Military veterans represent one segment of the population that deals with an all-too-common problem in the medical and psychological arenas: chronic pain. People who suffer chronic pain can experience significant physical symptoms and, often, psychological symptoms. Because the physical discomfort caused by chronic pain can mimic the somatic symptoms of depression, it is imperative that clinicians be able to distinguish between the two. One of the most widely used tools for measuring depression is the Beck Depression Inventory (BDI-II) Revised. This scale measures physical, psychological, and behavioral symptoms; therefore, its accuracy in identifying depression among chronic pain sufferers has been questioned. Michael N. Lopez, a researcher from the Veterans Affairs’ Neuropsychology Testing Laboratory, wanted to determine if the existing BDI-II could predict depression in individuals with chronic pain, or if specific factors on the BDI-II should be considered separately in order to obtain accurate identification of depressive symptoms.
In a recent study, Lopez assessed 345 male veterans who were part of an outpatient chronic pain treatment program. After examining all factors on the BDI-II, Lopez found that three stood out as relevant for the indication of depression among people with chronic pain. Lopez discovered that “somatic complaints” (SC), “mood” (M), and “negative rumination” (NR) were unique predictors of depression. Although suicidal thoughts and other symptoms should be considered, they did not warrant independent factor analyses. Lopez believes that clinicians who work with chronic pain clients should consider how responses on these particular factors of SC, M, and NR fluctuate from normal ranges. Doing so could help professionals better distinguish between which clients have clinical levels of depression and which are having depression symptoms overestimated on the BDI-II. Lopez hopes that future research will look at female and male chronic pain clients in order to gauge the limits of the BDI-II in both sexes. He also hopes that future attempts will support the predictive ability of the three factors outlined here. “Meanwhile, we highly recommend that clinicians and researchers that work with male chronic pain veterans to apply the norms presented in this study when using the BDI-II to better detect and treat depression,” Lopez said.
Lopez, M. N., Pierce, R. S., Gardner, R. D., Hanson, R. W. (2012). Standardized Beck Depression Inventory-II scores for male veterans coping with chronic pain. Psychological Services. Advance online publication. doi: 10.1037/a0027920
© Copyright 2012 GoodTherapy.org. All rights reserved.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.