A Summary of the Articles
Hagen’s article showed that the Beck Depression Inventory (BDI) is among the most commonly used instruments in measuring depression (Hagen, 2007). The BDI is used to evaluate levels of depression in patients and to observe the efficacy of other interventions such as antidepressants and electroconvulsive therapy (Hagen, 2007). Hagen (2007) notes that despite the widespread application of the BDI in clinical and research practices, limited nursing studies that critically examine it exist. Consequently, the author covers important elements of BDI such as origin, role, format, strengths, weaknesses and implications for mental health nursing.
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The BDI was initially developed as a 21-item inventory to assess depression severity, symptoms and attitudes of patients undergoing therapy. The BDI strengths include ease of use and monitoring, widespread usages and results are highly valid and reliable (Hagen, 2007). Conversely, its potential weaknesses include possible bias, issues of wording, ordering and scoring weight, gender bias, theoretical challenges, wrong applications and validity issues with regard to the DSM-IV criteria (Hagen, 2007).
Hagen (2007) notes implication of the BDI for nurses. The BDI shows depression (an abstract concept), which bears a social construction and remains relatively peculiar and elusive. The BDI simplicity implies that it cannot capture other factors related to mental health assessment. While the BDI shows the source of the problem, it cannot measure everything related to mental health within a larger context. Nurses, therefore, are encouraged to apply the BDI but they must understand its strengths as well as weaknesses and possible impacts of such underlying assumptions and values.
Krukowski, Friedman and Applegate (2010) acknowledged that the BDI was commonly applied in bariatric surgery psychological assessments. At the same time, they showed that other many items were available to evaluate physical outcomes of obesity instead of its depressive symptoms (Krukowski et al., 2010). Specifically, they focused on evaluating “discrimination accuracy of the BDI total score and the BDI subscales (i.e., cognitive–affective and somatic); the optimal cut points and the cognitive–affective subscale; and to study the differential endorsement patterns (somatic versus cognitive–affective items)” (Krukowski et al., 2010, p. 427).
The researchers based their studies on limitations of the BDI to capture depressive symptoms in certain medical populations (obesity and cancer patients). The use of the BDI in such patients could show medical symptoms instead of mood or affective symptoms and therefore affect its validity. Besides, researchers have demonstrated that “bariatric patients were more likely to endorse somatic items as compared to cognitive–affective symptoms on the BDI” (Krukowski et al., 2010, p. 427). The authors concluded that the BDI, with or without somatic items, was effective for measuring depression in bariatric surgery patients and in other patients with chronic pain. Nevertheless, they asserted that future studies were necessary to determine if other instruments could enhance discrimination accuracy.
A Comparison of the Articles
An article by Hagen (2007) is a critical view of the BDI while a study by Krukowski et al. (2010) attempts to show that the tool may have discrimination accuracy among patients with certain medical conditions like obesity and cancer. Both articles acknowledge the widespread use of BDI and its effectiveness in assessing depression. The articles differ in their areas of focus and insights. Hagen’s article presents several strengths, limitations and implications because of its broad critical approach while Krukowski et al. focused on specific cases. Both articles highlight potential limitations of BDI with regard to wrong use and validity based on result discrimination accuracy. Overall, they show that the BDI is a great tool, but requires careful application. In addition, new measures could be used to capture other items not in the BDI and enhance result accuracy.
Hagen, B. (2007). Measuring melancholy: A critique of the Beck Depression Inventory and its use in mental health nursing. International Journal of Mental Health Nursing, 16(2), 108–115. Web.
Krukowski, R. A., Friedman, K. E., & Applegate, K. L. (2010). The Utility of the Beck Depression Inventory in a Bariatric Surgery Population. Obesity Surgery, 20(4), 426–431. Web.