Assessment of psychosocial factors that may support or interfere with a chronically ill patient's course of medical treatment.

The MBMD assessment helps provide a broader understanding of the personal reality that each patient faces. By helping identify psychosocial assets and liabilities that may affect an individual’s response to treatment, the MBMD test enables clinicians to develop tailored treatment recommendations. Brief yet comprehensive, the MBMD inventory helps gather a range of information that it might otherwise require a battery of instruments to obtain. Two norm groups, one that includes a comprehensive sample of patients with chronic medical conditions, and one specific to bariatric surgery candidates, this contemporary test can help increase the likelihood of positive treatment outcomes and may thereby reduce the overall costs of care.

Psychologists, physicians, nurses and other professionals use the MBMD results to help:

• Identify patients who may have significant psychiatric problems and recommend specific interventions
• Pinpoint personal and social assets that may facilitate adjustment to physical limitations or lifestyle changes
• Determine whether patients need more communication and support in order to comply with prescribed medical regimens
• Structure post-treatment plans and self-care responsibilities in the context of the patient's social network

Key Features

• The MBMD’s recently added bariatric norms can help determine a candidate’s psychological suitability for surgery, assist patients in making significant lifestyle changes, and prepare medical staff to respond to patients’ likely reactions following surgery.  
• The MBMD’s broad normative sample permits the test’s use to be extended into sleep disorder centers, cancer treatment centers, cardiac rehabilitation programs, bariatric surgery departments, pain treatment centers, neurological rehabilitation units, military and veterans’ hospitals, primary care facilities and family medicine clinics.  
• The test’s 165 items require only 20–25 minutes to complete, helping to reduce patient resistance and fatigue.  
• By enabling more effective treatment planning, the MBMD test may help decrease healthcare costs in clinics and hospitals through reduced assessment time, more efficient triage and decreased complications after major procedures.

Scales

Response Patterns 

X - Disclosure
Y - Desirability
Z - Debasement

Negative Health Habits

Alcohol
Drugs
Eating
Caffeine
Inactivity
Smoking

Psychiatric Indicators

AA - Anxiety-Tension
BB - Depression
CC - Cognitive Dysfunction
DD - Emotional Lability
EE - Guardedness

Coping Styles

1 - Introversion
2A - Inhibited
2B - Dejected
3 - Cooperative
4 - Sociable
5 - Confident
6A - Nonconforming
6B - Forceful
7 - Respectful
8A - Oppositional
8B - Denigrated

Stress Moderators

A - Illness Apprehension
B - Functional Deficits
C - Pain Sensitivity
D - Social Isolation
E - Future Pessimism
F - Spiritual Absence

Treatment Prognostics

G - Interventional Fragility
H - Mediation Abuse
I - Information Discomfort
J - Utilization Excess
K - Problematic Compliance

Management Guide

L - Adjustment Difficulties
M - Psych Referral

Test Components

• Response Patterns
  Help gauge distorted response tendencies in the patient's self-report
• Negative Health Habits
  Help gauge recent or current problematic behaviors affecting health, such as Alcohol, Drug, Eating, Caffeine, Inactivity, and Smoking
• Psychiatric Indications
  Help identify psychiatric comorbidities that may affect health management such as Anxiety-Tension, Depression, Cognitive Dysfunction, Emotional Lability, and Guardedness
• Coping Styles
  Help identify patients' approaches to handling everyday problems, as well as their medical condition and major life stressors
• Stress Moderators
  Help identify attitudes and resources that may affect health care such as Illness Apprehension, Social Isolation, Future Pessimism, Pain Sensitivity and Spiritual Absence.

What is the MBMD test designed to do?

Medical researchers and healthcare practitioners understand that psychological and personality factors are major contributors to positive health outcomes. The MBMD test can help identify the main psychosocial factors that can contribute to the recovery from, relapse of, or progression of physical disease. By addressing these factors, behavioral health psychologists can help medical professionals better treat their patients. The results may be improved treatment success and rehabilitation/recovery from disease, as well as reduced medical utilization and contained healthcare costs.

When is it appropriate to use the MBMD test?

Because the MBMD test is normed on medical patients, it can be used with patients who are undergoing a variety of medical care or treatment regimens. The MBMD can help identify patients with psychiatric problems and recommend interventions. It can also help pinpoint personal and social assets that can help the patient adjust to physical limitations or lifestyle changes. It is not appropriate to use the MBMD test with adolescents. The age range for the MBMD test is 18 to 89 years old.

EXAMPLE TEST TWO:

Battery for Health Improvement 2 (BHI™ 2)

• Administration: Paper-and-pencil, Approximately 30 minutes (217 multiple-choice)
• Ages / Grades: Individuals 18-65

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.

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

Key Features 

• 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, helps guide the clinician to explore medical and psychological explanations for physical symptoms.
• The Diagnostic Probabilities section, 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.

Scales 

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

Norms 

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.

Other tests that can be administered include Neuropsychological tests, tests for Substance Abuse, and Personality tests.