Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory-Second Edition in a sample of college students

We examined the psychometric properties of the Beck Depression Inventory-Second Edition (BDI-II) [Beck et al., 1996, San Antonio: The Psychological Corporation]. Four hundred fourteen undergraduate students at two public universities participated. A confirmatory factor analysis supported the BDI-II two-factor structure measuring cognitive-affective and somatic depressive symptoms. In addition, the internal consistency was high and the concurrent validity of the BDI-II was supported by positive correlations with self-report measures of depression and anxiety. These findings replicate prior research supporting the validity and reliability of the BDI-II in a college sample.     

Beck Depression Inventory II: evaluation of the psychometric properties and cut-off points in a Turkish adult population

Numerous studies have been previously conducted to assess the Beck Depression Inventory-II's [BDI II; Beck et al., 1996] psychometric properties. However, none of these studies has examined whether the original cut-off scores were applicable to other cultures. Thus, in addition to evaluating its psychometric properties, we also determined the cut-off scores of the BDI II for the Turkish population. Data from nonclinical (n = 362) and clinical psychiatric outpatients diagnosed as depressive disorder according to DSM-IV criteria (n = 176) were gathered. Analyses for internal consistency and test-retest reliabilities and for convergent and discriminant validities were computed. Two confirmatory factor analyses, one derived from the present exploratory factor analyses and the other proposed in the original study were conducted for both groups. A receiver operating characteristics curve was utilized to determine the cut-off scores for the Turkish population revealing 0-12 for minimal, 13-18 for mild, 19-28 for moderate and 29-63 for severe depression. The internal consistency for the nonclinical and clinical groups were .90 and .89, respectively; test-retest stability was also high (r = .94). Convergent and discriminant validity results were satisfactory. Findings confirmed the present model for the clinical group and equally confirmed both models for the nonclinical group. Furthermore, the cut-off scores to classify minimal, mild, moderate, and severe depression were quite akin to the cut-off points previously suggested for the American population. Taken as a whole our findings revealed that BDI II has sound psychometric properties and comparable cut-off scores for the Turkish population.     

A comparison of the Major Depression Inventory (MDI) and the Beck Depression Inventory (BDI) in severely depressed patients

Abstract

Background. We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression. Methods. At the Department of Biological Psychiatry in Vienna currently depressed inpatients with either a depressive or a schizo-affective disorder filled out both MDI and BDI on day of admission and at a time-point two weeks later during their treatment. Furthermore the Hamilton Depression Scale (HAM-D) was administered by the treating clinician at both time-points. Results. In total, 51 patients were included in the study. The non-parametric item response analysis was preferred to the classical Cronbach coefficient α as the latter is influenced by the number of items in a questionnaire. MDI obtained a Mokken analysis coefficient above 0.40, indicating unidimensionality. To determine external validity severely depressed patients with psychotic symptoms (N = 10) were compared to the remaining non-psychotic depressed patients (N = 41). Although BDI and MDI showed a lower score for psychotic than for non-psychotic inpatients, the standard deviations for both were greater for psychotic inpatients. On the intercorrelations between the different scales, MDI showed for all coefficients values above 0.70. On the other hand BDI and MDI both showed the same degree of linear relationship as the usual versions of HAM-D. Conclusion. Our results demonstrate that the MDI had the highest coefficients values and was sufficient as a measure for depressive disorders in psychiatric patients.     

Use of the Beck Depression Inventory-II with African American primary care patients

The Beck Depression Inventory-II (BDI-II) is one of the most common self-report instruments used for depression screening. However, there is a lack of research examining the effectiveness of this instrument in detecting depression in an African American primary care sample. The current study included 220 African American primary care patients who completed the BDI-II and were administered a diagnostic interview to establish depressive diagnoses. Results indicated that depressed patients demonstrated significantly greater BDI-II total scores compared to non-depressed patients. The recommended cutoff score of 14 for screening for depression appears to be appropriate for African American patients in the primary care setting. This cutoff yielded sensitivity of 87.7% and specificity of 83.9%. Positive predictive value of the BDI-II was .70, and negative predictive value was .94. Similar to findings with predominantly Caucasian samples, current results suggest the BDI-II is an appropriate and accurate instrument to use for depression screening among African American primary care patients.     

Psychometric properties of an Arabic version of the fatigue severity scale in patients with stroke

Background: Post-stroke fatigue is a common symptom which needs to be assessed by a psychometrically sound tool.

Objectives: To investigate the psychometric properties of an Arabic version of the fatigue severity scale (FSS-A) in patients with stroke.

Methods: An observational, cross-sectional design was applied to 147 survivors of first-time stroke and 70 healthy participants. Internal consistency was measured by Cronbach’s α, while test-retest reliability was measured by intraclass correlation coefficients (ICCs). To assess validity, the FSS-A was correlated with the Fatigue Visual Analogue Scale (VAS-F), the Short Form 36 (SF-36) and its vitality domain (SF-36V), the stroke specific quality of life (SSQOL-A) and its energy domain (SSQOL-A-E), and the Beck Depression Inventory II (BDI-II).

Results: The FSS-A showed excellent internal consistency (Cronbach’s α = 0.934) and test-retest reliability (ICC = 0.920, 95% confidence interval (CI): 0.85–0.96). Exploratory factor analysis confirmed that the FSS-A is unidimensional. The FSS-A had high positive correlation with VAS-F, moderate positive correlation with BDI-II, high negative correlation with SSQOL-A-E and moderate negative correlations with SF-36, SF-36V, and SSQOL-A. It differentiated patients from healthy participants with a sensitivity of 78.4% and a specificity of 77.1%. The minimal detectable change with 95% CI was 1.02 (22.4%).

Conclusions: The FSS-A showed good psychometric properties suggesting its usefulness as a fatigue evaluation tool in patients diagnosed with stroke.     

Psychometric properties of a Persian-language version of the Automatic Thoughts Questionnaire: ATQ-Persian

AIMS: To examine the psychometric properties of a Persian-language version of Hollon and Kendall's (1980) Automatic Thoughts Questionnaire (ATQ-Persian)--a measure of negative automatic thoughts in depression. METHODS: In a sample of 125 student volunteers from two Iranian universities we assessed the internal consistency and test-retest reliability of ATQ-Persian, and examined its concurrent validity against the Beck Depression Inventory (Beck et al., 1996). We also examined the factor structure of the test through comparing the fit of various proposed factor-analytic models to the data using confirmatory factor analysis. RESULTS: ATQ-Persian had excellent internal consistency (Cronbach's alpha = 0.96), test-retest reliability (r = 0.84) and correlation with the Beck Depression Inventory (r = 0.77). Using a receiver operating characteristics curve, a score of 53 on ATQ-Persian was associated with a sensitivity of 89% and a specificity of 78% for detecting moderate to severe depression defined through Beck Depression Inventory. None of the proposed factorial models fitted the data well. However, models with correlated factors generally provided better fit than models with orthogonal factors, suggesting that the latent factors underlying ATQ-Persian are highly correlated. CONCLUSIONS: These data support the reliability and validity of ATQ-Persian as a measure of negative automatic thoughts in depression.     

Literacy and comprehension of Beck Depression Inventory response alternatives

This study explored the relationship of literacy level to comprehension of response alternatives from the Beck Depression Inventory (BDI). Twenty-nine adult basic education students, 14 senior citizens, and 20 oncology patients were given a brief literacy assessment and a comprehension test of selected BDI response alternatives. Three raters with clinical experience assessed comprehension. Lower literacy was significantly associated with less comprehension, even when other factors were controlled, yet comprehension problems were still found among higher literacy groups. The percent of participants who correctly paraphrased the selected BDI response alternatives ranged from 0 to 60%. These preliminary results suggest that poor comprehension of mental health measures is not only prevalent, but also cannot be estimated from patients' education or assessed reading levels.     

Psychometric evaluation of the Beck Depression Inventory in adults with social anxiety disorder.

Although the Beck Depression Inventory (BDI) is commonly used to assess levels of depressive symptoms in socially anxious adults, its psychometric properties in this context have never been formally examined. Therefore, we examined the psychometrics of the BDI in a sample of adults with a principal diagnosis of social anxiety disorder (N = 113). The BDI exhibited good internal consistency and re-test reliability. It also correlated significantly more strongly with other measures of depression than with measures of either social or non-social anxiety. Thus, the BDI appears to be a valid tool for the assessment of depressive symptoms in adults with social anxiety disorder.     

An appraisal of the psychometric properties of the Clinician version of the Apathy Evaluation Scale (AES-C)

This article examines the psychometric properties of the clinician version of the Apathy Evaluation Scale (AES-C) to determine its ability to characterize, quantify and differentiate apathy. Critical appraisals of the item-reduction processes, effectiveness of the administration, coding and scoring procedures, and the reliability and validity of the scale were carried out. For training, administration and rating of the AES-C, clearer guidelines, including a more standardized list of verbal and non-verbal apathetic cues, are needed. There is evidence of high internal consistency for the scale across studies. In addition, the original study reported good test-retest and inter-rater reliability coefficients. However, there is a lack of replication on these more stable and informative measures of reliability and as such they warrant further investigation. The research evidence confirms that the AES-C shows good discriminant, convergent and criterion validity. However, evidence of its predictive validity is limited. As this aspect of validity refers to the scale's ability to predict future outcomes, which is important for treatment and rehabilitation planning, further assessment of the predictive validity of the AES-C is needed. In conclusion, the AES-C is a reliable and valid measure for the characterization and quantification of apathy.     

Psychometric properties of the Chinese version of the adult ADHD Self-report Scale

Although attention deficit/hyperactivity disorder (ADHD) in adulthood has become a topic of considerable interest to psychiatrists over the past decade, little is known about the prevalence or correlates of adult ADHD in the Chinese population. As a first step in addressing this problem, this study presents data on the psychometric properties of the Chinese version of the World Health Organization's Adult ADHD Self-report Scale (ASRS) in a sample of 1031 young males from an army base and 3298 young adults from two colleges. All participants completed the Chinese ASRS. Participants from an army base also completed a clinical assessment including the Wender Utah Rating Scale (WURS) for assessing childhood ADHD, the Impulsiveness Scale for measuring the severity of current impulsive behaviors, and information about substance use. Results showed good concordance (intraclass correlations = 0.80 approximately 0.85) and internal consistency (Cronbach's alpha = 0.83 approximately 0.91) among the ASRS subscales and moderate to high correlations between these subscales and the WURS (Pearson's correlations = 0.37 approximately 0.66). The Chinese ASRS also demonstrated the ability to predict childhood disruptive problems and habitual use of substances. Our findings suggest that the Chinese ASRS is a reliable and valid instrument to assist in screening for adult ADHD.     

Principal components of the Beck Depression Inventory and regional cerebral metabolism in unipolar and bipolar depression.

BACKGROUND: We determined clustering of depressive symptoms in a combined group of unipolar and patients with bipolar disorder using Principle Components Analysis of the Beck Depression Inventory. Then, comparing unipolars and bipolars, these symptom clusters were examined for interrelationships, and for relationships to regional cerebral metabolism for glucose measured by positron emission tomography. METHODS: [18F]-fluoro-deoxyglucose positron emission tomography scans and Beck Depression Inventory administered to 31 unipolars and 27 bipolars, all medication-free, mildly-to-severely depressed. BDI component and total scores were correlated with global cerebral metabolism for glucose, and voxel-by-voxel with cerebral metabolism for glucose corrected for multiple comparisons. RESULTS: In both unipolars and bipolars, the psychomotor-anhedonia symptom cluster correlated with lower absolute metabolism in right insula, claustrum, anteroventral caudate/putamen, and temporal cortex, and with higher normalized metabolism in anterior cingulate. In unipolars, the negative cognitions cluster correlated with lower absolute metabolism bilaterally in frontal poles, and in right dorsolateral frontal cortex and supracallosal cingulate. CONCLUSIONS: Psychomotor-anhedonia symptoms in unipolar and bipolar depression appear to have common, largely right-sided neural substrates, and these may be fundamental to the depressive syndrome in bipolars. In unipolars, but not bipolars, negative cognitions are associated with decreased frontal metabolism. Thus, different depressive symptom clusters may have different neural substrates in unipolars, but clusters and their substrates are convergent in bipolars.     

Reliability, validity and clinical utility of a Japanese version of the Social Adaptation Self-evaluation Scale as calibrated using the Beck Depression Inventory

Aim: The Social Adaptation Self‐evaluation Scale (SASS) was developed to assess the social impairment caused by depression. The purposes of this study were to develop a Japanese version of the SASS (SASS‐J) and to evaluate its reliability and validity. Methods: The SASS‐J and the 21‐item Beck Depression Inventory (BDI) were administered to 322 participants (95 working patients who were working while under treatment for depression, 99 non‐working patients who were absent from their work due to depression, and 128 healthy controls). The healthy controls underwent both questionnaires twice, at baseline and 2 weeks later, in order to assess test–retest reliability. Results: Cronbach's alpha was 0.81. Significance correlations were found between SASS‐J scores at baseline and 2 weeks later in healthy controls (R = 0.845, P < 0.001). There were negative correlations between the SASS‐J and BDI scores (ρ = –0.683, P < 0.001). Mean SASS‐J scores differed significantly among the three groups (working patients: 33.7 ± 7.9; non‐working patients: 25.2 ± 7.8; healthy controls: 36.1 ± 6.0 [mean ± SD]). The best compromise between the true positive and the false negative rate in this study was at a cut‐off point of 25/26. Conclusion: SASS‐J showed sufficient reliability and validity, and could be considered a suitable instrument to evaluate social functioning in depressive patients.     

A general factor model for the Beck Depression Inventory-II: validation in a sample of patients hospitalized with acute myocardial infarction

OBJECTIVE: Many studies have linked symptoms of depression after an acute myocardial infarction (AMI) to negative health outcomes, including mortality. It has been suggested, however, that this link may be due to biased measurement of depressive symptoms in post-AMI patients related to confounding with somatic symptoms related to AMI. The objective of this study was to validate a factor model for the Beck Depression Inventory-II (BDI-II) that would allow for modeling of depressive symptoms after explicitly removing bias related to somatic symptom overlap. METHODS: A total of 477 hospitalized post-AMI patients from 10 cardiac care units were administered the BDI-II. Confirmatory factor analysis models for ordinal data were conducted with MPLUS to test the fit of a model with a single General Depression factor (all 21 BDI-II items) and uncorrelated Somatic (5 items) and Cognitive (8 items) factors (G-S-C model) compared to standard correlated two-factor models. RESULTS: The G-S-C model fit as well or better than previously published correlated two-factor models. Seventy-three percent of variance in BDI-II scores is accounted for by the General Depression factor, whereas 11% and 13% respectively are accounted for by uncorrelated Somatic and Cognitive factors. CONCLUSIONS: The G-S-C model is a novel approach to understanding the measurement structure of the BDI-II, presents advantageous statistical and interpretive properties compared to standard correlated factor models, and provides a viable mechanism to test links between symptoms of depression, as measured by the General Depression factor, and health outcomes among patients with AMI after explicitly removing variance from somatic symptoms unrelated to the General Depression factor.     

Psychometric properties of the Chinese version of the Swanson, Nolan, and Pelham, version IV scale - parent form

This study aimed to establish the psychometric properties of parent ratings on the Chinese version of the Swanson, Nolan, and Pelham IV scale (SNAP-IV) in a school-based sample of 3534 students in grades 1 to 8 from two cities and two suburbs in Taiwan and 189 children diagnosed with attention deficit/hyperactivity disorder (ADHD) (aged 6 to 15) consecutively recruited from a medical center in Taipei. Parents completed the Chinese versions of the SNAP-IV, Strengths and Difficulties Questionnaire, and Child Behavior Checklist. The Chinese SNAP-IV demonstrated similar three factor structure (Inattention, Hyperactivity/Impulsivity, and Oppositional) as its English version, and satisfactory test-retest reliability (intraclass correlation = 0.59 approximately 0.72), internal consistency (alpha = 0.88 approximately 0.90), concurrent validity (Pearson correlations = 0.56 approximately 0.72), and discriminant validity. Boys scored higher than girls across the eight school grade levels. The SNAP-IV clearly distinguished children with ADHD from school-based participants. Comorbidity with oppositional defiant disorder/conduct disorder predicted higher SNAP-IV scores among children with ADHD. Our findings suggest that the Chinese SNAP-IV is a reliable and valid instrument for rating ADHD-related symptoms in both clinical and community settings in Taiwan.     

Psychometric properties of the revised Developmental Behaviour Checklist scales in Dutch children with intellectual disability

The present study assessed the reliability and validity of the revised scales of the Developmental Behaviour Checklist (DBC) in a Dutch sample of children with intellectual disability (ID). The psychometric properties of the parent and teacher versions of the DBC were assessed in various subsamples derived from a sample of 1057 Dutch children (age range = 6–18 years) with ID or borderline intellectual functioning. Good test–retest reliability was shown both for the parent and teacher versions. Moderate inter‐parent agreement and high one‐year stability was found for the scale scores. Construct validity was satisfactory, although limited by high informant variance. The DBC scales showed good criterion‐related validity, as indicated by significant mean differences between referred and non‐referred children, and between children with and without a corresponding DSM‐IV diagnosis. The reliability and validity of the revised DBC scales are satisfactory, and the checklist is recommended for clinical and research purposes.     

Psychometric properties of the Korean version of the Short Post-Traumatic Stress Disorder Rating Interview (K-SPRINT)

Aims:  The Short Post-traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) is a validated, eight-item, brief global assessment scale for PTSD. This report investigated the psychometric properties of the Korean version of the SPRINT (K-SPRINT).
Methods:  Eighty-seven PTSD patients, 47 other psychiatric patients, and 63 healthy control subjects were enrolled in the study. All subjects completed a psychometric assessment package that included the K-SPRINT and the Korean versions of the Clinician-Administered PTSD Scale (CAPS), the Beck Depression Inventory (BDI), and the State Trait Anxiety Inventory (STAI).
Results:  The K-SPRINT showed good internal consistency (Cronbach's α = 0.86) and test–retest reliability ( r  = 0.82). K-SPRINT showed moderatecorrelations with CAPS ( r  = 0.71). An exploratory factor analysis produced one K-SPRINT factor. The optimal diagnostic efficiency (91.9%) of the K-SPRINT was found at a total score of 15, at which point the sensitivity and specificity were 90.8% and 92.7%, respectively.
Conclusions:  The present findings demonstrate that the K-SPRINT had good psychometric properties and can be used as a reliable and valid instrument for the assessment of PTSD.