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The Factor Structure and Stability of the Beck Depression Inventory-II (BDI-II) in a Population Undergoing Bariatric Surgery

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Abstract

Purpose

Depression is a multifaceted psychiatric condition that has been associated with suboptimal weight loss following bariatric surgery. Previous variations of Beck Depression Inventory-Second Edition (BDI-II) subscales been proposed, including those identified within bariatric populations; however, it is unclear whether the BDI-II items contained within these subscales would remain consistent after the procedure considering the physical and lifestyle changes that occur following bariatric surgery.

Materials and Methods

A two-step analytic approach that comprised of exploratory (EFA) and confirmatory factor analyses (CFA) that aimed to identify a stable factor structure using pre- and 6-month post-surgical BDI-II responses. Baseline BDI-II responses of 149 patients (Group 1) were used to identify an initial EFA model. Five BDI-II models underwent CFA using BDI-II responses of a comparable pre-surgical group (Group 2; n = 142), and 6-month post-surgical data from Group 1.

Results

EFA generated a two-factor solution. Of the five CFA models performed, the three-factor model that was initially identified by Hayes (2015) among patients undergoing bariatric surgery demonstrated superior fit across time and between groups.

Conclusions

Although the EFA initially identified a two-factor model, CFA determined that a previously defined three-factor model reliably fit both pre- and post-surgical BDI-II responses. This study supports using the Hayes (2015) subscales when monitoring pre- and post-bariatric surgery facets of depression specific to this population. Being able to accurately and reliably monitor depressive symptoms of patients that are undergoing bariatric surgery will allow for the provision and monitoring of targeted interventions aimed at improving their mental and physical health outcomes.

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Acknowledgements

Funding for data collection was provided by operating grants from the Canadian Institutes of Health Research (CIHR) (PJT-153424 and UD1-170,148). Doctoral fellowships were awarded to Mr. Woods by the Fonds de recherche du Québec—Santé (FRQS) and J.W. McConnell Memorial Graduate Fellowships. Dr Lavoie was supported by a UQAM Research Chair and FRQS Senior Research Award (34,757). Dr Bacon was supported by a CIHR-SPOR Mentoring Chair (SMC-151518) and a FRQS Chair (251,618). The REBORN Team includes: Bacon S.L. and Lavoie K.L. (principal investigators); Gautier, A. and Marion, P. (patient investigators); Alberga, A., Denis, R., Garneau, P., Lavigne, G., Pescarus, R., Raymond-Carrier, S., Santosa, S., and Studer, A.S. (co-investigators); and Ben-Porat, T., Delaney, K., Fortin, A., Julien, C., Mercier, L., Woods, R., and Yousefi, R (mentees).

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Authors and Affiliations

  1. Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS- NIM), Montréal, H3G 1M8, Canada

    Robbie Woods, Kim L. Lavoie & Simon L. Bacon

  2. Department of Psychology, Concordia University, Montréal, Canada

    Robbie Woods

  3. Department of Psychology, University of Quebec at Montreal (UQAM), Montréal, Canada

    Kim L. Lavoie

  4. Department of Health, Kinesiology & Applied Physiology, Concordia University, Montréal, Canada

    Simon L. Bacon

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Correspondence to Simon L. Bacon.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Competing Interests

Mr. Woods has no conflicts of interest to report. Dr. Lavoie has served on the advisory board for Schering-Plough, Takeda, AbbVie, Almirall, Janssen, GSK, Astellas, Novartis, Boehringer Ingelheim (BI), and Sojecci Inc. and received sponsorship for investigator-generated research grants from GSK and AbbVie; speaker fees from GSK, Astra-Zeneca, Astellas, Novartis, BI, Takeda, Janssen, AbbVie, Merck, Bayer, Pfizer, and Air Liquide; and support for educational materials from Merck, none of which are related to the current article. Dr. Bacon has received consultancy fees from Merck for the development of behavior change continuing education modules and speaker fees from Novartis and Janssen and has served on advisory boards for Bayer, Sanofi, and Sojecci Inc., none of which are related to the current article.

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Key points

• The Hayes (2015) three-factor model demonstrated superior fit when compared to all other competing models in the baseline and postoperative BDI-II responses across two groups.

• The three BDI-II subscales measure negative perceptions, cognitive dysregulation, and diminished vigor.

• These subscales could more readily identify facets of depression and streamline patient care by delivering targeted and personalized treatments.

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Supplementary file2 (DOCX 46 KB)

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Woods, R., Lavoie, K.L. & Bacon, S.L. The Factor Structure and Stability of the Beck Depression Inventory-II (BDI-II) in a Population Undergoing Bariatric Surgery. OBES SURG 32, 3732–3739 (2022). https://doi.org/10.1007/s11695-022-06277-5

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