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Factor Structure of the Beck Depression Inventory

Second Edition (BDI-II ) in a Student Sample

Mark A. Whisman, John E. Perez, Wiveka Ramel

Yale University

A confirmatory factor analysis was performed to evaluate the factorial

validity of the Beck Depression InventorySecond Edition ( BDI-II) in a large

sample of undergraduates (N 576). Results suggest that the revised

measure is internally consistent and consists of two underlying factors

assessing cognitive-affective and somatic symptoms of depression. Results

support the use of the BDI-II as a severity measure of symptoms of depres-

sion. 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 545551, 2000.

Keywords: depression; symptoms; factor analysis; assessment; Beck Depres-

sion Inventory

Since it was introduced in 1961, the Beck Depression Inventory (BDI; Beck, Ward, Men-

delson, Mock, & Erbaugh, 1961) has become one of the most widely used instruments for

evaluating the severity of depressive symptoms in psychiatric patients and in normal

populations (as reviewed by Beck, Steer, & Garbin, 1988). Although the original scale

was amended once before (BDI-IA; Beck, Rush, Shaw, & Emery, 1979), more recently

the Beck Depression InventorySecond Edition (BDI-II; Beck, Steer, & Brown, 1996)

was developed in order to adhere more closely with the diagnostic criteria for major

depressive episode in the 4th edition of the Diagnostic and Statistical Manual of Mental

Disorders (DSM-IV; American Psychiatric Association, 1994). Like the BDI, the BDI-II

has 21 items, each of which consists of four self-evaluative statements scored 0 to 3, with

increasing scores indicating greater depression severity. Responses are summed to yield

a total score that ranges from 0 to 63. In the revision process for the BDI-II

four items (Weight Loss, Body Image Change, Somatic Preoccupation, and Work Difficulty)

were dropped and replaced by four new items (Agitation, Worthlessness, Concentration Dif-

ficulty, and Loss of Energy) in order to index symptoms typical of severe depression or depres-

sion warranting hospitalization. Two items were changed to allow for increases as well as

decreases in appetite and sleep. Many of the statements (or alternatives) used in rating the

other symptoms were reworded (Beck et al., 1996, p. 1).

This study was supported by grant MH54372 from the National Institute of Mental Health, awarded to Mark A.Whisman. We would like to thank Todd Little for his consultation regarding the statistical analyses.Correspondence concerning this article should be addressed to Mark A. Whisman, University of Colorado at

Boulder, Department of Psychology, Campus Box 345, Boulder, CO 80309; e-mail: whisman@psych.colorado.edu.

JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 56(4), 545551 (2000)

2000 John Wiley & Sons, Inc.

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In addition, the time frame of the BDI-II was extended to two weeks (versus the

past week, including today in the BDI) in order to be consistent with DSM-IV criteria

for major depressive episode. Because the BDI-II constitutes a substantial revision

(Beck et al., 1996, p. 1) of the original BDI, studies are needed to evaluate the psycho-

metric properties of the BDI-II, including the factorial validity of the measure. Psycho-metric studies conducted on the original BDI have found that the factor structure represents

one underlying general syndrome of depression, which can be subdivided into three highly

interrelated factors reflecting Negative Attitudes Toward Self, Performance Impairment,

and Somatic Disturbance (as reviewed by Beck et al., 1988).

To date, few studies have been published on the factor structure of the BDI-II. Results

from an outpatient sample (N 500) with mixed psychiatric disorders yielded two fac-

tors, which were labeled Somatic-Affective and Cognitive (Beck et al., 1996). Similarly,

results from a student sample yielded two factors, labeled Cognitive-Affective and Somatic

symptoms ( Beck et al., 1996). The student sample, however, included only 120 individ-

uals, which generally is considered inadequate for the application of factor-analytic tech-niques (Comrey & Lee, 1992). Because self-report measures like the BDI (and BDI-II)

often are used as measures of depressive symptoms in studies of nonclinical samples,

including college students, the present study was conducted to provide normative infor-

mation on, and evaluate the factor structure of, the BDI-II in a large sample of

undergraduates.

Method

Participants

The original sample was composed of 606 undergraduate students who participated for

course extra credit. There was one age outlier and 29 respondents who had missing data

(27 cases with omission of one or more items on the BDI-II and two cases where gender

was not indicated). These cases were eliminated, and the analyses were conducted on the

remaining 576 students. There were 333 (57.8%) women and 243 (42.2%) men. The

mean age was 18.64 (SD 1.12) years old. The ethnic background of the sample con-

sisted of 350 (60.8%) Caucasian, 36 (6.3%) African American, 36 (6.3%) Hispanic, 120

(20.8%) Asian/Pacific Islander, and 23 (3.8%) other ethnic participants; 11 participants

(1.9%) did not indicate their ethnic background.

Analysis

A maximum-likelihood confirmatory factor analysis was performed on the 21 items of

the BDI-II using LISREL 8 (Jreskog & Srbom, 1996). The hypothesized model was

based on a principal-axis exploratory factor analysis of the BDI-II presented by Beck

et al. (1996) with a small student sample (N 120). The hypothesized model is presented

in Figure 1, where circles represent latent variables and rectangles represent measured or

manifest variables.Absence of a line-connecting variables implies no hypothesized direct

effect. Standardized regression coefficients of the manifest variables on the latent con-

structs are represented by the symbol lambda (). Standardized error variances of the

manifest variables are represented by the symbol epsilon (E). The variances of the latentconstructs were fixed at 1 to identify the solution and establish the scale of measurement.

Thus, the double-headed arrow between the latent variables, denoted by the symbol phi

(), represents a correlation.

Based on the initial factor analysis, a two-factor model of depression, Cognitive-

Affective and Somatic, was hypothesized. The following items served as indicators of the

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Cognitive-Affective factor: Sadness, Past Failure, Loss of Pleasure, Guilty Feelings, Pun-

ishment Feelings, Self-Dislike, Self-Criticalness, Suicidal Thoughts or Wishes, Crying,Agitation, Loss of Interest, Indecisiveness, Worthlessness, and Irritability. The following

items served as indicators of the Somatic factor: Loss of Energy, Changes in Sleeping

Pattern, Changes in Appetite, Concentration Difficulty, and Tiredness or Fatigue. Two

items with loadings less than .35 on both factors in the initial analysis, Pessimism and

Loss of Interest in Sex, were not estimated as indicators of either factor. However, error

variances and modification indices were estimated for these items.

Results

The mean BDI-II total score for the entire sample was 8.36 (SD 7.16; range 049).According to the cut scores and interpretive labels provided by Beck et al. (1996), 462

(80.2%) participants scored in the minimal range (013), 72 (12.5%) participants scored

in the mild range (1419), 33 (5.7%) participants scored in the moderate range (20

28), and 9 (1.6%) scored in the severe range (2963). Table 1 presents the means,

standard deviations, and percentages of individuals who were symptomatic (i.e., the

Figure 1. Hypothesized two-factor model of the BDI-II.

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percentages of individuals who endorsed a non-zero response option) on each of the 21

items of the BDI-II.

Coefficient alpha for the total scale was .89, which, although less than the alpha of .93

reported by Beck et al. (1996), suggests that the BDI-II exhibited a high level of internal

consistency. Table 1 also provides thecorrecteditemtotalcorrelations of the21 BDI-IIitems.

As can be seen in Table 1, these correlations ranged from .28 (Loss of Interest in Sex) to

.63 (Self-Dislike), with 19 of the 21 items exhibiting a corrected itemtotal correlation

of .40. The correlation matrix of the 21 BDI-II items is presented in Table 2.

The independence model that tests the hypothesis that all variables are uncorrelated

was easily rejected, 2(210, N 576) 3,645.71, p .01. The hypothesized model was

tested next. Although there was a significant improvement in fit between the indepen-

dence model and the hypothesized model, 2(190, N 576) 870.56, p .01, the fit

indices of the hypothesized model were unacceptable: Goodness of Fit Index (GFI)

.88, Adjusted Goodness of Fit Index (AGFI) .85, Comparative Fit Index (CFI) .80,Incremental Fit Index (IFI) .80, and Root Mean Square Error of Approximation

(RMSEA) .08.

Post hoc modifications were performed in an attempt to develop a better-fitting model.

Two very large modification indices suggested that a substantial improvement in model

fit could be achieved by allowing Pessimism and Loss of Interest in Sex to load on the

Table 1

Means, Standard Deviations, Percentages Symptomatic,

and Corrected ItemTotal Correlations

BDI-II Item and Label Mean SD % r

1. Sadness .35 .57 31 .59

2. Pessimism .36 .55 34 .51

3. Past Failure .34 .59 28 .45

4. Loss of Pleasure .35 .59 30 .62

5. Guilty Feelings .41 .61 35 .49

6. Punishment Feelings .18 .53 13 .49

7. Self-Dislike .36 .68 27 .63

8. Self-Criticalness .41 .66 33 .58

9. Suicidal Thoughts .16 .40 15 .52

10. Crying .38 .83 22 .43

11. Agitation .46 .59 42 .43

12. Loss of Interest .28 .55 24 .45

13. Indecisiveness .33 .65 26 .53

14. Worthlessness .26 .59 18 .60

15. Loss of Energy .49 .60 44 .54

16. Changes in Sleep .98 .73 74 .32

a. Increase 14

b. Decrease 60

17. Irritability .30 .56 26 .47

18. Changes in Appetite .70 .76 56 .43

a. Increase 24

b. Decrease 32

19. Concentration Difficulty .59 .72 47 .50

20. Tiredness or Fatigue .50 .62 44 .53

21. Loss of Interest in Sex .16 .46 13 .28

Note. % Percentage endorsing response choices 1, 2, or 3. r corrected itemtotal correlation.

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Table2

Intercorrelation

sAmongItemsFrom

theBDI-II

BDI-IIItemandLabel

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

1.

Sadness

.38

.24

.44

.33

.38

.40

.34

.37

.44

.32

.39

.30

.34

.33

.13

.37

.28

.25

.31

.19

2.

Pessimism

.41

.38

.26

.29

.42

.37

.30

.20

.22

.30

.31

.44

.29

.08

.23

.17

.31

.29

.13

3.

PastFailure

.30

.36

.33

.46

.32

.38

.10

.17

.17

.24

.43

.30

.11

.18

.16

.27

.22

.06

4.

LossofPleas

ure

.37

.31

.41

.37

.39

.27

.32

.44

.35

.44

.41

.20

.39

.26

.35

.37

.22

5.

GuiltyFeelings

.43

.34

.39

.31

.25

.29

.21

.33

.34

.20

.14

.22

.17

.21

.24

.14

6.

PunishmentF

eelings

.30

.33

.39

.28

.26

.29

.29

.36

.22

.09

.28

.17

.23

.18

.20

7.

Self-Dislike

.53

.36

.29

.28

.28

.35

.53

.36

.24

.31

.26

.32

.33

.24

8.

Self-Criticaln

ess

.35

.27

.27

.19

.38

.43

.27

.23

.26

.29

.31

.31

.20

9.

SuicidalThoughts

.37

.22

.24

.34

.40

.32

.10

.22

.21

.21

.19

.12

10.

Crying

.20

.24

.24

.29

.30

.19

.23

.23

.21

.19

.04

11.

Agitation

.19

.25

.28

.19

.16

.33

.21

.26

.20

.19

12.

LossofInterest

.24

.34

.37

.05

.28

.22

.21

.27

.22

13.

Indecisivenes

s

.37

.29

.16

.31

.28

.38

.27

.22

14.

Worthlessness

.25

.17

.24

.22

.32

.28

.23

15.

LossofEnergy

.26

.34

.32

.36

.51

.13

16.

ChangesinSleep

.18

.28

.30

.37

.09

17.

Irritability

.24

.25

.31

.18

18.

ChangesinA

ppetite

.28

.35

.18

19.

ConcentrationDifficulty

.46

.07

20.

TirednessorFatigue

.14

21.

LossofInterestinSex

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Cognitive-Affective factor. In addition, several residuals were correlated. Consequently,

after allowing Pessimism and Loss of Interest in Sex to be estimated as indicators of theCognitive-Affective factor, three pairs of theoretically meaningful correlated residuals

were estimated in order to achieve a satisfactory fit of the model to the data. A chi-square

difference test indicated a significant improvement in fit of the final model over the

original hypothesized model, 2(5, N 576) 325.98, p .01. Moreover, the final

model showed a good fit to the data: GFI .92, AGFI .90, CFI .90, IFI .90, and

RMSEA .06. The final model,1 with standardized coefficients, is presented in Figure 2.

The Somatic and (modified) Cognitive-Affective factors had alpha coefficients of .72 and

.87, respectively, suggesting that they both showed high levels of internal consistency.

1 In order to control for the positively skewed raw data (i.e., most scores centered on zero), a square roottransformation of the data was employed. Running the confirmatory factor analysis with the transformed datayielded an equivalent two-factor solution. The factor loadings of the manifest variables were essentially thesame and the fit indices were within one hundredth of a point. Thus, results of the confirmatory factor analysispresented in this article are based on the raw data. Finally, the test for a single factor showed a significantlyworse fit to the data, 2(1) 124.83, p .001.

Figure 2. Final modified two-factor model of the BDI-II with significant coefficients presented in standard-ized form. (Note: Variance explained in each manifest variable is the square of the loadings. The .71 correla-tion indicates a 50% overlap of the reliable variance in the two latent constructs.)

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Discussion

With some slight modification (i.e., allowing Pessimism and Loss of Interest in Sex to

load on the Cognitive-Affective factor), the current confirmatory factor analysis repli-

cated, in a large sample of undergraduates, the two-factor solution of the BDI-II obtained

by Beck et al. (1996). Therefore, the scale appears to represent two highly correlated

factors, measuring cognitive-affective and somatic symptoms. Furthermore, we found

that the internal consistency of the BDI-II total and factor scores was very good, support-

ing the reliability of the total and factor scores. Given that only three of the 21 items from

the BDI-IA were not revised in the BDI-II, and given that the BDI-II yields two factors

whereas the BDI has tended to yield three factors (see Beck et al., 1988 for a review), it

would appear that the BDI-II does, indeed, represent a substantial revision of the orig-

inal BDI (Beck et al., 1996, p. 1).

Future research is needed to determine ideal cut scores for the BDI-II for identifying

clinical depression (i.e., case detection), as research with the BDI has shown that not all

individuals with elevated scores meet diagnostic criteria for major depression in students(e.g., Deardorff & Funabiki, 1985) or community samples (e.g., Oliver & Simmons,

1984). However, given that the BDI-II was constructed to measure more closely the

DSM-IV symptoms of major depressive episode, it may be that the scale will be a more

sensitive measure than was its predecessor.

The results from the current study support the continued use of the BDI-II as an

indicator of the presence and degree of depressive symptoms (Beck et al., 1996, p. 6),

insofar as they suggest that it is a reliable measure that appears to consist of two under-

lying factors measuring cognitive-affective and somatic symptoms. The current findings,

combined with the results reported by Beck et al. (1996), suggest that although cognitive-

affective and somatic dimensions were observed in the BDI-II in both clinical and non-clinical (i.e., student) samples, individual affective items may load on different factors

depending upon the nature of the sample studied.

References

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Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New

York: Guilford Press.

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Beck, A.T., Steer, R.A., & Garbin, M.G. (1988). Psychometric properties of the Beck Depression

Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77100.

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Comrey, A.L., & Lee, H.B. (1992). A first course in factor analysis (2nd ed.). Hillsdale, NJ: Erlbaum.

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Jreskog, K.G., & Srbom, D. (1996). LISREL 8: Users reference guide. Chicago: Scientific

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