bsi handout

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The Brief Symptom Inventory (BSI)Anna Webster

Purpose:The BSI is a 53-item self-report inventory that screens for both general mental health

symptoms, and specific disorders. It offers a current, point-in-time psychologicalsymptom status, or can be used repeatedly to document trends over time.

Administer to:Adults and youth 13-years and older. It can be used for nonpatients, psychiatricoutpatient, and inpatient populations; there are separate norms for each of thesegroups, as well as for males and females.

Development:The BSI was derived from the SCL-90 to provide clinicians with a measure that wasmore time efficient. Developers chose chose 5-6 items per subscale from SCL-90 thatloaded highest. There is now an 18-item version of the BSI.

Normative Sample:The normative sample for the BSI included 1002 psychiatric outpatients, 974nonpatients, 423 psychiatric inpatients, and 2,409 adolescent nonpatients. The samplewas somewhat skewed towards lower SES, but minorities were well represented.

Dimensions:There are 9 primary symptom dimensions in the BSI; somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety,paranoid ideation, and psychotisism. There are 3 global indices; the global severityindex (GSI) provides a composite score of severity-of-illness, the positive symptomdistress index (PSDI) measures the intensity of symptoms, and the positive symptomtotal (PST) is the number of items that are positively endorsed.

Administration:The test can be completed via paper and pencil, audio cassette, or computer; it takes

approximately 10-minutes to complete. It is written at a grade-6 reading level; howeveraudio cassette administration makes it usable with individuals with lower reading levels.The BSI uses a 5-response format (0=not at all, 4=extremely). Administrators should beavailable during administration to answer any questions that may arise.



The Brief Symptom Inventory (BSI) cont.

Scoring:The BSI can be scored by hand, mail-in service, computer, or via optical scan scoring.

The computer scoring and mail-in service provide the option for profile, interpretive, andprogress reports.

Hand scoring can be a little more time consuming; scores for each of the dimensionsare summed, and then divided by the number of items endorsed to yield a raw score.The raw scores are plotted on a graph which also provides the t-score; these t-scorescan also be found in the appendix. To calculate the global severity index, sum all thescores (including from the 4 ‘additional items’) then divide by the number of itemsendorsed (i.e. 53 if all items were completed). To calculate the positive symptomdistress index, divide the sum of the scores by the number of items positively endorsed.

Validity:The BSI showed good convergent validity with the MMPI, and excellent convergentvalidity with the SCL-90. A number of independent studies have demonstrated thatoverall it has good predictive validity. There is evidence of construct validity based onfactor analytic studies.

Reliability:The BSI shows good internal consistency with alpha coefficients on all 9 scales rangingfrom .71(psychotisism) to .85 (depression). Test-retest reliability ranged from a low of

.68 (somatisation) to a high of .91 (phobic anxiety)

Limitations/critiques:Numerous independent studies have documented the need for culturally relevantnorms. Ironically, due to its efficiency, there are cases where the BSI is being used inclinical practice with populations it was not intended for (i.e. traumatic brain injury).Other studies have found the need for age-relevant norms, particularly in regards to theelderly.

bsi handout

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