The Behavioral Activation for Depression Scale (BADS): Psychometric Properties and Factor Structure

Kanter, Jonathan W.; Mulick, Patrick S.; Busch, Andrew M.; Berlin, Kristoffer S.; Martell, Christopher R.

doi:10.1007/s10862-006-9038-5

Cited by 403 publications

(426 citation statements)

References 34 publications

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“…First, this result provides support for the discriminant validity of the BADS, which was designed to assess increases in behavioral activation related to the treatment of depression, not general distress. 36 Second, this finding supports the independent contribution of improvement in negative cognitions as a unique predictor of patient improvement in depression and general psychological distress among patients with a mood disorder in an intensive CBT-oriented PH setting. Given that patients in PH treatment often present with multiple psychiatric diagnoses, it is important to identify improvements in specific domains (i.e., negative cognitions) that can have a broad impact on patient improvement.…”

Section: Summary Of Key Findingssupporting

confidence: 63%

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Cognitive and Behavioral Changes Related to Symptom Improvement Among Patients with a Mood Disorder Receiving Intensive Cognitive-behavioral Therapy

Christopher

Jacob

Neuhaus

et al. 2009

Journal of Psychiatric Practice

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DescriptionObjective: To examine the relationship between cognitive and behavioral changes associated with cognitive behavioral therapy (CBT) and treatment response in an intensive partial hospital (PH) setting. Methods: Study participants were 105 patients with mood disorders receiving treatment in a private psychiatric PH setting. The flexible treatment model used evidence-based CBT interventions adapted to the PH context, with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and discharge to assess psychological distress, depression, negative automatic thoughts, and behavioral activation. Mean treatment duration was 9 days. Results: Decreased negative automatic thoughts and increased behavioral activation predicted reduction of depressive symptoms; however, only decreased negative automatic thoughts was predictive of patients' overall level of psychological distress. Conclusions: These results suggest that a CBT intervention adapted for use in a PH setting can be an effective treatment for severe mood disorders. Furthermore, although the design used in this study precludes causal inferences, depressive symptom improvement appears to be associated with decreased negative automatic thoughts and increased behavioral activation. Implications for the delivery of CBT in PH programs and future directions for research are discussed. The final, definitive version of this document, which should be used for reference and citation purposes, may be found online at Journal of Psychiatric Practice (www.psychiatricpractice.com). Copyright restrictions may apply. The final, definitive version of this document, which should be used for reference and citation purposes, may be found online at Journal of Psychiatric Practice (www.psychiatricpractice.com). Copyright restrictions may apply. Disciplines Mental and Social Health | Psychiatry and Psychology | Psychology Cognitive and Behavioral Changes Related to Symptom AbstractObjective: To examine the relationship between cognitive and behavioral changes associated with cognitive behavioral therapy (CBT) and treatment response in an intensive partial hospital (PH) setting. Methods: Study participants were 105 patients with mood disorders receiving treatment in a private psychiatric PH setting. The flexible treatment model used evidence-based CBT interventions adapted to the PH context, with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and discharge to assess psychological distress, depression, negative automatic thoughts, and behavioral activation. Mean treatment duration was 9 days. Results: Decreased negative automatic thoughts and increased behavioral activation predicted reduction of depressive symptoms; however, only decreased negative automatic thoughts was predictive of patients' overall level of psychological distress. Conclusions: These results suggest that a CBT intervention adapted for use in a PH setting can be an effective treatment for severe mood dis...

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Section: Summary Of Key Findingssupporting

confidence: 63%

“…Finally, behavioral activation was assessed with the Behavioral Activation for Depression Scale (BADS). 36 Possible scores on the BADS range from 0 to 150, with higher scores indicating increased behavioral activation. All four measures have been shown to have adequate reliability and validity.…”

Section: Assessmentsmentioning

confidence: 99%

Cognitive and Behavioral Changes Related to Symptom Improvement Among Patients with a Mood Disorder Receiving Intensive Cognitive-behavioral Therapy

Christopher

Jacob

Neuhaus

et al. 2009

Journal of Psychiatric Practice

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“…In addition to information on age at depression onset and number of previous episodes collected using the SCID, 45 we also collected data on changes in specific behaviour [as assessed via the Behavioural Activation for Depression Scale (BADS)], 67 70 acceptability of BA and CBT for participants and clinicians (assessed with qualitative methods), and per protocol (PP) treatment adherence (from therapist case records). We collected qualitative data via semistructured interviews to access participants', BA MHWs' and CBT therapists' accounts of the mechanisms and impacts of treatment.…”

Section: Process Datamentioning

confidence: 99%

Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive–behavioural therapy for depression

Richards

Rhodes

Ekers

et al. 2017

Health Technol Assess

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BackgroundDepression is a common, debilitating and costly disorder. The best-evidenced psychological therapy – cognitive–behavioural therapy (CBT) – is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative.ObjectivesTo determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months’ follow-up, and to investigate the processes of treatments.DesignRandomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation.SettingThree community mental health services in England.ParticipantsAdults aged ≥ 18 years with major depressive disorder (MDD) recruited from primary care and psychological therapy services.InterventionsBA delivered by NHS junior mental health workers (MHWs); CBT by NHS psychological therapists.OutcomesPrimary: depression severity (as measured via the Patient Health Questionnaire-9; PHQ-9) at 12 months. Secondary: MDD status; number of depression-free days; anxiety (as measured via the Generalised Anxiety Disorder-7); health-related quality of life (as measured via the Short Form questionnaire-36 items) at 6, 12 and 18 months; and PHQ-9 at 6 and 18 months, all collected by assessors blinded to treatment allocation. Non-inferiority margin was 1.9 PHQ-9 points. We undertook intention-to-treat (ITT) and per protocol (PP) analyses. We explored cost-effectiveness by collecting direct treatment and other health- and social-care costs and calculating quality-adjusted life-years (QALYs) using the EuroQol-5 Dimensions, three-level version, at 18 months.ResultsWe recruited 440 participants (BA,n = 221; CBT,n = 219); 175 (79%) BA and 189 (86%) CBT participants provided ITT data and 135 (61%) BA and 151 (69%) CBT participants provided PP data. At 12 months we found that BA was non-inferior to CBT {ITT: CBT 8.4 PHQ-9 points [standard deviation (SD) 7.5 PHQ-9 points], BA 8.4 PHQ-9 points (SD 7.0 PHQ-9 points), mean difference 0.1 PHQ-9 points, 95% confidence interval (CI) –1.3 to 1.5 PHQ-9 points,p = 0.89; PP: CBT 7.9 PHQ-9 points (SD 7.3 PHQ-9 points), BA 7.8 PHQ-9 points (SD 6.5 PHQ-9 points), mean difference 0.0 PHQ-9 points, 95% CI –1.5 to 1.6 PHQ-9 points,p = 0.99}. We found no differences in secondary outcomes. We found a significant difference in mean intervention costs (BA, £975; CBT, £1235;p < 0.001), but no differences in non-intervention (hospital, community health, social care and medication costs) or total (non-intervention plus intervention) costs. Costs were lower and QALY outcomes better in the BA group, generating an incremental cost-effectiveness ratio of –£6865. The probability of BA being cost-effective compared with CBT was almost 80% at the National Institute for Health and Care Excellence’s preferred willingness-to-pay threshold of £20,000–30,000 per QALY. There were no trial-related adverse events.LimitationsIn this pragmatic trial many depressed participants in both groups were also taking antidepressant medication, although most had been doing so for a considerable time before entering the trial. Around one-third of participants chose not to complete a PP dose of treatment, a finding common in both psychotherapy trials and routine practice.ConclusionsWe found that BA is as effective as CBT, more cost-effective and can be delivered by MHWs with no professional training in psychological therapies.Future workSettings and countries with a paucity of professionally qualified psychological therapists, might choose to investigate the delivery of effective psychological therapy for depression without the need to develop an extensive and costly professional infrastructure.Trial registrationCurrent Controlled Trials ISRCTN27473954.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 46. See the NIHR Journals Library website for further project information.

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“…On this point, Kanter et al (2006) and Takagaki et al (2013) showed BADS Activation, regardless of whether activation is along values, was not associated with BADS Avoidance (r ¼ À.13 to À.14). In the present study, the correlation between BADS Activation and BADS Avoidance was .22 (p < .01) when controlling for depressive affect.…”

Section: Discussionmentioning

confidence: 90%

Relationships Among Valued Action, Behavioral Activation, Avoidance, and Reinforcement in a Sample of College Students

Doi

Yokomitsu²,

Sakano

2016

Psychol Rep

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Behavioral activation is a validated intervention for depression, which helps depressed people re-engage overt behaviors to facilitate contacts with reinforcing environmental contingencies and subsequent reductions in depression. Moreover, behavioral activation deals with values that are based on acceptance and commitment therapy. However, there is no empirical study that examines the role of behavior in line with values in behavioral activation. This study examined the role of behavior in line with values in behavioral activation by examining the association between behavior in line with values and variables of behavioral activation intervention targets, as well as the mediating effect of behavioral commitment. Japanese versions of the Personal Values Questionnaire II, the Behavioral Activation for Depression Scale, the Environmental Reward Observation Scale, and the Center for Epidemiological Studies Depression were completed by 292 Japanese undergraduate students (M age ¼ 19.2 yr., SD ¼ 1.7; 65 men, 226 women, 1 unknown). Results indicated that behavior in line with values was associated with focused, goal-directed activation and completion of scheduled activities, which were mediated by behavioral commitment to values.

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The Behavioral Activation for Depression Scale (BADS): Psychometric Properties and Factor Structure

Cited by 403 publications

References 34 publications

Cognitive and Behavioral Changes Related to Symptom Improvement Among Patients with a Mood Disorder Receiving Intensive Cognitive-behavioral Therapy

Cognitive and Behavioral Changes Related to Symptom Improvement Among Patients with a Mood Disorder Receiving Intensive Cognitive-behavioral Therapy

Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive–behavioural therapy for depression

Relationships Among Valued Action, Behavioral Activation, Avoidance, and Reinforcement in a Sample of College Students

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