Symptom validity indices for the Beck Depression Inventory-II: development and cross-validation in research and clinical samples

Objective: The present study sought to cross validate the recently developed total score cut-off for the Beck Depression Inventory-II (BDI-II) and identify additional embedded symptom validity indices within this commonly used self-report depression measure. Methods: Study 1 included a research sample of 379 veterans with diagnostic subgroups of Current and Lifetime Depression and Current and Lifetime Posttraumatic Stress Disorder (PTSD). Study 2 included a clinical sample of 224 veterans with diagnostic subgroups of Current Depression, Lifetime Depression, and No Depression. Three embedded BDI-II symptom validity indices were examined in the total samples and subgroups: the BDI-II Symptom Severity Scale (total raw score), BDI-II Extreme Symptom Scale (summed frequency of extreme responses), and the BDI-II Rare Items Scale (summed frequency of rarely endorsed items). Validity indices from the Personality Assessment Inventory were utilized in both studies, with the Miller Forensic Assessment of Symptoms Test also used in Study 1. Results: In Study 1, BDI-II validity index cut-off scores had to be adjusted the highest for the Current Depression or Current PTSD subgroups. The cut-offs were associated with sensitivity rates ranging from 0.12 to 0.53 and specificity rates ranging from 0.90 to 0.96. In Study 2, cut-offs had to be adjusted, the highest for the Current Depression subgroup. Identified cut-offs had sensitivity rates ranging from 0.22 to 0.65 and specificity rates ranging from 0.89 to 0.95. Conclusions: This study supports the use of all three proposed BDI-II embedded symptom validity indices.