Designed to present a concise, coordinated assessment of the biopsychosocial issues that are most relevant in evaluating medical patients. 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, reduce treatment time and improve a patient's quality of life.
| Administer To | Individuals 18–65 years old |
| Reading Level | 6th grade |
| Completion Time | 30–45 minutes (217 multiple-choice items) |
| Formats | Paper-and-pencil, audio CD, or computer administration |
| Report Options | Profile, Basic Interpretive, Enhanced Interpretive, Progress |
| Scoring Options | Q™ Local Software
Mail-in Scoring Service
|
| Scales | 2 Validity scales, 4 Physical Symptom scales, 3 Affective scales, 5 Character scales, and 4 Psychosocial scales |
| Norm Groups | A sample of 725 community individuals and a sample of 527 physical rehabilitation and chronic pain patients |
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:
Additional Concerns
Entitlement
Pain Fixation
Perceived Disability
Satisfaction with Care
Sleep Disorders
Suicidal Ideation
Violent Tendencies - 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.
Daniel Bruns, PsyD, and John Mark Disorbio, EdD, have collaborated on psychological test development since 1985. In addition to co-authoring the BHI™ 2 test, they are also the authors of the BBHI™ 2 (Brief Battery for Health Improvement 2) test and the BHI™ (Battery for Health Improvement) test. Both live and practice in Colorado.
Daniel Bruns, PsyD
Daniel Bruns' practice, Health Psychology Associates, is affiliated with the Ramazzini Center, a multidisciplinary facility providing a range of rehabilitation services for injured patients. In his 20 years of clinical practice, Dr. Bruns has come to specialize in the psychological assessment and treatment of medical patients. As a result, he has taught graduate classes and workshops and has made numerous presentations to international, national, and regional professional societies on psychological testing, psychopathology, somatoform disorders, and the assessment and treatment of pain. As a member of three task forces for the Colorado Division of Workers' Compensation, (Psychiatric Disability, Chronic Pain, and Complex Regional Pain Syndrome), he helped to develop evidence-based guidelines to regulate the treatment of injured workers in Colorado. In the past, he has worked on the Chronic Illness Team at the Wellness Center of North Colorado Medical Center. He is also the webmaster of www.healthpsych.com. Dr. Bruns received his MA and PsyD degrees in counseling psychology from the University of Northern Colorado in Greeley.
John Mark Disorbio, EdD
Currently Dr. Disorbio works as a psychologist at Integrated Therapies, an interdisciplinary outpatient clinic for evaluating and treating patients with delayed recovery from chronic pain that he co-founded with Julia Copeland, PT, in 1985. In addition, he is a consultant to major companies throughout the U.S. and serves on the board of the National Pain Foundation. Having spent the majority of his educational and clinical career in the diagnosis and treatment of patients with psychological factors related to medical conditions, he is a frequent presenter at national and international conferences and has published research articles in numerous journals. An active member of the Biofeedback Society for 20 years, he also has extensive training in biofeedback and self-regulation techniques. Dr. Disorbio received his MA degree in counseling psychology from the University of Northern Colorado. He has been licensed as a psychologist in the state of Colorado since 1987.
Validity Scales
- Self-Disclosure
- Defensiveness
Physical Symptom Scales
- Somatic Complaints
- Pain Complaints
- Functional Complaints
- Muscular Bracing
Affective Scales
- Depression
- Anxiety
- Hostility
Character Scales
- Borderline
- Symptom Dependency
- Chronic Maladjustment
- Substance Abuse
- Perseverance
Psychosocial Scales
- 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.
Profile Report
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.
Patient Profile
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.
Clinical Summary
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.
Validity
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
The 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.
Critical Items
If the patient endorsed any critical items, the item text and the patient's response are listed in this section of the report.
Omitted Items
The Omitted Items section of the report is included only if items are left blank or have multiple responses.
Item Responses
This optional section of the report lists each item number and the patient's response
Treatment Recommendations
This optional section of the report is based on positive BHI 2 findings, listing possible clinical interventions for the treating professional to consider.
Patient Summary
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™ Local Software - Enables you to score assessments, report results, and store and export data on your computer.
Mail-in Scoring Service - Specially designed answer sheets are mailed to us for processing within 24–48 hours of receipt and returned via regular mail.
- Allows you to score the assessments at your site.
Optical Scan Scoring - Specially designed answer sheets are faxed to us for processing within 1-2 hours of receipt and returned via fax.