Hello, this is our case study for Assessment techniques in Psychological testing.  I have included my rough answers to the questions. Can you please review my answers to make sure I am correct and see if there is a way to condense them? Thank you so much 


Critique: Beck Depression Inventory-II

You are a mental health counselor currently working in an outpatient counseling clinic with adult clients. You are considering whether or not to adopt the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in your practice. Many of your clients seem to suffer from depression, and you think that using an instrument that specifically assesses depressive symptoms would help you in making an accurate diagnosis. You currently work 40 hours each week at the clinic and see about 20 clients each week for hour-long individual counseling sessions. The rest of your time is devoted to treatment planning, writing progress notes, staff meetings, and supervision.

Norm Group

Two samples were used to evaluate the psychometric characteristics of the BDI-II:

A clinical sample of 500 individuals who sought outpatient therapy at one of four outpatient clinics on the U.S. east coast (two of which were located in urban areas, two in suburban areas). The sample consisted of 317 (63%) women and 183 (37%) men, ranged in age from 13 to 86 years, and the average age was 37.2 years. The sample consisted of four racial/ethnic groups: White (91%), African American (4%), Asian American (4%), and Hispanic (1%).

A nonclinical sample of 120 Canadian college students was used as a comparative normal group. It consisted of 67 (56%) women and 53 (44%) men, was described as predominantly White, and the average age of the sample was 19.58.

Reliability

Internal consistency: Analysis of internal consistency yielded a Cronbachs alpha of .92 for the clinical sample and .93.

Test-Retest Reliability: Test-retest reliability was assessed over a one-week interval among a sub-sample of 26 outpatients from one clinic site (r = .93).  

Validity

Content Validity: BDI-II item content was designed to be consistent with the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994).

Convergent Validity: Correlations between the BDI-II scores and other scales are as follows:  the Beck Hopelessness Scale (r = .68), the Revised Hamilton Psychiatric Rating Scale for Depression (r = .71), and the Symptom Checklist-90-R Depression subscale (r = .89).

Discriminant Validity: The correlation between the BDI-II and the Revised Hamilton Anxiety Rating Scale

 

 Describe and Evaluate the Norm Group:


A. Do you think this group is representative: 

I only find two aspects of the norm group being representative. The first representation was the equal sampling of urban and suburban clinics the second are the patients who were seeking outpatient treatment. However, there were several areas in which there was no adequate representation. My concerns include the deficiency in sampling a more diverse population.  Of the ethnicities being represented 91% were white which is not representative. There was also a large variance between the norm group composition of 63% women and 37% men. In addition, the non-clinical sample, comprised of Canadian college students, had a better (reword) woman and men variance; however, it was still comprised of 56% women and 44% men. Another example of a lack of representation is the average age since the clinic serves adult patients. The clinical sample yielded an average age of age 37.2, which is acceptable however with large variance between the non-clinical sample yielding an average age of only 19.58 years. 

B. Do you think the norm group is current? 

   I do not feel that the norm group is current because it is not representative. The (BDI-II) test was published in 1996 which indicates that the norm group that was used then would be out of date and consequently decreases the relevancy of the assessment. It is noted that the content of the BDI-II was updated to include the DSM-5 depression criteria. However, it would be appropriate to further discern if the norm group was also updated because it is important that the norm groups be updated with current demographics since each of the new editions of the DSMs consider current demographics .if one demographic is updated and one is not, there is no ????  Demographics change (POS REF DSM ON UPDATES IF THEY USE CURRENT DEMOGRAPHICS). 

C. Do you believe the size of the norm group was large enough? 

There are several factors that influence my position that the size of the norm groups used, for the BDI-II, is not large enough. It is imperative that the driving force in selecting a norm group is for it to be large enough for the subgroups of the population to be adequately represented to solidify the stability of test scores(Medicine et al., 2015). Appropriately, if a larger norm group was used it would have included a more diverse population instead of mostly Caucasian and females. Just as diversity is needed in demographics, there is a very important consideration, and this is the diversity on how a person had the manifestation of depressive symptoms. We utilize the DSM5 for diagnostic criteria; however, how a person began having depressive symptoms can be varied. I always tell my patients that we may have the same diagnosis but how we got to that diagnosis is an individual path. If a larger norm group was used, then the clinical considerations of individual manifestation of depressive symptoms would be appropriately included and increase the relevance of the norm group (ref text) 

 

D. Are the samples related to the population you intend to use the test with? 

I do not find the samples used related to the population that I am intending. As an example, I have an adult client base, an average age of 19.58 years, which is not being relevant. This is simply a personal perspective. It is not disclosed what the clinics current demographics are such as ethnicity, gender, rural or urban, and location. However, the norm group used is not large enough to be this inclusive and the location that the norm group members were selected is too specific to be considered relevant. 

E.  Describe and evaluate each method used to estimate reliability. 

 Internal consistency: 

Our measurement of internal consistency discloses the ability of the items on the inventory are measuring what they are intended (ref text). A means to assess this is the coefficient alpha which measures the internal consistency and has become the standard of consistency measurement. The BDI-II is measuring the level of depressive symptoms and the yielding of .92 and .93 shows a strong internal consistency. Having a high-reliability coefficient reveals that the items within the inventory are homogeneous. In other words, the inventory that we are using is measuring what we intended( ref text possibly reword) 

Test Reset Reliability:  

Test-retest reliability measures the consistency of results when you repeat the same test on the same sample at a different point in time. You use it when you are measuring something that you expect to stay constant in your sample REWORD The test-retest reliability is measuring mood changes is looking at the BDI-II one week would not be a long enough time and I would propose,  that there even be the third retest to strengthen the reliability. I understand that a third retest would be unusual but with depression and the level of the symptoms, a third test would strengthen the reliability outcome.  An intelligence test shed be consistent as intelligence doesn’t change over time; however, I contend that because the BDI-II  is measuring mood this should dictate a different approach to the test-retest reliability procedure used. Although the r=.93 and reflects a high correlation coefficient, I propose that this is somewhat misleading. A one-week interval has a high probability of creating a carryover effect in which one score will influence the second test taken can be influenced by the test taker remembering their answer from the first time it was taken a with only one week in between, Usually between 15-30 days is appropriate (ref text). A persons depression can be acute or chronic and a longer, up to 30 days,  interval and perhaps a third test would establish increased reliability. 

F.  Does the reliability evidence support a decision to use the instrument?

The reliability coefficients indicate high reliability and could contribute to a decision to use this assessment. However, just because the calculations and procedures were correctly followed resulting in high-reliability outcomes, the group being tested is not relevant/representative of what demographic should be considered. In other words, it may be reliable but not necessarily valid. With this being said, I would not support a decision to use this assessment in the clinic. 
Integrate this It goes back to the idea that a valid test is always reliable, but a reliable test might not be always valid. So, even if it yields high reliability from test-retest and internal consistency, it may not be always useful. A test can be consistent, (thus having a high-reliability measure) but it is not an assurance that it measures what it is supposed to measure (validity)

VALIDITY

B. Describe and evaluate each type of validity evidence.

Content validity: Content validity is significant considering that the BDI-II is designed to measure the level of depression. It is discussed that the BDI-II was designed to have consistency with the DSM-V and as a result, the content validity is very strong. 

Convergent validity: Convergent validity looks to measure the strength of the relationship between the BDI-II scores and the scores of similar instruments that are measuring depressive symptoms. The comparative coefficients are .68, .71, and .89. The convergent validity is high for the SCL-90-R as a result of the .89 coefficient. In comparison, the coefficient of .68 for the BHS and .71 on the HAM-D show significant convergent validity; however, the coefficients are not high enough to rule out any deficiencies (Sheperis et al., 2019)

Discriminate validity: Discriminant validity is similar to convergent validity in the sense that it is assessing the correlation between two measuring instruments. However, for discriminate validity, we are measuring the strength of the correlation between two assessments that are not to have a correlation. My stance is that the coefficients of .47 for the HAM-A and .60 on the BAI are high enough to support the conclusion that there is no strong enough evidence of discriminant validity between these two assessments and the BDI-II. 

C. Does the validity evidence support a decision to use the instrument?    The validity evidence shows a high content validity; however, the convergent coefficients reflect deficiencies against similar instruments. Furthermore, the discriminate validity coefficients aren’t high enough to make the BDI-II distinct in measuring depressive symptoms against symptoms of anxiety. Taking these results into account, I would not support a decision to use this instrument. 


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