General Behavior Inventory (GBI)

The General Behavior Inventory (GBI), first developed by Depue et al. (1981), was designed to identify the presence and severity of depressive and manic/hypomanic symptoms, as well as to assess for cyclothymia in adults. In their attempts to explore predisposition to bipolar disorder, the authors created a behavioural paradigm to identify persons at risk. Though intended for use in an adult population, a slightly modified version of the GBI has demonstrated potential as a parent-report measure of mood symptomatology amongst children and adolescents (Youngstrom, Findling, Danielson, & Calabrese, 2001). In addition, a short version has been developed via factor analysis that allows for it to be a screening tool in both adult and adolescent populations (Youngstrom, Murray, Johnson, & Findling, 2016).

The original self-report includes three dimensions, or subscales, that comprise 73 items on which respondents use a 4-point Likert-type scale (0 = never or hardly ever; 3 = very often/almost constantly) to indicate the frequency with which they experience a behaviour over the past year. The Depression scale sums 45 of the items whilst the Hypomanic/Biphasic scales combined sum 28 items. Questions include: “Have you become sad, depressed, or irritable for several days or more without really understanding why?” and “has your mood or energy shifted rapidly back and forth from happy to sad or high to low?” As suggested by Depue, Krauss, and Spoont (1987), the items may be scored using a dichotomous model. This involves dividing the population into cases and non-cases, where those individuals responding 0 or 1 to an item receive 0 points and those responding 2 or 3 to an item receive 1 point. The scale may also be scored in the traditional Likert fashion, where the responses are merely summed. Whilst higher scores reflect increased psychopathology, it is important to note that the GBI is not a diagnostic tool. Research has indicated that the scales can discriminate between bipolar and disruptive behaviour disorders, unipolar and bipolar depression, and mood and disruptive behaviour disorders or no diagnosis (Danielson, Youngstrom, Findling, & Calabrese, 2003).

The GBI has strong psychometric properties. In a recent evaluation study, it demonstrated excellent internal consistency (Cronbach’s ⍺ over .93 for both subscales; Pendergast et al., 2014). Results from the original validation study suggest the tool has good test-retest reliability (r = .73 over 15 weeks), excellent content validity, excellent construct validity, and excellent discriminative validity (Depue et al., 1981). More recent studies have found the GBI to have excellent discriminant validity (Youngstrom, Genzlinger, Egerton, & Van Meter, 2015) and good treatment sensitivity (Youngstrom et al., 2013).

Evidence has shown that gender differences have not compromised the overall psychometric properties of the GBI (Depue & Klein, 1988). However, Chmielewski and colleagues (1995) compared GBI data for African American, Asian American, Caucasian, and Latino samples, and discovered significant cultural differences – Caucasians scored lower than all other groups. Though two decades later, involving a combined Caucasian and African American sample, Pendergast et al. (2015) found that GBI scores were largely invariant across racial groups.

Free access to the GBI: https://cls.unc.edu/files/2014/06/GBI_self_English_v1a.pdf

References

Chmielewski, P. M., Fernandes, L. O., Yee, C. M., & Miller, G. A. (1995). Ethnicity and gender in scales of psychosis proneness and mood disorders. Journal of Abnormal Psychology, 104(3), 464-470. http://doi.org/10.1037/0021-843x.104.3.464

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(1), 29-39. https://doi.org/10.1023/A:1021717231272

Depue, R. A., & Klein, D. N. (1988). Identification of unipolar and bipolar affective conditions in nonclinical and clinical populations by the General Behavior Inventory. In D. L. Dunner, E. S. Gershon, & J. E. Barrett (Eds.), Relatives at risk for mental disorders (pp. 179- 202). New York: Raven Press.

Depue, R. A., Krauss, S., & Spoont, M. R. (1987). A two-dimensional threshold model of seasonal bipolar affective disorder. In D. Magnusson & A. Ohman (Eds.), Psychopathology: An interactional perspective (pp. 95-123). New York: Academic Press.

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.

Pendergast, L. L., Youngstrom, E. A., Brown, C., Jensen, D., Abramson, L. Y., & Alloy, L. B. (2015). Structural invariance of General Behavior Inventory (GBI) scores in Black and White young adults. Psychological Assessment, 27(1), 21-30. http://dx.doi.org/10.1037/pas0000020

Pendergast, L. L., Youngstrom, E. A., Merkitch, K. G., Moore, K. A., Black, C. L., Abramson, L. Y., & Alloy, L. B. (2014). Differentiating bipolar disorder from unipolar depression and ADHD: The utility of the General Behavior Inventory. Psychological Assessment, 26(1), 195-206. http://doi.org/10.1037/a0035138

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(2), 267-276. http://dx.doi.org/10.1037//1040-3590.13.2.267

Youngstrom, E. A., Genzlinger, J. E., Egerton, G, A., & Van Meter, A. R. (2015). Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania. Archives of Scientific Psychology, 3(1), 112-137.

Youngstrom, E. A., Murray, G., Johnson, S. L., & Findling, R. L. (2016). The 7 Up 7 Down Inventory: A 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory. Psychological assessment, 25(4), 1377-1383. http://doi.org/10.1037/a0033975

Youngstrom, E. A., Zhao, J., Mankoski, R., Forbes, R. A., Marcus, R. M., Carson, W., … Findling, R. L. (2013). Clinical significance of treatment effects with aripiprazole versus placebo in a study of manic or mixed episodes associated with pediatric bipolar I disorder. Journal of child and Adolescent Psychopharmacology, 23(2), 72-9. https://dx.doi.org/10.1089%2Fcap.2012.0024