The status of the Beck inventories (BDI, BAI) in psychology training and practice: A major shift in clinical acceptance

Abstract

While the Beck Depression Inventory I and II (hereon BDI) have been a mainstay in mental health assessment for many decades, a cursory review of survey-based “test use” studies in the 1990s finds that the Beck Anxiety Inventory (BAI) was not initially a highly ranked test in the assessment of anxiety or psychopathology. To date, a review of the extant literature on the popularity of the Beck inventories in professional psychology training or practice settings has not been systematically analyzed, although Piotrowski and Gallant (Journal of Instructional Psychology, 36, 2009, 84) found the BAI the most visible anxiety scale in the research literature between 2000 and 2005. Yet, quite evident, the field of clinical assessment remains highly competitive with a proliferation of mental health scales and measures introduced, perennially, in both the professional and research literature. In addition, since the mid-1990s, regulatory restrictions (i.e., managed care directives) on the feasibility of providing multimethod assessment services has also been a potent headwind in professional practice. Thus, historically, the professional acceptance of the BDI and BAI remains somewhat opaque, in terms of degree of usage in both training and practice settings compared to other assessment instruments. Hence, the aim of the current study is to address this gap in the literature. To that end, the author identified, through an extensive literature review, survey-based studies with regard to personality assessment that reported on graduate-level training in psychological testing and test usage patterns from 1989–2017. This systematic search yielded 45 articles (including 1 dissertation study) which served as the data pool for the current review (Training settings, n = 10; Practice settings, n = 35). The analysis found that the BDI has been relied upon to at least a moderate degree in 21 of the 35 (60%) of the surveys of practice settings and in 7 of the 10 (70%) of the studies of academic/internship training. Although the BAI has not been as popular as the BDI historically, this review clearly indicated that since 2010, the BAI has made a pivotal shift toward professional acceptance in practice, generated much enthusiasm in internship training, and been embraced by clinical faculty. Reflecting this emergent popularity of the Beck inventories, the current review indicated that, overall, 10 of the 14 studies (71%) since 2010 reported that both the BDI/BAI have been: (a) recognized and relied upon to a high degree in both assessment training and practice, (b) a valuable clinical tool for mental health clinicians, and (c) considered the instruments of choice amongst the myriad of brief, self-report measures in the assessment of mood disorders. Potential competing factors, such as other established and newly introduced measures of anxiety and depression (e.g., GAD-7, PROMIS, PHQ, DASS-21) that may impact future trends regarding usage of the Beck inventories, were discussed. Furthermore, research efforts should investigate the common factor of negative affectivity reflected in the Beck inventories when differentiating depression and anxiety states in monitoring treatment outcomes.