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The General Behavior Inventory (GBI) is a 73-item questionnaire designed by Richard Depue and colleagues to measure manic and depressive symptoms in adults. It is used to assess for Bipolar Spectrum Disorders (BSDs), especially cyclothymic disorder. It is one of the most widely used tools for measuring the severity of bipolar disorder symptoms, and it also can track the fluctuation of symptoms over time. Multiple short versions of the GBI have been developed for more convenient use and targeted assessment. Although the GBI was first designed for use with adults, the full version and the short forms have also been adapted into parent-report versions for use with children. All versions of the GBI are free to use and available in multiple languages. Measures for clinical use include the original full length GBI (self-report), the GBI-10-Item Mania Scale (GBI-10M), two 10 item Depression scales (GBI-10Da and GBI-10Db), the 7 Up-7 Down Inventory, and parent-report versions of all of these (P-GBI, PGBI-10M, PGBI-Da, PGBI-Db, PGBI-7U7D). Additional scales that have only been used in research or are currently in development include the GBI Sleep scale, P-GBI Sleep scale, and others.

Access and Use
The General Behavior Inventory is free to use in both research and clinical work. Some of the short forms have been formally CC-BY-SA licensed. The original author, Richard Depue, asks that you contact him to let him know about the project (rad5@cornell.edu). The GBI has been translated into several languages (in short forms as well as full length, and parent as well as self-report); links to the translated forms, as well as online and pdf versions of the GBI and GBI short forms, can be found at this page.

Brief History and Main Features
After publication of the original 1981 paper at the State University of New York at Buffalo by Depue and fellow authors, the GBI has been applied to clinical and research populations. It serves the purpose of assessing and tracking the symptoms of Bipolar Disorder: mania/hypomania and depression. Although population-level norms do not yet exist, the GBI can be used to measure clinically significant symptoms as part of an initial intake process and also assess changes in symptoms over time.

Because the GBI is free to use and modify, a number of derivative measures have been developed and used in both clinical and research contexts. These include a full-length version for caregivers to fill out about their children, as well as short forms for both caregiver- and self-report targeting specific symptom domains. GBI and its derivatives are available in several languages.

Much of the research on the GBI is focused specifically on children and adolescent populations, though it has been validated for adults as well.

Uses
The 10 item short form versions of the GBI can be especially useful for screening because they are quicker to take, though the full length GBI can also be used for screening. The full GBI works well for diagnosis. The GBI can also be used to monitor progress and outcomes of treatment in clinical and research settings.

The main service access application of the GBI is its use in therapy, but the areas of disability and special education could also benefit from mental health screening/tracking using the measure.

With regard to use in research, the GBI has utility within the research domain criteria (RDoC), which is a framework for research adopted by the National Institutes of Health (NIH). The RDoC provides levels of analysis to research and aims to keep research relevant longer since research isn't based solely on the DSM (Diagnostic and Statistical Manual of Mental Disorders), which changes over time. The GBI is focused on the behavior aspect of the RDoC matrix, with mania/hypomania corresponding to the positive valence domain and depression corresponding to the negative valence domain (high negative affect items) and low positive valence (anhedonic and low energy items).. The sleep scale is relevant to the regulatory processes and circadian rhythms domain.

Development of Measure Over Time
The GBI was originally made as a self-report instrument for college students and adults to use to describe their own history of mood symptoms. The original item set included clinical characteristics and associated features in addition to the diagnostic symptoms of manic and depressive states in the current versions of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. The first set of 69 items was increased to 73, with the final version having 73 mood items and 6 additional questions to check the validity of responses (which did not figure into the scale scores). The self-report version has also been validated for adolescent use, and a parent-report version of the GBI (PGBI) was developed and validated as well. The full length GBI and PGBI have been used extensively, accruing evidence of many facets of validity. However, because of its length and high reading level, short forms of the GBI have been developed to help with ease of use. The definition of BSDs has changed some with each revision of the psychiatric classification systems over time, but the GBI still appears to provide accurate measurement. A meta-analysis of the accuracy of self-report scales found a trend for the classification accuracy of scales to decrease over time, particularly for the ones that have been available for several decades. Part of this is likely due to a general pattern in the medical and scientific literature, where the initial findings have larger effect sizes, but tend to be based on smaller samples (increasing risk of false positive results), and also more homogeneous samples (reducing between case variability due to other effects). In addition, the DSM-IV and DSM-5 added additional types of bipolar disorders (the "Not Otherwise Specified" group in DSM-IV and "Other Specified Bipolar and Related Disorders" in DSM-5) that have less severe manic symptoms and fuzzier presentations, associated with lower average scores on the PGBI and GBI. This figure, adapted from the meta-analysis, shows that the GBI has accumulated more decades of research data than most other scales, spanning five editions of the DSM (III, III-R, IV, IV-TR, and -5). It shows a decrease in the standardized mean difference between cases with versus without bipolar diagnoses, but the trend is not significantly different than that for the rest of the measures (which also have fewer years of data available).

In recent years, the GBI's full length version was transformed into the 7Up-7Down, which was a shorter version. The 7Up-7Down asks about suicidal ideation which makes it unique compared to later short forms. Later, parcel research was done on the various factors that were being assessed for across items. From this research, 10 item short forms for mania and depression were created using questions from the original GBI. These are the most current and validated short forms and can used as a quicker alternative to giving the full GBI. They directly measure concepts of depression and mania.

Types of Forms
The original full-length General Behavioral Inventory (GBI) is a self-report measure for adolescents and adults. There is also a parent-report version of the full-length GBI. Many short forms have been created from the 73 item full-length GBI and validated for clinical use. There are three 10-item short forms, one for mania and two for depression (also called Depression A and Depression B short forms). The self-report version of these 10-item forms are validated for adolescents, and the parent-report versions are validated for children and adolescents. The GBI 7 Up 7 Down Inventory is a 14 item self-report short form for adolescents and adults. There is also a GBI Sleep Subscale that is a parent-report short form for children and adolescents.

Informants for Measures
Currently, the self-report full-length GBI and the GBI 7 up 7 down inventory versions of the GBI are validated for adult clients/research participants.

For adolescents, both self-report and parent-report versions of the full length GBI, the 10-item mania short form, and the 10-item depression (A & B) short forms have been validated for clinical use. For these forms, the parent or adolescent can be used as the sole informant or as cross informants if both self-report and parent-report version of the GBI or GBI short forms are given. Currently, there is only a self-report version of the 7 Up 7 Down Inventory and only a parent-report version of the GBI Sleep Subscale; both are appropriate for use with adolescents.

For children under the age of 11 (or 10 for the full length GBI), only parent-report versions of the GBI and GBI short forms should be used.

A teacher-report version of the full length GBI was developed and tested for children and adolescents, but was found to be invalid and is not recommended for clinical use.

General Behavior Inventory/Parent-General Behavior Inventory (GBI/PGBI)
The full length General Behavioral Inventory is a 73-item self-report questionnaire that assesses symptom frequency, duration, and intensity across many dimensions related to bipolar disorder. Due to the range of symptoms assessed, the GBI can be used to help discriminate between diagnostic groups, such as BSDs and disruptive behavior disorders, unipolar depression and bipolar disorder, and clinical populations and non-clinical populations. Each item asks the participant to rate a symptom's intensity or occurrence on a scale from 0: “never or hardly ever” to 3: “very often or almost constantly”. Depue's original study rated items from 1-4, but a 0-3 scale is now used in most research and clinical contexts. 28 of the 73 items focus on hypomanic/biphasic symptoms, such as extreme mood and energy, racing thoughts, and grandiosity. The other 46 of the 73 items focus on depressive symptoms, such as hopelessness, anhedonia, and rumination. The parent-report version of the GBI asks the same items but changes the wording from "you" to "your child." Like the self-report version of the GBI, the Parent-General Behavioral Inventory (PGBI) has evidence of validity at diagnostic differentiation, helping clinicians gain clinically meaningful insight in mood disorders of children and adolescents. The self-report version of the full length GBI has been validated for people age 10 to 85+, and the PGBI has been validated for children/adolescents age 5 to 17.



GBI 10 Item Short Forms: Mania, Depression A, Depression B (self-report and parent report)
The GBI and PGBI 10 Item Short Forms are three different measures carved from the full 73 item GBI. The 10 item Mania form assess manic symptoms such as elated mood, mood never being in the middle, and manic irritability. The two 10 item depressions forms (Depression 10A and Depression 10B) have no overlap with their questions and assess different types of depression symptoms including low positive affect such anhedonia and low energy in addition to other symptoms like feeling sad and hopeless. They do not include the GBI item on suicidal ideation. The two depression short forms were found to be equally reliable and valid. They can be used as parallel forms, for example using one as a baseline measure and the other to assess treatment progress. These 10 item forms were originally built from the PGBI by picking items that were the most effective at discriminating between clinical diagnostic groups while still loading on a single factor within the factor analysis structure. Even though these short forms were built based on data from the parent-report version of the GBI, further research showed that the forms were also valid as adolescent self-report measures. The parent-report version of the GBI 10 item short forms has been validated for children/adolescents age 5 to 18, and the self-report version has been validated for adolescents age 11 to 18+,

GBI 7 Up 7 Down Inventory (7U7D; Self-Report only)
The 7 Up-7 Down GBI Short Form (7U7D) is a 14 item inventory, carved from the full 73 item GBI, that was created to increase the clinical utility of the GBI assessment in settings were the full-version was too long to be realistically administrated. It was developed via factor analysis of the full length self-report GBI from nine separate samples pooled into two age groups, ensuring applicability for use in youth and adults. The 7 Up 7 Down was published before the 10 item short forms and is less preferable in most contexts, as the 10 item forms are higher in reliability and validity. This form has less content coverage, and the 7 up questions focusing on hypomanic symptoms have small but significant differences in reliability and validity compared to the 10 item mania scale. Another practical (and sometimes ethical) consideration is that the 7 Up 7 Down includes an item on suicidal ideation, whereas the 10 item depression short forms do not ask about suicidal ideation. The 7U7D has been validated for ages 11-85+. Currently, it is the only short form that is validated for adults. There is not a parent-report version of the 7 Up 7 Down.

PGBI Sleep Sub-Scale (Parent Report only)
The PGBI Sleep Sub-Scale is a 7 item measure, carved from the full-length PGBI, using all of the items that ask directly about sleep. This scale was found to be a reliable measure of mood-related sleep issues in children and adolescents. In a sample of 625 youth and their parents, children with bipolar spectrum disorders scored significantly higher on all 7 sleep-related items than the other participants in the study. The sleep sub-scale was as effective as the built-in hypomania and depression subscales of the original full length PGBI at discriminating children with bipolar spectrum disorders. This short form is validated for ages 5 to 18.

Competitive Comparison
The GBI is not the only measure commonly used to assess mood symptoms. Clinicians or researchers may also consider common alternatives such as the Child Mania Rating Scale (CMRS), Mood and Feelings Questionnaire (MFQ) , Child Behavior Checklist/Youth Self-Report(CBCL/YSR) , or the Family Index of Risk for Mood (FIRM). Use of the 10 item forms described above is generally recommended instead of the full-length GBI as they are far shorter and have similar diagnostic accuracy and reliability to the 73-item version. Reliability and validity information for versions of the GBI are presented in an earlier section.

The GBI (and its derivatives) perform well in comparisons of diagnostic utility. For example, research has shown that the 10 item versions outperform the Achenbach System of Empirically Based Assessment (ASEBA) scales, the YSR and CBCL, when identifying patients with mood disorders. The table below contains additional information for diagnostic utility of GBI short forms compared to the MDQ, CMRS, and FIRM using a base rate estimate of 5%. aFlesch-Kincaid estimate of grade level.

Computer Administration and Scoring
[Here we will put in links to the Assessment center measures once they are cleaned and fixed. I need to ask Eric about what code for the GBI is currently updated and open source online., I will also add some info on the pros and cons of computer vs. paper administration.]

The HGAPS Assessment Center offers online versions of the GBI (both self- and parent-report).

General Behavior Inventory/Parent-General Behavior Inventory
In Depue's anchor paper, the original 73 item version of the GBI used case scoring, where items were given values ranging from 1-4. Symptoms that were rated as 1 or 2 were considered to be absent and symptoms rated as 3 or 4 were considered to be present. However, as the GBI was developed over time, the authors of the measure decided to use Likert scaling instead of the dichotomous “case scoring,” to increase the sensitivity of the measure while remaining reliable. The items on the GBI and PGBI are now scaled from 0-3 rated as 0 (never or hardly ever present), 1 (sometimes present), 2 (often present), and 3 (very often or almost constantly present). This same scale is used for all of the GBI short forms as well.

When Depue factor analyzed the GBI, he found that GBI could be spilt into either two or three factors, which became the scales of the GBI. In both factor models, one of the factors, the depression scale, stayed consistent. The depression scale of the full length GBI/PGBI consists of a sum score of the following 46 items: 01, 03, 05, 06, 09, 10, 12, 13, 14, 16, 18, 20, 21, 23, 25, 26, 28, 29, 32, 33, 34, 36, 37, 39, 41, 44, 45, 47, 49, 50, 52, 55, 56, 58, 59, 60, 62, 63, 65, 67, 68, 69, 70, 71, 72, 73.

In the two factor model, the other factor was the hypomanic/biphasic scale of the full length GBI/PGBI, which consists of a sum score of the following 28 items: 02, 04, 07, 08, 11, 15, 17, 19, 22, 24, 27, 30, 31, 35, 38, 40, 42, 43, 44, 46, 48, 51, 53, 54, 57, 61, 64, 66. (Note that item 44 was included in both the depression and the hypomanic/biphasic scale of Depue's scoring due to factor cross-loading.) This two factor model with the depression scale and the hypomanic/biphasic scale is recommend by Depue for scoring and is used in most research on the full-length GBI.

In the three factor model, the items in the hypomanic/biphasic scale above loaded into two separate factors that Depue labeled the hypomania scale and the mixed scale. The hypomania scale of the full-length GBI consists of a sum score of the following 21 items: 04, 07, 08, 11, 15, 17, 22, 27, 30, 31, 38, 42, 43, 44, 46, 51, 54, 57, 61, 64, 66. The mixed scale of the full-length GBI consists of a sum score of the 7 following items: 02, 19, 24, 35, 40, 48, 53. (Note that in the 3 factor model, item 44 was still included in both the depression and the hypomania scale of Depue's scoring.)

Research by Youngstrom et al. further supports using the depression and biphasic/hypomanic scales for scoring and analysis. As part of that analysis, they grouped the 73 items into twenty parcels with three or four similar items each, 8 parcels containing items with hypomanic/biphasic content and 12 parcels with depressive items. Those 20 parcels are listed both in the figures on the short forms above and in the table below.

Missing Data
If the client/research participant did not answer every question, the GBI/PGBI can still be scored as long as they filled out 80% of the measure or scale being scored. If at least 80% of the items are present, prorate the summed score of the items they rated to the full length of the scale (equivalent to mean imputation). To do this, find the mean of the answered items by dividing the sum score of the answered items by the number of answered items. Then, multiply this average item score by the total number of items in the measure to find the prorated score. For the full length GBI/PGBI, this should be done for both the depression and hypomanic/biphasic scales as both are used for interpretation of the measure.

GBI/PGBI Short Forms
Like the current version of the full length GBI/PGBI, the GBI/PGBI 10 Item Short Forms: Mania, Depression A, Depression B, GBI 7 Up 7 Down Inventory, and PGBI Sleep Sub-Scale are scored on a Likert scale ranging from 0-3 with 0 as "never or hardly ever present", 1 as "sometimes present", 2 "often present", and 3 "very often or almost constantly present". If given as a standalone measure, the short forms are scored as a sum of all of the items.

The items to extract from the full GBI for each short form are as follows:


 * 10 item Mania: 53, 54, 4, 11, 22, 40, 27, 19, 64, 31.
 * 10 item Depression Form A: 3, 45, 68, 16, 56, 13, 5, 20, 50, 59.
 * 10 item Depression Form B: 34, 14, 63, 72, 62, 9, 23, 6, 32, 18.
 * 7 Up: 22, 31, 30, 64, 43, 46, 38.
 * 7 Down: 23, 34, 63, 47, 56, 62, 73.
 * Sleep Subscale (7 items): 5, 15, 18, 25, 31, 37, 52.

The expandable and sortable table below of all items in the full length GBI shows the overlap of items across the different short forms, along with the item content, Depue subscale designation, and parcel classification. Please note that the content column includes the text from the parent-report version of the GBI. For the self-report version, the content of items are the same except the language of "your child," "he/she," or "him/her" is written as "you" and "your child's" or "his/her" as "your."

General Behavior Inventory/Parent-General Behavior Inventory
Along with the raw score, the percent of max possible (POMP) score can be used for interpretation. To find this score, divide the raw sum score by the maximum possible score for the measure/scale and multiply that decimal by 100. For the full length GBI/PGBI if the 0-3 scale is used, the maximum possible score for the total measure is 219, the maximum possible score for the depression scale is 138, and the maximum possible score for the hypomanic/biphasic scale is 84. The raw scores and the POMP are both meaningful: the higher the raw score/POMP on the depression scale, the higher the likelihood of a mood disorder; the higher the raw score/POMP on the hypomanic/biphasic scale, the higher the likelihood of BSDs. While clinicians can look at the score of the whole measure to get a sense of the overall intensity of symptoms, looking at the individual depression vs. hypomanic/biphasic scales will give clinicians more accurate information on if the client is likely dealing with a BSD or other mood disorders like depression. There are currently not normed scores or published Diagnostic Likelihood Ratios for the full length GBI/PGBI.

GBI/PGBI Short Forms


Like with the full length GBI/PGBI, both the raw score and the percent of max possible (POMP) score can be used for interpretation. The method to calculate the POMP is described above. For the 10 item short forms (10 item Mania, Depression 10A, and Depression 10B), the maximum possible score is 30. For the 7 Up, 7 Down short forms, the maximum possible score is 42 for the measure overall and 21 for individual up and down scales. The higher the raw score or POMP score of the Depression 10A, Depression 10 B, and 7 Down scale, the higher the likelihood of a mood disorder. The higher the raw score or POMP score of the 10 item Mania form or the 7 Up scale, the higher the likelihood of BSDs. For the sleep subscale, the maximum possible score is 21. Research suggests that the higher the raw/POMP score on the sleep subscale, the higher the likelihood of not only mood-related sleep problems but also BSDs. However, more research is needed to confirm this finding.

In addition to the raw scores and POMP scores, clinicians can also use Diagnostic Likelihood Ratios (DiLRs) to help them interpret GBI/PGBI short form scores. DiLRs are the ratio in a given score range of the percentages of cases of people with versus without the target condition. This makes DiLRs a helpful and practical guideline for calculating the odds of a client having a certain disorder. The DiLRs can also be combined with previous information to update the probabilities of diagnoses for individual cases, either mathematically using Bayes' Theorem or visually using a probability nomogram as shown to the left.

* DiLRs based on a sample of 617 youth, 5 to 18 years of age, seeking outpatient mental health services at an academic medical clinic. The 10M DiLR predict the probability of a bipolar spectrum disorder (bipolar I, II, cyclothymic disorder, or Other Specified Bipolar and Related Disorder. The 10DepA and 10DepB DiLR predict any mood disorder (including major depression, dysthymic/persistent depressive disorder, and Other Specified Depressive Disorder as well as bipolar disorders).

* DiLRs based on a sample of 427 youth, 11 to 18 years of age, seeking outpatient mental health services at an academic medical clinic. The 10M and 7-Up DiLRs predict bipolar I, II, cyclothymic disorder, or Other Specified Bipolar and Related Disorder. The 10DepA, 10DepB, and 7-Down DiLRs predict any mood disorder (including major depression, dysthymic/persistent depressive disorder, and Other Specified Depressive Disorder as well as bipolar disorders).

Using the GBI to measure treatment response
The GBI has been used in several treatment studies, and it shows good sensitivity to treatment effects. The 10 item versions in particular are brief enough to be repeated during the course of treatment, but show similar effect sizes to interview-based ratings in research studies. The 7 Up-7 Down scales have not been tested in an extracted, standalone format in treatment studies yet.

Here are benchmarks for evaluating change during treatment: * The benchmarks are based on clinical and nonclinical norms, following the "clinically significant change" model by Jacobson and colleagues.

Interpretive example for measuring treatment progress and outcome
Juan's mother fills out a PGI-10M and PGBI-10Da as part of an evaluation. Both of these have raw scores that range from 0 to 30. Juan initially scores a 21, which is in a high risk range for potential bipolar disorder. After the feedback and first therapy session, the score comes down to a 17 (4 point drop). This is larger than the "Minimally Important Difference" (MID) of 3, suggesting that this is large enough for the person to believe that treatment might be helping some.

However, the amount of change needed to be be confident that treatment is actually contributing to reliable change would need to be larger: The 95% confidence in change target is 6 points for this measure (equating to a reliable change index > 1.96 in Jacobson's approach).

After several months of treatment, Juan's score according to his mother's report is down to a 7. This is enough to be confident that treatment is helping. The 14 point reduction (21-7 = 14 point difference) not only exceeds the targets for MID and reliable change, but it also is lower than the "Back" into the normal range threshold of 9. The Back threshold is the 95th percentile for a reference group without bipolar disorder (in this case often with other mild or moderate clinical issues, as there is no nonclinical standardization sample for the PGBI, like most clinical symptom assessments). Scores this high are likely to still be noticeable and may be concerning to others, but they are also within the range of what could also occur for other reasons besides having a bipolar disorder, including problems in daily living as a youth or adult. The Back threshold is the most liberal of the "clinically significant change" definitions proposed by Jacobson and colleagues.

Reducing the score to a 6 or lower would satisfy Jacobson's "Closer" definition -- reliable change combined with a score more typical of the nonbipolar than bipolar reference groups (operationally defined as the weighted mean of the two groups). Again, scores of 5-6 may be noticeable and sometimes irritating, but they also are a marked improvement compared to where Juan started. This would be an even more impressive example of clinically significant change.

If treatment continued and succeeded in getting his score down to a 0 or 1, that would not only show near complete elimination of the symptoms, but it also would satisfy Jacobson's most stringent definition of clinically significant change -- getting the score Away from the clinical reference group (e.g., below the 2.5th percentile of the clinical reference group). This is an exceptionally stringent definition, and impossible to achieve with many outcome measures, where two SDs below average would require negative raw scores.

Norms of Data
Currently, there are no known sex or age norms for the GBI, PGBI, and related short forms. More research is needed on how GBI scores differ across different demographic groups.

Integrating Information from Multiple Sources
For adolescents, both the self-report version and parent-report version of the full length GBI and of the 10-item short forms (10M, Da, & Db) have been validated for clinical use. Research has found that integrating the scores from both parent and self report versions of the full length GBI does not significantly improve the diagnostic assignment of participants. As the parent and self report version of the 10-item short-forms were found to have similar validity, clinicians can use their best judgement in choosing who to use as an informant for their adolescent clients. However, some evidence suggests that parent report data may be more accurate for youth manic symptoms, so clinicians should keep that in mind when choosing a informant for the GBI/GBI short forms or integrating the information from both the self and parent report.

Reliability and Validity
The first paper published on the GBI was in 1981, and research has appeared steadily since then. The GBI consistently has exceptional evidence of reliability, due to its combination of length and well-written (but complex) items. It has showed excellent evidence of discriminative validity in two meta-analyses, one focused on self-report in adults and the other looking at performance with children and teenagers.

Reliability
The table below provides the projected and actual Cronbach's alphas for all GBI short forms. Generally, shortened versions of measures see a decrease in reliability, and thus, a decrease in alpha. Comparing the projected alpha for a short form to its actual alpha allows researchers to determine whether there are factors affecting the alpha other than a reduction in length. In simpler terms, if a shortened measure has an actual alpha significantly lower than its projected alpha, then something other than the reduction in length is affecting the reliability of that shortened measure. Additionally, the table below provides the projected and actual correlation between a given short form and the full length GBI. The correlation between a short form and full length form indicates the overlap in content coverage between the short form and the full length form. Much like alpha, if the projected correlation between measures is significantly higher than the actual correlation, factors outside of length reduction are affecting the correlation.

The full length GBI exhibits strong internal consistency. When it was originally validated, the GBI produced and alpha of .94 and Depue et al. found that the sex of a patient did not affect the internal consistency. When the GBI was revalidated in a university study a few years later, Depue and colleagues reported that alphas ranged from .90 to .96 for both the full length GBI and the depressive and hypomanic scales.

Validity
The validity of the GBI has been heavily researched. When the GBI was first validated, researchers found that the GBI kept false positives low and was especially good at finding non-cases of depression, hypomania, or biphasic behavior. Additionally, the GBI was found to weed out neurotic patients or simply unhappy patients from depressed, hypomanic, or biphasic patients. Further studies support the GBI’s discriminative validity. One such study found that the GBI discriminated well between cyclothymes, dysthymes, non chronic major depressives, and patients with nonaffective disorders. The GBI correctly identified 88% of total cases. More specifically, the GBI correctly identified “All of the cyclothymes, 92% of dysthymes, 75% of the non chronic major depressives, and 87% of the patients with nonaffective disorders” (Outpatient study). Furthermore, the GBI was found to have good sensitivity and reliability when evaluating children and adolescents. Both the depression scale and the hypomanic/biphasic scale produced an AUC of .82 when discriminating between bipolar spectrum disorder and all others

Parent GBI
The discriminant validity of the PGBI was assessed between five groups. The first group, any mood disorder vs. no diagnosis assessed the PGBI's ability to discriminate between participants who had any mood disorder and those who had no diagnosis. The depression scale of the PGBI produced an AUC of .98 when distinguishing between participants with any mood disorder and no diagnosis. The Hypomanic/Biphasic scale of the PGBI produced and AUC of .94 when distinguishing between the same two groups. When attempting to distinguish between participants with a bipolar disorder diagnosis and participants with no diagnosis, both the depression scale and the hypomanic/biphasic scale produced and AUC of .97. The PGBI was also used to discriminate between participants who had any mood disorder and those who had no mood disorder but may have had another diagnosis. The depression scale produced an AUC of .88, while the hypomanic/biphasic scale produced an AUC of .81. Additionally, the PGBI was used to discriminate between participants with unipolar mood disorders and bipolar mood disorders. The depression scale produced an AUC of .40, meaning that it is not useful for this task. However, the hypomanic/biphasic scale produced and AUC of .87. Finally, the PGBI was used to discriminate between participants with bipolar spectrum disorders and those with disruptive behavior disorders. Both the depression scale and the hypomanic/biphasic scale produced an AUC of .84.

7 Up 7 Down
The 7up scale produced an AUC of .82 when discriminating between participants with bipolar disorder and no other diagnosis. However, the AUC fell to .59 when discriminating between participants with bipolar disorder and any other diagnosis, though this was not significantly different than the AUC of .62 that the full length mania scale produced when discriminating between the same two groups. The 7 down scale produced and AUC of.78 when discriminating between any mood disorder and no diagnosis. Furthermore, the 7 down produced and AUC of .67 when discriminating between any mood disorder and any other diagnosis. Interestingly, the full length depression scale also produced an AUC of .67 when discriminating between any mood disorder and any other diagnosis.

10 Item Short Forms
Area under the curve information for the various short forms is presented in the table below for both academic and community clinic settings.

Validity in special populations
While the GBI was originally validated in a predominantly white population, research has been done to determine whether or not the GBI is suitable for black populations. In this study, researchers used confirmatory factor analysis to test whether the two-factor structure of the GBI maintained configural invariance, weak invariance, strong invariance, strict invariance, and factorial invariance when used in a black young adult population. Before testing for invariance, researchers tested model fit on the white and black samples separately. Researchers concluded that the GBI’s two factor model had adequate fit for both white and black samples. Further testing revealed that the GBI demonstrated configural invariance, weak invariance, strong invariance, and factorial invariance. However, the GBI did not demonstrate strict invariance between samples.

Teacher-Report General Behavioral Inventory
The research study testing the teacher-report version of the GBI had a large sample of teachers complete the GBI to describe the mood and behavior of youths age 5 to 18 years old. The results indicated that there were many items that teachers did not have an opportunity to observe the behavior (such as the items asking about sleep), and others that teachers often chose to skip. Even after shortening the item list to those that teachers could report about, the validity results were modest even though the internal consistency reliability was high. The results suggested that it was challenging for teachers to tell the difference between hypomanic symptoms and symptoms attributable to attention-deficit/hyperactivity disorder, which is much more common in the classroom. The results aligned with findings from a large meta-analysis that teacher report had the lowest average validity across all mania scales compared to adolescent or parent report on the same scales. Based on these results, current recommendations are to concentrate on parent and youth report, and not use teacher report as a way of measuring hypomanic symptoms in youths.

LAMS 12 Item self report
Includes items: 52, 40, 44, 59, 19, 29 (factor 1); 11, 7, 31, 38, 22, 4 (factor 2)

Lewinsohn's 12-item version
Lewinsohn used a 12 item version in the Oregon epidemiological study: 4, 8, 11, 15, 30, 44, 51, 64 (all from Depue's hypomanic set); 2, 19, 24, 48 (from Depue's mixed set). Boldfaced items overlap with the 10M scale and could be used in a calibration study.

https://psycnet.apa.org/record/2003-04754-001

Jensen et al. Impulsive Aggression Scale
Jensen et al. rationally derived a 7 item impulsive aggression scale from the GBI using items: 27, 42, 44, 51, 14, 39, 53, 54.

https://www.sciencedirect.com/science/article/abs/pii/S0890856709616750

Angst Short Form
- (Zurich)

Hi Eric, I found this article by Angst where they used the GBI, but it seems to have been the full length rather than a variant- is there another paper to look for with a variant?

https://doi.org/10.1016/S0165-0327(98)00142-6

Johnson Short Form
-

Links

 * PubMed Search -- A current search of the GBI on PubMed, a free database that covers medicine (so some articles published in psychology journals might be missing). The entries will usually include abstracts, and sometimes will include a version of full text (especially if the project was grant funded). The search is designed to be highly specific (i.e., not including lots of irrelevant articles), but it might miss some articles.
 * The Open Translations Project (TOpTraP) -- an effort to gather the translated versions of the best free measures in one place. The GBI 10 item mania and depression scales are available in more than two dozen languages; the full length version is available in several.
 * EffectiveChildTherapy.Org information on Bipolar Disorder -- a website built for families to learn more about ways to improve social, emotional, and academic life for youths
 * Society of Clinical Child and Adolescent Psychology -- the professional society for psychologists focusing on helping youths and families dealing with emotional and behavioral challenges

Suggested Citation for Measures
Self report GBI, full length version

Depue, R. A., Slater, J. F., Wolfstetter-Kausch, H., Klein, D. N., Goplerud, E., & Farr, D. A. (1981). A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: A conceptual framework and five validation studies. Journal of Abnormal Psychology, 90, 381-437. https://doi.org/10.1037/0021-843X.90.5.381

and if using specifically in teens:

Danielson, C. K., Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2003). Discriminative validity of the General Behavior Inventory using youth report. Journal of Abnormal Child Psychology, 31, 29-39.

Parent-report full-length GBI (full length version)

Youngstrom, E. A., Findling, R. L., Danielson, C. K., & Calabrese, J. R. (2001). Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory. Psychological Assessment, 13, 267-276.

10 Item Mania and Depression forms

Parent-report

Youngstrom, E. A., Van Meter, A. R., Frazier, T. W., Youngstrom, J. K., & Findling, R. L. (2018). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. Journal of Clinical Child & Adolescent Psychology. https://doi.org/https://doi.org/10.1080/15374416.2018.1491006

Self report

Youngstrom, E. A., Perez Algorta, G., Youngstrom, J. K., Frazier, T. W., & Findling, R. L. (2020). Evaluating and Validating GBI Mania and Depression Short Forms for Self-Report of Mood Symptoms. Journal of Clinical Child & Adolescent Psychology, 1-17.

7 Up-7 Down

Youngstrom, E. A., Murray, G., Johnson, S. L., & Findling, R. L. (2013). The 7 Up 7 Down Inventory: A 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory. Psychological Assessment, 25, 1377-1383. https://doi.org/10.1037/a0033975

Sleep scale

Meyers, O. I., & Youngstrom, E. A. (2008). A Parent General Behavior Inventory subscale to measure sleep disturbance in pediatric bipolar disorder. Journal of Clinical Psychiatry, 69, 840-843. https://doi.org/ej07m03594

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