The stability and clinical significance of distress: A rejoinder to pepper and coyne

Abstract

Past research has established that some individuals with high Beck Depression Inventory (BDI) scores at one time point have scores that are lower at a second time point. Recently, we provided evidence indicating that the temporal instability of certain BDI scores may be due partly to the regression to the mean phenomenon. Pepper and Coyne (1996) question this statistical interpretation; they argue that distress among students is unstable for substantive reasons. In the current paper, we reaffirm our view that statistical and measurement factors may account, in part, for changes in BDI scores over time. Given this possibility, inferences about “distress” or “depression” as a latent construct in student samples are not warranted if these inferences are based on the administration of a single instrument such as the BDI; any conclusions about distress as a psychological construct must be qualified by acknowledging the possible roles of error and method variance. Clearly, empirical research is needed in order to obtain a better understanding of the nature of distress as a latent variable, especially in light of evidence which indicates that subthreshold levels of depression have a high degree of clinical significance.