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

  • Jonathan W. KanterEmail author
  • Patrick S. Mulick
  • Andrew M. Busch
  • Kristoffer S. Berlin
  • Christopher R. Martell
Original Paper


In Behavioral Activation (BA) for depression (Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001)), which has recently received empirical support in a large randomized trial, therapists pay close attention to the function of behavior and the role of aversive controlling stimuli and escape and avoidance behavior in depression. A key variable to measure in studies of BA is when and how clients become more activated over the course of treatment. This study sought to develop an initial set of items for the Behavioral Activation for Depression Scale (BADS), submit these items to an exploratory factor analysis in an initial administration (Study 1, N = 391), and submit the resulting scale to a confirmatory factor analysis in a second administration (Study 2, N = 319). Results indicated four factors (Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment) with good factor structure, internal consistency, and test-retest reliability. Evidence for construct and predictive validity is presented.


Behavioral activation Depression Scale development Psychotherapy Measurement 


  1. Armento, M. E. A., & Hopko, D. R. (in press). The Environmental Reward Observation Scale (EROS): Development, validity, and reliability. Behavior Therapy.Google Scholar
  2. Barlow, D. H. (2002). Anxiety and its Disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford.Google Scholar
  3. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.PubMedCrossRefGoogle Scholar
  4. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.Google Scholar
  5. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.PubMedGoogle Scholar
  6. Bollen, K. A. (1989). Structural equations with latent variables. Oxford, England: Wiley.Google Scholar
  7. Borkovec, T. D. (1994). The nature, functions, and origins of worry. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment, and treatment (pp. 5–33). New York: Wiley.Google Scholar
  8. Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–61). Newbury Park, CA: Sage.Google Scholar
  9. Craske, M. G. (1999). Anxiety disorders: Psychological approaches to theory and treatment. Boulder, CO: Westview.Google Scholar
  10. Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.PubMedCrossRefGoogle Scholar
  11. Dobson, K. S., Hollon, S. D., Dimidjian, S. A., Schmaling, K. B., Kohlenberg, R. J., Rizvi, S., & Dunner, D. L. (2004). Prevention of relapse. In S. D. Hollon (Chair), Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the treatment of Major Depression. Symposium conducted at the annual meeting of the American Psychiatric Association, New York, NY.Google Scholar
  12. Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857–870.PubMedCrossRefGoogle Scholar
  13. Gortner, E., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377–384.PubMedCrossRefGoogle Scholar
  14. Hayes, S. C., Hayes, L. J., Reese, H. W., & Sarbin, T. R. (Eds.). (1993). Varieties of scientific contextualism. Reno, NV: Context Press.Google Scholar
  15. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: Guilford.Google Scholar
  16. Hayes, S. C., Strosal, K., Willson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., et al. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54, 533–578.Google Scholar
  17. Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. D. (1996). Emotional avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168.PubMedCrossRefGoogle Scholar
  18. Herrnstein, R. J. (1970). On the law of effect. Journal of the Experimental Analysis of Behavior, 13, 243–266.PubMedCrossRefGoogle Scholar
  19. Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4, 383–395.CrossRefGoogle Scholar
  20. Hopko, D. R., Bell, J. L., Armento, M. E. A., Hunt, M. K., & Lejuez, C. W. (2005). Behavior therapy for depressed cancer patients in primary care. Psychotherapy: Theory, Research, Practice, Training, 42, 236–243.CrossRefGoogle Scholar
  21. Hopko, D. R., Lejuez, C. W., & Hopko, S. D. (2004). Behavioral activation as an intervention for co-existent depressive and anxiety symptoms. Clinical Case Studies, 3, 37–48.CrossRefGoogle Scholar
  22. Hopko, D. R., Lejuez, C. W., LePage, J. P., Hopko, S. D., & McNeil, D. W. (2003). A brief Behavioral Activation Treatment for Depression: A randomized trial within an inpatient psychiatric hospital. Behavior Modification, 27, 458–469.PubMedCrossRefGoogle Scholar
  23. Hopko, D. R., Lejuez, C. W., Ruggiero, K. J., & Eifert, G. H. (2003). Contemporary behavioral activation treatments for depression: Procedures, principles, and progess. Clinical Psychology Review, 23, 699–717.PubMedCrossRefGoogle Scholar
  24. Hopko, D. R., Sanchez, L., Hopko, S. D., Dvir, S. & Lejuez, C. W. (2003). Behavioral activation and the prevention of suicidal behaviors in patients with Borderline Personality Disorder. Journal of Personality Disorders, 17, 460–478.PubMedCrossRefGoogle Scholar
  25. Hoyle, R. H. (1995). Structural equation modeling: Concepts, issues, and applications. Thousand Oaks, CA: Sage.Google Scholar
  26. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
  27. Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., et al. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295–304PubMedCrossRefGoogle Scholar
  28. Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8, 255–270.CrossRefGoogle Scholar
  29. Jakupcak, M., Roberts, L., Martell, C., Mulick, P. Michael, S., Reed, R., et al. (2006). A pilot study of Behavior Activation for veterans with Post-Traumatic Stress Disorder. Journal of Traumatic Stress, 19, 387–391.Google Scholar
  30. Jöreskog, K. G, & Sörbom, D. (2003). Lisrel, 8.54. Hillsdale, NJ. SSI Scientific Software International.Google Scholar
  31. Just, N., & Alloy, L. B. (1997). The response styles theory of depression: Tests and an extension of the theory. Journal of Abnormal Psychology, 106, 221–229.PubMedCrossRefGoogle Scholar
  32. Kaiser, H. F. (1970). A second generation little jiffy. Psychometrika, 35, 401–415.CrossRefGoogle Scholar
  33. Kanter, J. W., Callaghan, G. M., Landes, S. J., Busch, A. M., & Brown, K. R. (2004). Behavior analytic conceptualization and treatment of depression: Traditional models and recent advances. The Behavior Analyst Today, 5, 255–274.Google Scholar
  34. Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2002). The brief Behavioral Activation Treatment for Depression (BATD): A comprehensive patient guide. Boston: Pearson Custom Publishing.Google Scholar
  35. LeJuez, C. W., Hopko, D. R., LePage, J., Hopko, S. D., & McNeil, D. W. (2001). A brief Behavioral Activation Treatment for Depression. Cognitive and Behavioral Practice, 8, 164–175.CrossRefGoogle Scholar
  36. Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. J. Friedman & M. M. Katz (Eds.), The psychology of depression: Contemporary theory and research (pp. 157–178). Washington, DC: Winston-Wiley.Google Scholar
  37. MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1, 130–149.CrossRefGoogle Scholar
  38. MacPhillamy, D. J., & Lewinsohn, P. M. (1982). The pleasant events schedule: Studies in reliability, validity, and scale intercorrelation. Journal of Consulting and Clinical Psychology, 50, 363–380.CrossRefGoogle Scholar
  39. Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New York: Norton.Google Scholar
  40. Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511.PubMedCrossRefGoogle Scholar
  41. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121.PubMedCrossRefGoogle Scholar
  42. Nolen-Hoeksema, S., Parker, L. E., & Larson, J. (1994). Ruminative coping with depressed mood following loss. Journal of Personality and Social Psychology, 67, 92–104.PubMedCrossRefGoogle Scholar
  43. Ottenbreit, N. D., & Dobson, K. S. (2004). Avoidance and depression: The construction of the Cognitive-Behavioral Avoidance Scale. Behaviour Research and Therapy, 42, 293–313.PubMedCrossRefGoogle Scholar
  44. Porter, J. F., Spates, C. R., & Smithan, S. (2004). Behavioral Activation group therapy in public mental health settings: A pilot investigation. Professional Psychology: Research and Practice, 35, 297–301.CrossRefGoogle Scholar
  45. Russell, D. W. (2002). In search of underlying dimensions: The use (and abuse) of factor analysis in personality and social psychology bulletin. Personality and Social Psychology Bulletin, 28, 1629–1646.CrossRefGoogle Scholar
  46. Satorra, A., & Bentler, P. M. (1994). Corrections to test statistics and standard errors in covariance structure analysis. In A. von Eye & C. C. Clogg (Eds.), Latent variable analysis: Applications for developmental research (pp. 399–419). Thousand Oaks, CA: Sage.Google Scholar
  47. Umberson, D., Wortman, C. B., & Kessler, R. C. (1992). Widowhood and depression: Explaining long-term gender differences in vulnerability. Journal of Health and Social Behavior, 33, 10–24PubMedCrossRefGoogle Scholar
  48. Watkins, E., Moulds, M., & Mackintosh, B. (2005). Comparisons between rumination and worry in a non-clinical population. Behavior Research and Therapy, 43, 1577–1585.CrossRefGoogle Scholar
  49. West, S. G., Finch, J. F., & Curran, P. J. (1995). Structural equation models with nonnormal variables: Problems and remedies. In R. H. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 56–75). Newbury Park, CA: Sage.Google Scholar
  50. Youngren, M. A. & Lewinsohn, P. M. (1980). The functional relationship between depressed and problematic interpersonal behavior. Journal of Abnormal Psychology, 89, 333–341.PubMedCrossRefGoogle Scholar
  51. Zeiss, A. M., Lewinsohn, P. M., & Muñoz, R. F. (1979). Nonspecfic improvement effects in depression using interpersonal skills training, pleasant activity schedules, or cognitive training. Journal of Consulting and Clinical Psychology, 47, 427–439.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Jonathan W. Kanter
    • 1
    Email author
  • Patrick S. Mulick
    • 2
  • Andrew M. Busch
    • 1
  • Kristoffer S. Berlin
    • 1
  • Christopher R. Martell
    • 3
  1. 1.Department of PsychologyUniversity of Wisconsin-MilwaukeeMilwaukeeUSA
  2. 2.Department of PsychologyGonzaga UniversitySpokaneUSA
  3. 3.Department of PsychologyUniversity of WashingtonSeattleUSA

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