Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 5 , Pages 958-965, May 2008

The Reliability and Validity of the Brief Symptom Inventory−18 in Persons With Traumatic Brain Injury

  • Sarah-Jane Meachen, MA

      Affiliations

    • Rehabilitation Institute of Michigan, Detroit, MI
    • Department of Psychology, Wayne State University, Detroit, MI
    • Corresponding Author InformationReprint requests to Sarah-Jane Meachen, MA, 261 Mack Blvd, Detroit, MI 48201
    • ,
  • Robin A. Hanks, PhD

      Affiliations

    • Rehabilitation Institute of Michigan, Detroit, MI
    • Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI.
    • ,
  • Scott R. Millis, PhD

      Affiliations

    • Rehabilitation Institute of Michigan, Detroit, MI
    • Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI.
    • ,
  • Lisa J. Rapport, PhD

      Affiliations

    • Department of Psychology, Wayne State University, Detroit, MI

Abstract 

Meachen S-J, Hanks RA, Millis SR, Rapport LJ. The reliability and validity of the Brief Symptom Inventory−18 in persons with traumatic brain injury.

Objective

To investigate the psychometric properties of the Brief Symptom Inventory−18 (BSI-18) among persons with traumatic brain injury (TBI).

Design

Inception cohort design with cross-sectional follow-up of 6 months to 15 years.

Setting

Rehabilitation hospital.

Participants

Adults (N=257) with moderate to severe TBI (81 inpatients and 176 follow-up participants, analyzed separately).

Interventions

Not applicable.

Main Outcome Measures

The BSI-18 is a brief screen of psychologic distress with a Global Severity Index (GSI), and 3 clinical subscales: somatization, anxiety, and depression.

Results

Internal consistency of the GSI was high in both follow-up participants (α=.91) and inpatients (α=.84), whereas estimates for the somatization, anxiety, and depression subscales were more variable (α range, .61–.84). As would be expected for a measure of affective state, retest reliability estimates were only moderate. The BSI-18 GSI correlated with multiple measures of psychosocial adjustment. After accounting for demographics, injury severity, inpatient functional status, years since injury, and various psychosocial factors, the BSI-18 showed incremental validity in predicting concurrent functional, psychosocial, and psychologic status.

Conclusions

The BSI-18 GSI had excellent reliability and validity among inpatients and follow-up participants. Modest reliability estimates may place an upper bound on the validity of the BSI-18 clinical subscales in inpatient TBI populations.

Key Words: Brain injuries, Rehabilitation, Reliability and validity

 

 Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133A020515).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00056-7

doi:10.1016/j.apmr.2007.12.028

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 5 , Pages 958-965, May 2008

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