Criterion validity, severity cut scores, and test-retest reliability of the Beck Depression Inventory-II in a university counseling center sample.

This study evaluated the psychometric characteristics of the Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in a primary care medical setting. A principal-components analysis with Promax rotation indicated the presence of 2 correlated factors, Somatic-Affective and Cognitive, which explained 53.5% of the variance. A hierarchical, second-order analysis indicated that all items tap into a second-order construct of depression. Evidence for convergent validity was provided by predicted relationships with subscales from the Short-Form General Health Survey (SF-20; A. L. Stewart, R. D. Hayes, & J. E. Ware, 1988). A receiver operating characteristic analysis demonstrated criterion-related validity: BDI-II scores predicted a diagnosis of major depressive disorder (MDD), as determined by the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ). This study demonstrated that the BDI-II yields reliable, internally consistent, and valid scores in a primary care medical setting, suggesting that use of the BDI-II in this setting may improve detection and treatment of depression in these medical patients.

To provide further information about the construct validity of the Beck Depression Inventory-II the inventory was administered to 210 psychiatric outpatients along with Derogatis' SCL 90-R. As hypothesized, the Beck Depression Inventory-II was more positively correlated with scores on the Depression subscale (r = .89) than it was with scores on the Anxiety subscale of the SCL-90-R (r = .71).

Vredenburg, Flett, and Krames's (1993) conclusion that self-reported distress in college students is an appropriate analog for diagnosable depression is examined in light of a broader literature. Self-reported distress is conceptually and empirically distinct from depression and depressive symptoms. Distress has stronger correlates with common psychological and social factors. Distress in college students tends to be mild and transient, and most distressed college students are not depressed. Some other features of college life also make generalizations to clinical and community samples of adults problematic. Overall, ubiquitous misunderstandings in the literature have limited recognition of the pitfalls of studying distress as an analog for diagnosable depression. It is undesirable for reasons of science, social responsibility, and the credibility of psychological models of depression.