Cognitive Therapy and Research [cotr] pp675-cotr-455267 November 14, 2002 9:38 Style ﬁle version Jun 14th, 2002
Cognitive Therapy and Research, Vol. 26, No. 6, December 2002 (
2002), pp. 719–727
Examining the High-End Speciﬁcity of the Beck
Depression Inventory Using an Anxiety Sample
Denise M. Sloan,
Brian P. Marx,
Margaret M. Bradley,
Cyd C. Strauss,
Peter J. Lang,
and Bruce C. Cuthbert
Although the Beck Depression Inventory (BDI) is one of the most widely used mea-
sures of depression, there is some concern whether high scores on the BDI represent
the nosologic category of depression or psychological distress more generally. In this
study the high-end speciﬁcity of the BDI was examined using a clinical sample of
anxiety-disordered individuals, a group characterized by high negative affect. Results
revealed using a high BDI cut score produced moderate speciﬁcity and sensitivity rates.
Additional analyses indicated an overall fair performance of the BDI in classifying
depression in the anxiety sample and an optimal cut score for differentiating anxiety
clients with and without comorbid depression was identiﬁed. However, using the op-
timal cut score resulted in nearly one third of the sample being incorrectly classiﬁed
on the basis on their BDI scores. The ﬁndings underscore the importance of not rely-
ing solely on BDI scores to classify depression samples, which is a current common
practice in psychological research.
KEY WORDS: BDI; high-end speciﬁcity; depression; anxiety.
The Beck Depression Inventory (BDI; Beck, Steer, & Brown, 1996; Beck, Ward,
Mendelson, Mock, & Erbaugh, 1961) is a widely used self-report measure of de-
pressive symptomatology that includes dimensions of cognition, somatization, and
motivation. Although the BDI was originally developed to examine evaluation of
treatment produced change (e.g., Beck et al., 1961), a common use of the measure,
particularly in the ﬁelds of personality and social psychology, is to classify individuals
into depressed and nondepressed groups based on their scores. (e.g., Tennen, Hall,
& Afﬂeck, 1995). Using the BDI to classify individuals by diagnostic group may be
Department of Psychology, Temple University, Philadelphia, Pennsylvania.
Department of Clinical and Health Psychology, Center for the Study of Emotion and Attention, Univer-
sity of Florida, Gainesville, Florida.
National Institute of Mental Health, Rockville, Maryland.
Correspondence should be directed to Denise M. Sloan, Department of Psychology, Weiss Hall, Temple
University, Philadelphia, Pennsylvania 19122; e-mail: email@example.com.
2002 Plenum Publishing Corporation