Highly Elevated Scores on the Beck Depression Inventory–Second Edition as an Indicator of Noncredible Symptom Report

Abstract

Some recent studies have revived the approach of investigating extreme levels of self-reported depressive symptoms as indicative of gross exaggeration. While scores above 40 on the Beck Depression Inventory–Second Edition (BDI-II) were discussed as indicating exaggerated symptom claims, different cut scores for identifying noncredible responding are now being discussed. A consecutive sample of 242 patients referred for forensic psychological assessment (mean age: 46.0 years, 47.7% women) with full data sets on the BDI-II and the Structured Inventory of Malingered Symptomatology (SIMS) were assessed. Of all patients, 13.2% scored above 40 and BDI-II scores correlated with SIMS total scores at .62. For different SIMS cutoffs (>14, >16, >19, >23) used as criterion standard, optimal cut scores for the BDI-II were computed. When specificity was set at a minimum of 90%, sensitivity estimates were below 50% for all four SIMS levels. Extreme scores on the BDI-II should raise concern about the credibility of self-reported depressive symptom load. Diagnosis as well as severity estimates should not be based primarily on self-report instruments. To avoid significant risks of bias, the development of reliable cut scores for BDI-II elevations should be based on more studies with samples from diverse contexts.