Brief Symptom Inventory

Keywords:
Psychological status and distress

Background:
The Brief Symptom Inventory is a 53-item self-report symptom inventory designed to reflect the
psychological symptom patterns of psychiatric and medical patients and non-patients. This
inventory reports profiles of nine primary symptom dimensions and three global indices of
distress (Derogatis, 1993).

Symptom Scales
SOM - Somatization
O-C - Obsessive-Compulsive
I-S - Interpersonal Sensitivity
DEP - Depression
ANX - Anxiety
HOS - Hostility
PHOB - Phobic Anxiety
PAR - Paranoid Ideation
PSY - Psychoticism

Global Indices
GSI - Global Severity Index, Helps measure overall psychological distress level
PSDI - Positive Symptom Distress Index, Helps measure the intensity of symptoms
PST - Positive Symptom Total, Reports number of self-reported symptoms

Key features:

! The BSI test is brief and requires only 8-10 minutes to complete, making it well-suited
for repeated administrations over time to evaluate patient progress.
! The BSI instrument provides an overview of a patient's symptoms and their intensity at a
specific point in time.
! The Global Severity Index (GSI) is designed to help quantify a patient's severity-of-
illness and provides a single composite score for measuring the outcome of a treatment
program based on reducing symptom severity.
 ! The reliability, validity, and utility of the BSI instrument have been tested in more than
400 research studies.

The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric
evaluation reveals it to be an acceptable short alternative to the complete scale. Both test--retest
and internal consistency reliabilities are shown to be very good for the primary symptom
dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are
quite high. In terms of validation, high convergence between BSI scales and like dimensions of
the MMPI provide good evidence of convergent validity, and factor analytic studies of the
internal structure of the scale contribute evidence of construct validity. Several criterion-oriented
validity studies have also been completed with this instrument. Answers are on a 5-point scale,
from 0 = "not at all", to 4 = "extremely". The BSI also has high internal consistency (Cronbach's
alpha: 0.71-0.85), test retest reliability, and convergent, discriminant, and construct validity.

Developer:
Leonard R. Derogatis, PhD

Copyright:
Pearson Assessments, 1993

Reliability:
Cronbach's alpha: 0.71-0.85

Assessment:
INSTRUCTIONS

I am going to read a list of problems and complaints that people sometimes have. For
each one, tell me how much that problem has bothered or distressed you during the past
week, including today. Please tell me whether each problem has bothered you not at all, a
little bit, moderately, quite a bit, or extremely.

1. Nervousness or shakiness inside. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

2. Faintness or dizziness. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

3. The idea that someone else can control your thoughts. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

4. Feeling others are to blame for most of your troubles. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

5. Trouble remembering things. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

6. Feeling easily annoyed or irritated. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

7. Pains in heart or chest. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

8. Feeling afraid in open spaces. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

9. Thoughts of ending your life. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

10. Feeling that most people cannot be trusted. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

11. Poor appetite. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

12. Suddenly scared for no reason. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

13. Temper outbursts that you could not control. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

14. Feeling lonely even when you are with people. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

15. Feeling blocked in getting things done. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

16. Feeling lonely. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

17. Feeling blue. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

18. Feeling no interest in things. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

19. Feeling fearful. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

20. Your feelings being easily hurt. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

21. Feeling that people are unfriendly or dislike you. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

22. Feeling inferior to others. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

23. Nausea or upset stomach. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

24. Feeling that you are watched or talked about by others. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

25. Trouble falling asleep. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

26. Having to check and double check what you do. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

27. Difficulty in making decisions. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

28. Feeling afraid to travel on buses, subways, or trains. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

29. Trouble getting your breath. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

30. Hot or cold spells. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

31. Having to avoid certain things, places, or activities because they frighten you.
(Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

32. Your mind going blank. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

33. Numbness or tingling in parts of your body. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

34. The idea that you should be punished for your sins. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

35. Feeling hopeless about the future. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

36. Trouble concentrating. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

37. Feeling weak in parts of your body. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

38. Feeling tense or keyed up. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

39. Thoughts of death or dying. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

40. Having urges to beat, injure, or harm someone. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

41. Having urges to break or smash things. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

42. Feeling very self-conscious with others. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

43. Feeling uneasy in crowds. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

44. Never feeling close to another person. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

45. Spells of terror or panic. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

46. Getting into frequent arguments. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

47. Feeling nervous when you are left alone. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

48. Others not giving you proper credit for your achievements. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

49. Feeling so restless you could not sit still. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

50. Feelings of worthlessness. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

51. Feeling that people will take advantage of you if you let them. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

52. Feelings of guilt. (Choose one)

Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

53. The idea that something is wrong with your mind. (Choose one)
Not at all 1
A little bit 2
Moderately 3
Quite a bit 4
Extremely 5
Refuse to Answer 8

References:
Derogatis, L.R. (1975). Brief Symptom Inventory. Baltimore: Clinical Psychometric Research.

Boulet, J., & Boss, M. (1991). Reliability and validity of the Brief Symptom Inventory. Journal of
Consulting and Clinical
Psychology, 3(3), 433-437.

Broday, S. F., & Mason, J. L. (1991). Internal consistency of the Brief Symptom Inventory for
counseling-center clients.
Psychological Reports, 68, 94.

Derogatis, L. R., & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report.
Psychological Medicine,
13, 595-605.
Piersma, H. L., Reaume, W. M., & Boes, J. L. (1994). The Brief Symptom Inventory (BSI) as an
outcome measure for adult
psychiatric inpatients. Journal of Clinical Psychology, 50(4), 555-563.