Sensitivity and Specificity of the Beck Depression Inventory-II in Persons With Traumatic Brain Injury

Homaifar BY, Brenner LA, Gutierrez PM, Harwood JF, Thompson C, Filley CM, Kelly JP, Adler LE. Sensitivity and specificity of the Beck Depression Inventory-II in persons with traumatic brain injury.ObjectivesOur objective was to examine the Beck Depression Inventory-II (BDI-II) in a traumatic brain injury (TBI) sample using a receiver operating characteristic (ROC) curve to determine how well the BDI-II identifies depression. An ROC curve allows for analysis of the sensitivity and specificity of a diagnostic test using various cutoff points to determine the number of true positives, true negatives, false positives, and false negatives.DesignThis was a secondary analysis of data gathered from an observational study. We examined BDI-II scores in a sample of 52 veterans with remote histories of TBI.SettingThis study was completed at a Veterans Affairs (VA) Medical Center.ParticipantsParticipants were veterans eligible to receive VA health care services.InterventionsNot applicable.Main Outcome MeasuresOutcome measures included the BDI-II and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV).ResultsWe generated an ROC curve to determine how well the BDI-II identifies depression using the SCID-IV as the criterion standard for diagnosing depression, defined here as a diagnosis of major depressive disorder. Results indicated a cutoff score of at least 19 if one has a mild TBI or at least 35 if one has a moderate or severe TBI. These scores maximize sensitivity (87%) and specificity (79%).ConclusionsClinicians working with persons with TBI can use the BDI-II to determine whether depressive symptoms warrant further assessment.