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Marjolein Fokkema, MSc Niels Smits, PhD Henk Kelderman, PhD Pim Cuijpers, PhD

Measurement invariance of the Beck Depression Inventory in assessing and comparing treatment effects. Marjolein Fokkema, MSc Niels Smits, PhD Henk Kelderman, PhD Pim Cuijpers, PhD Faculty of Psychology and Education Vrije Universiteit Amsterdam, the Netherlands. Introduction.

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Marjolein Fokkema, MSc Niels Smits, PhD Henk Kelderman, PhD Pim Cuijpers, PhD

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  1. Measurement invariance of the Beck Depression Inventory in assessing and comparing treatment effects Marjolein Fokkema, MSc Niels Smits, PhD Henk Kelderman, PhD Pim Cuijpers, PhD Faculty of Psychology and Education Vrije Universiteit Amsterdam, the Netherlands

  2. Introduction • Increasing use of routine outcome monitoring in clinical practice • No big or consistent differences found between therapies in depression research • Real change or response shift? • Measurement invariance across timepoints

  3. Data • National Institute of Mental Health Treatment of Depression Collaborative Research Program • First major attempt at comparing efficacy of treatments for depression: • 2 psychotherapy conditions (PSY) • 2 medication conditions (MED) • 239 subjects entered treatment (T0), 155 subjects completed treatment (T1).

  4. Beck Depression Inventory (BDI) • BDI (Beck et al, 1961) assesses depressive symptoms • 21 items with 4 response categories, ranging from neutral to maximum severity

  5. Example: item 8 Self Accusations (0) I don’t feel I am any worse than anybody else (1) I am critical of myself for my weakness or mistakes (2) I blame myself all the time for my faults (3) I blame myself for everything bad that happens

  6. Example: item 15 Work Inhibition (0) I can work about as well as before (1) It takes an extra effort to get started at doing something (2) I have to push myself very hard to do anything (3) I can’t do any work at all

  7. Beck Depression Inventory (BDI) • BDI (Beck et al, 1961) assesses depressive symptoms • 21 items with 4 response categories, ranging from neutral to maximum severity • Total score is widely used as outcome measure

  8. Methods • SEM approach (LISREL) • Measurement invariance between T0 and T1 : • Configural invariance • Metric invariance • Scalar invariance • Invariant uniqueness

  9. Configural invariance

  10. Invariance constraints

  11. Methods • SEM approach (LISREL) • Measurement invariance between T0 and T1 • IRT approach (MULTILOG) • Comparisons between groups (PSY and MED) and time points (T0 and T1)

  12. IRT analysis (MULTILOG) • Samejima’s (1969) Graded Response Model

  13. Item Characteristic Curves Item 4: Lack of satisfaction

  14. PSY T0 PSY T1 MED T0 MED T1

  15. Item Characteristic Curves Item 8: Self Accusations

  16. PSY T0 PSY T1 MED T0 MED T1

  17. Item Characteristic Curves Item 16: Sleep Disturbance

  18. PSY T0 PSY T1 MED T0 MED T1

  19. Item Characteristic Curves Item 19: Weight Loss

  20. PSY T0 PSY T1 MED T0 MED T1

  21. IRT analysis (MULTILOG) Samejima’s (1969) Graded Response Model Freely estimated model, compared with model with a-parameters constrained to be equal across time points across groups

  22. Invariance between T0 and T1

  23. Invariance between PSY and MED

  24. Discussion • Response shift occured • Therapies are very effective at improving ICC’s! • Response shift seems different in different groups • Future research: • Proper control group • Larger sample • Different measures for depression

  25. Questions, remarks, suggestions? Thank you for your attention! m.fokkema@psy.vu.nl

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