The Beck Depression Inventory-II (BDI-II) (1996) is a universally used instrument in assessing and screening depression in individuals ages 13 and over in clinical and non-clinical settings. The BDI-II was revised from the original BDI (1961), and the changes have shown improvements in psychometrics, and the revised BDI-II adheres to the contemporary diagnostic criteria for depression in the DSM-IV (Mental Measurements Yearbook, 2001).
Some BDI items have been dropped for the BDI-II such as items including body image change, work difficulty, weight loss, and somatic complaints, and have been replaced with items pertaining to agitation, worthlessness, loss of energy, and concentration difficulty.
The remaining original items still included on the BDI-II are:
Qualification Level: C; therefore, professional school counselors cannot administer this assessment but should understand it’s functions and results.
Some BDI items have been dropped for the BDI-II such as items including body image change, work difficulty, weight loss, and somatic complaints, and have been replaced with items pertaining to agitation, worthlessness, loss of energy, and concentration difficulty.
The remaining original items still included on the BDI-II are:
- Pessimism, past failures, guilty feelings, self-dislike, self-criticalness, suicidal thoughts or wishes, crying, loss of pleasure, irritability, changes in appetite, changes in sleep patterns, and indecisiveness (Mental Measurements Yearbook, 2001).
Qualification Level: C; therefore, professional school counselors cannot administer this assessment but should understand it’s functions and results.
Format and Administration
The BDI-II is paper-and-pencil format. It consists of 21 self-report items, each scored on a 4-point Likert-type response scale ranging from 0 (absence of symptom) to 3 (severe manifestation of symptom) (Erford & Muller, 2012). Examinees are to circle and rate each statement according to their feelings over the last two weeks. The reading level of the BDI-II is 5th to 6th grade level, and may be read aloud if needed. The BDI-II is quick and easy to administer, takes 5-10 minutes to complete, and can be administered individually or in groups.
Scoring and Interpretation
The BDI-II is not norm-referenced, rather it is criterion referenced. Scores range from 0 to 63, with increased scores indicating severity of depressive symptoms. The following criterion score range/cutoff scores are: 0-13=minimal depression, 14-19=mild depression, 20-28=moderate depression, and 29-63=major depression (Erford & Muller, 2012). The BDI-II can be scored by hand or by computer.
The BDI-II is paper-and-pencil format. It consists of 21 self-report items, each scored on a 4-point Likert-type response scale ranging from 0 (absence of symptom) to 3 (severe manifestation of symptom) (Erford & Muller, 2012). Examinees are to circle and rate each statement according to their feelings over the last two weeks. The reading level of the BDI-II is 5th to 6th grade level, and may be read aloud if needed. The BDI-II is quick and easy to administer, takes 5-10 minutes to complete, and can be administered individually or in groups.
Scoring and Interpretation
The BDI-II is not norm-referenced, rather it is criterion referenced. Scores range from 0 to 63, with increased scores indicating severity of depressive symptoms. The following criterion score range/cutoff scores are: 0-13=minimal depression, 14-19=mild depression, 20-28=moderate depression, and 29-63=major depression (Erford & Muller, 2012). The BDI-II can be scored by hand or by computer.
Psychometric Properties
To test the psychometric properties of the BDI-II a study was conducted with a clinical sample of 500 outpatients, and a convenience sample of 120 Canadian college students. Coefficient alpha estimates reliability for the BDI-II with the outpatient sample was .92, and was .93 for the college sample, which illustrates strong reliability. The test-retest reliability after one week of initial administration for both samples was very good (.93). There is an issue of false positives, where the non-clinical samples scores were inflated based on the established criterion ranges, which seems to be unrealistic, therefore, caution must be given when interpreting results of adolescents in non-clinical samples such as schools. Though a criterion was established there is a lack of diagnostic validity in using the cutoff scores. Concurrent and convergent validity shows moderately high correlations between the BDI-II with the Hamilton Psychiatric Rating Scale for Depression-Revised and the Beck Hopelessness Scale.
Developmental Considerations
Though the BDI-II is a widely used instrument in assessing adolescent depression, the instrument may be tailored more for adults. A criterion has been established, but developmental considerations of adolescence such as feelings of sadness, issues with self-image and esteem, agitation, irritability etc. can be a normal part of adolescent development, to some degree. The criterion established by the BDI-II does not take age into account. A 14-year female with a score of 36 is not equivalent to a score of 36 for a 40-year old male, though the established criterion would suggest this. There is a need for norm-comparative samples.
Cultural Considerations
It should be noted that the clinical sample used in testing the psychometrics of the BDI-II was comprised of 500 individuals which were represented by 63% females, 91% Caucasians, who lived in the U.S east coast (urban and suburban areas). The non-clinical convenience sample from a Canadian college (n=120), were predominately White and consisted of 56% females. The average ages of both the clinical and non-clinical samples were 37.2 years old. Caution should be warranted in interpreting scores of (1) adolescents, since they were underrepresented in both samples, (2) minorities, since both samples were predominately White, and (3) adolescents living in other geographical locations, such as rural areas. Further investigation with different samples representing minorities, specific ages groups, geographical locations, and SES, is needed.
*The BDI-II has a Spanish version but has not been researched on its psychometrics.
To test the psychometric properties of the BDI-II a study was conducted with a clinical sample of 500 outpatients, and a convenience sample of 120 Canadian college students. Coefficient alpha estimates reliability for the BDI-II with the outpatient sample was .92, and was .93 for the college sample, which illustrates strong reliability. The test-retest reliability after one week of initial administration for both samples was very good (.93). There is an issue of false positives, where the non-clinical samples scores were inflated based on the established criterion ranges, which seems to be unrealistic, therefore, caution must be given when interpreting results of adolescents in non-clinical samples such as schools. Though a criterion was established there is a lack of diagnostic validity in using the cutoff scores. Concurrent and convergent validity shows moderately high correlations between the BDI-II with the Hamilton Psychiatric Rating Scale for Depression-Revised and the Beck Hopelessness Scale.
Developmental Considerations
Though the BDI-II is a widely used instrument in assessing adolescent depression, the instrument may be tailored more for adults. A criterion has been established, but developmental considerations of adolescence such as feelings of sadness, issues with self-image and esteem, agitation, irritability etc. can be a normal part of adolescent development, to some degree. The criterion established by the BDI-II does not take age into account. A 14-year female with a score of 36 is not equivalent to a score of 36 for a 40-year old male, though the established criterion would suggest this. There is a need for norm-comparative samples.
Cultural Considerations
It should be noted that the clinical sample used in testing the psychometrics of the BDI-II was comprised of 500 individuals which were represented by 63% females, 91% Caucasians, who lived in the U.S east coast (urban and suburban areas). The non-clinical convenience sample from a Canadian college (n=120), were predominately White and consisted of 56% females. The average ages of both the clinical and non-clinical samples were 37.2 years old. Caution should be warranted in interpreting scores of (1) adolescents, since they were underrepresented in both samples, (2) minorities, since both samples were predominately White, and (3) adolescents living in other geographical locations, such as rural areas. Further investigation with different samples representing minorities, specific ages groups, geographical locations, and SES, is needed.
*The BDI-II has a Spanish version but has not been researched on its psychometrics.