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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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Presentation Transcript
slide1

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
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
slide3
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
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
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
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 bdi1
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
Methods
  • SEM approach (LISREL)
    • Measurement invariance between T0 and T1 :
      • Configural invariance
      • Metric invariance
      • Scalar invariance
      • Invariant uniqueness
methods1
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
IRT analysis (MULTILOG)
  • Samejima’s (1969) Graded Response Model
item characteristic curves
Item Characteristic Curves

Item 4: Lack of satisfaction

slide16

PSY T0

PSY T1

MED T0

MED T1

item characteristic curves1
Item Characteristic Curves

Item 8: Self Accusations

slide18

PSY T0

PSY T1

MED T0

MED T1

item characteristic curves2
Item Characteristic Curves

Item 16: Sleep Disturbance

slide20

PSY T0

PSY T1

MED T0

MED T1

item characteristic curves3
Item Characteristic Curves

Item 19: Weight Loss

slide22

PSY T0

PSY T1

MED T0

MED T1

irt analysis multilog1
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

discussion
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
slide27
Questions, remarks, suggestions?

Thank you for your attention!

m.fokkema@psy.vu.nl