Beck Depression Inventory vs. Hamilton Depression Scale Beck

Beck opinion Inventory vs. Hamilton drop-off Scale BeckThe revised Beck impression Inventory (BDI-II), publish in 1996 was authored by Aaron Beck, Robert A. Steer, and Gregory K. Brown. Similar to its predecessor, it consists of 21multiple choice questions that assist in determining the severity of natural slack. Each item consists of quad-spot renderments arranged in order to ascertain the severity of a certain symptom of depression. BDI-II conforms to the DSM-IV criteria for depression. Clients who ar presented with the BDI-II are asked to answer separately question based upon the way they pass felt for the past devil weeks in order to accurately conform to the DSM-IV criteria. The BDI-II is intended for adolescents and adults and should not be performed to those under the age of thirteen.ScoringThe BDI-II consists of cardinal one questions, all of which correspond to a particular symptom of depression. Each item consists of a four point shell of measurement rangin g from 0-3. Items 16 and 18 consist of seven items which are use to indicate an join on or decrease in both sleep patterns and appetite. A total score of 0-13 is considered minimal range, 14- 19 is considered piano, 20-28 is considered moderate, while 20-63 is considered to be painful (Beck, Steer and Brown, 1961). The BDI-II may be scored by hand or by using a software program such as Q Local, where the win may be preserve and monitored by the clinician. The adjudicate may be administered frequently, as it is intended to monitor symptoms that have occurred within a two week range.ReliabilityBecks Depression Inventory II has been used for more years with large(p) success. Its reliability is still questioned by some. Sprinkle, Lurie, Insko, Atkinson, Jones, Logan and Bassada (2002) state that Although the BDI-II manual of arms of arms (Beck, Steer, Brown, 1996) and various other reports (e.g., Dozois et al., 1998, and Steer, Kumar, Ranieri, Beck, 1998) have offered subst antial certainty for the instruments commendable split-half immanent consistency (with reported coefficient alphas of .91 and slightly higher), there are just now two published reports to date on the instruments test- retest reliability (par.6). Sprinkle et al., (2002) further report Beck, Steer, and Brown (1996) reported on 26 outpatients (no diagnostic information is offered) who were administered the BDI-II at the times of their first and second therapy sessions (approximately one week apart), producing a test-retest coefficient of correlation of .93 (par 6).ValidityValidity of the BDI-II appears to be favorable. A study conducted by Storch, Roberti and Roth (2002) examined the psychometric properties of the BDI-II. 414 students from two separate universities participated in the study. Their results supported BDI-II two-factor structure measuring cognitive-affective and somatic depressive symptoms (par.1). They think that the hardness of the BDI-II was supported by favorab le results with self-report measures of depression and anxiety (par.1). The results of this study duplicate past research of a college sample which supported the reliability and hardihood of the BDI-II.Arnau, Meager, Norris, and Bramson (2001) also conducted a psychometric evaluation of the BDI-II using primary burster patients. The study consisted of 340 primary care patients (7 of which were eliminated due to incomplete responses). 68.8% of the participants were female and the age group tested ranged from ages 18-54(M = 36.5, SD = 10.1, Arnau et al., 2001). The average score from the participants was 8.4 (SD = 9.7). They reported that scores of 14 or higher, suggesting at least a mild level of depression (Beck et al., 1996 as cited in Arnau et al., 2001) were observed in 23.2% of the sample (p.3). Arnau et al., (2001) also constitute an alpha coefficient of .94, which they considered to be excellent internal consistency. They concluded that the BDI-II yielded strong evidence fo r the factorial validity of the BDI-II in a primary care setting (p.6). They found that the BDI-II could easily be implemented into the primary care setting without disrupting patient flow.BDI-II ReviewsArbisi and Farmer, reviewers of BDI-II indicate that the BDI-II is comfortable to administer and requires approximately quint to ten minutes to complete. Arbisi states byplay however, that there are no validity indicators contained on the BDI or the BDI-II and the ease of administration of a self-report lends itself to the deliberate tailoring of self-report and distortion of the results (Beck, Steeler Brown, 1961 par. 5).Arbisi and Farmer concur that the manual BDI-II was well written and provides a multitude of supportive information regarding norms, factor structure, and notably, nonparametric item-option characteristic curves for each item (Beck, Steer Brown, 1961 par. 4). They contend that the BDI-II has improved upon the original by updating the items to reflect contempora ry diagnostic criteria for depression and utilizing state-of-the-art psychometric techniques to improve the discriminative properties of the instrument (Beck, Steer Brown, 1961 par. 10). Although the reviewers have noted their concern regarding the lack of room for diversity, Arbisi and Farmer appear to approve of its use as a depression sound judgement tool.Hamilton Depression ScaleThe Hamilton Depression Scale (abbreviated as HDS, HAMD or HAD) is used to measure the severity of symptoms of depression. For many years it was considered to be the gold standard. It was authentic by Max Hamilton in the late 1950s and was used to evaluate the performance of the first antidepressants. It was released in 1960. Upon its release, Hamilton acknowledged that it had room for improvement (p. 56). He revised the HDS in 1967. The HDS consists of 21 multiple choice questions. The first 17 questions determine the severity of the depression symptoms, while the additive four questions address the areas of paranoia and obsession and their relation to depression .The HDS can be administered to both children and adults. It is considered to be easy to read and interpret it is recommended that the HDS be administered only by a licensed professional.ScoringThe HDS was intended to be administered by an experienced clinician by conducting a clinical interview. Scoring and administrating the scale may be considered uneasy as Hamilton did not provide structured guidelines for this purpose. No standardized probe questions were provided to elicit information from patients and no behaviorally specific guidelines were developed for determining each items rating (Health Care Technology Systems, 2010). Seventeen items are rated on a 5-point (0-4) or a 3-point (0-2) scale. Overall scores of 0-6 are considered normal. Scores from 7-17 are indicative of mild depression. Scores from 18-24 represent moderate depression. Scores that are greater than 24 are representative of severe depression.Re liabilityBagby, Ryder, Schuller, and Marshall (2004) state that Clinician-rated instruments should demonstrate three types of reliability 1) internal reliability, 2) retest reliability, and 3) interrater reliability (par.4). They contend that the internal reliability of the HDS estimates ranged from 0.46 to 0.97, and 10 studies reported estimates 0.70 (par.5). They further contend that the majority of items contained in the HDS indicate sufficient reliability .Per their testing, the following items were met in each sample (Guilt, middle insomnia, psychic anxiety, somatic anxiety, gastrointestinal, general somatic) and an additional five items met the criteria in all but one sample (depressed mood, suicide, first insomnia, late insomnia, work and interests, hypochondriasis) (par.6). A potential problem was suggested with protestence of insight, as it had the greatest number of variables. Interrater reliability was considered to be poor. Cicchetti and Prusoff (1983, as cited in Re ynolds and Kobak, 1995) state in a study of interrater reliability of a 22-item version of the HDRS found low levels of reliability for undivided items, with 14 of the 22 items demonstrating intraclass correlation coefficients of less than .40 (par. 4).Retest ReliabilityScores for the retest reliability of the HDS ranged from 0.81 to 0.98. Williams (1998 at cited in Bagby et al., 2004) argued in favor of using structured interview guides to boost item and total scale reliability and developed the Structured Interview Guide for the Hamilton Depression valuation Scale (par.8). Doing so increased the retest reliability to 0.54 in spite of the fact that only four items met the necessary criteria for reliability i.e. depressed mood, early insomnia, psychic anxiety, and loss of libido (par.8).ValidityThe Hamilton Depression Scale is comprised of 1) Content, 2) Convergent, 3) Discriminant, 4 Factorial, and 5) Predicative Validity. Content validity is determined by examining scale items t o determine correspondence with known features of a syndrome (Bagby et al., 2004 par. 9). Convergent validity is sufficient when a scale indicates Pearsons r values of a minimum of 0.50 in conjunction with measures of the same syndrome. Discriminant validity is determined by indicating that groups that differ in diagnostic status may be separated through the use of the scale. Predictive validity of symptom severity measures such as the Hamilton depression scale is determined by a statistically significant (pHDS ReviewsBernard Carroll wrote a earn to the editor of the American Journal of Psychiatry in December, 2005 entitled why the Hamilton Depression Scale Endures. He offers three reasons why the HDS remains the gold standard. First of all, he contends that Hamiltons HDS pore on patients burden of malady (par.1). He suggests that this is the reason why the HDS contains examples of anxiety that are present in depressive episodes, but are not part of the diagnosis for depression. He further contends that Hamilton intended the use of this scale for clients that are well known by the clinician. In this light, the HDS displays a range from mild to extreme illness (par. 1).Second, Carroll contends that the demand for a revised scale based upon modern criteria of major depression is not realistic. Carroll confides that ongoing definitions of major depression, instantiated in DSM-IV, for instance, are deliberately atheoretical nominalist conventions that lack unifying constructs, predictive validity, and explanatory power (par.2). He believes that this is the reason why those who are diagnosed with DSM-IV criteria for major depression are so contrasting. He adds In the future, we readiness add biomarkers or endophenotypes to clinical symptoms in assessing depression, but that day is not here (par.2).Third, Carroll does not believe that the HDS has been outmatched in performance. He does not believe that the HDS is insensitive to changes in the severity of depre ssion symptoms. When compared to the Montgomery-Asberg Depression Rating Scale, he believes that the Hamilton Depression Scale is superior in its sensitivity to change and in detecting early change with treatment while having the advantage of far more comprehensive symptom coverage (par.3).Carroll concludes his letter by stating The endurance of the Hamilton depression scale is remarkable, considering how many unauthorized, nonvalidated, mutant versions now circulate (Hamiltons original 17 items have expanded to 28 at my last count). This is not progress, however, because the text versions and procedural use in many contemporary treatment trials are corrupted (par 4).Paul C Burnett, a reviewer of the HDS contends that the manual is extensive and comprehensive (par.2). The instructions for administering the test are clear and contain examples of the scoring process. All of the symptoms contained in the test are described and provide examples to be used in the interviewing process. He believes that the symptoms contained in the test conform to the criteria listed in the DSM-IV.The manual, which contains a sample of 202 depressed patients, is comprised of 76% inpatients, 24% outpatients, and 69% female (par.3). The manual contends that the demographics are fair, despite the fact that no data is provided to support this. He contends that the manual did not overwhelm data to support the procedure that was utilized to select this demographic.Burnett states that Internal consistency estimates were found to be .79 and .81 for the clinical and self-report forms respectively, indicating moderate reliability (par. 4). Other studies suggest that the internal consistency range from .45 to .95, which is stated in the manual as consistent with the results from the verification sample (par.4). Burnett does not consider a range of .45 to .81 as delicious internal consistency.Burnett concludes that the HDS consists of a well written and concise manual, which clearly describes the administration and scoring process. He finds that the two scales have moderate internal consistency, sound concurrent validity, and relatively consistent and stable factor structures (par. 7). His only complaint is that the verification sample is minimal and does not sufficiently describe the manner in which it was selected.The Stronger discernment ToolBoth Aaron Beck and Max Hamilton have created an assessment tool to determine the severity of the symptoms of depression. While Hamiltons Depression Scale was considered to be the gold standard, and may be administered to both children and adults, one would have to conclude that Becks Depression Inventory-II is the stronger of the two assessments. It appears that the BDI-II can be administered with ease and does not require an interviewing process. The BDI-II has been revised to monitor the severity of symptoms of depression for the last two weeks, while Hamiltons HDS does not state such strict guidelines. It also appears as tho ugh the BDI-II contains a stronger internal consistency with an alpha coefficient of .95 as opposed to the HDS internal coefficiency of .79 and .81.Another reason for this ending was the original intention of use of the scales. Hamiltons HDS was developed to evaluate the performance of the first generation of antidepressants, while Becks Depression Inventory was developed to determine the nature of the severity of symptoms of depression without the use of medication. Becks BDI-II appears to have surpassed the HDS as reviewers have considered this assessment tool as utilizing state-of-the-art psychometric techniques to improve the discriminative properties of the instrument (Beck, Steer Brown, 1961 par. 10). It appears as though Becks BDI-II is the preferred choice among todays clinicians.