Журнал депрессии и тревоги
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Examining the Psychometric Properties of the Beck Depression Inventory-IiUsing an Item Response Modelling Approach in an HIV Infected Population in Kampala, Uganda

Jayne Byakika Tusiime, David R Bangsberg and Wilson Mark

Abstract Background: Depression is prevalent among individuals living with HIV, with evidence suggesting that more than one third of people with HIV/AIDS may have mood disorders or clinically significant depressive symptoms. Sub-Saharan Africa bears the greatest burden due to HIV/AIDS. The social, economic and health impact of depression in sub-Saharan Africa is great. However, there are few scales for measuring depression that have been validated in this population. The Beck Depression Inventory (BDI-II) is one of the most widely used instruments for assessing depressive symptom severity. Although the BDI-II has been used in sub-Saharan Africa, the psychometric properties of the BDI have not been well studied in this region especially among HIV infected patients. The purpose of this analysis therefore, was to examine the psychometric properties of the BDI-II in a low income HIV-infected population using an item response modeling (IRM) approach. Methods: Data for this analysis were obtained from a survey of adult members of the Mother-To-Child-Transmission Plus Program in Kampala, Uganda. The BDI-II was administered to every study participant at enrollment. Data were analyzed using both the Classical Test Theory (CTT) approach and the Item Response Modeling (IRM) approach. Results: Mean depression score was 8.86 + 5.44. The Cronbach’s alpha was 0.79 and the reliability coefficient was 0.86. The Wright map showed a good spread of the items over the entire span of the construct of depression. Differential item functioning was observed for some items. There was evidence for validity based on instrument content, internal structure and relations to other external variables. Conclusion: In conclusion, this analysis demonstrated good psychometric properties of the BDI-II when used to screen for depression in a low income predominantly female HIV-infected population. These findings therefore support the use of the BDI-II in assessing depressive symptoms for HIV-infected patients in sub-Saharan Africa especially women.