Examining scale discriminability in the BDI and CES-D as a function of depressive severity.

Scale discriminability is the ability of a measure to discriminate among individuals ordered along some continuum, such as depressive severity. We used a nonparametric item-response model to examine scale discriminability in the Beck Depression Inventory (BDI) and Center for Epidemiologic Studies Depression Scale (CES-D) in both college and depressed outpatient samples. In the college sample, the CES-D was more discriminating than the BDI, but a standard CES-D cutoff score of 16 overestimated the likely prevalence of depression (45%). The CES-D may be more effective than the BDI in detecting differences in depressive severity in college students but may be less specific. In the depressed outpatient sample, the CES-D was again more discriminating than the BDI. The superior scale discriminability of the CES-D offers one explanation for its poorer specificity in college samples. Endorsing many items that discriminate at low levels of depressive severity can result in scores that exceed a cutoff criterion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increases in depressive symptomatology in the rural elderly: Results from a cross-sectional and longitudinal study.

Depressive symptomatology was examined in a large sample of noninstitutionalized older adults using the Center for Epidemiological Studies-Depression scale (CES-D). Both cross-sectional and longitudinal data showed age-related increases in mean CES-D scores and increases in the percentage of respondents scoring at or above the cutoff score of 16. Variables collected at baseline in the longitudinal study from 2,032 participants 65 yrs of age and older were significant predictors of depressive symptomatology 3 and 6 yrs later. Baseline CES-D scores accounted for the largest proportion of the variance. (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.     

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)     

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)     

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)     

Magnetic resonance imaging correlates of depression in early- and late-onset Alzheimer''s disease

Even today psychotic depression is connected to a lot of unanswered questions. A self-questionnaire (BFD) was developed in order to evaluate cognitions corresponding to mood congruent depressive delusions. They were assumed to indicate psychotic depression and to be related to severity of the depressive syndrome. 42 depressed inpatients were examined by the BFD, the Hamilton Depression Scale (HAMD) and the Beck Depression Inventory (BDI). BFD scores were found increased in psychotic depression (p = 0.009) and correlated to BDI scores (p = 0.002). 19 re-examined patients showed a significant improvement in HAMD and BDI scores but not concerning the delusion indicating cognitions (BFD), which were significantly correlated to suicidality items of BDI and HAMD (p = 0.005). The results prove the delusion indicating nature of cognitions measured by the BFD and their correlation to severe depression. Differences in treatment response are indicated and persisting or increasing BFD scores seem to be accompanied by more severe suicidal tendency.     

Comorbidity of mental and insomnia disorders in the general population

The co-occurrence of insomnia and mental disorders constitutes the most prevalent diagnosis pattern found in sleep disorder clinics. Yet, there remains a paucity of epidemiological information regarding comorbidity of mental disorders and sleep disorder symptomatology in the general population. The present study showed results based on a large representative French cohort (n = 5,622; 80.7% of the contacted stratified sample). A total of 997 (17.7%) individuals with insomnia complaints were identified and divided into six diagnostic categories: (1) Insomnia related to a Depressive Disorder; (2) Insomnia related to an Anxiety Disorder; (3) Depressive Disorder accompanied by insomnia symptomatology; (4) Anxiety Disorder accompanied by insomnia symptomatology; (5) Primary Insomnia; and (6) isolated insomnia symptomatology. Telephone interviews were conducted using the Sleep-Eval System. Subjects with insomnia related to a Mental Disorder have a longer history of insomnia complaints and are usually younger than those with Depressive or Anxiety Disorders accompanied by insomnia symptoms. Subjects with Insomnia related to a Depressive Disorder experienced more repercussions than any other group. A surprisingly high percentage of individuals with depressive symptomatology had sought independent medical treatment specifically for their sleep problems, which raises the unsettling possibility that many cases of depression go undetected by the general medical community. The distinct predictability of commonly undiagnosed depression leading to chronic depression speaks directly to the imperative that physicians receive additional training in this area of community mental health.     

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)     

Factors affecting agreement between severely mentally ill alcohol abusers' and collaterals' reports of alcohol and other substance abuse.

This study examined subject-collateral reports of alcohol use among a sample of 167 dually diagnosed individuals seeking outpatient treatment at a community mental health clinic. All subjects met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a schizophrenia-spectrum or bipolar disorder and for alcohol abuse or dependence. Subjects were recruited within 2 weeks of treatment entry and completed measures of cognitive functioning, alcohol dependence severity, psychiatric symptoms, and quantity and frequency of substance use over the previous 60 days using the Timeline Follow-Back interview (L. C. Sobell & M. B. Sobell, 1996). They also provided a urine sample, which was screened for recent drug use. Collateral interviews were conducted by phone and included an assessment of the subject's alcohol and drug use over the same 60-day period. Collaterals also reported their confidence in the accuracy of their reports. Overall, the results indicated generally poor subject-collateral agreement. However, subject-collateral agreement appeared better for those individuals (n = 97) with negative urine drug screens. The most consistent predictor of subject-collateral discrepancy scores was subjects' recent drug use. Recommendations for enhancing the validity of self-reports of substance use in a severely mentally ill population are discussed. (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)     

Women and the family of the future

Prognostic indicators of short-term outcome were identified in 69 women with the DSM-III-R diagnosis of bulimia nervosa who participated in a weekly 10-session structured cognitive-behavioral outpatient group program. Prior to treatment, all subjects completed the computerized Diagnostic Interview Schedule (DIS), the Moos Family Environment Scale (FES), the Diagnostic Survey for Eating Disorders (DSED), the Beck Depression Inventory (BDI), the Hopkins Symptom Checklist, Revised (SCL-90-R), the Bulimic Cognitive Distortions Scale (BCDS), the Eating Disorders Inventory (EDI), and the Bulimic Symptoms Checklist (BSCL). The latter three scales were readministered on completion of the 10-week group. Symptom improvement was assessed by examining percentage reduction in binge frequency, purge frequency, and summed scores for the EDI subscales Bulimia, Drive for Thinness, and Body Dissatisfaction. The only significant predictor of improvement in binge frequency and bulimic cognitions was family environment. Conflicted, controlling, and over-organized family environments appear to impede both reductions in binge frequency and changes in bulimic cognitions. Reduction in vomit frequency was associated with weight history and with laxative or diuretic use. The implications for planning psychotherapeutic interventions in bulimia nervosa are discussed.     

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.     

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)     

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)     

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)     

Induction of depressive affect after prolonged exposure to a mildly depressed individual.

Administered the Beck Depression Inventory (BDI) to 44 undergraduate roommate pairs during the 1st, 5th, and 11th wks of a 13-wk quarter. 22 pairs contained mildly or moderately depressed Ss; the other 22 pairs contained only nondepressed Ss (NSs). These mildly or moderately depressed Ss included 8 unremitted depressives and 14 transient-remitted depressives. Analyses indicated that after 5 wks and 11 wks of living together, the roommates of unremitted depressives had significantly higher BDI scores than NSs. Moreover, their BDI scores at 5 and 11 wks were significantly higher than they were at the 1st wk. Results also show that at 5 and 11 wks the BDI scores of the roommates of transient-remitted persons were significantly higher than scores of NSs. Possible causes for this induction of depressive affect include direct induction stemming from day-to-day contact, a modeling process, or increased dysphoria associated with an unhappy roommate relationship. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of intensity of post-stroke depression and its relationship with the cerebral lesion location

BACKGROUND: Several studies have suggested a close relationship between intensity of poststroke depression and lesion location, but the relationships are not clear for some authors. In this study we try to test the hypothesis that the intensity of depression in an early stage (4th week) of cerebral vascular accidents (CVA) in related to lesion location and type of lesion. PATIENTS AND METHODS: In a sample of one hundred and thirty patients in the fourth week of the evolution of an unilateral CVA, 48 patients fulfilled research diagnostic criteria (RDC) of post-stroke depression (34 major depression; 14 minor depression). Schedule for Affective Disorders and Schizophrenia (SADS) and standard measures of intensity of depression (Hamilton's HRDS, Montgomery-Asberg's MADRS and Beck's BDI) were used. RESULTS: In the fourth week of the evolution of CVA's, depression intensity measures (HRDS and BDI) were significantly higher in anterior lesion when compared to posterior lesions. No significant differences were found between right and left lesions, but both were higher than in non-hemispheric lesions. No significant differences of prevalence or intensity of depression were found in relation to lesion type (hemorrhagic/ischaemic). CONCLUSION: The results confirm a relationship between intensity mood disorders after a cerebral vascular accident and the topography of the lesion.     

Pathological gambling subtypes.

Although pathological gambling (PG) is regarded in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a non-treatment-seeking community sample of gamblers and identified 3 PG subtypes. Gamblers partitioned into a simple PG cluster, characterized by low rates of comorbid psychopathology and trait scores near the normative mean; a hedonic PG cluster, characterized by moderate rates of comorbid psychopathology and a proclivity for excitement seeking and positive affect; and a demoralized PG cluster, characterized by high rates of comorbid psychopathology and a propensity toward negative affect, low positive emotionality, and disinhibition. The findings provide preliminary support for an empirically based typology of gamblers, distinguishable in terms of personality structure, which may reflect different etiologies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)