Psychological Measures

Psychological Measures: Becks Depression Inventory

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PSY/475 Psychological Tests and Measurements

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Psychological Measure

Depression, a severe mental mood disorder, affects many people. Depression is brought on by a variety of events, such as trauma, tragedy, or even illness. Environmental surroundings and seasonal changes can also lead to depression. Aaron Beck developed the Beck Depression Inventory (BDI) in 1961, to measure depression in patients (Quilty, Zhang, & Bagby, 2010). The BDI contains questions related to the physical and mental symptoms of depression, such as irritability, weight changes, fatigue and general hopelessness. Originally, the BDI contained 21 questions, but currently there are 65.

Widely accepted and used in diverse health care settings, the BDI is applied by medical professionals in the clinical setting as well as research fields (Quilty et. al, 2010). The BDI is mainly suited for psychology and psychiatric medicine. This inventory allows psychiatrists to monitor patients and determine the extent of the depression from which they suffer. The BDI can be used multiple times to assess the progress or lack of progress in the patient. This allows care to be implemented affectively. Becks Depression Inventory

Both of the articles selected were gathered from Buros Mental Measurement Yearbook and review Becks Depression Inventory. The article from Janet Carlson’s (1993) review offered that the test was a well-known and widely used self- report inventory that can be used as a measure of severity of depression. Becks inventory covers 21 symptoms and attitudes rated on four point scale of severity and these items cover cognitive, affective, somatic, and vegetative features of depression. Waller’s (1993) review is in agreement with Carlson. Waller agrees that the test is a useful tool as a comprehensive measure for the severity of depression and is very much tailored to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria of depression. Although Waller (1993) agrees on most points with Carlson’s review it is suggested that in the area of somatic items the test is lacking. Waller and Carlson do agree that the use of this test in non-clinical settings is debatable and that this test should not be used as a diagnostic tool but as a measure of the extent of depression. However, Carlson (1993) offers that the uses for this test can span far beyond clinical uses and suggests that research and literature indicates its use in other applications. Both agree that the test is easy to use and can be given in a timely manner in either the individual or group setting but they both also suggest that if the intent is there faking on the test is an issue and should only be administered to cooperative examinees (Waller). Although both authors agree that the test is reliable, they suggest that the test does not offer enough literature on validity. In all the authors find this test to be a useful tool in best used in a clinical setting as a measurement in the severity of depressive symptoms.

Use, Administration, and Settings

Both reviews of the BDI offer that this scale should not be used for making a diagnosis but for determining levels of depressive symptoms (Carlson & Waller, 1993, 1993). However, Waller also suggests that the BDI is frequently used as a screening instrument in non-clinical samples. As a measure of depressive symptoms the BDI has been translated to several languages and Smarr (2003) puts forward that “Studies have been conducted in a variety of settings using medical populations, persons with disabilities, veterans, students, older adults, adolescents, and many populations with psychiatric diagnosis” (p. S134). McPherson and Martin (2010) offer that the BDI and amended versions have been validated for use in psychological research including addiction research and for psychometric purposes in long-term care facilities with medical outpatients, and treatment centers for drug abuse (p. 20). Carlson and Waller are in agreement that the inventory is best used in the clinical or research setting. Carlson states that research and literature indicate a number of applications, including research, screening, and assessment of therapeutic outcomes. The BDI requires minimal training for paraprofessionals or professionals to administer the inventory but that interpretation should be left to clinicians, and warns that because the BDI is a self-reporting instrument faking is possible and that should be considered for those who may be motivated to lie (Carlson, Smarr, 1993, 2003). Both Carlson and Waller offer that this instrument be used in a clinical setting with trained professionals and not recommended for purposes other than for what it was intended.

Population Differences

In general, sex and age are small or non-significant. Reading requirements are low, and the BDI can be used with adolescents. It is used with the elderly, but item 14 is age biased and may be wrongly scaled (Talbot, 1989). Empirical evidence for scaling all items is missing. There are indications of differences between socioeconomic groups. Differences include cultural differences such as language barriers, age and gender factors. Women have been found to have slightly higher scores than men (e.g., Knight, 1984, Nielsen & Williams, 1980; Oliver & Simmons, 1985). Relative to age, adolescents score higher than adults (Albert, Beck, 1975; Levine, 1982; Teri, 1982). However, Schnurr, Hoaken, and Jarrett (1976) found that younger psychiatric patients scored lower than older psychiatric patients. Education attainment is negatively correlated to BDI scores (Beck, 1967; Dorus & Senay, 1980; Oliver & Simmons, 1985). Non-White persons were at times found to score higher than White persons (e.g.., Oliver & Simmons, 1985). Beck, Steer, and Garbin, (1988) suggest that although the demographics correlates are statistically significant, they are probably more important for researchers to attend to than clinicians.

Scoring Validity and Reliability

Scoring is an important part of The BDI. Typically, only the total score is used in the manual), Beck and Steer suggest general guidelines with patients: 0 to 9 are within the normal range; .10 to .18, mild-moderate depression; .19 to .29, moderate to severe depression; and .30 and above, extremely severe depression. These suggestions are based on clinical ratings of patients with normal, scores greater than .15 may suggest depression. Relative to this is the Cronbach’s rating. The internal consistency rated by Cronbach’s coefficient alpha (Beck et., al, 1988) for 25 studies ranged from .73 to .95. The mean coefficient alpha for the nine psychiatric populations was .86. The mean population for the 15 non-psychiatric populations was .81. Test-retest stability correlations for depression are troublesome because of the variability of a person’s experience of depression. Pearson’s correlations for the non-psychiatric samples ranged from .60 to .83. The psychiatric samples had a correlation from .48 to .86. The time periods between testing ranged from hours to 4 months. The content validity is substantiated by comparing the BDI to the criteria of the American Psychiatric Association’s Diagnostic and Statistical Manual on Mental Disorders (1985).

Ethical Implications

The American Psychological Association (1992) has a code of ethics that must be honored by all APA members who conduct research. Among the researcher responsibilities covered by the code of ethics are the accurate advertising of psychological services, the confidentiality of information collected during the research, and the rights of human participants. The code of ethics was created to protect the rights of subjects and to avoid the possibility of having research conducted by unqualified people. It is the responsibility of the researcher balance ethical accountability and the technical demands of scientific research practices (Rosnow, 1997) Research participants have a certain legal rights pertaining to their physical treatment during a study, confidentiality of information, privacy, and voluntary consent(no one can be forced to take part in a study). Researchers who violate these rights, particularly in studies that involve physical or psychological risk can be subject to professional censure and possible litigation. It is not at all unusual for psychologists to face ethical conflicts in the conduct of their work, including in research (Bersoff, 1999).

Conclusion

The BDI is useful and effective in the psychiatric setting. To diagnose the depth of the patient’s depression, the medical professional administers the BDI to measure levels in clinical and non-clinical populations, adult and adolescent. Researchers have gained valuable information and insight into the rising numbers of depression in young people. Schools receive recommendations that help them support students who may suffer from depression. This measurement tool allows those in the clinical setting to assess their patients, and based on the results, develop appropriate treatment plans. The effectiveness of the data is determined by the administrators of the questionnaire and their ability to understand the answers. The data is only valid when the inventory is used correctly. Correct use allows the BDI Inventory to be an extremely helpful measurement tool for clinical professionals and researchers.

References

Albert, N., & Beck, A. T. (1975). Incidence of depression in early adolescence: A preliminary study. Journal of Youth and Adolescence, 4, 301-307.

American Psychiatric Association. (1985). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC; American Psychiatric Association

American Psychological Association. (1992). Ethical principles of psychologists and code of conduct. American Psychologist, 47, 1597-1611.

Beck, A.T., Steer, R.A., & Garbin, M.G. (1988). Psychometric Properties of the beck Depression Inventory: Twenty Five Years of Evaluation. Clinical Psychology Review, 8, 77-100.

Bersoff, D.N. (1999).Ethical conflicts in psychology (2nd.ed.). Washington, DC: American Psychological Association.

Carlson, J. F. (1993). Beck Depression Inventory. Mental Measurement Yearbook: 13. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=loh&AN=13%3a31&site=eds-live

Conoley, C., W., (1961-1987). Review of Beck Depression Inventory (Revised Edition). Associate Professor of Educational Psychology, University of Nebraska-Lincoln, Lincoln, NE Mental Measurements Yearbook Year book 11

Dorus, W., & Senay, E.C. (1980). Depression, demographic dimensios, and drug abuse. American Journal of Psychiatry, 137,699-704.n

Knight, R. G. (1984).Some general population norms for the short form Beck Depression Inventory Journal of Clinical Psychology, 40, 751-753.

Mcpherson, A. A, & Martin, C. R. (2010). A narrative review of the Beck Depression Inventory (BDI) and implications for its use in an alcohol dependent population. Journal of Psychiatric & Mental Health Nursing, 17(1), 19-30. doi:10.1111/j.1365-2850.2009.01469x

Muchinsky, P., M., (2003). Psychology applied to work 7th (ed.) An Introduction to Industrial and Organizational Psychology Thomson Wadsworth

Nielsen, A. C., & Williams, T. A. (1980). Depression in ambulatory medical patients: Prevalence by self-report questionnaire and recognition by non-psychiatric physicians. Archives of general Psychiatry, 37, 999-1004.

Oliver, J. M., & Simmons, M.E. (1985).Affective Disorders and Depression as measured by the Diagnostic Interview Schedule and the Beck Depression Inventory in an unselected adult population. Journal of Clinical Psychology, 41, 469-477.

Quilty, L. C., Zhang, K., & Bagby, R. (2010). The Latent Symptoms Structure of the Beck Depession Inventory-II in Outpatients with Major Depression. Psychological Assessment, 22(3), 603-608. Retrieved from EBSCOhost.

Rosnow, R.L. (1997). Hedgehogs, foxes and the evolving social contract in psychological science: Ethical challenges and methodological opportunities. Psychological Methods, 2 345-346.

Schnurr, R.., Hoaken, P.C.S., & Jarrett, F.J. (1976). Comparison of depression inventories in a clinical population Canadian Psychological Association Journal, 21, 473-476.

Smarr, K. L. (2003). Measures of depression and depressive symptoms: The Beck Depression Inventory (BDI), Center for Epidemiological Studies-Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Primary Care Evaluation of Mental Disorders-Mood Module (PRIME-MD). Arthritis Care & Research, 49(S5), S134-S146. doi: 10.1002/art.11410

Talbot, N.M. (1989). Age bias in the beck Depression Inventory: A Proposed modification for use with older women. Clinical Gerontologist, 9(2), 23-35.

Teri, l. (19820. The Use of the beck Inventory with adolescence. Journal of Abnormal Child Psychology, 10, 277-284.

Waller, N. G. (1993). Beck Depression Inventory. Mental Measurement Yearbook: 13. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=loh&AN=13%3a31&site=eds-live

References: Albert, N., & Beck, A. T. (1975). Incidence of depression in early adolescence: A preliminary study. Journal of Youth and Adolescence, 4, 301-307. American Psychiatric Association. (1985). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC; American Psychiatric Association American Psychological Association Beck, A.T., Steer, R.A., & Garbin, M.G. (1988). Psychometric Properties of the beck Depression Inventory: Twenty Five Years of Evaluation. Clinical Psychology Review, 8, 77-100. Bersoff, D.N. (1999).Ethical conflicts in psychology (2nd.ed.). Washington, DC: American Psychological Association. Carlson, J. F. (1993). Beck Depression Inventory. Mental Measurement Yearbook: 13. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=loh&AN=13%3a31&site=eds-live Conoley, C., W., (1961-1987) Dorus, W., & Senay, E.C. (1980). Depression, demographic dimensios, and drug abuse. American Journal of Psychiatry, 137,699-704.n Knight, R Nielsen, A. C., & Williams, T. A. (1980). Depression in ambulatory medical patients: Prevalence by self-report questionnaire and recognition by non-psychiatric physicians. Archives of general Psychiatry, 37, 999-1004. Oliver, J. M., & Simmons, M.E. (1985).Affective Disorders and Depression as measured by the Diagnostic Interview Schedule and the Beck Depression Inventory in an unselected adult population. Journal of Clinical Psychology, 41, 469-477. Quilty, L. C., Zhang, K., & Bagby, R. (2010). The Latent Symptoms Structure of the Beck Depession Inventory-II in Outpatients with Major Depression. Psychological Assessment, 22(3), 603-608. Retrieved from EBSCOhost. Rosnow, R.L. (1997). Hedgehogs, foxes and the evolving social contract in psychological science: Ethical challenges and methodological opportunities. Psychological Methods, 2 345-346. Schnurr, R.., Hoaken, P.C.S., & Jarrett, F.J. (1976). Comparison of depression inventories in a clinical population Canadian Psychological Association Journal, 21, 473-476. Teri, l. (19820. The Use of the beck Inventory with adolescence. Journal of Abnormal Child Psychology, 10, 277-284. Waller, N. G. (1993). Beck Depression Inventory. Mental Measurement Yearbook: 13. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=loh&AN=13%3a31&site=eds-live