Screening for Depression through Beck Depression Inventory

The Beck Depression Inventory (BDI) is a series of questions developed to measure the intensity, severity, and depth of depression in patients with psychiatric diagnoses. Its long form is composed of 21 questions, each designed to assess a specific symptom common among people with depression. A shorter form is composed of seven questions and is designed for administration by primary care providers. Aaron T. Beck, a pioneer in cognitive therapy, first designed the BDI.

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Development and history
Historically, depression was described in psychodynamic terms as "inverted hostility against the self". By contrast, the BDI was developed in a novel way for its time; by collating patients' verbatim descriptions of their symptoms and using these to structure a scale which could reflect the intensity or severity of a given symptom.

Throughout his work, Beck drew attention to the importance of "negative cognitions": sustained, inaccurate, and often intrusive negative thoughts about the self. In his view, it was the case that these cognitions caused depression, rather than being generated by depression.

Beck developed a triad of negative cognitions about the world, the future, and the self, which play a major role in depression. An example of the triad in action taken from Brown (1995) is the case of a student obtaining poor exam results:
  • The student has negative thoughts about the world, so he may come to believe he does not enjoy the class.
  • The student has negative thoughts about his future, because he thinks he may not pass the class.
  • The student has negative thoughts about his self, as he may feel he does not deserve to be in college.
The development of the BDI reflects that in its structure, with items such as "I have lost all of my interest in other people" to reflect the world, "I feel discouraged about the future" to reflect the future, and "I blame myself for everything bad that happens" to reflect the self. The view of depression as sustained by intrusive negative cognitions has had particular application incognitive behavioral therapy (CBT), which aims to challenge and neutralize them through techniques such as cognitive restructuring.
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BDI Purpose: Designed to determine presence and severity of symptoms of depression.

Population: Adolescents and adults.

Score: Produces single score indicating intensity of the depressive symptoms.

Time:  5-10 minutes, longer for patients with severe depression or obsession disorders.

Author: Aaron T. Beck, Robert A. Steer, and Gregory K. Brown.

Description: The Beck Depression Inventory Second Edition (BDI-II) is a 21-item self-report instrument intended to assess the existence and severity of symptoms of depression as listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 1994).  This new revised edition replaces the BDI and the BDI-1A, and includes items intending to index symptoms of severe depression, which would require hospitalization. Items have been changed to indicate increases or decreases in sleep and appetite, items labeled body image, work difficulty, weight loss, and somatic preoccupation were replaced with items labeled agitation, concentration difficulty and loss of energy, and many statements were reworded resulting in a substantial revision of the original BDI and BDI-1A. When presented with the BDI-II, a patient is asked to consider each statement as it relates to the way they have felt for the past two weeks, to more accurately correspond to the DSM-IV criteria.
    Suggested use:  The BDI-II is intended to assess the severity of depression in psychiatrically diagnosed adults and adolescents 13 years of age and older.  It is not meant to serve as an instrument of diagnosis, but rather to identify the presence and severity of symptoms consistent with the criteria of the DSM-IV.  The authors warn against the use of this instrument as a sole diagnostic measure, as depressive symptoms may be part of other primary diagnostic disorders.

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