Validation of the Behavioral Activation for Depression Scale in Individuals With Substance Use Disorders (BADS-SUD)

November 3, 2026 updated by: Lauro Gutiérrez Castro

Psychometric Validation of the Behavioral Activation for Depression Scale (BADS) in a Clinical Sample of Individuals With Substance Use Disorders

This cross-sectional observational study evaluates the psychometric properties, structural validity, item response characteristics, and concurrent criterion validity of the Behavioral Activation for Depression Scale (BADS) in adults receiving clinical treatment for substance use disorders (SUD). The study examines the scale's dimensional structure, reliability, and association with environmental reward (Environmental Reward Observation Scale, EROS) in a primary clinical cohort of 289 participants. Concurrent and discriminant validity analyses with additional clinical measures (assessing borderline symptom severity, impulsivity, anxiety, and anger expression) were evaluated in a verified sequential subcohort of 59 participants with fully confirmed individual-level linkage across multi-scale administration sheets. This retrospective study record documents the completed psychometric evaluation conducted within a specialized residential therapeutic community.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

This study employs a cross-sectional observational design to evaluate the psychometric properties and dimensional structure of the Spanish version of the Behavioral Activation for Depression Scale (BADS) in individuals receiving residential or intensive clinical treatment for substance use disorders. The completed validation protocol comprises two complementary analytic components:

  1. Primary Cohort Analyses (N = 289):

    Analyses of internal structure, categorical confirmatory factor analysis (using WLSMV estimation on polychoric correlations), exploratory structural equation modeling (ESEM), bifactor modeling, item response theory (Samejima's Graded Response Model), and internal consistency reliability were conducted in a primary clinical sample of 289 adult patients. Item completeness reached 99.7% across the 25 BADS items (288 complete records, 1 record with six items omitted). Concurrent criterion validity with perceived environmental reward was examined across this entire cohort using the Environmental Reward Observation Scale (EROS).

  2. Secondary Multi-Scale Clinical Analyses (Verified n = 59):

Concurrent and discriminant relationships with external clinical constructs-including borderline symptom severity (BSL-23), impulsivity (BIS-11), generalized anxiety (GAD-7), and anger expression (STAXI-2)-were evaluated. Although 155 multi-scale records were captured during clinical testing and earlier study drafts described an analytic target of 127 participants, retrospective quality control revealed an unindexed row offset in spreadsheet transcriptions beginning at record 60. To maintain strict scientific integrity and avoid mispairing, concurrent multi-battery analyses are reported exclusively on the initial sequential subcohort of 59 participants whose individual identity, sex, age, and questionnaire administration sequence are verified at 100%. Remaining captured records remain designated as pending verification against institutional physical charts.

This record reflects the retrospective documentation and post-completion reconciliation of the completed study protocol.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
289

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Mexico
    • Jalisco
      • Ajijic, Jalisco, Mexico, 45920
        • Comunidad Terapéutica Under The Tree

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 68 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adults receiving residential treatment for substance use disorders in a therapeutic community setting. Participants represent a clinically relevant population characterized by difficulties in mood regulation, behavioral activation, emotional dysregulation, and related psychological symptoms commonly associated with substance use disorders.

Description

Inclusion Criteria:

  • Adults aged 18 to 68 years.
  • Primary clinical diagnosis of Substance Use Disorder (evaluated in accordance with DSM-5 criteria) currently receiving residential or intensive clinical treatment in a therapeutic community setting.
  • Literacy and fluency in Spanish sufficient to complete self-report instruments.
  • Provision of voluntary written informed consent.
  • Completion of the Behavioral Activation for Depression Scale (BADS).

Exclusion Criteria:

  • Severe cognitive impairment, active psychosis, or acute neurological conditions precluding accurate self-reporting.
  • Active substance intoxication or acute withdrawal symptoms at the time of testing that interfere with questionnaire completion.
  • Substantial missing data preventing psychometric modeling (participants with at least 75% item completion on the primary instrument were retained for categorical estimation under pairwise/FIML algorithms).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: CASE_ONLY
  • Time Perspectives: CROSS_SECTIONAL

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Individuals With Substance Use Disorders

Single clinical group composed of adults receiving treatment for substance use disorders who completed the Behavioral Activation for Depression Scale (BADS) and additional self-report measures as part of a cross-sectional observational study.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Psychometric Validity of the Behavioral Activation for Depression Scale (BADS)
Time Frame: Baseline (single cross-sectional assessment).

Psychometric properties of the Behavioral Activation for Depression Scale (BADS), including internal structure (confirmatory factor analysis), internal consistency reliability (Cronbach's alpha and/or omega), and construct validity (convergent and discriminant validity), assessed using self-report data collected at a single time point in individuals with substance use disorders. Subscale scores will also be examined, with higher scores reflecting greater expression of the respective behavioral domains.
Baseline (single cross-sectional assessment).

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Convergent and Discriminant Validity of the Behavioral Activation for Depression Scale With the Borderline Symptom List-23
Time Frame: Single cross-sectional assessment conducted at the time of psychological evaluation during residential treatment.

Convergent and discriminant validity of the Behavioral Activation for Depression Scale will be examined through its association with scores on the Borderline Symptom List-23, a self-report measure of borderline symptom severity and behavioral dysregulation. The Borderline Symptom List-23 provides a mean total score ranging from 0 to 4, with higher scores indicating greater severity of borderline symptomatology. Associations will be analyzed using continuous scores to evaluate the extent to which behavioral activation and avoidance patterns measured by the Behavioral Activation for Depression Scale relate to clinical severity and emotional dysregulation in individuals with substance use disorders. The Borderline Symptom List-23 is a 23-item self-report scale scored on a 5-point Likert-type format (0 to 4), producing a mean total score ranging from 0 to 4. Higher scores indicate greater severity of borderline symptomatology and emotional dysregulation.
Single cross-sectional assessment conducted at the time of psychological evaluation during residential treatment.
Convergent Validity of the Behavioral Activation for Depression Scale With the Environmental Reward Observation Scale
Time Frame: Single cross-sectional assessment conducted at the time of psychological evaluation during residential treatment.

Convergent validity of the Behavioral Activation for Depression Scale (BADS) will be evaluated through its association with the Environmental Reward Observation Scale (EROS), a self-report measure assessing perceived availability and frequency of environmental positive reinforcement. The EROS consists of 10 items scored on a 4-point Likert-type scale (1 = strongly disagree to 4 = strongly agree), yielding total scores ranging from 10 to 40, with higher scores indicating greater perceived availability of environmental positive reinforcement. Correlations between BADS subscale and total scores and EROS scores will be analyzed as continuous variables across the primary clinical cohort (N = 289) to examine the theoretical correspondence between behavioral activation processes and perceived environmental reinforcement in a residential substance use treatment setting.
Single cross-sectional assessment conducted at the time of psychological evaluation during residential treatment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Lauro Gutiérrez Castro

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Lauro Gutiérrez Castro, Under The Tree Therapeutic Community

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 18, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 30, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 22, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 7, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 6, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 9, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • BADS-SUD-VALID-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings