Talk:Beck Depression Inventory

Article changed to refer to BDI-II
Hi, could whoever has changed this article please change it back? The title of the article is BDI, not BDI-II. Whilst it's true that the BDI-II is the most recent copy, a lot of us still use the BDI-I for various reasons. I suggest the BDI-II is incorporated as a new heading or a new article.

--PaulWicks 16:20, 15 December 2005 (UTC)

Hi Paul, I agree that it makes sense to have a section for both BDI-II and also the original BDI. I went ahead and made some preliminary changes. Have a look. Cshay 03:18, 18 December 2005 (UTC)

Copyright issues
The test itself is copyrighted and they aggressively pursue violators so it should not be posted. For the curious, it's easy to find various illicit copies using google. --Cshay 18:31, 13 May 2005(UTC)

BDI and 1 week period
The original 1961 paper states 'In order that the instrument reflect the current status of the patient, the items were presented in such a way as to elicit the patient's attitude at the time of the interview' (top right p562), so where did the 1 week time period come in? - it seems to be on my copy of the BDI 155.198.63.112 19:13, 29 June 2006 (UTC)

Says it on mine too (in case you're is in German?) --PaulWicks 21:02, 29 June 2006 (UTC)

On the subject of the 1 week time period, the current external link to BDI links to a BDI version which says "how you have been feeling during the past few days" for this reason I suggest we delete the link as this is inaccurate. --87.11.210.101 13:15, 1 July 2006 (UTC)

Google Search Link
Please leave the finely tuned google links in place. Here's why: Any single link you include will not survive as owners of the Beck test are shutting down web sites. It's best to use the google search and let people find whatever happens to be available at the moment. Thanks for your cooperation!!! Cshay 23:36, 12 August 2005 (UTC)

Recent Additions to the Limitations Section
These two paragraphs were recently anonymously added:

'''On the other hand, depressed individuals with main symptoms of negative cognitions may get unusually high scores on the BDI. This is because it is weighed toward cognitive symptoms. The first two-thirds scores cognitive symptoms and the remaining third scores somatic symptoms.'''

'''The BDI is an established and validated tool, but one must avoid over-reliance on a single assessment instrument, especially if results are found to be unexpectedly high or low. It may be useful to bear in mind how the BDI was initially validated: by comparison with clinicians' impressions of depressed patients, who then completed the questionnaire. '''

This sounds a bit like conjecture and I don't see why it matters that the test is weighted in this way. Are there more firm citations or what not to back this up? The second paragraph is a bit vague and confusing as well and I am leaning towards deleting it also. The person who added this may well have a good point, but I'd like to see some citations, studies or at the very least a clearer explanation. Any interested parties' opinions or edits to clean this up would be much appreciated Cshay 04:05, 17 July 2006 (UTC)


 * In my eyes this first statement is meaningless. If you're depressed, any high score can not, by definition, be unusual. The second paragraph is also not that helpful; no clinician would rely upon the BDI for diagnosis, it is merely a tool used for e.g. tracking response to drugs, or research. I can see where the editor is coming from, and perhaps these are statements they've read in a textbook or heard in a lecture, but I don't think they're all that relevant here. Happy with deletion. --PaulWicks 07:30, 17 July 2006 (UTC)

Perhaps there are some studies that show that in some circumstances (other than during illness, which is already mentioned in the section) high scorers on the BDI are judged not actually severely depressed. If anyone can find such studies and include them in this section, this would be a better way to document alleged limitations in the BDI. Cshay 22:38, 19 July 2006 (UTC)

I know that in some cases, extremely high (above 40) scores on the BDI or BDI-II are seen as exagerations, or as a case of people just checking all the higher numbers to falsely create a more severe case. (I've heard of this happening in people with factitious disorders, but I've never seen anything in print.) In some instances, very low scores can be seen as faking in the other direction, to try to minimize symptoms, making a "molehill out of a mountain", to turn a phrase. I can add some stuff about this within the next few days. Dlmccaslin 05:06, 2 August 2006 (UTC)

Contrasts with Hamilton Depression Rating Scale
Do you think we should mention contrasts with the Hamilton Depression Rating Scale as both these scales are used in research. I've heard that these scales actually have quite a low correlation which is worrying as they are meant to both measure the same thing. --193.204.167.87 09:37, 24 July 2006 (UTC)

Sure, so long as it's referenced from cited material. If you don't know how to do references properly just bung them in and i'll come and reformat them. I think that would be a very useful contribution. --PaulWicks 13:45, 24 July 2006 (UTC)

Adding some info
I recently finished a research broject using the BDI-II, so I've read so much info about the test that I figure I need to use it for something, so I'm adding it here. Everything will be well-sourced, so I can back up all of this stuff with my giant stach of EbscoHost docs. I also added mention of the short-lived BDI-1A (1993) and I may go into that a little more. I've only been editing Wikipedia for a couple of months now, so let me know if I screw anything up. Dlmccaslin 04:05, 2 August 2006 (UTC)

Your edits look great! I look forward to your adding some more details to the body of the article about the BDI-1A... what it changed, why it was changed, why it was short lived, etc. As Paul said, don't worry about formatting problems, just add the content and we can help clean up. Thanks for your contributions! Cshay 04:11, 2 August 2006 (UTC)

Under the "BDI" section, you added: ''' Some items on the BDI have more than one statement marked with the same score. For instance, under the heading Mood there are two responses that score a 2, "2a, I am blue or sad all the time and I can't snap out of it," and "2b, I am so sad or unhappy that it is very painful." '''

I was under the impression these multiple choice modifications were added to the BDI-II, not the original BDI. Or is this the BDI-1A enhancement you mentioned? Cshay 12:31, 2 August 2006 (UTC)

No, the BDI was the only one of the three to have the "multiple choice" modifications. Beck even included them in Depression: Causes and Treatment in '67. (That's the funny part: Harcourt wants to crack down on piracy, but the whole first version ofthe test was published in the back of a 16-dollar book I picked up for $6 on amazon. It was also heavily included in its entirety in other old books. Anyway, I'll (hopefully) get around to adding some info on the BDI-1A today. Dlmccaslin 11:49, 3 August 2006 (UTC)

Ok, I had a look and you are indeed right about the original 1961 BDI. However [this test] does not contain any of the "extra" multiple choice options, but it is not the BDI-II. Is this the 1971 revision or the 1993 BDI-1A revision? Cshay 19:03, 3 August 2006 (UTC)

I figured it out. There is no 1993 revision. I read an article that cited a revised version of the BDI-IA manual, which was published in 1993. The '71 rewrite IS the BDI-IA. I've notes this in the article, and will add my references. Dlmccaslin 01:41, 4 August 2006 (UTC)

BDI-IA
Cshay, I wanted the BDI-IA section as a subsection of the BDI, as it is a revision of the first version and not a full re-write like -II. Can I change it back?Dlmccaslin 16:17, 4 August 2006 (UTC)

Oh, ok. I went ahead and reverted my change to what you had before. Cshay 22:56, 4 August 2006 (UTC)

BDI-II Alpha (Ambrosini et al. 1991)
This seems weird. The BDI-II wasn't published until 1996, and I find it difficult to believe that this reference preceded publication by 5 years. Unfortunately, I can't find a copy of the study online. I'm going to move it to the BDI-IA subsection, because that seems more logical. If I'm wrong, go ahead and change it back.Dlmccaslin 04:29, 8 August 2006 (UTC)

Good Article
I'm pretty new at this. Does anyone here think this article is ready for a Good Article nomination? Dlmccaslin 17:04, 11 August 2006 (UTC)
 * From the casual reader's POV, I think this is pretty close to GA. Here's what I'd do:
 * ISBN numbers for the books in the References list
 * Unusued publications and references could maybe go into a Further Reading section
 * PrimroseGuy 14:34, 31 August 2006 (UTC)

Unused references
These are the unused references that I removed from the article. If anyone wants to add them back in, please reference them in the text. Maybe we should put the above one back in, as this is actually citing the original inventory and is usually the one that is cited in research papers 194.83.142.171 13:24, 24 August 2006 (UTC)
 * Beck A.T. (1988). "Beck Hopelessness Scale." The Psychological Corporation.
 * Beck A.T., Ward C., Mendelson M. (1961). "Beck Depression Inventory (BDI)". Arch Gen Psychiatry 4: 561-571.
 * If you can cite what it says, go ahead. I don't have a copy of this manual, so I can't reference anything with it. If you can,. feel free. Dlmccaslin 22:37, 24 August 2006 (UTC)

Dlmccaslin 17:35, 11 August 2006 (UTC)
 * Craven J.L., Rodin G.M., Littlefield C. (1988). The Beck Depression Inventory as a screening device for major depression in renal dialysis patients. Int J Psychiatry Med 18: 365-374

Failed GA nomination
I failed this article because:
 * Parts of it are hard for non-specialists to understand.
 * The lead section has no references.
 * And there are no images.
 * Some P.  E  rson  16:30, 31 August 2006 (UTC)

These are all solvable issues. The only one I'm struggling with is a picture. You could have a picture of me (a psychologist) administering one to someone. Then I'd be wikifamous! Alternatively we could have a picture of the legendary Aaron T Beck (I saw him in person once), e.g. http://mail.med.upenn.edu/~abeck/. --PaulWicks 20:13, 31 August 2006 (UTC)

More suggestions: If I were to compare this article against six good article criteria, I would rate it as follows:


 * 1. Well written?: I would say not so much that it is poorly written but that it could be written better. Take for example the statement "The original BDI, first published in 1961." That introductory statement is such a tease. Where did the test come from?  It's not like someone found it on the street and said "hey let's start using this thing."  How was it developed? By one individual or many? Did it develop from a school of thought?  Was its use controversial?  Was it hailed as a breakthrough? Where was it published? How did it catch on?  Were tests or studies done on its efficacy?  Are there differences in how the test does with females versus males? Children versus adults?  Is it in use in other countries?  I am just pulling toics out of a hat, but some (if not all) of these topics need to be approached in an article about "one of the most widely used instruments for measuring the severity of depression." Also you might comment on the future of the test.  Does it have competition?  Is it being supplanted by other tests?  Is it obsolete?  This article just alludes to some of these ideas, but doesn't flesh it out.  Additionally, each heading only has one paragraph, which, generally, is frowned upon.  If a topic deserves its own heading, there should be enough for at least two paragraphs.  If not, merge these paragraphs under a unifying heading.  But I think, really, these sections just need to be expanded more.  Additionally this article is written as if the reader is already familiar with psychology.  Example: Phrases like "updated DSM-IV criteria for depression" is dropped with no explanation. Or take this monster "The internal consistency for the BDI-IA was good, with a Cronbach's alpha coefficient of around 0.85."  To see another article that deals with a like topic very well, see Intelligence quotient.  Of course, this takes time, and it is somewhat different, but at least you can get some ideas.
 * 2. Factually accurate?: Well referenced
 * 3. Broad in coverage?: Commented on this matter above.
 * 4. Neutral point of view?: Good here. Scientific approach, almost sterile.
 * 5. Article stability? Good.
 * 6. Images?: None, which isn't grounds for failure, but sure doesn't help. For pics that won't violate GDFL, try covers of publications, ads about the test, this pics: Image:AaronBeck.jpg, Diagnostic and Statistical Manual of Mental Disorders, and/orDiagnostic and Statistical Manual of Mental Disorders.  Wikimedia Commons might have some pics that would enhance the article.  You might even create charts about its use, statistics of patients, etc...

These are just some ideas I have as an independant reviewer.--Esprit15d 20:39, 31 August 2006 (UTC)
 * Thanks for the feedback. I'll start working on some of these changes. I think there is a picture of Beck on his Wikipedia page. I may just use that image.Dlmccaslin 00:40, 1 September 2006 (UTC)


 * Thanks Espirit. I'll try my hand at some of the issues you've raised here. --PaulWicks 16:56, 1 September 2006 (UTC)

Do other editors on this agree that BDI is almost ready for re-nomination? --PaulWicks 18:17, 14 October 2006 (UTC)

Recently added background information
I moved the recently added historical/motivation/development information to it's own section. I think this section could benefit from the addition of more information about the development of the BDI when time allows. Cshay 10:55, 2 September 2006 (UTC)
 * Looks good. But should we move that section to right before we talk about the first test, so that we read about the development before we read about the test? Dlmccaslin 15:33, 2 September 2006 (UTC)
 * That's certainly a possibility. I was sort of thinking that the main thrust of the article was the test itself, with the history and motivation of the test sort of an interesting side bar. Another way to say it is: the history/motivation/development section could eventually grow to be quite long since there must be plenty of history. Do we really want to put off giving the details of the test itself until after all of the history has been provided? Someone reading the article to learn about the test itself might be frusterated by all the history coming first before getting to the "meat".  One way we could avoid this scenario, yet move this section to where you want it is to beef up the first section to include more details about the test thus passing this info on before the history section... Just my thoughts however, feel free to edit as you please... Cshay 06:03, 3 September 2006 (UTC)
 * No, I think you're right.Dlmccaslin 14:54, 3 September 2006 (UTC)

Re-evaluation
I was invited to look at this article again. The improvements have been dramatic and the article has definitely improved. I see expansion in several areas and topics - especially background. This is good. But, as it currently is, I still would not promote it to GA status. Here are the reasons why (mostly cosmetic):

(1) All headings should be in sentence case (first letter capitalized and the rest lowercase, unless a subsequent word contains a proper noun or acronym)

(2) History should always go first, so the "Development and History of the BDI should go before the "BDI" section. Additionally this section is not well-reference enough.

(3) The numbers in this article 21 and 13 should be capitalized (They aren't figures).

(4) The un-cited references mentioned above should be restored to the article under a heading called "References" that comes after the "Notes" section. The section with the footnotes should be called Notes.

(5) This statement:

should go in a section on the test's impact. This isn't really about it's development, but its impact on the community. Then the resulting impact section should be expanded some.

(6) The article still, although very nice in what is here, just doesn't seem comprehensive enough to me. Like, this would be an ideal article: Myers-Briggs Type Indicator. But since this is going for GA, and FAC, I think it may be thorough enough to make it if the above items. I looked at other Psychological tests, and this one (by far) looked like one of the better ones. I also want to mention that the lead section is excellent. Great job overall.

GA Promotion
I'm going to go ahead and declare this a Good article. I found it clear and compelling, and I think the concerns on this talk page have been essentially addressed. I edited this article a few times just now, cleaning up some small issues.

As a future direction, one thing I hope to see is more discussion of the theoretical merits of Beck's work. Some of the language of "psychodynamics" seems a little dated to me. Has a more modern understanding of depression changed psychiatrists' opinion of the BDI? Twinxor t 09:58, 27 October 2006 (UTC)

Outstanding! Thanks Twinxor and thanks to everyone for their hard work. There's just one last thing to do and that's to let Professor Beck know about the page (and its good article status) to see if he has anything to add. Emailing now... --PaulWicks 16:06, 27 October 2006 (UTC)

Thanks to Paul and the other experts who spent their valuable time improving this article! It is really looking good! Cshay 03:40, 28 October 2006 (UTC)

Wow. You guys have really done a lot to improve this since I stopped working on it (for time reasons). Thanks a lot. I' really hapy to se this get Good Article status. Now, does any adventurous soul want to go over to the Beck Hopelessness Scale or the Self-report inventory Page and work your magic there? Dlmccaslin 17:16, 30 October 2006 (UTC)

Feedback from Dr. Beck and copyvio link
Dear Paul,

Thank you for sending me the information about the Beck Depression Inventory. You did a great job, and I very much appreciate it.

Warm regards, ATB

P.S. My publisher will be very unhappy to know that the BDI-II can be Googled. Can you remove it from your reference list?

--PaulWicks 21:42, 27 October 2006 (UTC)


 * I understand his concern, but linking Google does not violate copyright, nor, arguably, is Google violating copyright. Is it really necessary to delete the links? Twinxor t 22:45, 27 October 2006 (UTC)


 * I suppose anyone that wants to find it can google it easily enough anyway, but I suppose the point is that by including a pre-defined search term the links are helping to violate copyright. The BDI-II is used only with a licence fee. Is there guidance on this? u--PaulWicks 23:04, 27 October 2006 (UTC)


 * Hi all, I was the one who originally included these links when I first created this article. It is not a simple matter to craft a google query that reliably pulls up the test so I knew it would be useful to people. So obviously my vote is to keep these links unless there is a clear Wikipedia policy against it (and not just a recommendation). I realize the publisher might not like it, but that's not reason enough not to include it in my mind. It is not against the law in the USA to link to copvio sites. Also, it makes the test more accessible to depressed people who might want to see how severely they are depressed. Paul, I see that you deleted the links, could we perhaps take a vote on the matter to see what the consensus is first? Or maybe we could at least leave the BDI-I since Beck is selling BDI-II these days? Thanks. (On a lighter note, I am guessing you are printing and framing your ATB email? :) Cshay 03:26, 28 October 2006 (UTC)


 * Whilst Dr. Beck asked only that we take down the BDI-II, I still have to pay $4 a copy for the original BDI-I so I must assume that's under copyright and licence as well. I'm going to try and find some relevant bits from WP:C to justify (or not) removing the links. From what I can see the relevant text is here:
 * Linking to copyrighted works
 * "External sites can possibly violate copyright. Linking to copyrighted works is usually not a problem, as long as you have made a reasonable effort to determine that the page in question is not violating someone else's copyright. If it is, please do not link to the page. Knowingly and intentionally directing others to a site that violates copyright has been considered a form of contributory infringement in the United States (Intellectual Reserve v. Utah Lighthouse Ministry). Also, linking to a page that illegally distributes someone else's work sheds a bad light on us. If the site in question is making fair use of the material, linking is fine."
 * From what I can tell, I think that the sites that are hosting the BDI-I and BDI-II are violating copyright. Most of them don't say that they have permission to use the instrument, they don't cite the original paper, and in the licence when you buy a copy it explicitly says not to make electronic copies. Now each of these separate users may have made a licence deal with Harcourt individually, but it seems unlikely. A lot of the google hits that come up are appendices and lecture notes from university projects; I don't think there is an exemption for educational use, but then university psychology departments often buy a "portfolio" of test copyrights for limited use. This would not normally extend to use on the web however. In terms of next steps, I actually think this is one of the rare occasions where a consensus is not the way to go, but rather we could list the issue at WP:CP?
 * If it's an issue of helping depressed people, I'm not sure having people just fill out the form will do them much good. After all it just produces a number, it's only useful in context. One option would be to have a link to a therapeutic community as these may be of some help . For instance, MoodGym is a site which allows users to self-administer cognitive behavioral strategies.
 * (Will go next to type-written letter from Oliver Sacks about cycad toxicity in Guam and the link to ALS...) --PaulWicks 09:48, 28 October 2006 (UTC)
 * Paul, I must take issue with the reference to the "contributory infringement" mentioned in the Wiki page you mention. In almost all cases, linking to a website is simply not a violation under US law. Whoever wrote that was searching hard for the one court case that made their point. I realize you were asked directly by Beck and you like the man, and so this puts you in a difficult spot, but I think we should reconsider the deletion of the links. Those links have been included in the article for well over a year without incident and I feel they help the reader. Cshay 03:15, 29 October 2006 (UTC)
 * While I can possibly see the argument for removing the Google search for BDI-II I cannot see why you should remove the BDI-I link. It was published before 1963 which may mean it is now in the public domain (see US copyright laws). Secondly A.Beck did not even mention deleting the BDI-I link in his email, and you would think he would have asked if it was under copyright. The fact that it cost $4 may have just been the cost of printing it. 194.83.140.31 18:15, 31 October 2006 (UTC)

I have in the past opposed links to sites that breech copyrights, and I will remain consistent here. However, it is a shame that the scale remains under copyright. This is not the only clinical rating scale that is under copyright, and I fear that such copyright enforcement prevents its widespread dissemination, and in the long term will make it much harder for other researchers to validate the BDI. JFW | T@lk  21:32, 29 October 2006 (UTC)


 * Whilst I agree, in principle, with the argument that it would be good if scales were free, I can understand why it is not! In fact I will soon be running the free-to-use Major Depression Inventory (MDI) against the Beck to see how the two compare. However our problem is the facts as they stand. Cshay, I'm also not disputing that they help the reader. However there are several instances I've come across where links, as useful as they may be, have been removed from Wikipedia for reasons of copyright or unencyclopediarity (neat word huh?). Are there any other editors who want to weigh in? --PaulWicks 18:31, 30 October 2006 (UTC)

Items in the cognitive subscale
The article says, "The cognitive subscale contains eight items," but listed only seven items. I added the eighth item. Using this source I suppose I did this correctly. Can someone with a more primary source check my work? --US 30 17:53, 15 November 2006 (UTC)

Looks good to me. Thanks! --PaulWicks 22:51, 15 November 2006 (UTC)

Yeah, that would've been my bad. Thanks for the correction.Dlmccaslin 19:54, 17 January 2007 (UTC)

Question regarding references
The article says, "In this respect, the BDI-II is positively correlated with the Hamilton Depression Rating Scale with a Pearson r of 0.71, showing good agreement. The test was also shown to have a high one-week test-retest reliability (Pearson r =0.93), suggesting that it was not overly sensitive to daily variations in mood." Is it only the second sentence that refers to reference 8 (the BDI=II manual) or is it also the correlation against the Hamilton Depression scale as this is not made very clear. Many thanks (Fliss 17:14, 28 February 2007 (UTC))

Factor structure
I removed the following from the article (added by this anonymous edit):
 * [This section is wrong. A Meta-Analysis of 33 published factor analyses of the BDI has demonstrated that the BDI has at least a 3-factor structure, and probably better a 4-factor structure: negativity toward the self, dysphoric mood, performance impairment, and somatic symptoms. (Schafer A, J Clin Psychol, Jan 2006)]

And added a disputed-section instead. Wonder what reference this is, maybe this? /skagedaltalk 21:49, 26 June 2014 (UTC)

Interpretation of Scores section
This section was lifted almost word for word from a about.com article. I have reverted it. If you wish to include it, please paraphrase. It was a bit wordy anyway and could benefit from being condensed. http://depression.about.com/od/diagnostictools/fl/Mild-Moderate-or-Severe-Depression.htm Cshay (talk) 02:23, 14 March 2016 (UTC)

Two-factor approach to depression section
An IP added some interesting content here, but it needs to be rewritten in a form that is accessible to non-technical readers and that uses proper footnoting. I am not an expert on the subject so I am having difficulty editing it. In addition, there appears to be disputed content here. If no one touches it for a few months I will take a stab at it. Cshay (talk) 10:40, 7 September 2016 (UTC)
 * Might have forgotten this. It is a good article and being unsourced I will probably remove it unless you can fix it up. AIRcorn (talk) 01:31, 26 March 2018 (UTC)
 * Actually seeing as you haven't edited for a while I will remove it for now. If you return you can add it back in. AIRcorn (talk) 01:32, 26 March 2018 (UTC)