[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-brief-symptom-inventory":3,"all-assessments-nav":455,"related-assessments-query":1133},{"id":4,"title":5,"body":6,"category":411,"categoryTitle":412,"clinicalCitations":413,"copyright":411,"description":423,"disclaimer":411,"downloadLink":411,"extension":424,"faqs":425,"featured":444,"i18nReady":444,"icon":411,"interpreter":411,"lastReviewed":445,"meta":446,"navigation":447,"path":448,"permissionsNote":411,"published":444,"recommendedFrequency":411,"relatedCodes":411,"relatedConditions":411,"reviewedBy":411,"seo":449,"slug":450,"stem":451,"summary":452,"takeaways":411,"timeline":411,"type":453,"usedToDiagnose":411,"__hash__":454},"assessments\u002Fassessments\u002Fbrief-symptom-inventory.md","Brief Symptom Inventory",{"type":7,"value":8,"toc":399},"minimark",[9,13,18,21,24,27,31,34,41,51,54,57,61,64,67,189,192,197,200,314,317,321,324,386,392,396],[10,11,12],"p",{},"The BSI is a validated 53-item self-report measure of psychological symptom distress across 9 dimensions (Somatization, OC, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, Psychoticism) plus 3 global indices. Derogatis & Melisaratos (1983).",[14,15,17],"h2",{"id":16},"what-is-the-brief-symptom-inventory","What is the Brief Symptom Inventory?",[10,19,20],{},"The Brief Symptom Inventory (BSI) is a validated 53-item self-report\nsymptom inventory developed by Leonard Derogatis and Norman Melisaratos (1983) as a\nshortened version of the SCL-90-R. Respondents rate each symptom on a 5-point distress\nscale (0 = not at all to 4 = extremely) for the past seven days. It is one of the most\nwidely used psychiatric symptom assessment tools in clinical trials, outcome monitoring,\nand psychological research.",[10,22,23],{},"The BSI produces scores on 9 symptom dimensions and 3 global\nindices. The Global Severity Index (GSI), the mean of all\n53 items, is the single best indicator of current distress level and psychiatric\ncaseness. Scores are interpreted using age- and gender-referenced T-scores\n(mean=50, SD=10); a T-score ≥63 on the GSI (or ≥2 dimensions at T≥63) indicates\nclinical caseness.",[10,25,26],{},"The BSI-18 is a brief 18-item version covering only Somatization,\nDepression, and Anxiety with a GSI, designed for medical settings and population\nscreening. Both BSI and BSI-18 are published by Pearson Assessments\nand require purchase for clinical and research use.",[14,28,30],{"id":29},"interpreting-bsi-t-scores","Interpreting BSI T-Scores",[10,32,33],{},"BSI dimension and global index scores are expressed as T-scores normed against a published adult reference sample (mean = 50, SD = 10). Because the BSI is a multidimensional profile instrument rather than a unidimensional screener, there are no literature-supported mild\u002Fmoderate\u002Fsevere total-score bands. The validated threshold is a single caseness criterion.",[10,35,36,40],{},[37,38,39],"strong",{},"Clinical caseness"," is met when either of the following conditions is satisfied (Derogatis & Melisaratos, 1983; Michel et al., 2024):",[42,43,44,48],"ul",{},[45,46,47],"li",{},"GSI T-score ≥ 63, or",[45,49,50],{},"T-score ≥ 63 on two or more of the nine symptom dimensions.",[10,52,53],{},"A T-score of 63 corresponds approximately to the 90th percentile of the normative outpatient sample and signals that the level of psychological distress warrants further clinical evaluation. Scores below this threshold should still be interpreted within clinical context — the caseness rule identifies a clinically meaningful threshold, not a clean diagnostic boundary.",[10,55,56],{},"Separate normative tables are available for adult outpatient, adult non-patient (community), and adolescent non-patient samples. Choosing the appropriate norm group matters: the same raw score can yield different T-scores when referenced against outpatient versus community norms.",[14,58,60],{"id":59},"bsi-nine-symptom-dimensions","BSI Nine Symptom Dimensions",[10,62,63],{},"Each dimension produces a raw score (sum of item ratings ÷ number of items in that dimension) and a T-score relative to the normative sample. Dimension T-score ≥ 63 on two or more subscales, alongside GSI T ≥ 63, supports the clinical caseness determination.",[10,65,66],{},"The nine dimensions and their clinical focus are:",[68,69,70,86],"table",{},[71,72,73],"thead",{},[74,75,76,80,83],"tr",{},[77,78,79],"th",{},"Dimension",[77,81,82],{},"Abbrev.",[77,84,85],{},"Clinical Focus",[87,88,89,101,112,123,134,145,156,167,178],"tbody",{},[74,90,91,95,98],{},[92,93,94],"td",{},"Somatization",[92,96,97],{},"SOM",[92,99,100],{},"Physical complaints linked to autonomic arousal — cardiovascular, gastrointestinal, respiratory, and musculoskeletal distress",[74,102,103,106,109],{},[92,104,105],{},"Obsessive-Compulsive",[92,107,108],{},"O-C",[92,110,111],{},"Thoughts, impulses, and behaviours that are experienced as irresistible, persistent, and ego-dystonic",[74,113,114,117,120],{},[92,115,116],{},"Interpersonal Sensitivity",[92,118,119],{},"I-S",[92,121,122],{},"Feelings of personal inadequacy and inferiority; self-deprecation and discomfort in interpersonal comparisons",[74,124,125,128,131],{},[92,126,127],{},"Depression",[92,129,130],{},"DEP",[92,132,133],{},"Dysphoric mood, loss of interest, hopelessness, suicidal ideation, and reduced motivational energy",[74,135,136,139,142],{},[92,137,138],{},"Anxiety",[92,140,141],{},"ANX",[92,143,144],{},"Nervousness, tension, trembling, and free-floating apprehension; somatic correlates of anxiety",[74,146,147,150,153],{},[92,148,149],{},"Hostility",[92,151,152],{},"HOS",[92,154,155],{},"Thoughts, feelings, and actions characteristic of anger — irritability, aggression, and resentment",[74,157,158,161,164],{},[92,159,160],{},"Phobic Anxiety",[92,162,163],{},"PHOB",[92,165,166],{},"Persistent, irrational fear and avoidant behaviour triggered by people, places, or situations",[74,168,169,172,175],{},[92,170,171],{},"Paranoid Ideation",[92,173,174],{},"PAR",[92,176,177],{},"Projective thinking, suspiciousness, grandiosity, centrality, and fears of loss of autonomy",[74,179,180,183,186],{},[92,181,182],{},"Psychoticism",[92,184,185],{},"PSY",[92,187,188],{},"Withdrawn, isolated, schizoid lifestyle; hallucinations and thought disorder symptoms on a continuum",[10,190,191],{},"Note: The 53 BSI items are distributed across these nine dimensions; four items contribute to global indices but are not assigned to any single dimension subscale. Per-dimension item counts are specified in the proprietary scoring manual (Derogatis, 1993).",[193,194,196],"h3",{"id":195},"bsi-vs-bsi-18-vs-scl-90-r","BSI vs BSI-18 vs SCL-90-R",[10,198,199],{},"Three scales from the same family — choose based on clinical setting, administration time, and dimensional coverage needed.",[68,201,202,218],{},[71,203,204],{},[74,205,206,209,212,215],{},[77,207,208],{},"Feature",[77,210,211],{},"SCL-90-R",[77,213,214],{},"BSI",[77,216,217],{},"BSI-18",[87,219,220,234,248,261,274,288,302],{},[74,221,222,225,228,231],{},[92,223,224],{},"Items",[92,226,227],{},"90",[92,229,230],{},"53",[92,232,233],{},"18",[74,235,236,239,242,245],{},[92,237,238],{},"Admin time",[92,240,241],{},"~12–15 min",[92,243,244],{},"~8–10 min",[92,246,247],{},"~4–5 min",[74,249,250,253,256,258],{},[92,251,252],{},"Symptom dimensions",[92,254,255],{},"9",[92,257,255],{},[92,259,260],{},"3 (SOM, DEP, ANX)",[74,262,263,266,269,271],{},[92,264,265],{},"Global indices",[92,267,268],{},"3 (GSI, PST, PSDI)",[92,270,268],{},[92,272,273],{},"1 (GSI only)",[74,275,276,279,282,285],{},[92,277,278],{},"Primary use case",[92,280,281],{},"Detailed outpatient \u002F research profiling",[92,283,284],{},"Outpatient outcome monitoring, clinical trials",[92,286,287],{},"Medical settings, population screening",[74,289,290,293,296,299],{},[92,291,292],{},"Additional items (not in any dimension)",[92,294,295],{},"7",[92,297,298],{},"4",[92,300,301],{},"—",[74,303,304,307,310,312],{},[92,305,306],{},"Publisher",[92,308,309],{},"Pearson Assessments",[92,311,309],{},[92,313,309],{},[10,315,316],{},"The SCL-90-R is preferred when comprehensive dimensional profiling is required and administration time is not a constraint. The BSI achieves comparable reliability and validity across all nine dimensions in roughly half the time, making it the most common choice in outpatient clinical research. The BSI-18 sacrifices dimensional breadth to maximize brevity, and is best suited to rapid distress screening in primary care or oncology settings where the full nine-dimension profile is unnecessary (Derogatis, 1993; Michel et al., 2024).",[193,318,320],{"id":319},"three-global-indices","Three Global Indices",[10,322,323],{},"The BSI produces three global indices that summarize different aspects of the overall symptom burden. All three are reported alongside the nine dimension T-scores (Michel et al., 2024).",[68,325,326,342],{},[71,327,328],{},[74,329,330,333,336,339],{},[77,331,332],{},"Index",[77,334,335],{},"Abbreviation",[77,337,338],{},"How It Is Computed",[77,340,341],{},"What It Captures",[87,343,344,358,372],{},[74,345,346,349,352,355],{},[92,347,348],{},"Global Severity Index",[92,350,351],{},"GSI",[92,353,354],{},"Sum of all 53 item ratings ÷ 53",[92,356,357],{},"Overall severity and breadth of distress; the single best indicator of current psychological status and the primary caseness indicator",[74,359,360,363,366,369],{},[92,361,362],{},"Positive Symptom Total",[92,364,365],{},"PST",[92,367,368],{},"Count of items rated > 0",[92,370,371],{},"Number of symptoms endorsed, regardless of intensity; reflects breadth of symptom burden",[74,373,374,377,380,383],{},[92,375,376],{},"Positive Symptom Distress Index",[92,378,379],{},"PSDI",[92,381,382],{},"Sum of all item ratings ÷ PST",[92,384,385],{},"Average intensity of symptoms that were endorsed; reflects how intensely the respondent experiences each reported symptom",[10,387,388,391],{},[37,389,390],{},"Interpreting the three indices together"," provides a richer clinical picture than any one index alone. For example, a high GSI combined with a high PST suggests broad, diffuse distress across many symptom domains. A high GSI with a lower PST but high PSDI points toward fewer symptoms that are each experienced with considerable intensity — a pattern that may reflect a more focal but severe clinical picture. Conversely, a high PST with a relatively low PSDI indicates that many symptoms are acknowledged but none is particularly distressing, which can occur in individuals with broad subclinical worry who lack frank psychological distress.",[14,393,395],{"id":394},"psychiatric-outcome-tracking-in-hiboop","Psychiatric Outcome Tracking in HiBoop",[10,397,398],{},"BSI alongside PHQ-9, GAD-7, PCL-5, and PANSS, integrated psychiatric symptom monitoring across outpatient, residential, and clinical trial settings.",{"title":400,"searchDepth":401,"depth":401,"links":402},"",3,[403,405,406,410],{"id":16,"depth":404,"text":17},2,{"id":29,"depth":404,"text":30},{"id":59,"depth":404,"text":60,"children":407},[408,409],{"id":195,"depth":401,"text":196},{"id":319,"depth":401,"text":320},{"id":394,"depth":404,"text":395},null,"Psychiatric Assessment",[414,417,420],{"text":415,"link":416},"Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychol Med. 1983;13(3):595-605.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F6622612\u002F",{"text":418,"link":419},"Thomas ML. Rewards of bridging the divide between measurement and clinical theory: demonstration of a bifactor model for the Brief Symptom Inventory. Psychol Assess. 2012;24(1):101-113.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F21767026\u002F",{"text":421,"link":422},"Michel G, Baenziger J, Brodbeck J, et al. The Brief Symptom Inventory in the Swiss general population: Presentation of norm scores and predictors of psychological distress. PLoS One. 2024;19(7):e0305192.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F38959205\u002F","The BSI is a 53-item self-report psychiatric symptom inventory measuring 9 dimensions (Somatization, OC, Depression, Anxiety, Hostility, Phobic...","md",[426,429,432,435,438,441],{"question":427,"answer":428},"What GSI T-score indicates clinical caseness on the BSI?","A Global Severity Index (GSI) T-score of 63 or above indicates clinical caseness on the BSI. This threshold represents approximately the 90th percentile relative to the normative sample and signals that the level of psychological distress is elevated enough to warrant clinical attention. Alternatively, meeting T≥63 on two or more of the nine symptom dimensions also meets the caseness criterion.",{"question":430,"answer":431},"What is the difference between the BSI, BSI-18, and SCL-90-R?","All three scales measure psychological symptom distress but differ in length and scope. The SCL-90-R (90 items, 12–15 minutes) provides the most detailed profiling across 9 dimensions. The BSI (53 items, 8–10 minutes) covers the same 9 dimensions plus 3 global indices and is preferred for outpatient clinical research. The BSI-18 (18 items, 4–5 minutes) assesses only Somatization, Depression, and Anxiety with a GSI, making it suitable for medical settings and population screening.",{"question":433,"answer":434},"What does the BSI Global Severity Index (GSI) measure?","The GSI is the mean of all 53 BSI items and is the single best indicator of overall psychological distress level. It captures the breadth and intensity of symptom burden across all nine dimensions simultaneously. The GSI is the primary caseness indicator, with a T-score ≥63 indicating clinically significant distress requiring further evaluation.",{"question":436,"answer":437},"How is the BSI scored and interpreted?","Each of the 53 BSI items is rated on a 5-point distress scale (0 = not at all, 4 = extremely) for the past seven days. Dimension raw scores are calculated as the sum of items in each dimension divided by the number of items in that dimension. Raw scores are converted to T-scores using published normative tables referenced against adult outpatient or community normative samples. T-score ≥63 on the GSI or on two or more dimensions indicates clinical caseness.",{"question":439,"answer":440},"Who publishes the BSI and is it freely available?","The BSI is published by Pearson Assessments (formerly National Computer Systems) and requires purchase for clinical and research use. Both the BSI and BSI-18 are proprietary scales; licensing fees apply. The BSI-18 is also available through Pearson and was developed to meet demand for shorter tools in medical and primary care settings.",{"question":442,"answer":443},"What does a high BSI Psychoticism subscale score mean?","The BSI Psychoticism subscale (5 items) spans a range from mild interpersonal alienation to more pronounced evidence of psychosis, including auditory hallucinations and thought broadcasting. A high T-score on this dimension warrants careful clinical assessment, though it does not automatically confirm a psychotic disorder — it reflects the degree of psychotic-like distress as self-reported. Clinical context, interview data, and functional assessment are essential for interpretation.",false,"2026-06-03",{},true,"\u002Fassessments\u002Fbrief-symptom-inventory",{"title":5,"description":423},"brief-symptom-inventory","assessments\u002Fbrief-symptom-inventory","The BSI is a 53-item self-report psychiatric symptom inventory measuring 9 dimensions (Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, Psychoticism) plus 3 global indices including GSI. T-score ≥63 = clinical caseness. Derogatis & Melisaratos (1983).","assessment","dr8FetZ5zJjFszCpst533mbEDctSrPOHgtZE5fjevnA",[456,461,466,470,474,479,484,488,493,498,503,508,513,518,522,526,531,535,540,544,548,552,557,562,566,570,574,575,579,584,589,594,599,604,608,612,617,621,625,629,633,637,642,647,651,656,661,666,671,676,680,684,689,693,697,702,706,711,715,720,724,728,732,737,742,746,751,756,760,764,768,772,777,781,785,789,793,797,802,807,811,815,819,823,827,832,836,840,844,849,853,858,863,867,871,875,879,883,888,893,897,901,905,909,913,917,921,925,929,934,938,942,946,950,954,959,963,968,972,976,981,985,989,993,997,1001,1006,1010,1014,1019,1023,1027,1031,1035,1039,1043,1047,1052,1057,1062,1067,1071,1075,1079,1083,1087,1091,1095,1099,1104,1108,1112,1116,1120,1124,1129],{"title":457,"slug":458,"path":459,"categoryTitle":460},"ACE Score","aces","\u002Fassessments\u002Faces","Trauma & PTSD",{"title":462,"slug":463,"path":464,"categoryTitle":465},"ADHD Clinical Outcome Scale, Self-Report 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