An Evaluation of Beck Depression Inventory - Term Paper Example

Evaluation of Beck Depression Inventory ID # Number & Section Beck Depression Inventory is an efficient and reliable psychological test for measuring the presence and severity of depression in patients. This paper therefore evaluates the instrument, looking at its design and format, its Psychometric properties and finally the strengths and weakness of the instrument. With regard to design and format, BDI comes in a form of a questionnaire with a 21 item describing depressive signs and symptoms with each item being rated on a 4-point Likert-type scale from 0-3 and the total possible score being 84. Total scores of above 10 points are considered an indication of depression. The reliability and validity of the test was shown to be very strong with reliability coefficients ranging from .77 to .89 in different studies and a strong correlation with scores of other common instrument. The tool was also shown to be valuable across several settings from clinical, through counseling to research purposes and finally, the strength and weakness of the instrument were considered. Evaluation of Beck Depression Inventory The Beck Depression Inventory is a psychological test that is widely acknowledge and accepted. The test was first created by Beck and his colleagues in the 1960s; however, since then the reliability and validity of the instrument have been examined in several languages amongst several populations and the general efficiency of the test as an instrument for measuring cognitive values has been widely established. The Beck Depression Inventory comes in questionnaire form that allows for self evaluation based on a point grade system of the questions contained in the questionnaire. Arnault, Saint, Shinji Sakamoto, Aiko Moriwaki (2006) reports that a study has been carried out with a Japanese population that validated the use of the instrument, Chellappa and Arajo 2006 also reported a validation of a Portuguese version of the test among a Brazilian sample, while Carano et al. (2006) also reported a stock taking and evaluation of the Psychometric properties of the test after twenty five years carried out by Beck et al (1988) Obviously, Beck Depression Inventory has undergone serious and several tests of validity, reliability and efficiency, and in most cases, the value of the instrument in measuring depressive symptoms have been credibly established. Purpose, Design and Format of Beck Depression Inventory In the commonest cases, and perhaps, as the name of the instrument suggests; Beck Depression Inventory is an instrument that is used for taking 'inventory' of the depressive tendencies and/or depressive symptoms in a sample population. It is sometimes used in conjunction with other psychological tests to evaluate other forms of cognitive values, for instance, Zywiak et al (2006) made use of BDI as an instrument to predict negative affect relapses in men undergoing formal treatment for alcoholism. However, in most cases, Beck Depression Inventory is aimed at measuring the severity of depression in a population. The questions of the instrument are so designed as to evaluate the patients' self report of activities, moods and behaviors for signs of depression symptoms and the severity of the symptoms, if present. In this regard, the instrument contains twenty one items that focuses majorly on the cognitive symptoms of depression. Each items in the instrument is rated on a four-point Likert-type scale with scores ranging from 0 - 3. The sum of the points of all the items in the instrument indicates the BDI score of the client, which is also an indication of the presence or otherwise, and the severity of depression in the client. The total possible score of the instrument is 84. A BDI score of between 0 and 9 is regarded as lack of, or minimal depression, total BDI scores of 10 - 18 is an indication of mild depression, while a total BDI score of 19 - 29 is an indication of moderate depression, any score above 29 is an indication of severe depression that requires urgent therapy. The instrument is most applicable to adults; 18years above, as it requires the patient to record their moods, emotions, and experiences throughout a given period of time. For example, in the study carried out by Saint Arnault, Sakamoto and Moriwaki (2006), forty-four female college students in the USA and Japan were instructed, orally, on the use of diaries and provided with written instructions. Afterwards, they were provided with a packet of seven diaries and required to complete the diaries in seven consecutive days. By completing the diaries daily, respondents were required to reflect on their experiences of each day, after the day's work and then record same in the diaries. However, on the other hand, in a study to evaluate excessive daytime sleepiness in patients with depressive disorders and how it impacts the severity of depression and suicidal tendencies, Chellappa and Arajo (2006) interviewed a sample of seventy outpatients of a psychiatric hospital in Brazil after providing full explanations and assisting the patients with self evaluation. Apparently, as can be inferred from the two studies mentioned above, while BDI is an instrument for measuring the severity of depression in patients with depressive or personal disorders, it is also valuable as a depression screening instrument for the general population. Psychometric Properties of Beck Depression Inventory Besides being a widely used instrument for measuring the severity of depressive symptoms in patients, Beck Depression Inventory has also been shown to have a strong reliability and validity, in a number of studies. Saint Arnault, Sakamoto and Moriwaki (2006) reported that in variety of culturally diverse samples, Beck Depression Inventory reportedly had reliability coefficients ranging from .77 to .89. They also reported the case of the Japanese study with BDI with a strong reliability, a Cronbach's alpha value of .87 and an adequate correlation (r= 0.69, p = .001), between the total score derived from BDI and the score derived from another common instrument for measuring depression; the CES-D. Also, in a Japanese study that validated the Beck Depression Inventory with a sample of thirty Japanese samples diagnosed of major depressive disorder the instrument was shown to have a sensitivity of 90percent to major depressive disorder, a specificity of 83.3percent, a false positive rate of 17.3 percent and a false negative rate of 10 percent, using 11 as the basal score point. In the study carried out by Carano et al (2006), Beck Depression Inventory had a Cronbach alpha value of .84, while in the study carried out by Saint Arnault, Sakamoto and Moriwaki (2006), the Cronbach's alpha was .79 for the Japanese samples and .87 for the American samples. The Use of BDI in Counseling, Clinical or Research Settings Beck Depression Inventory serves a multitude of functions; it is an instrument that is applicable for counseling, clinical or research purposes, as long as the subject has to do with depression. Several studies abound to substantiate the utility of BDI in all of these settings. First, for the purpose of research, Saint Arnault, Sakamoto and Moriwaki (2006), investigating the correlation between depressive symptoms and somatic symptoms across a cultural divide, sampled forty four college women from a Japanese University and an American University. The samples were tutored, both orally and with written instructions, on how to use a diary and then provided with a packet of seven diaries to record their life experiences fo4r seven consecutive days, by analyzing the scores of the subjects using the BDI and another instrument for measuring somatic symptoms, they were able to establish a cultural difference in the relationship of depressive symptoms with somatic pains. Also, in a clinical setting, Carano et al (2006) investigated the correlation between a disorder called Alexithymia and body image perception/worth in a sample of patients receiving treatment for Binge eating Disorder, in a private medical center in Italy. Using BDI to measure depression in the patients and other instruments like the Toronto Alexithymia Scale to measure Alexithymia and Body Shape Questionnaire-Short Version (BSQ-S), the Body Uneasiness Test (BUT), and the Body Attitude Test (BAT) to measure body image perception, they gained valuable insights into how the presence of the personality disorder Alexithymia affects the severity of Binge Eating Disorder. Also, as a valuable tool for counseling, BDI can be used to diagnose the slightest traces of depression in clients and to assist them get over it before it becomes a major disorder. Strengths and Weaknesses of Beck Depression Inventory The most obvious strength of the BDI as an instrument for measuring depression is reliability and validity. There are several studies that have demonstrated the reliability and validity of the instrument. Some of these have been mentioned earlier on in this paper. Most striking is the study of Saint Arnault, Sakamoto and Moriwaki (2006), where BDI was reported to have Cronbach's alpha value of .79 for the Japanese sample and a value of .87 for the American sample. However, another strength of the test mentioned by Schade (1998) is the tendency of the informing physicians and counselors of undiagnosed depressed patients in their practices. However, the primarily weakness of the test, as reported by Schade (1998) is lack of sensitivity and specificity, though he also attributed this weakness to other tools employed for measuring depression. This lack of sensitivity and specificity is also indicated in the study carried out by Hasama and Fujii (1989), as reported by Saint Arnault, Sakamoto and Moriwaki (2006), where though the cut of point for BDI was set at 11 instead of the normal 10, the specificity rate was 83.3 percent, with a false negative of 10 percent and a false negative of 17.3 percent. Also, Schade (1998) opined that though BDI as a depression screening tool indicates the severity of depression in patients, these patients were not in any way better than control subjects over a 12months follow up period. References CHELLAPPA, Sarah Laxhmi and ARAUJO, John Fontenele (2006). Excessive Daytime sleepiness in Patients with depressive disorder. Rev. Bras. Psiquiatr., vol.28, no.2, p.126-129. ISSN 1516-4446. Carano, Alessandro; De Berardis, Domenicoa; Gambi, Francescoa; Di Paolo, Cinzia; Campanella, Danielaa; Pelusi, Luciaa; Sepede, Giannaa; Mancini, Enrico; La Rovere, Raffaellaa; Salini, Gabrielea; Cotellessa, Carlaa; Salerno, Rosa Mariaa; Ferro, Filippo Mariaa (2006). Alexithymia and Body Image in Adult Outpatients with Binge Eating Disorder. International Journal of Eating Disorders, Vol: 39, Issue: 4, pp. 332 - 340 Schade, Charles P. (1998). A Ten-Year Review of the Validity and Clinical Utility of Depression Screening. Psychiatr Serv., Vol. 49 pp55-61 Saint Arnault, Denise, Shinji Sakamoto, Moriwaki Aiko (2006). Transcultural Psychiatry. Vol 43. No. 2 pp. 275-286. Zywiak, William H, Robert L. Stout, Winston B. Trefry, Irene Glasser, , Gerard J. Connors, Stephen A. Maisto, Verner S. Westerberg. (2006). Journal of Substance Abuse Treatment. Vol. 30. pp 349- 353 Carano, Alessandro, Domenico De Berardis, Francesco Gambi, Cinzia Di Paolo, Daniela Campanella, Lucia Pelusi, Gianna Sepede, Enrico Mancini, Raffaella La Rovere, Gabriele Salini, Carla Cotellessa, Rosa Maria Salerno, Filippo Maria Ferro (2006). International Journal of Eating Disorders. Vol. 39. No.4 pp. 332-340. Read More