Author/s: Daniel Bruns and John Mark Disorbio
Publication year: 2003
Age Range: 18 years to 65 years old
Administration: Individual – 30 to 45 minutes
Scores/ Interpretation: Q-global™ Web-based Administration, Scoring, and Reporting and Q Local™ Scoring and Reporting Desktop Software
Report options: Profile, Basic Interpretive, Enhanced Interpretive, and Progress Reports
Assessment of validity, physical symptoms, psychological, character, environment, and social factors that can impact response to normal course of treatment and recovery of patients with injuries.
Designed to present a concise, coordinated assessment of the biopsychosocial issues that are most relevant in evaluating patients with injuries. Because psychological and social factors that go undetected can significantly interfere with a patient’s response to treatment, the BHI 2 test can help caregivers shape an appropriate treatment plan, that may reduce treatment time and improve a patient’s quality of life.
How to Use This Test
The BHI 2 test can be used by psychologists, psychiatrists, anesthesiologists, neurologists, physical therapists, surgeons, rehabilitation specialists, and nurses to help:
- Measure the relationship among and impact of physical, environmental, and psychological factors on the patient’s treatment
- Support evaluations for cases involving orthopedic, occupational, and auto injuries; workers compensation; and long-term disabilities
- Evaluate the patient’s emotional readiness for surgery
- Facilitate physician-psychologist communication as well as communication within a multidisciplinary treatment team
- Assess the patient’s readiness for vocational training or job placement
- Evaluate treatment effectiveness and monitor clinical outcomes
- The objective information provided by the BHI 2 test can be used to help reduce treatment time, improve treatment planning, and improve the patient’s quality of life.
- Requiring only 30-45 minutes to administer, the BHI 2 test helps measure numerous outcomes, including reduction of pain, improvement in function, and satisfaction with care.
- The BHI 2 test includes 31 Critical Items that draw attention to a wide variety of risk factors including:
Satisfaction with Care
- The Scale Summary section highlights the patient’s significant scores and summarizes noteworthy findings.
- The Pain Complaints section uses a nationally standardized 1–10 pain scale, which assesses multiple dimensions of the pain experience, including level of pain in 10 body areas, pain tolerance, pain range, and peak pain.
- The Somatic Complaints section, available in the Enhanced Interpretive Report, helps guide the clinician to explore medical and psychological explanations for physical symptoms.
- The Diagnostic Probabilities section, available in the Enhanced Interpretive Report, provides a percentage (probability) that indicates how closely the patient’s pain complaints match the pain complaints of patients with the same diagnosis.
- Within each scale, content areas help distinguish possible reasons for the patient’s psychological or psychosocial problems. Presented in graphic format, this additional delineation helps further support the development of suitable treatment plans.
- Both interpretive reports include a Patient Summary, written in lay person’s language, to help the clinician explain test results to the patient.
Physical Symptom Scales
- Somatic Complaints
- Pain Complaints
- Functional Complaints
- Muscular Bracing
- Symptom Dependency
- Chronic Maladjustment
- Substance Abuse
- Family Dysfunction
- Survivor of Violence
- Doctor Dissatisfaction
- Job Dissatisfaction
The BHI 2 test was normed using a sample of 725 community individuals and a sample of 527 physical rehabilitation and chronic pain patients. The report compares the patient to both norm groups and uses the average physical rehabilitation patient as a benchmark for interpretations and recommendations.
As well as comparing the patient to the community sample and the patient sample, the BHI 2 instrument also compares the patient to individuals with a similar condition for the five reference groups listed below. These groups are based on common diagnostic categories of injuries often seen in rehabilitation settings and are used by the Pain Complaints scale.
- Head injury/headache
- Neck injury
- Upper extremity injury
- Lower extremity injury
- Back injury
In addition, the Pain Complaints scale also uses a chronic pain reference group, while the Defensiveness and Self-Disclosure scales use reference groups for symptom magnification (Faking Bad) and symptom minimization (Faking Good) as additional benchmarks (or comparisons) for clinical interpretation.
Provides a patient profile that includes a graphical representation of the patient’s raw and T scores in comparison to both the patient and community norms, as well as the patient’s rating and percentile. The report also includes a section on Validity Issues, Critical Items, Content Areas, Omitted Items, and Item Responses.
View a sample Profile Report.
Basic Interpretive Report
Provides a concise interpretation of test results, including a profile graph and scale summary. The report also includes brief scale category narratives including validity issues, Pain Complaints Item Responses, Content Areas, Critical Items, Omitted Items, Item Responses, Treatment Recommendation, and a Patient Summary.
View a sample Basic Interpretive Report.
Enhanced Interpretive Report
Provides a more extensive interpretation of the patient’s test results, including in-depth scale category narratives. In additional to all the components of the Basic Interpretive Report , this report also includes section on Somatic Complaints, Item Responses, and Diagnostic Probabilities.
View a sample Enhanced Interpretive Report.
View a sample annotated Enhanced Interpretive Report.
Sections of the Profile, Basic Interpretive and Enhanced Interpretive Reports are briefly described below.
The Patient Profile is a graphical representation of a patient’s BHI 2 results. The profile lists the patient’s raw scores for each scale.
The Clinical Summary section provides a brief overview of the patient’s BHI 2 scales that were not assigned a score in the Average range. Actual rating levels for these scales, along with an interpretive sentence for each, are also presented.
The Validity section provides a description of any validity concerns as identified by the Validity Index and the Defensiveness and Self-Disclosure scales.
Pain Complaints Item Responses
pain graphicThe Pain Complaints Item Responses section consists of an analysis of the patient’s 17 individual pain ratings. First, the patient’s 10 localized pain ratings are listed. If the clinician selected a Pain Diagnostic Category, the median scores for patients in that category are listed in the second column. If “none of the above” was selected for the Pain Diagnostic Category, the median scores for individuals in the community are listed in the second column. Several other ratings are also listed: overall highest and overall lowest level of pain the past month, overall pain level at time of testing, Maximum Tolerable Pain, Pain Range in the past month, Peak Pain, and Peak Tolerance Index.
Pain Diagnostic Probabilities
In this section of the Enhanced Interpretive Report, each Pain Diagnostic Category is listed along with a percentage (probability) that indicates how closely the patient’s pain complaints match the pain complaints of patients with that diagnosis.
Somatic Complaints Item Responses
The Somatic Complaints Item Responses section consists of a summary of the patient’s individual somatic complaints. For each of the 26 items on the Somatic Complaints scale that is endorsed with a Moderate Problem or Big Problem response, the item is listed along with some possible medical and psychological explanations.
Content Area Profile
The Content Area Profile is a graphical representation of a patient’s within-scale results. The profile lists the patient’s rating for each of the 40 content areas. This section provides additional information about the types of items that the patient endorses.
If the patient endorsed any critical items, the item text and the patient’s response are listed in this section of the report.
The Omitted Items section of the report is included only if items are left blank or have multiple responses.
This optional section of the report lists each item number and the patient’s response
This optional section of the report is based on positive BHI 2 findings, listing possible clinical interventions for the treating professional to consider.
The optional Patient Summary describes and explains the patient’s BHI 2 results in layman’s terms with sensitivity to the patient in mind.
Q-global™ Web-based Administration, Scoring, and Reporting – Enables you to quickly assess and efficiently organize examinee information, generate scores, and produce accurate comprehensive reports all via the Web.
Q Local™ Scoring and Reporting Desktop Software – Enables you to score assessments, report results, and store and export data on your computer.
PAD (Patient Assessment Device) Hand-held Electronic Device – Administer the test on a portable, hand-held device. The PAD is placed on a docking station connected to a printer and a results report is printed immediately
Using Psychological Evaluations to Improve Patient Care and Outcomes
Assessment and Treatment of Chronic Pain: A Physician’s Guide
Expanding the Horizon for Chronic Pain Patients: Advanced Spinal Cord Stimulation Technology Offers New Hope
Chronic Pain and Biopsychosocial Disorders
Case Study Articles
BBHI 2 Bibliography
BHI 2 Q-global Enhanced Interpretive Report Starter Kit
Includes BHI 2 manual, 3 answer sheets, 1 test booklet, and 3 Q-global administrations