The Revised Behavior and Symptom Identification Scale (BASIS-R): Reliability and validity

Center for Health Quality Outcomes and Economics Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA.
Medical Care (Impact Factor: 3.23). 01/2005; 42(12):1230-41. DOI: 10.1097/00005650-200412000-00010
Source: PubMed


To assess outcomes of health services, providers need brief, responsive, reliable, and valid measures that can be implemented in clinical settings with minimal cost and burden. The Behavior and Symptom Identification Scale (BASIS-32) is a self-report measure developed in 1984 to assess mental health treatment outcomes. During the past 3 years, multiple methods were used to revise the instrument to improve reliability, validity, and applicability to diverse groups of mental health service recipients.
The objective of this study was to field test the revised instrument, make further changes based on analysis of the field test data, and assess reliability and validity of the final version (BASIS-24).
A field test was implemented at 27 treatment sites across the United States. A total of 2656 inpatients and 3222 outpatients participated. Factor analytic methods, classic test theory, and item response theory modeling were used to select the most discriminating, nonredundant items for inclusion in the final version of the instrument and to assess its reliability and validity. Item response theory modeling was used to score the instrument.
The final instrument includes 24 items assessing 6 domains: depression/ functioning, interpersonal relationships, self-harm, emotional lability, psychosis, and substance abuse. Test-retest and internal consistency reliability were acceptable. Tests of construct and discriminant validity supported the instrument's ability to discriminate groups expected to differ in mental health status, and its correlation with other measures of mental health.
Analyses of the BASIS-24 supported its reliability and validity for assessing mental health status from the patient's perspective.

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    • "Study specific recovery curve algorithms, using the same process described above, were derived for the local CMHC sample. Comparing this local CMHC sample to the Eisen et al. (2004) national sample, we observed an agreement of ␬ ϭ 0.871 (95% confidence interval [CI] ϭ 0.793–0.945) for designation of off track status corresponding to very good agreement per Byrt (1996). "
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    ABSTRACT: We describe the development and evaluation of a clinician feedback intervention for use in community mental health settings. The Community Clinician Feedback System (CCFS) was developed in collaboration with a community partner to meet the needs of providers working in such community settings. The CCFS consists of weekly performance feedback to clinicians, as well as a clinical feedback report that assists clinicians with patients who are not progressing as expected. Patients in the randomized sample (N = 100) were predominantly female African Americans, with a mean age of 39 years. Satisfaction ratings of the CCFS indicate that the system was widely accepted by clinicians and patients. A hierarchical linear models (HLM) analysis comparing rates of change across conditions controlling for baseline gender, age, and racial group indicated a moderate effect in favor of the feedback condition for symptom improvement, t(94) = 2.41, p = .017, d = .50. Thirty-six percent of feedback patients compared with only 13% of patients in the no-feedback condition demonstrated clinically significant change across treatment, χ2(1) = 6.13, p = .013. These results indicate that our CCFS is acceptable to providers and patients of mental health services and has the potential to improve the effectiveness of services for clinically meaningful depression in the community mental health setting. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 06/2015; 83(4). DOI:10.1037/a0039302 · 4.85 Impact Factor
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    • "The items cover six domains including: depression/functioning, interpersonal relationships, psychotic symptoms, alcohol/drug use, and emotional lability . The measure has demonstrated acceptable test-retest reliability and internal consistency and good construct and discriminant validity (Eisen et al. 2004). Further studies have supported the reliability, concurrent validity, and sensitivity of the BASIS-24 in specific racial groups (Eisen et al. 2006). "
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    ABSTRACT: There is substantial evidence that cognitive therapy is an effective intervention for the treatment of major depressive disorder. Although dynamic psychotherapies have been widely studied and are commonly practiced worldwide, there are few randomized comparisons of cognitive therapy and dynamic therapy for major depressive disorder. We are completing data collection on a randomized non-inferiority trial comparing the effectiveness of cognitive therapy and short-term dynamic psychotherapy in the treatment of major depressive disorder in the community mental health setting. Therapists employed in the community setting have been recruited for training in either short-term dynamic psychotherapy or cognitive therapy. Patients seeking services at the community site who meet criteria for major depressive disorder based on a blind independent diagnostic interview are randomized to 16 sessions of treatment. All patients are assessed at baseline and months 1, 2, 4, and 5 utilizing a comprehensive battery. This study adds to the growing literature evaluating the effectiveness of short-term dynamic psychotherapy for specific diagnostic groups. These results will have implications for the dissemination of effective interventions for major depressive disorder in community mental health settings. This trial is registered at, a service of the United States National Institute of Health. NIH Identifier: NCT01207271. Registered 21 September 2010.
    12/2014; 2(1):47. DOI:10.1186/s40359-014-0047-y
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    • "Conversely, SRMH was considered a minor variable if it was included as a covariate in models without being discussed in much detail, or if it was not a primary focus in descriptive studies. Studies classified in the minor group [14, 17, 22–35] were tabulated but excluded from synthesis. "
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    ABSTRACT: A single-item measure of self-rated mental health (SRMH) is being used increasingly in health research and population health surveys. The item asks respondents to rate their mental health on a five-point scale from excellent to poor. This scoping study presents the first known review of the SRMH literature. Electronic databases of Medline, CINAHL, PsycINFO, EMBASE and Cochrane Reviews were searched using keywords. The databases were also searched using the titles of surveys known to include the SRMH single item. The search was supplemented by manually searching the bibliographic sections of the included studies. Two independent reviewers coded articles for inclusion or exclusion based on whether articles included SRMH. Each study was coded by theme and data were extracted about study design, sample, variables, and results. Fifty-seven studies included SRMH. SRMH correlated moderately with the following mental health scales: Kessler Psychological Distress Scale, Patient Health Questionnaire, mental health subscales of the Short-Form Health Status Survey, Behaviour and Symptom Identification Scale, and World Mental Health Clinical Diagnostic Interview Schedule. However, responses to this item may differ across racial and ethnic groups. Poor SRMH was associated with poor self-rated health, physical health problems, increased health service utilization and less likelihood of being satisfied with mental health services. Poor or fair SRMH was also associated with social determinants of health, such as low socioeconomic position, weak social connections and neighbourhood stressors. Synthesis of this literature provides important information about the relationships SRMH has with other variables. SRMH is associated with multi-item measures of mental health, self-rated health, health problems, service utilization, and service satisfaction. Given these relationships and its use in epidemiologic surveys, SRMH should continue to be assessed as a population health measure. More studies need to examine relationships between SRMH and clinical mental illnesses. Longitudinal analyses should look at whether SRMH is predictive of future mental health problems.
    BMC Health Services Research 09/2014; 14(1):398. DOI:10.1186/1472-6963-14-398 · 1.71 Impact Factor
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