Measurement invariance of the Beck Depression Inventory in assessing and comparing treatment effects
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Marjolein Fokkema, MSc Niels Smits, PhD Henk Kelderman, PhD Pim Cuijpers, PhD - PowerPoint PPT Presentation


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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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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

  • 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


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).


  • Beck Depression Inventory (BDI)

    • BDI (Beck et al, 1961) assesses depressive symptoms

    • 21 items with 4 response categories, ranging from neutral to maximum severity


    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


    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


    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


    Methods

    • SEM approach (LISREL)

      • Measurement invariance between T0 and T1 :

        • Configural invariance

        • Metric invariance

        • Scalar invariance

        • Invariant uniqueness


    Configural invariance


    Invariance constraints


    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)


    IRT analysis (MULTILOG)

    • Samejima’s (1969) Graded Response Model


    Item Characteristic Curves

    Item 4: Lack of satisfaction


    PSY T0

    PSY T1

    MED T0

    MED T1


    Item Characteristic Curves

    Item 8: Self Accusations


    PSY T0

    PSY T1

    MED T0

    MED T1


    Item Characteristic Curves

    Item 16: Sleep Disturbance


    PSY T0

    PSY T1

    MED T0

    MED T1


    Item Characteristic Curves

    Item 19: Weight Loss


    PSY T0

    PSY T1

    MED T0

    MED T1


    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


    Invariance between T0 and T1


    Invariance between PSY and MED


    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


    Questions, remarks, suggestions?

    Thank you for your attention!

    m.fokkema@psy.vu.nl


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