What Is The Beck Depression Inventory?
Updated May 19, 2020
Reviewer Whitney White, MS. CMHC, NCC., LPC
The Beck Depression Inventory (BDI) is a 21-question self-report rating that measures the symptoms of depression in an individual. It's used by clinicians to determine what level of treatment a person needs for depression. It was developed by Aaron T. Beck, a renowned psychiatrist, who is considered the "father of Cognitive Behavior Therapy."
To understand what the Beck Depression Inventory is and how it is used, it's crucial to first to learn about how it was developed. You can request to take the Beck Depression Inventory from your doctor, or you can find it online to take a self-assessment. That can help you when you speak to a medical professional to report your symptoms.
What Is Depression?
Depression is a clinical term that describes a persistent depressed mood. When a person is depressed, they experience a loss of interest in activities they once enjoyed. Depression is known for causing significant problems in a person's daily life. It is common for people to experience some sadness in life when there's a death in the family, financial stress, a breakup, or when they lose a job. However, when sadness persists for long periods without reason, you may be experiencing clinical depression.
One can have a depressive episode that is isolated. Some people experience one episode, and that's it. Others may experience repeated bouts of depression and are diagnosed with major depressive disorder. A depressive episode is one that mimics major depressive disorder but could be a completely isolated incident. The major depressive disorder is characterized by repeated episodes of depression over a long period.
A chemical imbalance can cause depression in the brain. It is treated through psychotherapy and sometimes with medications, such as antidepressants. 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 psychiatrist who brought new insights into 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. The instructions for the depression scale changed slightly, as did some of the questions. However, this scale had some shortcomings. With the publication of the DSM-V, the manual used to diagnose mental health disorders at the time; the scale was revised again 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-V
The BDI-II, the most recent version, is based on the diagnostic criteria for a major depressive episode in the DSM-V. The DSM (Diagnostical Statistical Manual for Mental Disorders) is the gold standard for clinicians seeking to diagnose mental illness.
The diagnostic criteria of the DSM-Vequire 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
- Visible agitation
- Fatigue or 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's currently used today by many clinicians, psychologists, and 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 in the family, 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-V 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 in hobbies or activities you once enjoyed
- 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 straightforward. The inventory requires 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. 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 relatively simple. Each of the four multiple choice answers is assigned a point value from 0 to 3. At the end of the assessment, you 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 find sources to take the inventory online. After you take the BDI, you'll get a score that you can then use to determine if you should seek out additional help.
if you're 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 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. The online therapists at BetterHelp are experts in helping people who have symptoms of depression. If you're seeking help for depression or any other mental health issue, don't be afraid to reach out for help. Online therapy can be a great place to talk through feelings of depression and more.