Beck’s Depression Inventory

Aim: To measure the symptoms and severity of depression in adults and adolescents using

Beck’s depression inventory

Introduction

Depression is a mood disorder that causes persistent feelings of sadness, emptiness, and loss of

joy. It is different from the mood fluctuations that people regularly experience as a part of life. A

mood disorder is a mental health condition that primarily affects your emotional state. It’s a

disorder in which you experience long periods of extreme happiness, extreme sadness or both.

Certain mood disorders involve other persistent emotions, such as anger and irritability.

Depression often persists in spite of a change of circumstances and causes feelings that are

intense, chronic, and not proportional to a person’s circumstances. It causes severe symptoms that

affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or

working. Depression is a very prevalent mental health condition and can affect people of all ages,

races, ethnicities, and genders.

Depression is the most common psychiatric disorder reported in most of the community based

studies. It is also reported as one of the most common psychiatric disorders in the outpatient

clinic population and in subjects seen in various medical and surgical settings. It is also reported

to be the most common psychiatric disorder in elderly subjects across various settings. Studies

from India have also shown that life events during the period preceding the onset of depression

play a major role in depression. Studies on women have also shown the importance of identifying
risk factors like interpersonal conflicts, marital disharmony and sexual coercion.

The exact cause of the depression is not exactly known. It cannot be narrowed down to ant one

particular reason. As with many mental disorders, a variety of factors may be involved, such as:

● Biological differences. People with depression appear to have physical changes in

their brains. The significance of these changes is still uncertain, but may eventually

help pinpoint causes.

● Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that

likely play a role in depression. Recent research indicates that changes in the

function and effect of these neurotransmitters and how they interact with neural

circuits involved in maintaining mood stability may play a significant role in

depression and its treatment.

● Hormones. Changes in the body's balance of hormones may be involved in causing

or triggering depression. Hormone changes can result with pregnancy and during

the weeks or months after delivery (postpartum) and from thyroid problems,

menopause or a number of other conditions.

● Inherited traits. Depression is more common in people whose blood relatives also

have this condition. Researchers are trying to find genes that may be involved in

causing depression.

Depression affects how people think, feel and act. Depression makes it more difficult to manage

from day to day and interferes with study, work and relationships. A person may be depressed if
for more than two weeks they have felt sad, down or miserable most of the time or have lost

interest or pleasure in most of their usual activities, and have also experienced several of the

signs and symptoms across at least three of the categories in the list below. It’s important to note,

everyone experiences some of these symptoms from time to time and it may not necessarily mean

a person is depressed. Equally, not every person who is experiencing depression will have all of

these symptoms. It is crucial to spot and recognise the symptoms of depression as they can have a

wide range of symptoms that can vary in severity and duration. And while these symptoms are

common, not everyone with depression will have the same ones. How severe they are, how often

they happen, and how long they last can vary.Some common symptoms of depression may

include:

● Trouble concentrating, remembering details, and making decisions

● Feelings of guilt, worthlessness, and helplessness

● Pessimism and hopelessness

● Insomnia, early-morning wakefulness, or sleeping too much

● Crankiness or irritability

● Restlessness

● Loss of interest in things once pleasurable, including sex

● Overeating or appetite loss

 ● Aches, pains, headaches, or cramps that won't go away

● Digestive problems that don't get better, even with treatment

● Persistent sad, anxious, or "empty" feelings

● Suicidal thoughts or suicide attempt

● Lose pleasure in life

Types of depression

There are different types of depression. The symptoms for each can range from relatively minor

through to severe.

● Major depression

Major depression, or major depressive disorder is the technical term used by health professionals

and researchers to describe the most common type of depression. Other terms sometimes used

include unipolar depression or clinical depression. Depression can be described as mild,

moderate or severe.

● Persistent Depressive Disorder (PDD)

Persistent depressive disorder refers to a type of chronic depression present for more days than

not for at least two years. It can be mild, moderate, or severe. People might experience brief

periods of not feeling depressed, but this relief of symptoms lasts for two months or less. While

the symptoms are not as severe as major depressive disorder, they are pervasive and long-lasting.

● Seasonal affective disorder (SAD)

SAD is a mood disorder that has a seasonal pattern. The cause is unclear, but may be related to

the variation in light exposure in different seasons. SAD is characterized by mood disturbances

(either periods of depression or mania) that begin and end in a particular season. Depression in

winter only is the most common way in which people experience SAD. SAD is usually diagnosed

after the person has had the same symptoms during winter for two or more years.

People with SAD are more likely to experience lack of energy, sleep too much, overeat, gain

weight and crave carbohydrates.

● Bipolar Disorder

Bipolar disorder is a mood disorder characterized by periods of abnormally elevated mood

known as mania. These periods can be mild (hypomania) or they can be so extreme as to cause

marked impairment with a person's life, require hospitalization, or affect a person's sense of

reality. The vast majority of those with bipolar disorder also have episodes of major depression.

In addition to depressed mood and markedly diminished interest in activities, people with
depression often have a range of physical and emotional symptoms.

● Postpartum Depression (PPD)

Pregnancy can bring about significant hormonal shifts that can often affect a woman's moods.

Depression can have its onset during pregnancy or following the birth of a child. Currently

classified as depression with peripartum onset, postpartum depression (PPD) is more than just the

"baby blues." Mood changes, anxiety, irritability, and other symptoms are not uncommon after

giving birth and often last up to two weeks. PPD symptoms are more severe and longer-lasting.

● Premenstrual Dysphoric Disorder (PMDD)

Among the most common symptoms of premenstrual syndrome (PMS) are irritability, fatigue,

anxiety, moodiness, bloating, increased appetite, food cravings, aches, and breast tenderness.

Tools used to assess depression

Clinical diagnosis of depression is traditionally carried out in adherence to standardized

classification systems of DSM-5 and ICD-11. However, beyond this there are also a myriad of

screening questionnaires which are commonly used to determine the possible presence of

depression and assess the severity of depressive symptoms, either within the clinical domain, or

by researchers trying to search for biomarkers or exploring alternatives to the often-criticized

categorical approach to diagnosis offered by DSM.With estimates in 2006 suggesting that there

were 280 depression questionnaires developed over the previous eight decades, there is no
shortage of assessment tools to choose from, although of course some have stood the test of time

more than others. Knowing this is really important in order to decide which depression

assessment questionnaire(s) to use in a given situation, as it has a significant impact on results

relating the scores of symptom severity against other behavioral or neuroimaging measures that

would then be collected. It also helps interpret and decipher consistencies or inconsistencies in

results when comparing across studies, and also when interpreting epidemiological findings in

the past, present and future. Some of the most commonly used depression assessment tools in

psychological testing are:

Patient Health Questionnaire (PHQ)

The Patient Health Questionnaire (PHQ) is often a first-choice tool used by primary care

professionals for most people. This is because it can help diagnose depression between 78% and

94% of the time. It can either be a two-question survey (PHQ-2) or a nine-question survey

(PHQ-9). The PHQ-2 is typically given first to assess the overall presence of depressed mood. If

necessary, it will be followed by the PHQ-9, which is more detailed and can help detect the

overall severity of depression. The PHQ asks how many days per week you experience specific

symptoms.

Beck’s Depression Inventory (BDI)

The Beck Depression Inventory (BDI) consists of 21 depression-related questions. It asks that
you rate the presence of key symptoms on a scale between 0 and 3. Higher scores indicate a more

severe form of depression. The BDI is generally considered a reliable and accurate test.

Children’s Depression Inventory (CDI)

The Children’s Depression Inventory (CDI) is given to children and adolescents between the

ages of 7 and 17. It’s written in simple language at a first-grade reading level. It has between 10

and 27 questions. A 2016 study showed that it’s between 44% and 76% effective at helping

diagnose depression in children.

Hamilton Depression Rating Scale (HAM-D)

The HAM-D is designed to rate the severity of depression in patients. Although it contains 21

areas, calculate the patient’s score on the first 17 answers. The instrument is designed to be

administered by clinicians after a structured or unstructured interview of the patient to determine

their symptoms. A total score is calculated by summing the individual scores from each question.

The Montgomery-Åsberg Depression Rating Scale (MADRS)

The Montgomery-Åsberg Depression Rating Scale (MADRS) is a validated, widely-used,

10-item, clinician-rated measure of depression severity. Individual items of the MADRS may

contribute differently to the same overall depression severity across patients.

Beck’s Depression Inventory (BDI)

The BDI was first published in 1961 by Dr. Aaron T. Beck, a psychiatrist who is considered the

father of cognitive therapy.The BDI was designed to measure the severity of depression, as well

as to serve as a tool for screening for depression. The original BDI consisted of 21 items, each of

which corresponded to a symptom of depression. Dr. Beck and his colleagues found that the BDI

had good reliability and validity. The BDI has been widely used in research studies and clinical

practice. In 1996, the BDI was revised to include additional items and to reflect changes in the

Diagnostic and Statistical Manual of Mental Disorders (DSM). The revised BDI, known as the

BDI-II, is the most widely used version of the questionnaire.

The Beck Depression Inventory (BDI) is a 21-item test presented in multiple-choice format,

which measures presence and degree of depression in adolescents and adults consistent with the

DSM-IV. It is not intended as a diagnostic instrument. It is used mostly as a screening instrument

and for clinical research. Each of the 21-items of the BDI attempts to assess a specific symptom

or attitude which appear(s) to be specific to depressed patients, and which are consistent with

descriptions of the depression contained in the psychiatric literature. The BDI evaluates 21

symptoms of depression, 15 of which cover emotions, four cover behavioural changes, and six

somatic symptoms. The 21 items cover sadness, pessimism, past failure, self-dislike,

self-criticism, suicidal thoughts or wishes, crying, agitation, loss of interest, indecisiveness,

worthlessness, loss of energy, changes in sleeping patterns, irritability, changes in appetite,

difficulty concentrating, tiredness or fatigue, and loss of interest in sex. The reading level of the

revised version is at a fifth or sixth grade level. Scoring/Interpretation: Each answer is scored on

a scale value of 0-3. Measures of 0–9 indicates that a person is not depressed, 10–18 indicates

mild-moderate depression, 19–29 indicates moderate-severe depression and 30–63 indicates

severe depression. General guidelines of scores are: Less than 10 = no or minimal

depression,10-18 = mild-to-moderate depression,19-29 = moderate-to-severe depression, 30+ =

severe depression.

Methodology

Procedure

The administration of the test was carried out in a classroom in Mithibai College in Vile Parle

West. The participant was brought to the classroom. A comfortable environment, good lighting

and proper distance between the participants were ensured. The test was carried out in the

presence of a supervisor, Dr. Deepti Puranik It was made sure that the participant was

comfortably seated, then a rapport building was followed and the case history and personal

details of the participant were recorded, and after that the test administration took place.

Instructions were explained to the participant clearly and then the test was conducted. After the

test had been completed, the participant was asked to wait for the scoring and interpretation.

After the response was scored, the results were explained to the participant. The participant was
thanked for their time and participation and was escorted out of the classroom.

Materials Used

Beck Anxiety Inventory booklet, response sheet and pencil.

Participant Details

Name T.S

Age 26

Gender Female

Marital Status Unmarried

Educational Qualification BA Liberal Arts

Occupation Student

Geographical Location Mumbai

Religion and Caste Hindu - Marathi

Socioeconomic Status Upper middle class

Family Structure Nuclear

Ordinal Position Only child

Mother’s Educational Background B.A

Mother’s Occupation Homemaker

Father’s Educational Background B.E civil

Father’s Occupation Businessman

Genogram

Case History

The participant is a 27-year-old female. She is pursuing her masters in psychology. She is an only

child. There is some history of depression on the paternal side with the participant’s father having

had a period of it in his youth. Besides that, no major mental health disorders or relevant medical

history was mentioned.

Instructions

The instructions were given to the participant verbatim as mentioned in the manual.“This

questionnaire consists of 21 groups of statements. Please read each group of statements carefully.

And then pick out the one statement in each group that best describes the way you have been
feeling during the past two weeks, including today. Circle the number beside the statement you

have picked. If several statements in the group seem to apply equally well, circle the highest

number for that group. Be sure that you do not choose more than one statement for any group.”

Results and interpretation

Table 10

Table showing the total scores and interpretation for Beck’s Depression Inventory.
Total score 5

Interpretation Low severity

Discussion

The score observed of the given participant is well below the threshold for clinical

depression. The participant obtained a total score of 5 on the Beck Depression Inventory. This

score for a nonclinical case suggests that the individual has a minimal level of depressive

symptoms. It can be inferred that the individual may experience mild feelings of sadness or low

mood, but not to an extent that would significantly interfere with their daily functioning. It is

important to make a note of that a score of 5 on the BDI is well below the threshold for clinical

depression, which is typically considered to be a score of 14 or higher. Overall, a total score of 5

on the BDI for a nonclinical case suggests that the individual is likely experiencing mild
depressive symptoms that may not require immediate clinical intervention and that these ups and

downs are normal. However, it is important to monitor these symptoms over time and consider

seeking professional

help if they persist or worsen. It is imperative to monitor the symptoms and the signs of persiting

sadness.

BDI is just one assessment tool and should not be used in isolation to make clinical

decisions or diagnoses. It is important to consider the individual's history, current life

circumstances, and other mental health symptoms when interpreting the BDI score. In this case,

the fact that the participant engages in healthy coping mechanisms, such as meditation and

journaling, may have contributed to the low score on the BDI. Additionally, if there were no

major life changes or stressful events that occurred recently, this may also explain why the

participant did not report significant depressive symptoms in the relevant time frame. It is

important to continue to monitor the individual's mental health symptoms and provide support as

needed. If symptoms persist or worsen, it may be appropriate to explore further assessment and

intervention options.

Conclusion

Based on the information provided, the participant has scored a 5 on the Beck

Depression Inventory, which suggests minimal levels of depressive symptoms. However, it is

important to note that this score should be interpreted in conjunction with other clinical

information and evaluations. Additionally, the fact that the participant engages in healthy coping
mechanisms may have contributed to the low score.The score suggests that the individual is likely

experiencing mild depressive symptoms that may not require immediate clinical intervention.

However, it is important to continue to monitor their symptoms and provide support as needed. It

may also be beneficial to explore potential underlying causes or contributing factors to the

individual's depressive symptoms.

 References

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General Psychiatry, 4, 561-571.

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Depression: Causes, Symptoms, Types & Treatment. (n.d.). Cleveland Clinic.

https://my.clevelandclinic.org/health/diseases/9290-depression

McDowell, I. & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and

Questionnaires. (2nd ed.). New York: Oxford University Press.

What Is Depression? (n.d.).

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