-point scale for each item ranging from 0 to 3.

On two items (16 and 18) there are seven options to indicate either an increase or decrease of appetite and sleep.  The items are summed to obtain a total score that can range from 0 to 63.

Score interpretation:

0-13 = minimal range

14-19 = mild

20-28 = moderate

29-63 = severe

Reliability:  Beck depression inventory has been used for 35 years to identify and assess depressive symptoms and has been reported to be highly reliable regardless of the population.  It has a high coefficient alpha, (.80) its construct validity has been established, and it is able to differentiate depressed from non-depressed patients.

For the BDI-II the coefficient alphas (.92 for outpatients and .93 for the college students) were higher than those for the BDI- 1A (.86).  The correlations for the corrected item-total were significant at .05 level (with a Bonferroni adjustment), for both the outpatient and the college student samples. 

Test-retest reliability was studied using the responses of 26 outpatients who were tested at first and second therapy sessions one week apart.  There was a correlation of .93, which was significant at p < .001.  The mean scores of the first and second total scores were comparable with a paired t (25) =1.08, which was not significant.

Validity: One of the main objectives of this new version of the BDI was to have it conform more closely to the diagnostic criteria for depression, and items were added, eliminated and reworded to specifically assess the symptoms of depression listed in the DSM-IV and thus increase the content validity of the measure.  With regard to constructing validity, the convergent validity of the BDI-II was assessed by the administration of the BDI-1A and the BDI-II to two sub-samples of outpatients (N=191). 

The order of presentation was counterbalanced and at least one other measure was administered between these two versions of the BDI, yielding a correlation of .93 (p<.001) and means of 18.92 (SD = 11.32) and 21.888 (SD = 12.69) the mean BDI-II score being 2.96 points higher than the BDI-1A. 

A calibration study of the two scales was also conducted, and these results are available in the BDI-II manual. It Consistent with the comparison of mean differences, the BDI-II scores are 3 points higher than the BDI-1A scores in the middle of the scale. 

Factorial Validity has been established by the inter-correlations of the 21 items calculated from the sample responses.

Norms: The normative sample included 500 outpatients from rural and suburban locations. All patients were diagnosed according to DSM-III-R or DSM-IV criteria were used to investigate the psychometric characteristics of BDI-II.

The group was comprised of 63% women, and 37% men, the mean age was 37.20 years, range of 13-86 years.  The racial/ethnic makeup was 91% White, 4% African American, 4% Asian American, and 1% Hispanic.  A student sample of 120 college students in Canada served as a comparative normal group.

Suggested use:  The BDI-II is intended to assess the severity of depression in psychiatrically diagnosed adults and adolescents 13 years of age and older.  It is not meant to serve as an instrument of diagnosis, but rather to identify the presence and severity of symptoms consistent with the criteria of the DSM-IV. 

The authors warn against the use of this instrument as a sole diagnostic measure, as depressive symptoms may be part of other primary diagnostic disorders.

Read More: Beck Depression Inventory (BDI)

Reference:

Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4:561–71.

Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: Guilford Press; 1979.

Beck AT, Steer RA, Brown GK. Beck Depression Inventory: second edition manual. San Antonio (TX): The Psychological Corporation; 1996.

Beck AT, Steer RA, Brown GK. BDI: Fast Screen for medical patients manual. San Antonio (TX): The Psychological Corporation; 2000.

Beck AT, Steer RA. Manual for the Beck Depression Inventory. San Antonio (TX): The Psychological Corporation; 1987.

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