Beck Depression Inventory: Self-Report for Assessing Depression, Summaries of History

The Beck Depression Inventory (BDI) is a widely-used, self-reporting questionnaire for assessing depression severity in both normal and psychiatric populations. Developed in 1961, the BDI was based on the theory of negative cognitive distortions and has undergone several revisions since. It consists of 21 items, each rated on a 4-point scale, and covers affective, cognitive, somatic, and vegetative symptoms. The questionnaire is commonly self-administered and takes 5-10 minutes to complete. Scores range from 0 to 63, with higher scores indicating greater symptom severity. The BDI has demonstrated high validity and reliability, making it a valuable tool for detecting and measuring depression.

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Beck Depression Inventory questionnaire
A brief history
The Beck Depression Inventory (BDI) is a 21-item self reporting questionnaire for
evaluating the severity of depression in normal and psychiatric populations [1, 2].
Developed by Beck et al in 1961, it relied on the theory of negative cognitive
distortions as central to depression [3]. It underwent major revisions in 1978; the
BDI-IA and 1996; the BDI-II, both copyrighted [4]. The BDI-II does not rely on
any particular theory of depression and the questionnaire has been translated into
several languages. A shorter version of the questionnaire; the BDI Fast Screen for
Medical Patients (BDI-FS) is available for primary care use. That version
contains seven self-reported items each corresponding to a major depressive
symptom in the preceding two weeks.
Description
The questionnaire was developed from clinical observations of attitudes and
symptoms occurring frequently in depressed psychiatric patients and infrequently
in non-depressed psychiatric patients [5]. Twenty-one items were consolidated
from those observations and ranked 0-3 for severity. The questionnaire is
commonly self-administered although initially designed to be administered by
trained interviewers [3]. Self-administration takes 5-10 minutes. The recall period
for the BDI-II is 2 weeks for (major depressive symptoms) as operationalized in
the fourth edition of Diagnostic and Statistical Manual (DSM-IV).
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Beck Depression Inventory questionnaire A brief history The Beck Depression Inventory (BDI) is a 21-item self reporting questionnaire for evaluating the severity of depression in normal and psychiatric populations [1, 2]. Developed by Beck et al in 1961, it relied on the theory of negative cognitive distortions as central to depression [3]. It underwent major revisions in 1978; the BDI-IA and 1996 ; the BDI-II, both copyrighted [ 4 ]. The BDI-II does not rely on any particular theory of depression and the questionnaire has been translated into several languages. A shorter version of the questionnaire; the BDI Fast Screen for Medical Patients (BDI-FS) is available for primary care use. That version contains seven self-reported items each corresponding to a major depressive symptom in the preceding two weeks. Description The questionnaire was developed from clinical observations of attitudes and symptoms occurring frequently in depressed psychiatric patients and infrequently in non-depressed psychiatric patients [5]. Twenty-one items were consolidated from those observations and ranked 0 - 3 for severity. The questionnaire is commonly self-administered although initially designed to be administered by trained interviewers [3]. Self-administration takes 5-10 minutes. The recall period for the BDI-II is 2 weeks for (major depressive symptoms) as operationalized in the fourth edition of Diagnostic and Statistical Manual (DSM-IV).

Items The BDI-II contains 21 items on a 4-point scale from 0 (symptom absent) to 3 (severe symptoms). Anxiety symptoms are not assessed but affective, cognitive, somatic and vegetative symptoms are covered, reflecting the DSM-IV criteria for major depression. Scoring is achieved by adding the highest ratings for all 21 items. The minimum score is 0 and maximum score is 63. Higher scores indicate greater symptom severity. In non-clinical populations scores above 20 indicate depression [6]. In those diagnosed with depression, scores of 0 – 13 indicate minimal depression, 14 – 19 (mild depression), 20 – 28 (moderate depression) and 29 – 63 (severe depression) [4]. Validity Content validity of the BDI-II has improved following item replacements and rewording to reflect DSM-IV criteria for major depressive disorders. Mean correlation coefficients of 0.72 and 0.60 have been found between clinical ratings of depression and the BDI for psychiatric and non-psychiatric populations [3]. Construct validity is high for the medical symptoms measured by the questionnaire, α = 0.92 for psychiatric outpatients and 0.93 for college students [7]. High concurrent validities have been demonstrated between the questionnaire and other measures of depression such as the Minnesota Multiphasic Personality Inventory-D, r = 0.77 [3]. Criterion validity of the BDI-II is positively correlated with the Hamilton Depression Rating Scale (r = 0.71) with a high one week test- retest reliability r = 0.93 (suggesting robustness against daily variations in mood) and an internal consistency of α = 91 [4].

References:

  1. Piotrowski C, Sherry D, Keller JW. Psychodiagnostic test usage: a survey of the society for personality assessment. Journal of Personality Assessment 1985 , 49 : 115 - 119.
  2. Steer RA, Beck AT, Garrison B. Applications of the Beck Depression Inventory. In Sartorius N, Ban TA, (Eds.), Assessment of Depression. Geneva, Switzerland: World Health Organization, 1986
  3. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988 , 8: 77 - 100.
  4. Beck AT, Steer RA, Brown GK. BDI-II: Beck Depression Inventory Manual. 2nd ed. San Antonio: Psychological Corporation; 1996.
  5. Beck AT, Ward CH, Medelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961, 4 : 561 – 571.
  6. Kendall PC, Hollon SD, Beck AT, Hammen CL, Ingram RE. Issues and recommendations regarding use of the Beck Depression Inventory. Cognitive Ther Res 1987 , 11: 289 – 99.
  7. Beck AT, Steer RA. Manual for the Beck Depression Inventory. San Antonio (TX): The Psychological Corporation, 1987.
  8. Gorenstein C, Andrade L, Zanolo E, Artes R. Expression of depressive symptoms in a nonclinical Brazilian adolescent sample, Can J Psychiatry 2005 , 50 : 129 – 137.
  9. Poole H, Bramwell R, Murphy P. The utility of the Beck Depression Inventory Fast Screen (BDI-FS) in a pain clinic population. Eur J Pain 2009, 13 :865- 9.
  1. Frasure-Smith N, Lespérance F. Depression and anxiety as predictors of 2- year cardiac events in patients with stable coronary artery disease, Arch Gen Psychiatry 2008 , 65: 62 - 71.