title: Factorial structure of the Brief Symptom Inventory (BSI)-18 among Chinese drug users.
abstract: BACKGROUND
  Although the Brief Symptom Inventory-18 (BSI-18) has been widely used for mental health screenings in both clinical and non-clinical populations, the validation of its application to Chinese populations has been very limited. The objective of this research is to assess the factorial structure of the BSI-18 within a Chinese drug using population.
  
  
  RESULTS
  A total sample of 303 drug users recruited via Respondent Driven Sampling (RDS) from Changsha, China was used for the study. Our results show: (1) The BSI-18 item scores are highly skewed; (2) With dichotomous items measures (1 - problem at least moderately caused respondent discomfort during the past week; 0 - otherwise), our findings support the designed 3 - factor solution of the BSI-18 (somatization, depression, and anxiety); (3) The BSI-18 has a hierarchical factorial structure with 3 first-order factors and an underlying second-order factor (general psychological distress); (4) Tentative support should also be given to a single dimension of general psychological distress in Chinese drug using populations. Our study recommends a useful alternative approach for evaluating the factorial structure of the BSI-18 - i.e. CFA with dichotomous item measures. Both the total BSI-18 score and the three subscales (SOM, DEP, and ANX) can be used in applications of the BSI-18.
  
  
  CONCLUSIONS
  Overall, our findings suggest the BSI-18 is useful with Chinese drug users, and shows potential for use with non-Western and substance using populations more generally.
authors.affiliation: Children's National Medical Center, George Washington University, United States.
authors.forename: Jichuan
authors.initials: J
authors.lastname: Wang
authors.forename: Brian C
authors.initials: BC
authors.lastname: Kelly
authors.forename: Tieqiao
authors.initials: T
authors.lastname: Liu
authors.forename: Guanbai
authors.initials: G
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Hao
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D044466:Asian People; D002681:China / Q000453:epidemiology; D003627:Data Interpretation, Statistical; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D055030:Drug Users / Q000523:psychology*; D005006:Ethnicity; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D015233:Models, Statistical; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D018401:Sample Size; D012737:Sex Factors; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
keywords: BSI-18; China; Confirmatory factor analysis; Drug users; Psychological distress
references.citation: Int J Addict. 1984 Dec;19(8):849-57
references.pmid: 6335710
references.citation: Addict Behav. 2007 May;32(5):924-37
references.pmid: 16901654
references.citation: J Couns Psychol. 2012 Jul;59(3):424-436
references.pmid: 22642268
references.citation: J Nurs Meas. 1996 Winter;4(2):117-27
references.pmid: 9170779
references.citation: Br J Math Stat Psychol. 1991 Nov;44 ( Pt 2):347-57
references.pmid: 1772802
references.citation: Addict Behav. 2010 Jan;35(1):23-9
references.pmid: 19733442
references.citation: Psychol Bull. 1992 Sep;112(2):351-62
references.pmid: 1454899
references.citation: J Psychoactive Drugs. 2007 Jun;39(2):167-72
references.pmid: 17703711
references.citation: J Abnorm Psychol. 2005 Nov;114(4):522-36
references.pmid: 16351375
references.citation: Psychosomatics. 2001 May-Jun;42(3):241-6
references.pmid: 11351113
references.citation: Int J Geriatr Psychiatry. 2010 Jun;25(6):578-87
references.pmid: 20013879
references.citation: Arch Gen Psychiatry. 2004 Aug;61(8):807-16
references.pmid: 15289279
references.citation: Patient Educ Couns. 2000 Feb;39(2-3):237-42
references.pmid: 11040723
references.citation: J Acquir Immune Defic Syndr. 2006 Apr 1;41(4):486-92
references.pmid: 16652058
references.citation: Drug Alcohol Depend. 2005 May 9;78(2):147-57
references.pmid: 15845318
references.citation: J Psychopharmacol. 2006 May;20(3):417-24
references.pmid: 16574716
references.citation: Psychol Assess. 2010 Dec;22(4):912-22
references.pmid: 21133550
references.citation: Psychother Psychosom Med Psychol. 2011 Feb;61(2):82-6
references.pmid: 21337286
references.citation: Annu Rev Psychol. 1999;50:215-41
references.pmid: 15012460
references.citation: Am J Addict. 2003 Jan-Feb;12(1):60-70
references.pmid: 12623741
references.citation: Psychol Assess. 2006 Mar;18(1):22-32
references.pmid: 16594809
references.citation: Am J Orthopsychiatry. 1996 Jan;66(1):17-31
references.pmid: 8720638
references.citation: J Psychosom Res. 2006 Apr;60(4):365-70
references.pmid: 16581360
references.citation: J Stud Alcohol. 2006 Jul;67(4):493-501
references.pmid: 16736068
references.citation: Cultur Divers Ethnic Minor Psychol. 2006 Apr;12(2):367-75
references.pmid: 16719583
references.citation: Dev Psychol. 2002 May;38(3):376-93
references.pmid: 12005381
references.citation: J Addict Dis. 1998;17(4):71-90
references.pmid: 9848033
references.citation: Psicothema. 2008 Nov;20(4):844-50
references.pmid: 18940093