The Beck Anxiety Inventory: A psychometric analysis.

Provides information on the Beck Anxiety Inventory (BAI) with respect to psychometric properties, gender differences, and relation to depression. A sample of 291 psychiatric patients (mean age 36.9 yrs) completed the BAI, and a subsample of 251 completed the Beck Depression Inventory (BDI). The results from factor analyses demonstrated that the BAI has 2 factors, corresponding to cognitive and somatic symptoms. Although men and women did not differ in terms of factor structures, they did differ on mean levels of cognitive and somatic symptom scores and on total BAI scores. Finally, it was found that BAI items were distinguishable from BDI items, suggesting that the symptoms measured in the 2 scales are not entirely overlapping. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia

Psychometric properties of the Beck Anxiety Inventory (BAI) (Beck and Steer, 1990) were investigated in a sample of 82 patients suffering from panic disorder with agoraphobia. Before and after brief treatment, patients completed a battery of questionnaires and, for 2-week periods, kept a daily panic diary in which they recorded panic attacks, fear of panic, and average anxiety. The BAI demonstrated excellent internal consistency and good test-retest reliability over a 5-week interval. A partial multitrait, multimethod correlation matrix provided evidence of convergent validity with other measures of anxiety and of divergent validity vis á vis measures of depression. Factor analyses of pretest scores and residual gain scores used to address criticism that the BAI is excessively panic-centric yielded mixed results. In one analysis, the BAI was loaded with multimethod measures of panic and anxiety and, in the other, with questionnaire methods of assessing anxiety and depression. However, the BAI was clearly distinguished from measures of fear of fear, a central construct in panic disorder, and agoraphobic avoidance. Finally, the BAI proved sensitive to change with treatment, yielding effect sizes for improvement comparable to those of other anxiety measures.     

The Beck Depression Inventory and Research Diagnostic Criteria: Congruence in an Older Population.

This study examined the congruence between conventional cutoff scores on the Beck Depression Inventory (BDI) and selected diagnostic classifications of the Research Diagnostic Criteria in a sample of 102 elders seeking psychological treatment. Only 16.67% were misclassified by customary BDI cutoff scores. Minor Depressive Disorders were less clearly identified than Major Depressive Disorders or nondepressed status. Similar results were obtained in a second sample of elders not seeking treatment. Findings support the utility of the BDI as a screening instrument for identification of clinically depressed elders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric evaluation of the Beck Anxiety Inventory with older medical patients.

Disadvantaged older medical outpatients (N?=? 197; ages 55–92) completed the Beck Anxiety Inventory (BAI). The instrument demonstrated high internal consistency and no significant differences by sex or race, suggesting that it is appropriate to use with diverse populations. Total BAI score correlated negatively with age. Confirmatory factor analysis revealed a good fit to a 4-factor model consisting of cognitive, autonomic, neuromotor, and panic symptoms. Although scores on the BAI and 2 widely used depression scales were significantly correlated, factor analysis distinguished BAI and depression scale items, suggesting that the instruments measure distinct constructs. These findings suggest that the BAI could serve as a valuable screening test for anxiety symptoms among primary care patients who are older and have low income. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decline in self-reported dysphoria after treatment entry in inner-city cocaine addicts.

This study examined self-reported dysphoria in 82 consecutive admissions to intensive outpatient treatment for cocaine abuse on whom data for the Beck scales for depression, anxiety, and hopelessness were available for intake and 4 subsequent weeks with no more than 1 missing data point. Mean scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) decreased significantly between intake and Week 1, with no further significant changes from Weeks 1–4. Similar drops in the rate of clinically significant BDI and BAI scores also were observed. Scores on the Beck Hopelessness Scale (BHS) showed no significant changes. By Week 4, rates of clinically significant depression, anxiety, and hopelessness were similar (17%, 13%, and 16%, respectively) . These findings suggest that assessing depression and anxiety using the BDI and BAI in this population should be postponed for at least 1 week after intake and that intake levels of self-reported mood may be inappropriate baseline measures for evaluating treatment effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric properties of the Beck Depression Inventory for Youth in a sample of girls.

A new measure has been developed to assess depressive symptoms, the Beck Depression Inventory for Youth (BDI-Y; J. S. Beck, A. T. Beck, & J. B. Jolly, 2001). This research extends previous validation research of BDI-Y total scores by examining internal consistency and convergent and predictive validity within a school-based sample (n = 859) of girls 9-13 years old by age level and for selected races or ethnic groups. Scores had high internal consistency, and there was support for using the BDI-Y to assess depressive symptoms. Reliability was slightly lower for 9-year-olds, but reliability and validity estimates did not differ by race or ethnic group. Finally, confirmatory factor analysis results provide some support for unidimensionality of scores but also point toward possible refinements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The latent symptom structure of the Beck Depression Inventory–II in outpatients with major depression.

The Beck Depression Inventory–II (BDI–II) is a self-report instrument frequently used in clinical and research settings to assess depression severity. Although investigators have examined the factor structure of the BDI–II, a clear consensus on the best fitting model has not yet emerged, resulting in different recommendations regarding how to best score and interpret BDI–II results. In the current investigation, confirmatory factor analysis was used to evaluate previously identified models of the latent symptom structure of depression as assessed by the BDI–II. In contrast to previous investigations, we utilized a reliably diagnosed, homogenous clinical sample, composed only of patients with major depressive disorder (N = 425)—the population for whom this measure of depression severity was originally designed. Two 3-factor models provided a good fit to the data and were further evaluated by means of factor associations with an external, interviewer-rated measure of depression severity. The results contribute to a growing body of evidence for the Ward (2006) model, including a General (G) depression factor, a Somatic (S) factor, and a Cognitive (C) factor. The results also support the use of the BDI–II total scale score. Research settings may wish to model minor factors to remove variance extraneous to depression where possible. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

This study compared the efficacy of 3 16-week treatments for depression in 63 patients with multiple sclerosis (MS) and major depressive disorder (MDD): individual cognitive- behavioral therapy (CBT), supportive expressive group therapy (SEG), and the antidepressant sertraline. Significant reductions were seen from pre- to posttreatment in all measures of depression. Intent-to-treat and completers analyses using the Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward, M. Medelson, J. Mock, & J. Erbaugh, 1961) and MDD diagnosis found that CBT and sertraline were more effective than SEG at reducing depression. These results were largely supported by the BDI-18, which eliminates BDI items confounded with MS. However, the Hamilton Rating Scale for Depression (M. Hamilton, 1960) did not show consistent differences between treatments. Reasons for this inconsistency are discussed. These findings suggest that CBT or sertraline is more likely to be effective in treating MDD in MS compared with supportive group treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a generalizable model of symptoms in major depressive disorder

BACKGROUND: This study has two goals: 1) to establish a generalizable model of the symptoms observed in outpatients with major depressive disorder (MDD); and 2) to compare symptom coverage of the Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C) and Self-Report (IDS-SR) to that of the Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI). METHODS: A factor analysis of IDS-C, IDS-SR, HDRS, and BDI items was carried out on 324 adult outpatients with MDD. Patients with coexisting Axis I or III illness or those taking psychotropic medication were excluded. RESULTS: Ten primary factors were identified, six of which were substantially intercorrelated, defining a second-order factor of general depression severity. Schmid-Leiman orthogonalization identified the symptoms most associated with general severity. CONCLUSIONS: The IDS provided more complete factors coverage than did the HDRS or BDI and thus may be more useful in research on symptom profiles.     

Utility of the Beck Depression Inventory with psychiatrically hospitalized adolescents.

Investigated whether the Beck Depression Inventory (BDI) is a psychometrically sound instrument for measuring depressive symptomatology in 78 12–16 yr old psychiatrically disturbed adolescents. Test–retest, item-total, and coefficient alpha estimates of reliability were found to be statistically acceptable. BDI scores discriminated between patients with a hospital diagnosis of major depressive disorder and a diagnostically heterogeneous group of patients with nonaffective conditions. Results suggest that the BDI can be used profitably in clinical and treatment studies of depressive phenomena in early adolescence. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Normative values for the Beck Anxiety Inventory, Fear Questionnaire, Penn State Worry Questionnaire, and Social Phobia and Anxiety Inventory.

Community norms are reported for the Beck Anxiety Inventory (BAI; A. T. Beck, N. Epstein, G. Brown, & R. A. Steer, 1988), Fear Questionnaire (FQ; I. M. Marks & A. Mathews, 1979), Penn State Worry Questionnaire (PSWQ; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990), and Social Phobia and Anxiety Inventory (SPAI; S. M. Turner, D. C. Beidel, C. V. Dancu, & M. A. Stanley, 1989). The demographic profile of the samples closely matched the 1990 U.S. national census. On the SPAI, women scored higher than men on the Agoraphobia subscale, and the lowest income group scored higher than higher income participants on the Difference and Social Phobia subscales. Participants under 45 years of age exceeded those aged 45–65 on the BAI, the PSWQ, and FQ Social Phobia, Blood/Injury, and Total Phobia scores. Percentile scores are provided for all measures, as well as discussion of their usefulness for assessing clinical significance of therapy outcomes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Brain Lesion Volume and Neuropsychological Function Predict Efficacy of Treatment for Depression in Multiple Sclerosis.

This study examined the effects of brain lesions and neuropsychological impairment on the efficacy of treatment for depression in patients with comorbid diagnoses of multiple sclerosis (MS) and major depressive disorder (MDD). Thirty patients meeting criteria for MS and MDD received 1 of 3 16-week treatments for depression and were followed for 6 months following treatment cessation. T2-weighted magnetic resonance imaging and neuropsychological evaluations were also obtained. End-of-treatment Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) results residualized for baseline BDI were related to right temporal periventricular lesion volume (R2=.32, p=.002) and left temporal grey-white junction lesion volume (R2=.19, p=.02) but were not statistically related to lesion volume in any other brain region or to neuropsychological function. BDI results at 6-month follow-up, residualized for end-of-treatment BDI, were predicted by total lesion volume (R2=.22, p=.005), lesion volume in many discrete areas, and neuropsychological functioning (R2=.29, p=.0009). The effect of total lesion volume on 6-month follow-up BDI results was fully mediated by neuropsychological function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The latent structure of analogue depression: Should the Beck Depression Inventory be used to classify groups?

Research on depression is often conducted with analogue samples that have been divided into depressed and nondepressed groups using a cutoff score on the Beck Depression Inventory (BDI). Although the relative merits of different cut scores are frequently debated, no study has yet determined whether the use of any cut score is valid, that is, whether the latent structure of BDI depression is categorical or dimensional in analogue samples. The BDI responses of 2,260 college students were submitted to 3 taxometric procedures whose results were compared with those of simulated data sets with equivalent parameters. Analyses provided converging evidence for the dimensionality of analogue depression, arguing against the use of the BDI to classify analogue participants into groups. Analyses also illustrated the notable impact of pronounced skew on taxometric results and the value of using simulated comparison data as an interpretive aid. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder.

The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential functioning of the Beck Depression inventory in late-life patients: Use of item response theory.

The present analyses examined age-related measurement bias in responses to items on the revised Beck Depression Inventory (BDI) in depressed late-life patients versus midlife patients. Item response theory (IRT) models were used to equate the scale and to differentiate true-group differences from bias in measurement in the 2 samples. Baseline BDI data (218 late life and 613 midlife) were used for the present analysis. IRT results indicated that late-life patients tended to report fewer cognitive symptoms, especially at low to average levels of depression. Conversely, they tended to report more somatic symptoms, especially at higher levels of depression. Adjusted cutoff scores in the late-life group are provided, and possible reasons for age-related differences in the performance of the BDI are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of change in depressive symptoms during smoking cessation: Who's at risk for relapse?

The authors examined patterns of change in depressive symptoms during smoking cessation treatment in 163 smokers with past major depressive disorder (MDD). Cluster analysis of Beck Depression Inventory (A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) scores identified 5 patterns of change. Although 40% of participants belonged to clusters characterized by increasing depressive symptoms during quitting (rapid increasers, n=31, and delayed increasers, n=35), almost 47% were in clusters characterized by decreasing symptoms (delayed decreasers, n=24, and rapid decreasers, n=52). Both rapid and delayed increasers had especially poor smoking cessation outcomes. Results suggest that among smokers with an MDD history there is substantial heterogeneity in patterns of depressive symptoms during quitting and that patterns involving increased symptoms are associated with low abstinence rates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two-Year Prospective Naturalistic Study of Remission From Major Depressive Disorder as a Function of Personality Disorder Comorbidity.

In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the Longitudinal Interval Follow-Up Evaluation at 6-, 12-, and 24-month follow-ups. Survival analyses revealed an overall 24-month remission rate of 73.5% for MDD that differed little by gender. Participants with MDD who had certain forms of coexisting PD psychopathology (schizotypal, borderline, or avoidant) as their primary PD diagnoses had a significantly longer time to remission from MDD than did patients with MDD without any PD. These PDs emerged as robust predictors of slowed remission from MDD even when controlling for other negative prognostic predictors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A psychometric comparison of the Beck Depression Inventory-II in English and Spanish.

The Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) is a widely used measure of depressive symptomatology originally authored in English and then translated to Spanish. However, there are very limited data available on the Spanish translation. This study compared the psychometric characteristics of the BDI-II in Spanish and English in a sample of 895 college students. The instrument was administered twice with a 1-week interval, either in the same language on both occasions or in a different language on each occasion. Results show strong internal consistency and good test-retest reliability in both languages. Confirmatory factor analysis demonstrated that the published English-language factor structure showed good fit with data from the Spanish instrument. Among bilingual participants who took the BDI-II in both languages, there was no significant language effect. These data provide initial evidence of comparable reliability and validity between the English and Spanish BDI-II in a nonclinical sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specificity and generality of motivational components in depression: A personal projects analysis.

Features of depression, as measured by the Beck Depression Inventory (BDI), were distinguished from anxiety, as assessed by the Beck Anxiety Inventory (BAI), and were explored from a goals perspective using the Personal Projects Analysis methodology (B. R. Little, 1983). Ss were 152 undergraduates. Depression and anxiety were found to reflect a "negative" appraisal pattern characterized by goals rated high in stress and difficulty, and low in structure, control, perceived skill, and positive outcome expectancy. Depression also revealed distinctive features not found in anxiety (e.g., goals that are perceived as being less visible to important others). A goal-based approach to research and diagnosis is presented, and implications for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exercise of young thoroughbred horses increases impact strength of the third metacarpal bone

OBJECTIVE: The aim of this study was to assess the frequency and severity of depressive symptoms, to determine the rate of depressive disorder, to explore possible reasons for the development of depressive symptoms and to examine the effects of depression in a group of human immunodeficiency virus (HIV)-positive patients. METHOD: HIV-positive patients attending an outpatient treatment facility were assessed by the research psychologist and completed a number of questionnaires: the Beck Depression Inventory (BDI); the Life Event Inventory (LEI); the Core Bereavement Item (CBI-17) questionnaire; and the Psychosocial Adjustment to illness Scale (PAIS). Patients scoring > or = 14 on the BDI were seen by the psychiatrist for further assessment, and where appropriate, diagnoses were made according to DSM-III-R criteria. RESULTS: One hundred and ninety-two patients participated in the study; 95 scored > or = 14 on the BDI and one-third of these were found to have a depressive disorder. Factors significantly predictive of a BDI score > or = 14 were: an LEI score > 77; a diagnosis of acquired immunodeficiency syndrome (AIDS); being on sickness benefits or a pension; no current relationship; and a past history of depression. Few differences were demonstrated between those with a depressive disorder and those with a BDI score > or = 14 but no diagnosis of depressive disorder. Both groups had high mean PAIS scores indicating significant illness effects in multiple areas of function. CONCLUSIONS: Depressive symptoms are common among patients with HIV infection. Few factors differentiate between patients with a depressive disorder and those whose depressive symptoms do not meet diagnostic criteria. Substantial disability is present in both groups.