Testing and Assesssment: Comprehensive review of the revised Beck Depression Inventory (BDI-IA) Daniel Beaulieu
The Revised BDI (1993)
Publication Dates: 1961-93
Authors: Aaron T. Beck and Robert A. Steer.
Price Data, 1994: $46 per complete kit including 25 record forms and manual ('93, 24 pages); $25.50 per 25 record forms; 22.50 per manual
The revised Beck Depression Inventory (BDI-IA), introduced at the Center for Cognitive Therapy (CCT) in 1971, is a 21 item self-report rating inventory which measures characteristic attitudes and symptoms for the purpose of assessing the severity of depression in adolescents and adults (BDI, 1993). The BDI "has become one of the most widely accepted instruments in clinical psychology and psychiatry for assessing the intensity of depression in psychiatric patients and for detecting possible depression in normal populations." (BDI, 1993, p. 1). Theoretical Background
When Beck began studying depression in the 1950's, the psychoanalytic theory prevailed, which viewed the syndrome as inverted hostility against the self. In contrast to this explanation, Beck (1967) observed that depressed patients could be more accurately described as having negative views of themselves, their present and future experiences. This lead Beck to propose his theory on negative cognitive triads (i.e.: negative thoughts are about the self, the world, and the future) as a framework for understanding the phenomenology of depression (Beck, 1967). The BDI clearly reflects this theory through a multitude of items represented in the test such as: "I feel that the future is hopeless and that things cannot improve" to reflect the future, "I feel I am a complete failure as a person" to reflect the self, and "I have lost all interest in other people" to reflect the world. Secondly, the development of the BDI emerged to address the difficulties in obtaining a consistent and adequate diagnosis of depression. Beck et al. (1961) devised an instrument which aimed to produce an objective, measurable and verifiable classification of criteria based on behavioural manifestations of depression. Because of reports on the low degree of interclinician agreement on diagnoses, we could not depend on clinical diagnoses, but had to formulate a method of defining depression that would be reliable and valid (Beck et al., 1961, p. 53).
Beck et al. (1961) collected self reports of depressed patients' own idiosyncratic descriptions of their attitudes and symptoms, and contrasted them with those infrequently given by non-depressed psychiatric patients. The self reports were used to create a scale which could reflect the intensity or severity of a given symptom. The items of the instrument were created in relation to objective verbatim reports and overt behavioral manifestations of depression from patients themselves. Hence, the BDI was not biases by a purely subjective theoretical basis. "The items were chosen to assess only the severity of depression, and were not selected to reflect any particular theory of depression" (BDI, 1993, p. 1). The BDI was embraced by the professional community as internal consistency (i.e.: extent to which tests items or procedures assess the same characteristic) was high, and the comparisons between the scores on the inventory and the clinical diagnosticians' judgment indicated a high degree of validity (Beck, 1967). In sum, the development of the BDI was an important event in psychiatry and psychology because it represented a dramatic change in healthcare professionals' view of depression from a psychodynamic perspective, to one guided by the patient's own cognitions and behavior (Abela & D'Allesandro, 2002). Test Description, Scoring and Administration
As mentioned above, the BDI items were initially drawn from clinical observations and descriptions of symptoms...