Research That Matters (January 17 - 20, 2008)

Purpose: Although preliminary studies have suggested that the Beck Depression Inventory-II may be a valid and reliable depression measure across some racial groups, there has been a paucity of research on the psychometric properties of the BDI-II among African Americans, and none we know of in a sample of suicidal African-Americans. Depression is a well established precursor for eventual suicide completion; therefore, a vital factor in ascertaining the benefit of suicide-related treatments, especially psychosocial interventions, is to determine whether a clinically significant degree of symptom reduction, like major depression, has occurred. Accurate assessment of depression among ethnic minorities, especially in individuals with a history of suicide behavior, is therefore an important task. Therefore, this study sought to examine the psychometric properties of the BDI-II in a psychiatric sample of African American participants who recently attempted suicide.

Method: In this study we sought to test the fit of a second-order two-factor model and internal reliability of the BDI-II in a sample of 133 African-Americans with a recent history of suicide attempts. Additionally, the convergent validity with the Hamilton Rating Scale for Depression was examined. A confirmatory factor analytic (CFA) strategy using AMOS 5.0 was chosen because the goal of the current study was to cross-validate the fit of that two-factor model in a sample of African American suicide attempters. The Kaiser-Meyer-Olkin (KMO) was used to assess the appropriateness of the sample for factor analysis.

Results: Descriptive statistics for the BDI-II item responses indicated that the item means were distributed around the center of the response range. Coupled with minimal skewness (item skewness ranged from .52 to -.40), the 21 items revealed fairly normal response distributions in this clinical sample. Corrected item-total correlations for items within each first order factor ranged from .47 to .70, suggesting all items would load well and contribute to the reliability of the respective scales. The CFA results indicated the proposed second-order, two-factor model did not explain all of the variance and covariance in the data, ÷2 (188, N = 133) = 276.86, p < .05. However, other goodness-of-fit indices indicated an acceptable fit for this model, CFI = .92, IFI = .93, RMSEA = .06 (90% Confidence Interval = .04 - .07).

Implications: This study also makes a rare contribution to our understanding of suicidal depression. The results indicated that the BDI-II is a reliable and valid measure of depressive symptoms for African-American suicide attempters. Establishing validity and reliability of such assessment tools in diverse racial and ethnic groups minimizes the likelihood of poor treatment decisions or erroneous research conclusions.