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)     

Anxiety and depression of mothers of children undergoing bone marrow transplant: Symptom prevalence and use of the Beck Depression and Beck Anxiety Inventories as screening instruments.

This study examined anxiety and depressive symptoms among 115 mothers of children undergoing bone marrow transplant and evaluated the ability of the Beck Anxiety Inventory (BAI; A. T. Beck, N. Epstein, et al., 1988) and the Beck Depression Inventory (BDI; A. T. Beck, 1978) to serve as screening tools for assessing generalized anxiety disorder (GAD), panic disorder (PD), and major depressive disorder (MDD). Mothers with BAI or BDI scores greater than or equal to 14 were administered a structured clinical interview. An additional 20% was randomly selected for interview to determine whether the scale cutoff was an accurate screening method. Among the 64 mothers interviewed, 20% received at least 1 of the 3 diagnoses. Although the BAI did not demonstrate predictive accuracy in assessing GAD and PD, the BDI did in assessing MDD. The results suggest that a subset of mothers may have an anxiety or depressive disorder and that investigators should use caution before using the BAI as a screening instrument for anxiety disorder. (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)     

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)     

Symptom communication of life event scales.

Investigated the extent to which symptom-like events (changes in eating, sleeping habits, social activities, revision of personal habits) on the Schedule of Recent Experiences contribute to correlations between the Beck Depression Inventory (BDI) and the Social Readjustment Rating Scale (SRRS). While symptom-like events were more highly correlated with the BDI scores of 170 postpartum women (mean age 26.6 yrs) than were SRRS items, removing them did not significantly lower SRRS–BDI correlations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement of depression and neuropsychological impairment in HIV-1 infection.

Depression and neuropsychological (NP) impairment were examined in 30 HIV-1 seropositive symptomatic, 15 seropositive asymptomatic, and 14 seronegative control participants. Items on the Beck Depression Inventory (BDI) were separated into somatic and affective components to examine effects of illness on depression. Twenty-two NP tests tapped motor and psychomotor function, cognitive flexibility, and memory. The symptomatic seropositive group had the highest mean depression scores. However, these group differences were seen with the somatic component, not the affective. No significant correlations were obtained between NP tests and the affective component. Although 3 of 11 psychomotor measures were modestly correlated with the BDI total and somatic component, depression was generally unrelated to NP performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the revised Beck Depression Inventory with intravenous drug users not in treatment.

Administered the revised Beck Depression Inventory (BDI) to 1,290 iv drug users who were not currently enrolled in a treatment program. A principal-components analysis indicated that the cognitive–affective and somatic–performance components found in psychiatric patients were also present in iv drug users, and subscales based on the compositions of these 2 components were derived. The correlations of the BDI total and 2 subscale scores with 25 of the iv drug users' background characteristics were calculated, and stepwise multiple regression analyses were used to identify the most meaningful correlates. Self-reported poor health was the most important correlate. The usefulness of the BDI for measuring self-reported depression in iv drug users who are not in treatment is discussed. (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.     

Screening for depression in primary care patients: Dimensionality of the Short Form of the Beck Depression Inventory.

In an attempt to discover factors that might explain the high misclassification rate of the short form of the Beck Depression Inventory (BDI) as a screening tool for depression in primary health care patients (primarily due to false positives), confirmatory factor analysis was used to test the dimensionality of the instrument with data from a sample of 598 family practice outpatients. A dual-factor specification provided a superior fit, with 2 moderately correlated factors (r?=?.722), identified and labeled Nonsomatic Symptoms and Somatic Symptoms. The items work inhibition and fatigue loaded together on the Somatic Symptoms factor, whereas the anorexia item loaded on both factors, and it is hypothesized that these symptoms are elevated in otherwise nondepressed, medically ill patients. Caution is urged in interpreting positive screens of the shorter BDI where somatic symptoms are elevated in the absence of nonsomatic symptoms. Alternative screening and diagnostic testing algorithms are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relaxation and cognitive treatments of anger.

60 undergraduates, selected on the basis of scores on the Trait form of the State-Trait Anger Scale, participated in cognitive and relaxation coping skill interventions for anger reduction or in a no-treatment control. Ss also completed measures such as the State form of the State-Trait Anxiety Inventory and the Beck Depression Inventory. By 4-wk follow-up, cognitive and relaxation groups reported significantly less general anger, physical symptoms of anger, daily ratings of anger, and less state anger and tendency to cope with verbal antagonism in response to imaginal provocations than did controls and did not differ from one another. Constructive coping in the imaginal provocations and trait anxiety showed the cognitive condition improved relative to the control, whereas the relaxation group did not differ significantly from other groups. No between-groups differences were found for personal anger situations, depression, or heart rate and coping via physical antagonism in response to provocations. One-year follow-up revealed maintenance of patterns for general anger and anxiety reduction. Results are discussed in terms of the value of applied relaxation for anger reduction. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A psychometric evaluation of the Beck Depression Inventory–II.

This article provides psychometric information on the second edition of the Beck Depression Inventory (BDI–II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996), with respect to internal consistency, factorial validity, and gender differences. Both measures demonstrated high internal reliability in the full student sample. Significant differences between the mean BDI and BDI-II scores necessitated the development of new cutoffs for analogue research on the BDI–II. Results from exploratory and confirmatory factor analyses indicated that a 2-factor solution optimally summarized the data for both versions of the inventory and accounted for a cumulative 41% and 46% of the common variance in BDI and BDI–II responses, respectively. These factor solutions were reliably cross-validated, although the importance of each factor varied by gender. The authors conclude that the BDI–II is a stronger instrument than the BDI in terms of its factor structure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral therapy in geriatric depression: Comment on Steuer et al.

Comments on and agrees with the findings of J. L. Steuer et al (see record 1987-21146-001) that both cognitive-behavioral and psychodynamic group therapies led to significant reductions in depression in geriatric patients, as measured by the short form of the Beck Depression Inventory (BDI) and by the Hamilton Psychiatric Rating Scale, but disagrees with their conclusion that the cognitive therapy did not produce a clinically meaningful treatment superiority. For the present study, a regression equation was used to predict equivalent short-form BDI values from full-scale scores in a clinical sample of 208 adult outpatients with affective disorders. It is suggested the significant treatment superiority obtained for cognitive therapy on the BDI is accurate and meaningful. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classifying college students as depressed or nondepressed using the Beck Depression Inventory: An empirical analysis.

In Study 1, the classification of 150 college students as nondepressed or mildly or moderately depressed was compared using Beck Depression Inventory (BDI) scores obtained on 2 occasions, either on the same day or 1 wk later. Whereas the overall test–retest reliability coefficients were acceptable, particularly when both administrations occurred on the same day, the consistency of classification of Ss into the mild and moderate levels of depression was poor. In an attempt to determine the factors contributing to the poor classification consistency, a 2nd study with 207 Ss compared the effect of exposure to the BDI on subsequent BDI responses. Ss who completed the BDI on 2 occasions showed significantly lower BDI scores compared to Ss exposed to an alternate depression inventory (the Self-Rating Depression Scale [SRDS]) or no prior questionnaire. In addition, a large percentage of Ss classified as moderately depressed following the initial BDI administration failed to be classified within the moderate categories on retesting the same day. Ss tested using the SRDS maintained the same depression classification when retested on the BDI. Item analyses failed to reveal significantly different amounts of change among individual BDI items. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common and specific dimensions of self-reported anxiety and depression: Implications for the cognitive and tripartite models.

The common and specific symptom dimensions of anxiety and depression proposed by the tripartite (L. A. Clark and D. Watson, see record 1991-32000-001) and cognitive (A. T. Beck, 1976; see also PA, Vol 74:33248) models were investigated in 844 psychiatric outpatients and 420 undergraduates. Principal-factor analyses with oblique rotations performed on the 42 items of the Beck Depression Inventory and Beck Anxiety Inventory for both samples revealed that there were 2 correlated factors, Depression and Anxiety. Second-order factor analyses of the interfactor correlation matrices indicated a large general distress or negative affect factor underlying the relationship between the 2 first-order factors. Specific depression and anxiety dimensions were apparent even after controlling for negative affect. The results were consistent with both the tripartite and cognitive models, with the cognitive and motivational symptoms specific to depression and the physiological arousal symptoms unique to anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of death within 11 years on cognitive performance in old age.

Six different cognitive tests and the Beck Depression Inventory (BDI) were given to 3,572 active community residents aged 49 to 93 years. Causes of death were ascertained for 443 who died between 36 and 3,903 days later. Subsequent survival predicted test scores during the 3,903 days and independently during Days 36 to 1,826 and Days 1,827 to 3,903. Scores on the BDI and cumulative verbal learning and vocabulary tests predicted mortality after demographics and performance on other cognitive tests had been considered. Predictors were similar for deaths from heart disease, malignancies, and other causes. A new finding that cognitive tests did not predict survival duration within the sample of deceased explains previous findings of greater terminal decline in performance for young than for elderly adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of activity to depression in adolescents: Development of the Adolescent Activities Checklist.

Developed an adolescent activities checklist (AAC) consisting of 100 items that assess pleasant and unpleasant activities. In an initial study with 151 8th–12th graders, the AAC subscales demonstrated high internal consistency and homogeneity. In a validation study conducted on 145 Ss, Unpleasant Activities total scores were correlated with Beck Depression Inventory (BDI) scores and with the Pleasant Activities total scores. Analysis of Ss with extreme BDI scores indicated differences on Unpleasant but not on Pleasant Activities total scores. The AAC appears to be a reliable index of the frequency of pleasant and unpleasant activities reported by adolescents. (20 ref) (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.     

"Cognitive-behavioral therapy in geriatric depression": Reply to Riskind, Beck, and Steer.

Responds to the challenge by J. H. Riskind et al (see record 1986-12531-001) to the interpretation by J. L. Steuer et al (see record 1984-21146-001) that changes observed on the Beck Depression Inventory (BDI) in depressed geriatric patients treated with cognitive-behavioral (CB) group psychotherapy did not demonstrate superiority for CB therapy over a psychodynamic approach. Riskind et al proposed that somatic items on the other rating instruments used might not be valid in geriatric patients and thus might render those scales less sensitive. Reanalyses of the psychotherapy data and data from a placebo-controlled study of tricyclic antidepressants by the present 3rd author et al (see record 1983-21474-001) did not support this assertion. Somatic items proved to be sensitive to change in both studies. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective ratings and startle modulation in people with nonclinical depression.

This study tested predictions based on the emotion context insensitivity (ECI) hypothesis of Rottenberg, Gross, and Gotlib (2005) that a nonclinical sample of people with depressive symptoms would show reduced responses to both positive and negative stimuli relative to people without depression and would show an enhanced response to novelty. Seventy individuals completed diagnostic questionnaires, made ratings of 21 affectively valenced pictures, and then viewed the same 21 pictures and 21 novel pictures while startle blink responses were recorded from electromyographic activity of the orbicularis oculi. People with scores on the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) indicative of depression demonstrated a lack of affective startle modulation compared to the nondepression group. For all participants, the startle response was larger for novel pictures than for previously viewed pictures, but scores on the BDI were not related to response to novelty. Taken together, the results suggest that nonclinical depression is associated with a lack of affective modulation of startle, as has been shown for clinical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unique and interactive effects of depression, age, socioeconomic advantage, and gender on cognitive performance of normal healthy older people.

A sample of 4,243 residents of Manchester and Newcastle-upon-Tyne, England, aged 50 to 93 yrs, completed the Beck Depression Inventory and a battery of 6 different cognitive tests. Beck scores were low, indicating gradations of dysphoria rather than clinical depression. Beck scores did not vary with age but were significantly higher for women than for men and for disadvantaged than for advantaged socioeconomic groups. Measures of fluid, but not of crystallized, ability declined as age increased. Socioeconomic disadvantage was associated with poorer performance on all cognitive tests. Men scored higher on a test of spatial reasoning, and women scored higher on a test of word definition and on 2 tests of verbal memory and learning. However, after variance associated with these demographic and individual difference variables was considered, and within a range indicative of dysphoria rather than clinical depression, higher Beck scores were associated with significantly poorer performance on both crystallized and fluid measures of cognitive ability. This association was less marked in women than in men, but age, socioeconomic advantage, and estimated lifetime intellectual ability did not act as protective or risk factors for vulnerability of cognitive processes to dysphoria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)