Beck Depression Inventory

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The Beck Depression Inventory ( BDI - Beck, Ward, Mendelson, Mock & Erbaugh, 1961) is a psychological test method that records the severity of depressive symptoms in the clinical field. It is not the depression per se, but only the severity of the depression that should be recorded (example BDI-FS). The method cannot be used as a screening method in the normal population because a corresponding representative sample is missing. According to the S3 guideline for unipolar depression, the following questionnaires are recommended for screening: "WHO-5 questionnaire on well-being", "Health questionnaire for patients (short form PHQ-D)" and the general depression scale (ADS). Another way of quickly identifying a possible depressive disorder is the so-called " two-question test ". However, the BDI and BDI-II are recommended for progress diagnosis.

The BDI was developed by the American psychiatrist Aaron T. Beck and named after him. In the questionnaire with 21 questions, the participant determines which of the four statements is most appropriate for him / her this week. For the evaluation, the sum values ​​of the individual ticked statements are added up. In the course of time, the procedure, initially intended as a standardized interview, was further developed into two processed forms, the BDI-1A (1978) and the BDI-II (1996). In addition to these two forms, there has been a short form of the BDI-II in German since autumn 2013, which is called BDI-FS (FS stands for "FastScreen") and records the severity of depression on the basis of the non-somatic symptoms. The different versions make it difficult to compare different research papers, which is why the version used should always be specified.

Development and history

The Beck Depression Inventory was developed in 1961 based on observations of depressed patients and their complaints. Symptoms were then described in the questionnaire that were often reported by depressed patients and not by non-depressed patients. In order to adapt the BDI to the changed diagnostic criteria of the DSM-IV, there was a revision of the American version of the BDI in 1996, which is called BDI-II.

A first adaptation of the BDI was published in 1994 by Martin Hautzinger , Maja Bailer, Hellgard Worall, and Ferdinand Keller. In 1995 a second revised edition of the BDI was published by the same authors. The German adaptation of the BDI-II comes from Martin Hautzinger, Ferdinand Keller, Christine Kühner. In 2000, Schmitt and Maes attempted a simplification as part of a DFG-funded longitudinal project. On the one hand, they did not answer the question about weight loss, since studies have shown that this question has the lowest selectivity (Hautzinger et al., 1994; Kammer, 1983), and on the other hand, they replaced the four alternative answers with a six-point scale (from 0 / never until 5 / almost always).

BDI

In the original American version from 1961, the subjects were asked how they were feeling right now. It was not until the 1978 version that they were asked retrospectively for a week. The first translations by Lukesch (1974) and Kammer (1983) are not exactly identical and refer to the first version from 1961.

The translation by Hautzinger et al. In 1994 was based on the American version from 1978. This translation from 1994 accordingly consists of 21 questions about how the patient has felt in the past week. There are four possible answers to each question, which are sorted according to their intensity.

Example:
(0) I am not sad.

(1) I am sad.

(2) I'm sad all the time and can't get away from it.

(3) I am so sad or unhappy that I can hardly bear it anymore.

The addition of the individual points can result in total BDI values ​​between 0 and 63.

The second revised edition of the German translation from 1995 is standardized for an age group between 18 and 80 years. The processing time is between 10 and 15 minutes. In the context of individual diagnosis, however, it is not justified to make a diagnosis of depression solely on the basis of a high BDI value, although values ​​of 18 and above were assessed as clinically significant in the 1994 manual.

BDI-1A

The BDI-1A is a revision of the original version. In this version, Beck made it easier to process the questions in the 1970s through simplified answer options. The internal consistency of this revised version was very good, with a Cronbach's alpha of 0.85. Unfortunately, the questionnaire did not cover all of the nine diagnostic criteria from DSM- III.

BDI-II

For the revised version BDI-II of the original version published in 1996, items matching the DSM-IV criteria for major depression were constructed on the one hand, and existing items were reformulated specifically for better comprehensibility and greater information gain on the other. The four questions have been replaced by new ones that cover symptoms of restlessness, worthlessness, difficulty concentrating and loss of energy. The questions about sleep and appetite disorders have been rephrased to include changes in both directions. Items related to symptoms, changes in body image, intense preoccupation with physical symptoms, weight loss, and work difficulties were eliminated from the procedure. In contrast to the BDI, the questioned period in the BDI-II was extended to two weeks. New thresholds have been calculated. The German translation comes from Hautzinger, Keller and Kühner in 2006. However, no findings on the German translation were reported in the manual.

Nowadays, the instrument is used not only in practice but also in research as a diagnostic tool and is used internationally. It has been translated into several European languages ​​as well as Arabic, Chinese, Japanese, and Persian.

Limit values ​​for the BDI-II:

  • 0–8: No depression
  • 9–13: Minimal depression
  • 14–19: Mild depression
  • 20–28: Moderate depression
  • 29–63: Severe depression

BDI-FS

The short form of BDI-II, published in 2013, was originally written by Aaron T. Beck , Gregory K. Brown and Robert A. Steerder and was published in 2000. The short form of the Depression Inventory excludes the somatic criteria of depression for the diagnosis of major depression according to DSM-IV and DSM-5 . As a result, the questionnaire works with only seven items. The processing time, like the evaluation, is 5 minutes each. The omission of the items on somatic complaints and performance is intended to improve the diagnosis of patients with medical problems, for whom the inclusion of the somatic criteria in the BDI-II led to a false increase in the prevalence of depression. The test procedure is therefore intended in practice for patient groups with specific clinical pictures, such as multiple sclerosis , cancer , chronic pain , addictions , HIV , but also with mixed underlying medical diseases.

execution

There is no time limit for completing the test (with pencil and paper or on the computer). Only the time it took to answer each individual item is noted. So there is no time pressure when processing. In the German version of the BDI there are four possible answers to each statement. It takes an average of 5 to 10 minutes including instruction.

evaluation

For the evaluation, all values ​​of the individual statements are added and then compared with limit values ​​(cut-off values). If a test person has marked several alternative answers for a question (for example 1 and 2), the marking with the highest point value is given (in this example 2). A separate gender or age-specific consideration of the values ​​was dispensed with in the BDI, as no systematic gender or age differences were found that could not be explained by chance.

According to the BDI, values ​​between 11 and 17 points indicate a "mild to moderate expression of depressive symptoms". In the BDI, values ​​of 18 and above are rated as clinically relevant, since this value is two standard deviations above the mean value for healthy people. In the context of individual diagnosis, however, it is not justified to make a diagnosis of depression solely on the basis of a high BDI value, although values ​​of 18 and above were assessed as clinically significant in the 1994 manual. The diagnosis should also be made differently in the BDI-II and the BDI-II should only be used to measure the severity.

According to Annex 2 of the S3 guideline / national care guideline for unipolar depression, the following values ​​apply to the BDI:

  • 0–9: no depression or clinically normal or remitted
  • 10–19: mild depressive syndrome
  • 20–29: moderate depressive syndrome
  • ≥ 30: severe depressive syndrome

According to Annex 2 of the S3 guideline / national care guideline for unipolar depression, the following values ​​apply to the BDI-II:

  • 0–12: no depression or clinically normal or remitted
  • 13-19: mild depressive syndrome
  • 20–28: moderate depressive syndrome
  • ≥ 29: severe depressive syndrome

See also

literature

  • M. Hautzinger, M. Bailer, H. Worall, F. Keller: BDI Beck Depression Inventory Test Manual . 2nd, revised edition. Publisher Hans Huber, Bern 1995.
  • M. Hautzinger, F. Keller, Ch. Kühner: BDI-II. Beck Depression Inventory. Revision. 2nd Edition. Pearson Assessment, Frankfurt 2009.
  • Aaron T. Beck, Gregory K. Brown, Robert A. Steer: Beck Depression Inventory FS (BDI-FS). Manual. German adaptation by Sören Kliem & Elmar Brähler. Pearson Assessment, Frankfurt am Main 2013.

Individual evidence

  1. ↑ a b c Bernhard Uhl: Palliative medicine in gynecology . Thieme, 2014, ISBN 978-3-13-171711-5 , pp. 30 ( limited preview in Google Book search).
  2. ↑ a b c d Lutz F. Hornke, Manfred Amelang, Martin Kersting, Niels Birbaumer, Dieter Frey: Subject area B: Methodology and methods / psychological diagnostics / personality diagnostics . Hogrefe Verlag, 2011, ISBN 978-3-8409-1525-3 , pp. 44–45 ( limited preview in Google Book search).
  3. ↑ a b DGPPN, BÄK, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs, DGRW (ed.): S3 Guideline / National Care Guideline Unipolar Depression - Long Version (Long Version Version 5) . 1st edition. 2009, p. 67 and 73 ( online ).
  4. ↑ Christian Schaipp: Validity and diagnostic usefulness of selected indirect and direct survey methods for diagnosing aggressiveness, neuroticism and psychological stability . Herbert Utz Verlag, 2001, ISBN 978-3-8316-0001-4 , p. 41–49 ( limited preview in Google Book search).
  5. ↑ Stefan Troche: On the dissociability of identity and location priming: Do age and idiopathic Parkinson's syndrome influence priming effects differentially . 1st edition. Cuvillier, Bern 2005, ISBN 978-3-86537-355-7 , p. 48 ( limited preview in Google Book search).
  6. ↑ a b c Brickenkamp Handbook of Psychological and Educational Tests . Hogrefe Verlag, 2002, ISBN 978-3-8409-1441-6 , Sp. 808–809 ( limited preview in Google Book search).
  7. ↑ Beck Depression Questionnaire - II . pearsonclinical.de. 18th July 2019.
  8. ↑ Optimization of the Beck Depression Inventory . uni-landau.de. Retrieved June 2, 2012.
  9. ↑ a b c d e f g Christian Schaipp: Validity and diagnostic usefulness of selected indirect and direct survey methods for diagnosing aggressiveness, neuroticism and psychological stability . Herbert Utz Verlag, 2001, ISBN 978-3-8316-0001-4 , p. 41 ( limited preview in Google Book search).
  10. ↑ a b c d e Martin Hautzinger, Maja Bailer, Hellgard Worall, Ferdinand Keller: Beck Depression Inventory (BDI). Test manual . 2nd Edition. Hans Huber, Bern 1995, ISBN 3-456-82702-4 .
  11. ↑ a b c d e Annette Schaub, Elisabeth Roth, Ulrich Goldmann: Cognitive-psychoeducational therapy for coping with depression: A therapy manual . Hogrefe Verlag, 2013, ISBN 978-3-8409-2432-3 , pp. 17 ( limited preview in Google Book search).
  12. ↑ Volker Köllner, Henning Schauenburg: Psychotherapy in dialogue - diagnostics and evaluation . Georg Thieme Verlag, 2012, ISBN 978-3-13-170041-4 , p. 38 ( limited preview in Google Book search).
  13. ↑ Aaron T. Beck, Gregory K. Brown, Robert A. Steer (2013). Beck Depression Inventory FS (BDI-FS). Manual. German adaptation by Sören Kliem & Elmar Brähler. Frankfurt am Main: Pearson Assessment.
  14. ↑ Volker Köllner, Henning Schauenburg: Psychotherapy in dialogue - diagnostics and evaluation . Georg Thieme Verlag, 2012, ISBN 978-3-13-170041-4 , p. 38 ( limited preview in Google Book search).
  15. ↑ Ralf F. Tauber, Carola Nisch: Treating Depressive Disorders Successfully: Practical Guide to Cognitive-Behavioral Approaches . Klett-Cotta, 2014, ISBN 978-3-608-20033-1 , p. 67–68 ( limited preview in Google Book Search).
  16. ↑ Bartmann et al. (Ed.): Clinical Psychiatric Rating Scales for Children and Adolescents ; Hogrefe Publishing House; 2011; Page 154ff; limited preview in Google Book search

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