Screening for Depression in Prisoners Using the

¶ … Screening for Depression in Prisoners Using the Beck Depression Inventory" by Boothby & Durham examines depression levels of a random sample of 1,494 prisoners admitted into the North Carolina state prison system between September 1995 and February 1997 using the Beck Depression Inventory (BDI) (1999). The article first addresses its potential significance to the criminal justice and psychological fields; it states that incarceration is an event characterized by lack of control, undesirability, and threat. Situations involving these characteristics typically precede depressive symptoms.

Reactions to feelings of depression can lead to disciplinary infractions, assault, self-injury, and suicide, among other problems. Boothby & Durham argue that reducing these problems would not only alleviate suffering, but save prisons money. Furthermore, unlike Boothby & Durham's study, existing literature related to screening for depression among prison populations using the BDI focus on specific groups within the prison system, rather than a random, general sample. These studies consistently found inmate depression levels well above that of the general U.S.

population and a high degree of variation of prevalence rates of depression among samples. Boothby & Durham's study found, by using the Beck Depression Inventory, that a "significant number" of prisoners report depressive symptoms, with levels of depression varying along lines such as race, if the prisoner has been previously incarcerated (argued, in this article, as a product of age), gender, and incarceration level (severity of crime). The prevalence of depressive symptoms of Boothby & Durham's sample was well above that of the mean U.S. population.

Unlike Boothby & Durham, "Screening for Anxiety and Depression in Community Mental Health: The Beck Anxiety and Depression Inventories" by Eack et al. focused on the diagnostic accuracy of not only the BDI, but also the Beck Anxiety Inventory (BAI). This was achieved by comparing the Structured Clinical Interview of DSM-IV (SCID) scores of a sample of 288 distressed women seeking treatment for their children to the same sample's scores on the BDI and BAI. Eack et al.

explain that the necessity of this study derives from the fact that the BDI and the BAI "were not developed for diagnostic purposes, and few studies have examined the accuracy of using [them] in screening for mental disorders in community settings." The article defines the way these instruments can be measured for their ability to identify degrees of psychopathology: their "sensitivity," or ability to detect afflicted cases, and "specificity," or ability to correctly classify healthy cases.

These two dimensions can be derived from the instruments' "cut-points," or the specific scores the instruments provide that reflect psychopathology. Existing literature suggests that the BDI and BAI can potentially serve as brief screening devices for illuminating clinically significant anxiety and/or depression, but, as found in some studies, are not reliable for detecting more severe cases (read: higher "cut-points") when cross-referenced with scores from the SCID.

The current study found that both the BAI and BDI were significantly better than chance at diagnosing anxiety and depression, but sometimes suffered from problems with "specificity" and "sensitivity." More specifically, both the BAI and BDI were adept at identifying specific disorders while over-diagnosing other disorders. As such, the articles suggest, these instruments represent valuable tools for diagnosing specific disorders but, concerning other disorders, caution should be applied. While both articles had as one of their central facets the BDI, their emphases.