Battery for Health Improvement 2

(BHI™ 2) Information

©2004 by Bruns and Disorbio. All Rights Reserved.
Last update 2/2/2004


The BHI 2 is a 217 item psychological inventory designed for the assessment of medical patients. It is administered via paper and pencil, and takes about 30-40 minutes to complete. The BHI 2 was developed over an 18 year period, and the present published version is the sixth version of the test. The BHI 2 is published by Pearson Assessments, which is the sole distributor of the MMPI. The purpose of the BHI 2 is to assess the interaction between medical and psychological factors.

As part of the BHI 2 scientific validation, data was gathered at 106 sites in 36 US states. This produced two normative samples matched to US census data, one being a rehabilitation patient sample, and the other being a sample of persons in the community. This project was probably the largest single research study ever conducted of psychological factors effecting rehabilitation patients. It involved administering the BHI 2, MMPI-2, MCMI-III, Tennessee Self Concept Scale, Minnesota Satisfaction Questionnaire, Toronto Alexithymia Scale, McGill Pain questionnaire, a Projective Pain Drawing, as well as medical and other information from the patient sample. This data was used as the basis for the BHI 2 test.

Research in the fields of psychology and medicine has indicated that psychological factors influence medical outcome in a variety of ways. Many studies have found that psychosocial factors have been more predictive of medical outcome than have medical diagnosis or other medical factors. As a result, there is a growing recognition in the medical protocols of a variety of organizations that psychological assessment and interventions play an important role in effectively treating chronic medical conditions.

The BHI 2 was designed to facilitate the interdisciplinary treatment of medical patients. It can help a mental health professional know what questions to a physician, and can assist a medical professional in knowing when to make a psychological referral.

The scales of the BHI 2 are as follows:

Scales of the BHI 2

Defensiveness (DEF)

The Defensiveness scale assesses the tendency of a patient to bias information in either a positive or negative light. This may be a conscious or unconscious tendency.

Self Disclosure (DIS)

Some patients may be very open about their private lives, while others may be more secretive or concerned with privacy. The Self Disclosure scale assess a broad tendency of a patient to disclose personal information about emotions, conflicts and psychological dysfunction.

Somatic Complaints (SOM)

This scale assesses a tendency towards diffuse physical complaints, which are often associated with stress and somatoform disorders.

Pain Complaints (PAIN)

The 0-10 pain scale is commonly used, but the BHI 2's version of this is the first one to be nationally validated. This scale assesses pain in ten areas of the body.

Functional Complaints (FNC) This scale assesses limitations in the ability to function, in the form of self-perceptions of disability and handicap.

Muscular Bracing (MB)

This scale assesses a tendency to react to stress, illness or injury with increased levels of muscle tension. This is thought to be associated with the "fight or flight" response.

Depression (DEP)

Assesses characteristics of depression including feelings of loss or grief around health problems, and perceived helplessness.

Anxiety (ANX)

Measures a tendency to worry, especially about physical symptoms.

Hostility (HOS)

Assesses hostile traits including a cynical belief system, angry feelings and aggressiveness.

Borderline (BOR)

Assesses primary borderline personality characteristic, considered by many to be underlying characteristics of most personality disorders.

Symptom Dependency (SYM)

Measures the tendency to seek the attention and support of others when experiencing pain or illness symptoms.

Chronic Maladjustment (CHR)

Assesses a general pattern of difficulties achieving a stable life adjustment, including a history of difficulties with school, work, finances, interpersonal relationships and the law.

Substance Abuse (SUB)

Elevations on this scale indicates that the patient is reporting a past or present substance use problem.

Perseverance (PER)

Assess the patient traits of optimism, emotional resilience and action orientation, and to some extent, stubbornness.

Family Dysfunction (FAM)

This scale assesses the degree to which the patient feels his/her family environment is emotionally unhealthy and non supportive.

Survivor of Violence (SRV)

High scores indicate that the patient is reporting a history of surviving multiple traumatic, violent events. Survivors may have heightened feelings of vulnerability, be more physiologically reactive to stress, and may more readily engage in self-protective behaviors. Such paitients may react to injury, illness or pain differently.

Doctor Dissatisfaction (DOC)

Assesses a dislike or distrust of physicians, including perceptions that physicians are uncaring and ineffective.

Job Dissatisfaction (JOB)

This scale assesses negative attitudes towards the employer, boss, co-workers and the job itself.


Miscellaneous information about the BHI 2

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