The Beck Depression Inventory: item order and the impact of response sets.

The lack of subtle content in the item groups of the Beck Depression Inventory (BDI) and the consistency in the ordering of the items from least to most pathological make this instrument unduly susceptible to either defensive or malingering response sets. Two experimental forms were developed for the BDI: a backwards version (a simple reversal of the order of items within each group) and a random-order version. These forms, together with the original item order, were given to college undergraduate women along with the Depression scale from the MMPI and the Burks-Martin Questionnaire covering recent life changes and current stressful situations. The random order BDI results in a significantly higher depression score than did either the original or backwards version. Correlations with the other instruments were comparable for all three forms. The random order of items within each set appears to break up a response set to endorse either the first or last item and is, therefore, recommended.