Utility of the Brief Symptom Inventory (BSI) in psychiatric outpatients with intellectual disabilities.
The Brief Symptom Inventory is a psychometrically sound screener for depression, anxiety, and phobic anxiety in adults with mild intellectual disability.
01Research in Context
What this study did
Rojahn et al. (2012) checked if the Brief Symptom Inventory works in adults with mild intellectual disability. They gave the 53-item self-report to psychiatric out-patients and looked at how the scores hung together. The goal was to see if the BSI could flag depression, anxiety, and phobic anxiety in this group.
What they found
The BSI showed good internal consistency and clear separation between the key psychiatric sub-scales. In plain words, the questions measure what they claim to measure and give steady results in adults with mild ID. The tool is safe to use as a quick screener for emotional distress.
How this fits with other research
Freeman et al. (2015) later compared the BSI head-to-head with the Mini-PASADD, an informant interview. Both tools agreed on general distress, giving the BSI a second vote of confidence. Weiss et al. (2001) and Van der Molen et al. (2010) did similar psychometric work, but on the Behavior Problems Inventory for externalising behaviours; the BSI study mirrors their methods for internalising problems. Rojahn et al. (2012) part II even released a 30-item short form of the BPI the same year, showing the field's push for brief, solid measures across different domains.
Why it matters
You now have a five-minute self-report that reliably spots depression and anxiety in clients with mild ID. No need to rely only on caregiver guesses or long interviews. Add the BSI to your intake packet, score it in session, and let the numbers guide your next steps for mental-health referrals or skill-building goals.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Print the 53-item BSI, give it to your next adult client with mild ID, and use the depression sub-scale score to decide if a referral to psychiatry is needed.
02At a glance
03Original abstract
BACKGROUND: Diagnostics and care for people with intellectual disabilities (ID) and psychiatric disorders need to be improved. This can be done by using assessment instruments to routinely measure the nature and severity of psychiatric symptoms. Up until now, in the Netherlands, assessment measures are seldom used in the psychiatric care for this population. The objective of the present paper is to evaluate the use of the Brief Symptom Inventory (BSI), a widely used standardised questionnaire in general psychiatry, in a well-defined sample of people with borderline intellectual functioning or mild ID diagnosed with one or more psychiatric disorders. METHODS: A total of 224 psychiatric outpatients with either borderline intellectual functioning or mild ID participated in this study. All participants were new patients of Kristal, Centre for Psychiatry and Intellectual Disability in the Netherlands, in the period between 1 April 2008 and 1 October 2009. All participants were assessed by a multidisciplinary team, including a certified psychiatrist. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria were applied. The mean total intelligence quotient was measured with the Wechsler Adult Intelligence Scale (WAIS-III). The BSI was administered in an assisted fashion. Utility and psychometric properties of the BSI were investigated. Internal consistency coefficients (Cronbach's alphas) were computed. Bivariate correlations between the sub-scales were computed to assess differentiation between the scales. Mean sub-scale scores were compared between different DSM-IV-TR subgroups to investigate the discriminant abilities of the scales. A confirmatory factor analysis was conducted. RESULTS: The results suggest that the BSI is practically useful. Internal consistencies ranged from 0.70 to 0.96 and thus are considered good to adequate. Sub-scale inter-correlations showed there is a degree of differentiation between the sub-scales. Discriminant validity was shown for the sub-scales depression, anxiety and phobic anxiety. Confirmatory factor analysis showed that the underlying structure of the BSI could be described by the same nine-factor model as reported in previous studies. CONCLUSIONS: As a result of the psychometric properties illustrated, this study supports the use of the BSI as a screener for psychopathology and a general outcome measure in people with ID.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01440.x