Beck Depression and Anxiety Inventories: Scoring and Interpretation Guide

About this resource

The BDI-II and the BAI are the two most widely used of Aaron Beck's self-report inventories. The BDI-II (Beck, Steer and Brown, 1996) is a 21-item measure of the severity of depressive symptoms over the past two weeks, revised from the original 1961 inventory so that its content matches the DSM-IV criteria for a major depressive episode. The BAI (Beck, Epstein, Brown and Steer, 1988) is a 21-item measure of the severity of anxiety symptoms over the past week, built to capture the somatic and cognitive symptoms of anxiety while overlapping as little as possible with depression. Both take five to ten minutes and both produce a total between 0 and 63.

This resource is a scoring and interpretation guide. Both inventories are copyrighted and are sold by Pearson; they are not free to reproduce, and we do not list the items. The guide describes the format and scoring, gives the severity bands published in the test manuals, summarises the psychometric evidence you can rely on, and explains how to use the two measures together in assessment and outcome monitoring. It also covers the two points clinicians most often get wrong: the BDI-II and the BAI use different reference periods, and the BAI's somatic emphasis means it reads panic and physical health problems as anxiety.

For clinicians delivering CBT, the pair works well as a baseline and end-of-treatment measure, with a free instrument such as the PHQ-9 or GAD-7 used for session-by-session tracking if cost is a concern. Where you do use the Beck inventories every session, the manuals' bands give you a shared language with the client for what the numbers mean.

How to use it

1. Obtain the official BDI-II and BAI record forms and manuals from the publisher. Administer both at assessment, ideally before the first full interview, and give the client a quiet few minutes to complete them.
2. Score each inventory by summing the 21 item ratings for a total between 0 and 63. Place each total in the severity band from the relevant manual. There are no reverse-scored items on either measure.
3. On the BDI-II, look at the suicide item before you do anything else with the form. Any rating above zero on that item requires a direct conversation about suicidal thinking in the same session and a risk assessment appropriate to your setting.
4. Feed the results back to the client in terms of the band and the pattern of items, not just the number. Tie individual items to the formulation: for example, high ratings on the cognitive items of the BDI-II point to the beliefs that cognitive work will target, and high ratings on the somatic items of the BAI point to interoceptive work.
5. Repeat at agreed intervals (every four to six sessions is common when the inventories are used as bookends) and at the end of treatment. Describe change in terms of movement between bands and a sustained score in the minimal range, and interpret any rise in the suicide item as a prompt for reassessment regardless of the total.

References

• Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. Psychological Corporation.
• Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897.
• Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77-100.
• Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory manual. Psychological Corporation.