Introduction
BDI is a self-reporting inventory with 21 items on a four-point scale covering the cognitive, semantic, and affectionate items lasting for the past two weeks (Faro & Pereira, 2020). The patient can self-administer it or the mental health professionals (electronically, by paper and pen, or through the phone). The other method of administering BDI is through oral self-reports in a group. However, the final score interpretation must be done by a trained mental health specialist.
Summary of reliability evidence
The BDI yields a highly reliable score even after translation into Persian, Turkish, Brazilian, Japanese, Arabic, Swedish, Dutch, Lithuanian, Icelandic, and German (Mignote, 2018).
The internal consistency reliability for Indonesian is (α=.90), Persian (α=.87), Turkish (α=.90), and Japanese (α=.83) (Mignote, 2018).
The BDI’s test-retest reliability ranges from 0.73 to 0.92, with an internal consistency of 0.9 (Cuncic, 2018).
However, despite the credibility of the evaluation of depression symptomatology, there are disputing results regarding its measurement structure (Faro & Pereira, 2020).
Summary of validity evidence
The BDI has a remarkable convergent and discriminant validity, indicating a high correlation with other tools used in measuring depression (Cuncic, 2018). The developers are improving the content validity of the scales by adding and rewording some words to assess the diagnostic and statistical manual (DSM) criteria for depression (Mignote, 2018). The BDI’s construct validity measure has been evaluated based on the convergent and divergent validity in several research and yields positive correlation as follows:
- Center for Epidemiologic Studies Depression Scale (r=0.69).
- Coolidge Axis II Inventory Depression sub-scale (r=0.66).
- Coolidge Axis II Inventory Anxiety sub-scale, Perceived Stress Scale (r=0.60).
- Hamilton Rating Scale for Depression (r =0.66).
- Short Psychological Well-Being Scale total score (r=-0.60) (Mignote, 2018).
Populations utilized with:
Patients from different sociocultural, economic, and geographic settings have utilized the BDI. It is one of the most widely accepted tools for depression by mental health professionals throughout the globe used for adult and adolescent populations (Faro & Pereira, 2020).
Summary of Participants Used for Developing BDI
During the development of the BDI test, the researchers led by Beck conducted several studies with different participants from all demographic backgrounds. Mainly, there were 118 studies done using a total of 60,126 participants worldwide (Wang et al., 2022). The participants were from the general population, with years ranging from 13 to 80 years old (Wang et al., 2022). Specifically, in the original studies, the population included 91% white, 4% Asian, 4% African, and 1% Hispanic ethnic group, All living in the United States (Mignote, 2018). In consecutive studies to revise the BDI, the sample included more minority populations across the continent. Thus, the population’s demographics included both the male and female genders from different cultures across the globe.
Clinical Use of BDI
The primary clinical use for the BDI is screening, reflecting, and monitoring of major depressive disorder and other symptoms of depression. In addition, the BDI is a valuable tool for measuring the severity of depression and making the proper diagnosis (Wang et al., 2022). The patients can self-administer and share the results with their mental health provider to help in assessment and diagnosis. Sometimes, clinical researchers use the tool as a questionnaire to assess depression in a target population. The BDI can be used for pre-test and post-test to compare severity and determine the effectiveness of treatment for clients undergoing pharmacotherapy and counseling.
Recommendations for practical clinical use
The BDI test can be used as a screening tool for the general population of healthy adults and adolescents, clinical patients, geriatric inpatients, and people with chronic medical illnesses (Mignote, 2018).
Administration of the BDI should be done by trained individuals, mental health specialists, or paraprofessionals.
The timeframe for correspondence of the client’s symptoms is within the last two weeks; therefore, the people administering should ensure adherence.
Scoring is done by getting the sum of the highest ratings for each of the 21 items and using the scoring criterion to assess severity (Mignote, 2018).
The BDI should be used alongside the DSM for diagnosis.
Summary of research use
Study to investigate the degree of differences between three tools used in measuring depression, including the BDI General Health Questionnaire (GHQ-12) and the short Mental Health Index (MHI-5) (Elovanio et al., 2020).
An adult sample will be used to investigate the factor structure by gender of the BDI-Second edition (Faro & Pereira, 2020).
To investigate the correspondence between parents and their adolescent dyads with the second edition of BDI and assess validity and credibility (Rausch et al., 2019).
Example of use in research: (Mayer et al., 2022).
Objective
To use the BDI self-reports in assessing the cognitive and emotional regulation of youths with attention-deficit/hyperactivity disorder (ADHD) in comparison with a demographically healthy control group. The other aim of the research was to determine if there is an association between adolescents with ADHD and developing depressive symptoms.
Method/Design
The study utilized experimental research designs, which included the research and the control groups. Mainly, 40 adolescents and young adults were diagnosed with ADHD (mean age of 22.93 years) and 40 healthy match individuals (mean age of 20.80 years). All the participants were recruited from the same hospital to normalize other demographic characteristics. They self-administered the BDI, and the researchers analyzed the scores. The findings were analyzed using statistical methods, including multivariate and univariate analysis.
Results
The experimental group (those with ADHD) had a higher probability of developing depression compared to the control group. The former group used maladaptive self-reporting languages, which cause depression-related alterations in cognitive and emotional regulation strategies.
Future research needed
Future studies should establish if the BDI can be used for younger populations such as school-going children. The other area of investigation is to test the credibility and validity of the BDI tests, which have twelve or six items (Elovanio et al., 2020). The other area of study is to find out if people who self-administer the BDI can cause harm by wrongful interpretation or diagnosis. Moreover, given that the first study on developing BDI was done in America, it is essential to replicate the study in other countries before its use. There is a need to assess why there are differences in credibility and validity for the different translations of the BDI and see if changes in wording interfere with some meaning.
Overall impression of measure
The BDI is a short, simple, credible tool with high validity for screening depression among adults and adolescents. I think it is great for all mental health professionals and should be used regularly. It is excellent that, with continuous research, it is now available in many parts of the world.
References
Cuncic, A. (2022). What is the Beck Depression Inventory? Verywell Mind. Web.
Elovanio, M., Hakulinen, C., Pulkki-Råback, L., Aalto, A., Virtanen, M., Partonen, T., & Suvisaari, J. (2020). General health questionnaire (GHQ-12), Beck Depression Inventory (BDI-6), and mental health index (MHI-5): Psychometric and predictive properties in a Finnish population-based sample. Psychiatry Research, 289, 112973. Web.
Faro, A., & Pereira, C. R. (2020). Factor structure and gender invariance of the Beck Depression Inventory – second edition (BDI-II) in a community-dwelling sample of adults. Health Psychology and Behavioral Medicine, 8(1), 16-31. Web.
Mayer, J. S., Brandt, G. A., Medda, J., Basten, U., Grimm, O., Reif, A., & Freitag, C. M. (2022). Depressive symptoms in youth with ADHD: The role of impairments in cognitive emotion regulation. European Archives of Psychiatry and Clinical Neuroscience, 272(5), 793-806. Web.
Mignote, H. G. (2018). An Analysis of Beck Depression Inventory 2nd Edition (BDI-II). Global Journal of Endocrinol Metabolism, 2(3), 1-5. Web.
Rausch, E., Racz, S. J., Augenstein, T. M., Keeley, L., Lipton, M. F., Szollos, S., Riffle, J., Moriarity, D., Kromash, R., & De Los Reyes, A. (2019). A multi-informant approach to measuring depressive symptoms in clinical assessments of adolescent social anxiety using the Beck Depression Inventory-II: Convergent, incremental, and criterion-related validity. Child & Youth Care Forum, 46(5), 661-683. Web.
Wang, M., Shou, Y., Wu, J., Chen, H., Yang, C., & Takemura, K. (2022). From west to east: Recent advances in psychometrics and psychological instruments in Asia. Frontiers Media SA.