Critique: Beck Depression Inventory-II



Critique: Beck Depression Inventory-II

You are a mental health counselor currently working in an outpatient counseling clinic with adult clients. You are considering whether or not to adopt the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in your practice. Many of your clients seem to suffer from depression, and you think that using an instrument that specifically assesses depressive symptoms would help you in making an accurate diagnosis. You currently work 40 hours each week at the clinic and see about 20 clients each week for hour-long individual counseling sessions. The rest of your time is devoted to treatment planning, writing progress notes, staff meetings, and supervision.

Information about the BDI-II is located in Chapter 13. You are also provided with psychometric information below. After reviewing information about the BDI-II, answer the questions that follow.

Norm Group

Two samples were used to evaluate the psychometric characteristics of the BDI-II:

1. A clinical sample of 500 individuals who sought outpatient therapy at one of four outpatient clinics on the U.S. east coast (two of which were located in urban areas, two in suburban areas). The sample consisted of 317 (63%) women and 183 (37%) men, ranged in age from 13 to 86 years, and the average age was 37.2 years. The sample consisted of four racial/ethnic groups: White (91%), African American (4%), Asian American (4%), and Hispanic (1%).

2. A nonclinical sample of 120 Canadian college students was used as a comparative “normal” group. It consisted of 67 (56%) women and 53 (44%) men, was described as “predominantly White,” and the average age of the sample was 19.58.

Reliability

Internal consistency: Analysis of internal consistency yielded a Cronbach’s alpha of .92 for the clinical sample and .93.

Test-Retest Reliability: Test-retest reliability was assessed over a one week interval among a sub-sample of 26 outpatients from one clinic site (r = .93).

Validity

Content Validity: BDI-II item content was designed to be consistent with the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994).

Convergent Validity: Correlations between the BDI-II scores and other scales are as follows: the Beck Hopelessness Scale (r = .68), the Revised Hamilton Psychiatric Rating Scale for Depression (r = .71), and the Symptom Checklist-90-R Depression subscale (r = .89).

Discriminant Validity: The correlation between the BDI-II and the Revised Hamilton Anxiety Rating Scale = .47. The correlation between the BDI-II and the Beck Anxiety Inventory .60.

Questions:

1. Describe and evaluate the norm group. Do you think it is representative? Do you think the norm group is current? Do you believe the size of the norm group was large enough? Are the samples related to the population you intend to use the test with? Explain.

When considering this question I began thinking of all my interactions with parents about the assessments their students participated in. The norm group in the exam is based on the results of Americans residing on the East coast ages 13-86 and a non clinical sample of Canadian College students who’s average age was 19.58 years old. The Americans from the East Coast used as a norm group were White, African American, Asian American, and Hispanic. I think the norm group could of used people of Native American decent to help give a more representative norm group. I do not feel as if this assessment is current because it is not representative. In order for a assessment to be current, it must be representative. I do not believe the size of the norm group was large enough for my liking, but I feel as if the creators have a good starting point for further research. The samples are related to the population I intend on using it with because most of my students are Caucasian and ages 13 and above. Most of the students within the populous I intend on using this assessment are from Rural and Urban settings; this makes using this assessment more justifiable for me since the norm group is similar to the population I will provide Beck Depression Inventory-II to.

2. Describe and evaluate each method used to estimate reliability. Does the reliability evidence support a decision to use the instrument? Explain.

Reliability simple refers to the degree in which the test scores are dependable, consistent, and stable across all items of the test, across different forms of the test (computerized, paper and pencil), or across repeat administrations of the test. The methods used to estimate reliability in this instrument are Internal Consistency and Test-retest Reliability. Internal Consistency tells us how well each item relates independently to other items on the test, and how well they relate to the overall test score. Test-retest Reliability is found when we give the same test to the same test takers on two separate occasions. We can refer to the first time the test is given as T1, and the second time that the test as T2. The scores on the two occasions are then correlated. I find both of these methods to test reliability useful as I personally like using instruments that have a internal consistency reliability. The reliability evidence produced does make a supportive decision to use this instrument as they provide why their instrument is valid and reliable.

3. Describe and evaluate each type of validity evidence. Does the validity evidence support a decision to use the instrument? Explain.

To evaluate if this instrument is valid the creators are using content, convergent, and discriminative validity. In order to truly use this instrument I would want to use an updated version of the Beck Depression Inventory-II because the content validity is correlates to the DSM-4. Enhancements have been made to the DSM-IV in the new DSM-V. Content validity is where the content of an instrument clearly represents the content domain that the instrument is designed to asses. Convergent validity is where one should be able to reveal a correspondence or convergence between similar constructs. This instrument shows a connection with the Revised Hamilton Psychiatric Rating Scale for Depression, and the Symptom Checklist-90-R Depression subscale, who’s r= .89. Overall I believe the instrument is valid and shows supportive evidence that would benefit my students.

4. Describe the practical aspects of the instrument, focusing on issues related to time required for administration, ease of administration and ease of scoring.

I believe this instrument is practical for my use within the school setting. Since my priority is to enhance the academic achievement of my students I cannot keep them too long away from the classroom. This instrument helps me support my student’s needs while respecting my time constraints. The BDI-II takes approximately 5 minutes to administer by someone whose qualification level is B (Masters level credentials or experience in related field). Scoring can be done with ease by manually scoring the assessment or by processing it online with Q-global Scoring & Reporting.

5. Summarize the strengths and weakness of the inventory.

A major strength in this inventory is that the instrument is relatively inexpensive (about $60 with a software based scoring and reporting). This instrument is both reliable and valid, and can be administered in minutes. A weakness in this inventory is that it does not provide a diagnosis. This instrument solely reveals symptoms that can be correlated to a diagnosis in the DSM-IV. Overall I think it is a good instrument to use.

6. Based on your review of the BDI-II, would you adopt this instrument? Explain your answer.

Based on my review of the BDI-II I would adopt use of this instrument because it is both valid, and reliable, and aligns with use to the population I will be serving as a School Counselor. I anticipate the creators of the BDI-II to incorporate the DSV-V into their content. I say this because the DSM-V is relatively new. It would only make sense to have content validity with the new updates of every axis in mental health diagnosis. I would like to see the norm group expand to Native Americans as they contribute allot to what can be considered “normal” in the U.S. Other than these few gripes I have, I think it is a great tool for mental health professionals.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

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