Elsevier

Behavior Therapy

Volume 33, Issue 2, Spring 2002, Pages 253-269
Behavior Therapy

Original Research
Assessing clinical significance: Application to the beck depression inventory

https://doi.org/10.1016/S0005-7894(02)80028-4Get rights and content

Traditionally, psychotherapy outcome research has been analyzed using statistical tests of significance. Inherent limitations in this approach, however, have contributed to the assessment of clinical significance being advocated as a method by which to evaluate change. In this study, Tingey, et al, 1996a, Tingey, et al, 1996b extensions and clarifications of Jacobson, Follette, and Revenstorf's (1984) method for evaluating clinically significant change were applied to the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961; Beck, Rush, Shaw, & Emery, 1979). A three-sample normative continuum (asymptomatic community, community, and clinically symptomatic) was formulated from the community and the existing literature. The distinctness of the normative samples was assessed by using three statistical procedures, including a t test, a d test, and a test of bioequivalence; and reliable change indices and cutoff points were calculated. The cutoff scores that were developed may prove useful in research and clinical practice.

References (53)

  • BeckA.T. et al.

    An inventory for measuring depression

    Archives of General Psychiatry

    (1961)
  • BerginA.E. et al.

    Changing frontiers in the science of psychotherapy

    (1972)
  • BurnsD. et al.

    Cognitive behavior modification of mood disorders

  • ClementP.W.

    Evaluation in private practice

    Clinical Psychology: Science and Practice

    (1996)
  • CohenJ.

    Statistical power-analysis for the behavioral sciences

    (1977)
  • DerogatisL.R.

    SCL-90-R: Administration, scoring, and procedures manual

    (1983)
  • FosterS.L. et al.

    Assessing social validity in clinical treatment research: Issues and procedures

    Journal of Consulting and Clinical Psychology

    (1999)
  • FroydJ.E. et al.

    A review of practices of psychotherapy outcome measurement

    Journal of Mental Health

    (1996)
  • GladisM.M. et al.

    Quality of life: Expanding the scope of clinical significance

    Journal of Consulting and Clinical Psychology

    (1999)
  • HaagaD.A.F.

    Introduction to the special section on stepped care models in psychotherapy

    Journal of Consulting and Clinical Psychology

    (2000)
  • HansenN.B. et al.

    Clinical significance: An overview of methods

    Journal of Mental Health

    (1996)
  • Hansen, N. B., Lambert, M. J., & Forman, E. M. (in press). The psychotherapy dose-response effect and its implications...
  • HauckW. et al.

    Type of bioequivalence and related statistical considerations

    Journal of Clinical Pharmacology, Therapy and Toxicology

    (1992)
  • HorowitzL.M. et al.

    Inventory of interpersonal problems: Psychometric properties and clinical applications

    Journal of Consulting and Clinical Psychology

    (1988)
  • HorowitzL.M. et al.

    Interpersonal problems in brief dynamic psychotherapy

    (1988)
  • JacobsonN.S. et al.

    Statistics for assessing the clinical significance of psychotherapy techniques: Issues, problems, and new developments

    Behavioral Assessment

    (1988)
  • Cited by (147)

    • Effects of nature-based intervention in the treatment of depression: A multi-center, randomized controlled trial

      2023, Journal of Environmental Psychology
      Citation Excerpt :

      The mean of the BDI at pre-measurement in the data (clinical population) was 24.12 and standard deviation 9.80. For the normative population, mean 7.22 and standard deviation 6.33 were used (Seggar et al., 2002). A BDI cutoff point 13.85 between normative and clinical populations was computed.

    View all citing articles on Scopus
    View full text