Robert A. Steer

Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation

Abstract Research studies focusing on the psychometric properties of the Beck Depression Inventory (BDI) with psychiatric and nonpsychiatric samples were reviewed for the years 1961 through June, 1986. A meta-analysis of the BDIs internal consistency estimates yielded a mean coefficient alpha of 0.86 for psychiatric patients and 0.81 for nonpsychiatric subjects. The concurrent validitus of the BDI with respect to clinical ratings and the Hamilton Psychiatric Rating Scale for Depression (HRSD) were also high. The mean correlations of the BDI samples with clinical ratings and the HRSD were 0. 72 and 0.73, respectively, for psychiatric patients. With nonpsychiatric subjects, the mean correlations of the BDI with clinical ratings and the HRSD were 0.60 and 0.74, respectively. Recent evidence indicates that the BDI discriminates subtypes of depression and differentiates depression from anxiety.

Internal consistencies of the original and revised beck depression inventory

Studied internal consistencies of the 1961 and 1978 versions of the Beck Depression Inventory in two different samples of psychiatric patients. The alpha coefficient for the 598 inpatients and outpatients who were administered the 1961 version was .88, and the alpha coefficient for the 248 outpatients who were self-administered the 1978 version was .86. The patterns of corrected item-total correlations were also similar, and it was concluded that the internal consistencies of both versions were comparable.

Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care.

To ascertain how effective the Beck Depression Inventory for Primary Care (BDI-PC) was for differentiating medical inpatients who were and were not diagnosed with DSM-IV major depression disorders (MDD), this 7-item self-report instrument composed of cognitive and affective symptoms was administered to 50 medical inpatients along with the Depression subscale (HDS) from the Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983, Acta Psychiatrica Scandinavica, 67, 361-370). The Mood Module from the Primary Care Evaluation of Mental Disorders (Spitzer et al., 1995, Prime-MD instruction manual updated for DSM-IV) was used to diagnose MDD. The internal consistency of the BDI-PC was high (alpha = 0.86), and it was moderately correlated with the HDS (r = 0.62, P < 0.001). The BDI-PC was not significantly correlated with sex, age, ethnicity, or type of medical diagnosis. A BDI-PC cut-off score of 4 and above yielded the maximum clinical efficiency with both 82% sensitivity and specificity rates. The clinical utility of the BDI-PC for identifying medical inpatients who should be evaluated for MDD is discussed.

Scale for suicide ideation: Psychometric properties of a self‐report version

A self-report version of the Scale for Suicide Ideation (SSI) was administered to 50 inpatients diagnosed with mixed DSM-III psychiatric disorders and 55 outpatients with affective disorders. The self-report SSI was written for both paper-and-pencil and computer administration. The correlations between the self-reported and clinically rated versions for both inpatients and outpatients were greater than .90, which suggests strong concurrent validity. The Cronbach coefficient alphas for the paper-and-pencil and computer versions were also in the .90s and indicated high internal consistency. Furthermore, the mean SSI scores of the computer version for both the inpatients and outpatients were higher than the mean SSI scores of the clinical ratings; the patients described more severe suicide ideation than clinicians reported.

Sexually Abused Children Suffering Posttraumatic Stress Symptoms: Initial Treatment Outcome Findings

This study examined the differential effects of child or non-offending mother participation in a cognitive behavioral intervention designed to treat posttraumatic stress disorder (PTSD) and other behavioral and emotional difficulties in school-aged sexually abused children. The 100 participating families were randomly assigned to one of three experimental treatment conditions—child only, mother only, or mother and child—or to a community control condition. Pre- and post-treatment evaluation included standardized measurement of childrens behavior problems, anxiety, depression, and PTSD symptoms as well as of parenting practices. Two-by-two least-squares analyses of covariance were used to compare outcome measures. Results indicated that mothers assigned to the experimental treatment condition described significant decreases in their childrens externalizing behaviors and increases in effective parenting skills; their children reported significant reductions in depression. Children who were assigned to the experimental intervention exhibited greater reductions in PTSD symptoms than children who were not. Implications for treatment planning and further clinical research are discussed.

Dimensions of the Beck depression inventory‐II in clinically depressed outpatients

To ascertain the dimensions of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in clinically depressed outpatients, exploratory factor analyses were performed with the BDI-II responses of 210 adult (> or =18 years) outpatients who were diagnosed with DSM-IV depressive disorders. Two factors representing Somatic-Affective and Cognitive dimensions were found whose compositions were comparable to those previously reported by Beck, Steer, and Brown (1996) for psychiatric outpatients in general. A subsequent confirmatory factor analysis supported a model in which the BDI-II reflected one underlying second-order dimension of self-reported depression composed of two first-order factors representing cognitive and noncognitive symptoms. The clinical utility of using subscales based on these two latter first-order symptom dimensions was discussed.

Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients.

The psychometric properties of the Scale for Suicide Ideation--Current (SSI-C; Beck, Kovacs & Weissman, 1979, Journal of Consulting and Clinical Psychology, 47, 343-352) and the Scale for Suicide Ideation--Worst (SSI-W; Beck, Brown, Steer, Dahlsgaard & Grisham, 1997, in press) were explored. These 19-item clinician-administered scales measure current suicide ideation (SSI-C) as well as suicide ideation at its worst point in the patients life (SSI-W). For a sample of 4063 outpatients, both scales were positively correlated with a diagnosis of a principal mood disorder, a diagnosis of a personality disorder, and measures of depression and hopelessness. The relationship between the SSI-W and a history of suicide attempts was stronger (r = 0.50, P < 0.001) than the relationship between the SSI-C and previous suicide attempts (r = 0.31, P < 0.001). For 444 current and 1764 past suicide ideators, the SSI-C and the SSI-W had high internal consistencies (coefficient alpha s = 0.84 and 0.89, respectively). The SSI-C and the SSI-W were moderatedly correlated with each other (r = 0.51, P < 0.001). Iterated maximum-likelihood principal-factor analyses identified comparable Preparation and Motivation dimensions underlying both scales.

Prediction of eventual suicide in psychiatric inpatients by clinical ratings of hopelessness

A 9-point clinical rating scale was used to assess the severity of hopelessness in 141 patients hospitalized with suicidal ideation. The patients were followed from 5 to 10 years, and 10 (7.1%) eventually committed suicide. The mean hopelessness rating for the patients committing suicide was significantly higher than that for the patients not committing suicide. A cutoff score of 6 or above successfully predicted 9 (90.0%) of those committing suicide. The results supported previous findings in which self-reported hopelessness on the Beck Hopelessness Scale was reported to predict suicide in both psychiatric outpatients and inpatients.

Comparative Efficacies of Supportive and Cognitive Behavioral Group Therapies for Young Children Who have been Sexually Abused and their Nonoffending Mothers

The differential efficacies of supportive and cognitive behavioral group therapy models designed for young children (ages 2 to 8) who have experienced sexual abuse and their nonoffending mothers were compared. Forty-four mothers and their respective children participated in either supportive or cognitive behavioral therapy groups with the group format being randomly determined. Repeated measures MANOVAs indicated that compared to mothers who participated in the support groups, the mothers who participated in cognitive behavioral groups reported greater reductions at posttest in (a) their intrusive thoughts and (b) their negative parental emotional reactions regarding the sexual abuse. The children treated with cognitive behavioral therapy demonstrated greater improvement in their knowledge regarding body safety skills at posttest than did the children who received supportive therapy.

Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms

OBJECTIVE The present study sought to determine whether the 12-session pre- to posttest therapeutic gains that had been found by Deblinger, Lippmann. and Steer (1996) for an initial sample of 100 sexually abused children suffering posttraumatic stress disorder (PTSD) symptoms would be sustained 2 years after treatment. METHOD These sexually abused children, along with their nonoffending mothers, had been randomly assigned to one of three cognitive-behavioral treatment conditions, child only, mother only, or mother and child, or a community comparison condition, and were followed for 3 months, 6 months, 1 year, and 2 years after treatment. RESULTS A series of repeated MANCOVAs, controlling for the pre-test scores, indicated that for the three measures of psychopathology that had significantly decreased in the original study (i.e., externalizing behavior problems, depression, and PTSD symptoms), these measures at 3 months, 6 months, 1 year, and 2 years were comparable to the posttest scores. CONCLUSIONS These findings suggest that the pre- to post-treatment improvements held across the 2-year follow-up period. The clinical and research implications of these findings are discussed.