Adaptation and Validation of the Indonesian Version of Behavioral Activation for Depression Scale – Short Form (BADS-SF) Using Confirmatory Factor Analysis and Rasch Modeling
DOI:
https://doi.org/10.15408/jp3i.v15i1.51044Keywords:
behavioral activation, depression, measurement, Rasch analysis, reliability, validityAbstract
The Behavioral Activation for Depression Scale – Short Form (BADS-SF) is a brief instrument designed to measure activation levels in individuals undergoing behavioral activation (BA) therapy for depression. With the broad potential for implementing BA therapy, including in Indonesia, the BADS-SF needs to be cross-culturally adapted. While the original validation study supported a two-factor model, subsequent adaptations, particularly in non-Western settings, have yielded inconsistent results. In addition, given the practical application of the BADS-SF total score as an overall indicator of behavioral activation, it is essential to evaluate its psychometric properties as a unidimensional measure. The objectives of this study are: (1) to culturally adapt the BADS-SF into the Indonesian language (Bahasa Indonesia); (2) to examine its underlying factor structure and convergent validity; and (3) to evaluate its psychometric properties using item response theory (IRT), specifically Rasch modeling. The cultural adaptation process demonstrated good content validity based on Aiken’s V (.75 to 1 for all items) and confirmed the scale readability. The confrmatory factor analysis (CFA) results revealed a different factor structure than the original, with a 6-item one-factor model providing the best fit and confirmed convergent validity. Rasch analysis further showed that the Indonesian version of BADS-SF had good psychometric properties, including excellent item reliability, acceptable person reliability, and supported unidimensionality following the exclusion of a misfitting item (Item 8). Based on the overall results, the 6-item version of BADS-SF Bahasa Indonesia is recommended to be used for both research and clinical practice. Further implications of the findings are discussed.
References
Abbafati, C., Abbas, K. M., Abbasi-Kangevari, M., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abegaz, K. H., Abolhassani, H., Aboyans, V., Abreu, L. G., Abrigo, M. R. M., Abualhasan, A., Abu-Raddad, L. J., Abushouk, A. I., Adabi, M., Adekanmbi, V., Adeoye, A. M., Adetokunboh, O. O., … Murray, C. J. L. (2020). Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1223–1249. https://doi.org/10.1016/S0140-6736(20)30752-2
Anselmi, P., Colledani, D., & Robusto, E. (2019). A Comparison of Classical and Modern Measures of Internal Consistency. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.02714
Anvari, M. S., Hampton, T., Tong, M. P., Kahn, G., Triemstra, J. D., Magidson, J. F., & Felton, J. W. (2023). Behavioral Activation Disseminated by Non–Mental Health Professionals, Paraprofessionals, and Peers: A Systematic Review. Behavior Therapy, 54(3), 524–538. https://doi.org/10.1016/j.beth.2022.12.007
Arroisi, J., & Himaya, N. N. (2023). Abu Zayd Al-Balkhi’s Perspective on Depression: Countering Sadness with Cognitive Theory in the Book of Mashalih al Abdan wa al Anfus. TAZKIYA Jounal of Psychology, 11(1), 11–12. https://doi.org/https://doi.org/10.15408/tazkiya.v11i1.29913
Bond, T. G., & Fox, C. M. (2015). Applying the Rasch model: Fundamental measurement in the human sciences (Third edition). Routledge.
Boone, W. J., Yale, M. S., & Staver, J. R. (2014). Rasch analysis in the human sciences. In Rasch Analysis in the Human Sciences. https://doi.org/10.1007/978-94-007-6857-4
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present : Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
Brown, T. A. (2015). Confirmatory factor analysis for applied research (Second edition) (Second edi). The Guilford Press.
Cappelleri, J. C., Lundy, J. J., & Hays, R. D. (2014). Overview of Classical Test Theory and Item Response Theory for quantitative assessment of items in developing patient-reported outcome measures. Clinical Therapeutics, 36(5), 648–662. https://doi.org/10.1016/j.clinthera.2014.04.006.Overview
Crego, A., Yela, J. R., Gómez-Martínez, M. Á., Riesco-Matías, P., & Petisco-Rodríguez, C. (2021). Relationships between mindfulness, purpose in life, happiness, anxiety, and depression: Testing a mediation model in a sample of women. International Journal of Environmental Research and Public Health, 18(3), 1–16. https://doi.org/10.3390/ijerph18030925
Cuijpers, P., Karyotaki, E., Harrer, M., & Stikkelbroek, Y. (2023). Individual behavioral activation in the treatment of depression: A meta analysis. Psychotherapy Research, 1–12. https://doi.org/10.1080/10503307.2023.2197630
Dimidjian, S., Martell, C. R., Addis, M. E., & Herman-Dunn, R. (2008). Behavioral activation for depression. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (4th edition) (pp. 328–364). The Guilford Press.
Dimidjian, Sona, Barrera, M., Martell, C., Muñoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38. https://doi.org/10.1146/annurev-clinpsy-032210-104535
Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014). Behavioural activation for depression; An update of meta-analysis of effectiveness and sub group analysis. PLoS ONE, 9(6). https://doi.org/10.1371/journal.pone.0100100
Ferster, C. B. (1973). A functional analysis of depression. American Psychologis, 28, 857–870.
Field, A. (2009). Discovering statistics using SPSS (3rd Editio). Sage Publication.
Fuhr, K., Hautzinger, M., Krisch, K., Berking, M., & Ebert, D. D. (2016). Validation of the Behavioral Activation for Depression Scale (BADS) - Psychometric properties of the long and short form. Comprehensive Psychiatry, 66, 209–218. https://doi.org/10.1016/j.comppsych.2016.02.004
González-Roz, A., Secades-Villa, R., & Muñiz, J. (2018). Validity evidence of the Behavioral Activation for Depression Scale-Short Form among depressed smokers. International Journal of Clinical and Health Psychology, 18(2), 162–169. https://doi.org/10.1016/j.ijchp.2018.03.002
Hayes, A. F., & Coutts, J. J. (2020). Use Omega Rather than Cronbach’s Alpha for Estimating Reliability. But…. Communication Methods and Measures, 14(1), 1–24. https://doi.org/10.1080/19312458.2020.1718629
Heine, S. J. (2020). Cultural psychology (4th edition). W. W. Norton & Company.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
International Test Commission. (2017). The ITC Guidelines for Translating and Adapting Tests (Second edition). [www.InTestCom.org]. https://doi.org/10.1111/j.1464-0597.1975.tb00322.x
Jabrayilov, R., Emons, W. H. M., & Sijtsma, K. (2016). Comparison of Classical Test Theory and Item Response Theory in Individual Change Assessment. Applied Psychological Measurement, 40(8), 559–572. https://doi.org/10.1177/0146621616664046
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral Activation Treatment for Depression: Returning to Contextual Roots. Clinical Psychology: Science and Practice, 8(3), 255–270. https://doi.org/10.1093/clipsy.8.3.255
Kanter, J. W., Mulick, P. S., Busch, A. M., Berlin, K. S., & Martell, C. R. (2007). The Behavioral Activation for Depression Scale (BADS): Psychometric properties and factor structure. Journal of Psychopathology and Behavioral Assessment, 29(3), 191–202. https://doi.org/10.1007/s10862-006-9038-5
Kanter, J. W., & Puspitasari, A. J. (2016). Global dissemination and implementation of behavioural activation. The Lancet, 388(10047), 843–844. https://doi.org/10.1016/S0140-6736(16)31131-X
Kanter, J. W., Puspitasari, A. J., Santos, M. M., & Nagy, G. A. (2012). Behavioural activation: History, evidence and promise. British Journal of Psychiatry, 200(5), 361–363. https://doi.org/10.1192/bjp.bp.111.103390
Koşan, Y., & Kaya, S. (2023). Psychometric Properties and Factor Structure of the Turkish Version of the Short Form of Behavioral Activation for Depression Scale (BADS-SF) in Non-Clinical Adults. E-International Journal of Educational Research, 14(3), 198–211. https://doi.org/https://doi.org/10.19160/e-ijer.1227934
Krings, A., Bortolon, C., Yazbek, H., & Blairy, S. (2021). Psychometric properties and factor structure of the french version of the behavioral activation for depression scale (bads) in non-clinical adults. Psychologica Belgica, 61(1), 20–32. https://doi.org/10.5334/pb.542
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Lehmann, D. C., & Bördlein, C. (2020). A Systematic Review of Culturally Adapted Behavioral Activation Treatments for Depression. Research on Social Work Practice, 30(6), 688–702. https://doi.org/10.1177/1049731520915635
Li, M., Ding, C., Kanter, J. W., Zeng, Q., & Yang, D. (2014). Further evaluation of the psychometric properties of the behavioral activation for depression scale. International Journal of Psychology and Psychological Therapy, 14(1), 45–57.
Linacre, J. M. (2012). Winsteps [Software]. http://www.winsteps. com/index.html.
Linacre, J. M. (2020). A user’s guide to Winsteps Ministep Rasch-model computer programs. winsteps.com.
Lubis, F. Y., Abidin, F. A., Qodariah, L., Anindhita, V., & Purba, F. D. (2024). Coping strategies and psychological distress among mothers during COVID-19 pandemic: The moderating role of social support. PLoS ONE, 19(4 April), 1–12. https://doi.org/10.1371/journal.pone.0300365
Luitel, N. P., Jordans, M. J. D., Kohrt, B. A., Rathod, S. D., & Komproe, I. H. (2017). Treatment gap and barriers for mental health care: A cross-sectional community survey in Nepal. PLoS ONE, 12(8), 1–15. https://doi.org/10.1371/journal.pone.0183223
Manos, R. C., Kanter, J. W., & Luo, W. (2011). The Behavioral Activation for Depression Scale-Short Form: Development and Validation. Behavior Therapy, 42(4), 726–739. https://doi.org/10.1016/j.beth.2011.04.004
Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adults: A meta-analysis and review. Clinical Psychology: Science and Practice, 16(4), 383–411. https://doi.org/10.1111/j.1468-2850.2009.01178.x
Mekonen, T., Chan, G. C. K., Connor, J. P., Hides, L., & Leung, J. (2021). Estimating the global treatment rates for depression: A systematic review and meta-analysis. Journal of Affective Disorders, 295(September), 1234–1242. https://doi.org/10.1016/j.jad.2021.09.038
Mohammadi, A., & Amiri, M. (2010). Behavioral Activation for Depression Scale: Psychometric properties and confirmatory factor analysis for Persian version. Iranian Journal of Psychiatry and Clinical Psychology, 16(1), 65–73.
Mousavi, A., & Cui, Y. (2020). The effect of person misfit on item parameter estimation and classification accuracy: A simulation study. Education Sciences, 10(11). https://doi.org/10.3390/educsci10110324
National Institute for Health and Clinical Excellence. (2022). Depression in adults: treatment and management NICE guideline. In NICE Guideline (Issue June). www.nice.org.uk/guidance/ng222
Oh, J.-H., Hwang, N.-R., Cha, Y.-J., Lee, E.-B., Choi, K.-H., & Seo, H.-J. (2017). The Reliability and Validity of the Korean Version of Behavioral Activation for Depression Scale. Journal of Korean Neuropsychiatric Association, 56(2), 89. https://doi.org/10.4306/jknpa.2017.56.2.89
Peristianto, S. V., Subandi, M. A., & Utami, M. S. (2025). Empathy and self-awareness (rasa rumangsa) in the Javanese cultural context. Culture and Psychology, 31(2), 713–733. https://doi.org/10.1177/1354067X251315737
Petrillo, J., Cano, S. J., McLeod, L. D., & Coon, C. D. (2015). Using classical test theory, item response theory, and rasch measurement theory to evaluate patient-reported outcome measures: A comparison of worked examples. Value in Health, 18(1), 25–34. https://doi.org/10.1016/j.jval.2014.10.005
Petts, R. A., Foster, C. S., Douleh, T. N., & Gaynor, S. T. (2016). Measuring activation in adolescent depression: Preliminary psychometric data on the Behavioral Activation for Depression Scale-Short Form. Behavior Analysis: Research and Practice, 16(2), 65–80. https://doi.org/10.1037/bar0000036
Raes, F., Hoes, D., Van Gucht, D., Kanter, J. W., & Hermans, D. (2010). The Dutch version of the behavioral activation for depression scale (BADS): Psychometric properties and factor structure. Journal of Behavior Therapy and Experimental Psychiatry, 41(3), 246–250. https://doi.org/10.1016/j.jbtep.2010.02.001
Ryder, A. G., Yang, J., & Heine, S. J. (2002). Somatization vs. Psychologization of Emotional Distress: A Paradigmatic Example for Cultural Psychopathology. Online Readings in Psychology and Culture, 10(2), 1–22. https://doi.org/10.9707/2307-0919.1080
Sagar, R., Pattanayak, R. D., Chandrasekaran, R., Chaudhury, P. K., Deswal, B. S., Lenin Singh, R. K., Malhotra, S., Nizamie, S. H., Panchal, B. N., Sudhakar, T. P., Trivedi, J. K., Varghese, M., Prasad, J., & Chatterji, S. (2017). Twelve-month prevalence and treatment gap for common mental disorders: Findings from a large-scale epidemiological survey in India. Indian Journal of Psychiatry, 59(1), 46–55. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_333_16
Setiyawati, Diana, Jatmika, Wulan Nur, Read, Ursula M, & Colucci, Erminia. (2025). “They think we are trying to combine knowledges, whereas we are trying to harmonize them”: A visual exploration of what promotes successful collaboration between mental health workers and healers in Indonesia. Transcultural Psychiatry, 13634615251338906. https://doi.org/10.1177/13634615251338906
Shudo, Y., & Yamamoto, T. (2017). Assessing the relationship between quality of life and behavioral activation using the Japanese Behavioral Activation for Depression Scale-Short Form. PLoS ONE, 12(9), 1–9. https://doi.org/10.1371/journal.pone.0185221
Shudo, Y., Yamamoto, T., & Sakai, M. (2017). Longitudinal Predictions of Depression Symptoms Using the Activation and Avoidance Subscales of the Japanese Behavioral Activation for Depression Scale-Short Form. Psychological Reports, 120(1), 130–140. https://doi.org/10.1177/0033294116680794
Stein, A. T., Carl, E., Cuijpers, P., Karyotaki, E., & Smits, J. A. J. (2021). Looking beyond depression: A meta-analysis of the effect of behavioral activation on depression, anxiety, and activation. Psychological Medicine, 51(9), 1491–1504. https://doi.org/10.1017/S0033291720000239
Sugiarto, R., & Suparno, K. (2025). The Javanese Rasa: Sense, psychology, and spirituality. Culture and Psychology, 31(2), 734–765. https://doi.org/10.1177/1354067X241300978
Sumintono, B., & Widhiarso, W. (2013). Aplikasi model Rasch untuk penelitian ilmu-ilmu sosial. Tim Komunikata Publishing House.
Sun, J. (2005). Assessing goodness of fit in confirmatory factor analysis. Measurement and Evaluation in Counseling and Development, 37(4), 240–256. https://doi.org/10.1080/07481756.2005.11909764
Teismann, T., Ertle, A., Furka, N., Willutzki, U., & Hoyer, J. (2016). The German Version of the Behavioral Activation for Depression Scale (BADS): A Psychometric and Clinical Investigation. Clinical Psychology & Psychotherapy, 23(3), 217–225. https://doi.org/10.1002/cpp.1948
The WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychological Medicine, 28, 551–558. https://doi.org/10.1017/S0033291798006667
Umar, J., & Nisa, Y. F. (2020). Uji Validitas Konstruk dengan CFA dan Pelaporannya. Jurnal Pengukuran Psikologi Dan Pendidikan Indonesia (JP3I), 9(2), 1–11. https://doi.org/10.15408/jp3i.v9i2.16964
Uphoff, E., Ekers, D., Robertson, L., Dawson, S., Sanger, E., South, E., Samaan, Z., Richards, D., Meader, N., & Churchill, R. (2020). Behavioural activation therapy for depression in adults. Cochrane Database of Systematic Reviews, 2020(7). https://doi.org/10.1002/14651858.CD013305.pub2
Uphoff, E., Pires, M., Barbui, C., Barua, D., Churchill, R., Ekers, D., Fottrell, E., Mazumdar, P., Purgato, M., Rana, R., Wright, J., & Siddiqi, N. (2019). Behavioural activation therapies for depression in adults with non-communicable diseases. Cochrane Database of Systematic Reviews, 2019(10). https://doi.org/10.1002/14651858.CD013461
van de Vijver, F., & Tanzer, N. K. (2004). Bias and equivalence in cross-cultural assessment: An overview. Revue Europeenne de Psychologie Appliquee, 54(2), 119–135. https://doi.org/10.1016/j.erap.2003.12.004
Wagener, A., Van Der Linden, M., & Blairy, S. (2015). Psychometric properties of the French translation of the Behavioral Activation for Depression Scale-Short Form (BADS-SF) in non-clinical adults. Comprehensive Psychiatry, 56, 252–257. https://doi.org/10.1016/j.comppsych.2014.10.008
WHO. (1996). WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment, field trial version, December 1996. In World Health Organization (pp. 1–16). https://apps.who.int/iris/bitstream/handle/10665/63529/WHOQOL-BREF.pdf?sequence=1&isAllowed=y
Widhiarso, W., & Sumintono, B. (2016). Examining response aberrance as a cause of outliers in statistical analysis. Personality and Individual Differences, 98, 11–15. https://doi.org/10.1016/j.paid.2016.03.099
World Health Organization. (2016). mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings: Version 2.0. In World Health Organization. World Health Organization.
World Health Organization. (2022). World mental health report: Transforming mental health for all. World Health Organization.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Salma Salma, Restu Tri Handoyo, Ajeng J. Puspitasari, Rahmat Hidayat, Rachel Leonard, Jonathan Kanter

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.





