title: Psychometric validation of the BDI-II among HIV-positive CHARTER study participants.
abstract: Rates of depression are high among individuals living with HIV. Accurate assessment of depressive symptoms among this population is important for ensuring proper diagnosis and treatment. The Beck Depression Inventory-II (BDI-II) is a widely used measure for assessing depression, however its psychometric properties have not yet been investigated for use with HIV-positive populations in the United States. The current study was the first to assess the psychometric properties of the BDI-II among a large cohort of HIV-positive participants sampled at multiple sites across the United States as part of the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study. The BDI-II test scores showed good internal consistency (α = .93) and adequate test-retest reliability (internal consistency coefficient = 0.83) over a 6-mo period. Using a "gold standard" of major depressive disorder determined by the Composite International Diagnostic Interview, sensitivity and specificity were maximized at a total cut-off score of 17 and a receiver operating characteristic analysis confirmed that the BDI-II is an adequate diagnostic measure for the sample (area under the curve = 0.83). The sensitivity and specificity of each score are provided graphically. Confirmatory factor analyses confirmed the best fit for a three-factor model over one-factor and two-factor models and models with a higher-order factor included. The results suggest that the BDI-II is an adequate measure for assessing depressive symptoms among U.S. HIV-positive patients. Cut-off scores should be adjusted to enhance sensitivity or specificity as needed and the measure can be differentiated into cognitive, affective, and somatic depressive symptoms.
authors.affiliation: Department of Psychiatry, Duke University.
authors.forename: Andréa L
authors.initials: AL
authors.lastname: Hobkirk
authors.affiliation: Department of Psychology, University at Albany, State University of New York, SUNY.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Starosta
authors.affiliation: Department of Psychology, University of North Carolina.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: De Leo
authors.affiliation: Department of Neurology, University of Washington School of Medicine.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Marra
authors.affiliation: Department of Psychiatry, University of California.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
authors.affiliation: Department of Psychology, University at Albany, State University of New York.
authors.forename: Mitch
authors.initials: M
authors.lastname: Earleywine
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D020276:HIV Long-Term Survivors / Q000523:psychology*; D006679:HIV Seropositivity / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000379:methods* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results
chemical_list: D019380:Anti-HIV Agents