What does the beck depression inventory measure in myocardial infarction patients? a psychometric approach using item response theory and person-fit.

Publisher: John Wiley & Sons Country of Publication: United States NLM ID: 9111433 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-0657 (Electronic) Linking ISSN: 10498931 NLM ISO Abbreviation: Int J Methods Psychiatr Res Subsets: MEDLINE

Publication: Hoboken, NJ : John Wiley & Sons
Original Publication: Chichester ; New York : Wiley, c1991-

Psychiatric Status Rating Scales* ; Psychometrics*; Depression/*diagnosis ; Depression/*etiology ; Myocardial Infarction/*complications ; Myocardial Infarction/*psychology; Aged ; Female ; Humans ; Male ; Middle Aged ; Personality Inventory

Observed associations between depression following myocardial infarction (MI) and adverse cardiac outcomes could be overestimated due to patients' tendency to over report somatic depressive symptoms. This study was aimed to investigate this issue with modern psychometrics, using item response theory (IRT) and person-fit statistics to investigate if the Beck Depression Inventory (BDI) measures depression or something else among MI-patients. An IRT-model was fit to BDI-data of 1135 MI patients. Patients' adherence to this IRT-model was investigated with person-fit statistics. Subgroups of "atypical" (low person-fit) and "prototypical" (high person-fit) responders were identified and compared in terms of item-response patterns, psychiatric diagnoses, socio-demographics and somatic factors. In the IRT model, somatic items had lower thresholds compared to depressive mood/cognition items. Empirically identified "atypical" responders (n = 113) had more depressive mood/cognitions, scored lower on somatic items and more often had a Comprehensive International Diagnostic Interview (CIDI) depressive diagnosis than "prototypical" responders (n = 147). Additionally, "atypical" responders were younger and more likely to smoke. In conclusion, the BDI measures somatic symptoms in most MI patients, but measures depression in a subgroup of patients with atypical response patterns. The presented approach to account for interpersonal differences in item responding could help improve the validity of depression assessments in somatic patients.
(Copyright © 2015 John Wiley & Sons, Ltd.)

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Keywords: Beck Depression Inventory (BDI); depression; item response theory; myocardial infarction; person-fit

Date Created: 20150522 Date Completed: 20161101 Latest Revision: 20210109

20221213

PMC6878327

10.1002/mpr.1467

25994207