What Is The Beck Depression Inventory?
Updated May 17, 2019
Reviewer Whitney White, MS. CMHC, NCC., LPC
The Beck Depression Inventory is a self-report assessment that measures symptoms of depression. It is often used by clinicians and doctors to determine if a patient needs treatment for a depressive episode or major depressive disorder. The Beck Depression Inventory has gone through two revisions over the years since its inception.
To better understand what the Beck Depression Inventory is and how it is used, it is important first to understand what it measures, how it was developed, and how to use it. You can request to take the Beck Depression Inventory from your doctor, or you can find it online to take a self-assessment for use in determining if you need to seek help from a professional.
What Is Depression?
Depression is a clinical term used to describe unreasonable or unfounded feelings of sadness. It is common for people to experience some sadness about events that occur in their lives, such as a loss, financial stress, or emotional relationships and situations. However, when a mood of sadness persists for a long period with no rational prompting, or with no resolution even if an event prompts it, it becomes a clinical diagnosis.
One can have a depressive episode that is isolated, or they may be diagnosed with the major depressive disorder. A depressive episode is one that mimics major depressive disorder but may be a completely isolated incident. The major depressive disorder is characterized by repeated episodes of depression over a long period.
A chemical imbalance causes depression in the brain. It is often treated through psychotherapy and medication therapy. Psychotherapy provides the patient with coping mechanisms and techniques that relieve symptoms of depression, while medication therapy corrects the chemical imbalance.
Who Is Beck?
The Beck Depression Inventory was developed by Aaron T. Beck, a famous psychologist that brought new insights to psychotherapy and metrics for diagnosing mood disorders. In addition to developing the Beck Depression Inventory, he also developed the Beck Hopelessness Scale and the Beck Anxiety Inventory. He also was the leading driving force behind the development of cognitive behavioral therapy, which is now universally used to treat some mood and emotional disorders.
History Of The Beck Depression Inventory
The Beck Depression Inventory was initially developed in 1961. It was based on statements that were frequently made by people who were diagnosed with depression. The inventory measured the severity of different statements to determine how much depression symptoms were affecting the lives of the patient.
There was some initial criticism of the scale, and it was revised in 1978 to the BDI-IA. The instructions for the depression scale changed slightly, as did some of the questions. However, this scale also had some shortcomings. With the publication of the DSM-IV, the manual used to diagnose mental health disorders at the time, the scale was revised again to the BDI-II in 1996. Most of the questions changed in this revision, although the instructions and the scoring remained very similar. The BDI-II is the version most commonly used today.
The Validity Of The Beck Depression Inventory
The validity of the Beck Depression Inventory has been verified again and again over the years. Multiple studies have been done, both by Beck and by others, that have proven that this depression scale is a good indicator of the presence of depression in outpatient settings. The studies find that it has about an 80 percent accuracy rate in assisting in diagnosis and treatment.
BDI-II Based On Diagnostic Criteria Of DSM-IV
The BDI-II, the most recent version of the Beck Depression Inventory, is based on the diagnostic criteria for a major depressive episode or major depressive disorder found in the DSM-IV, which is the universal diagnostic tool used by mental health professionals.
The diagnostic criteria of the DSM-IV require that symptoms be present for at least two weeks, which is reflected in the instructions of the Beck Depression Inventory. It also requires that these symptoms include persistent feelings of sadness as well as at least five additional symptoms.
The symptoms for diagnosis, and that are the basis for the questions on the BDI-II, are:
- Sad mood most of the day
- Lessening of pleasure in all or most activities
- Unintentional weight loss or weight gain
- Changes in sleep habits, such as insomnia or sleeping too much
- Agitation noticed by others
- Fatigue and tiredness, a lack of energy
- Feelings of worthlessness and excessive guilt
- Difficulty concentrating or making decisions
- Recurring thoughts of death or suicide
Once the Beck Depression Inventory was revised to include questions that relate to these symptoms, it was much more widely accepted. It is currently used today by many clinicians, psychologists, and even primary care doctors to determine if people need to seek out professional outpatient treatment for depression.
Who Should Take The Beck Depression Inventory
The Beck Depression Inventory should be taken by anyone who has overwhelming feelings of sadness lasting at least two weeks. The inventory can be used to determine if further intervention needs to occur. If you have recently gone through a significant loss, such as a death, or other events that would typically cause sadness, you may not need to take the Beck Depression Inventory. However, if you have feelings of sadness that do not stem from such an event or that last for months or years after the event, you may require further assistance. The BDI can help you determine if that help is needed.
Questions On The BDI-II
There are 21 questions on the Beck Depression Inventory. These 21 questions are based on the diagnostic criteria found in the DSM-IV manual used by psychiatrists and psychologists for the diagnosis of mental health disorders. The 21 questions are multiple choice, with the scoring of 0 to 3 assigned to the answers.
The questions on the Beck Depression Inventory relate to:
- Past failure
- Loss of pleasure
- Guilty feelings
- Punishment feelings
- Suicidal thoughts
- Loss of interest
- Loss of energy
- Changes in sleep
- Changes in appetite
- Concentration difficulty
- Fatigue or tiredness
- Loss of interest in sex
These 21 points are covered in multiple choice questions that are designed to determine the severity of these symptoms. Answering with the first answer of the multiple choice indicates that you do not have a problem with that symptom at all, while the final choice would indicate severe impairment.
How To Take The Beck Depression Inventory
Taking the beck depression inventory is extremely easy to do. The inventory does require a fifth to sixth-grade reading level to be able to understand the questions, and multiple choice answers fully. Someone with a lower reading level may need assistance in filling out the questionnaire.
The BDI takes about ten minutes to complete. Some people may be able to complete it much faster, especially if they have taken the assessment in the past and are familiar with the questions. However, someone with a lower reading level or severe difficulty concentrating may take longer to take the assessment.
For the assessment, you are asked to think about how the questions relate to the last two weeks specifically. Each question has four multiple choice answers to choose from, ranging in severity. Simply choose the answer that most closely describes how you have been feeling in the last two weeks.
Scoring For The Beck Depression Inventory
The scoring for the Beck Depression Inventory is fairly simple. Each of the four multiple choice answers is assigned a point value from 0 to 3. At the end of the assessment, you simply add up the total points from the answers throughout the 21 questions. The scoring assessment is as follows:
0 - 13 Minimal Depression
14 - 19 Mild Depression
20 - 28 Moderate Depression
29 - 63 Severe Depression
When And Where The BDI-II Is Used
The Beck Depression Inventory is used to measure the severity of symptoms of depression by psychiatrists, psychologists, counselors, therapists, and even primary care physicians. It is frequently used to determine if treatment is necessary to aid in diagnosis. It is also used throughout treatment to determine if symptoms are lessening with the treatment, to determine whether or not treatment is successful.
You can request to take the BDI-II from your doctor, or you may be asked to fill out the questionnaire when you seek treatment for depression. You can also find some sources to take the inventory online, where you will be given a score that you can then use to determine if you should seek out additional help.
It is important that if you are experiencing symptoms of depression for two weeks or more that you seek the help of a therapist. A therapist or psychiatrist can accurately diagnose if you have a depressive episode or if you have the major depressive disorder. They can assign you to helpful psychotherapy such as cognitive behavioral therapy, or they may suggest and prescribe antidepressant medications. The first step, as always, is to seek out the help you need to determine if you have a problem and correct that problem if it exists.