Multifactor Health Inventory
 (MHI)

The Multifactor Health Inventory (MHI) provides a rapid assessment of a wide variety of stress-related symptoms. Based on a factor analytically-derived study of somatic symptoms, the clinically-validated 111 item questionnaire assesses psychophysiological and psychological symptoms, screens for substance abuse and psychiatric problems, and measures health attitudes and other traits related to outcome and compliance. The MHI is especially useful in providing a quick scan of problem areas and has been employed in multiple settings, including pain assessment, biofeedback, and primary care. The MHI takes only 10 minutes to administer and is an excellent instrument for initial patient evaluation, charting treatment progress, and assessing individual and group outcomes.

The MHI was influenced by the work of Smith and Seidel (1982) who reported on a factor analysis of physical symptoms related to stress. Derived from a pool of 1500 items gleaned from nine questionnaires, from medical and psychiatric texts, and from interview data, the first group of MHI items was developed and grouped by content area to fit 17 of 18 derived factors. New items were written to represent important psychological domains, in addition to some items for assessing neurological symptoms, sexual difficulties, memory problems, and balance difficulties.

Psychological symptoms related to depression, thought disturbance, anxiety, hostility, social discomfort, alcohol dependence, and drug dependence were also added to strengthen the screening capability of the inventory. A limited number of attitude items were also included. One group of items was written to relate to the “Type A” trait described by Friedman and Rosenman (1974) and Friedman (1980), while another group was included which related to one’s sense of personal control in life.

This group includes the concept of locus of control (Hartke and Kunce, 1982) and control over one’s state of health (Wallston, et al, 1976); both are importantly related to treatment outcome. The MHI is grouped into nine major parts. The first three parts follow the grouping of Smith and Seidel, who relied on Whitehead’s theory of psychosomatic symptom development (Whitehead, et al, 1979). Physical symptoms thought not to be obvious to others (without verbal report) and not involving an abrupt onset of pain or discomfort were considered to be “simple stress arousal reactions.” Symptoms that could be highly visible to others without verbal report were thought to be subject to “operant conditioning” effects. Reactions (symptoms) which involved an abrupt onset of pain or discomfort were thought to be subject to “classical conditioning” effects. The first 48 of the Multifactor Health Inventory’s 111 items fall into those divisions (A, B, & C) and represent 16 of the 18 interpretable factors of Smith and Seidel. See reverse for a complete list of symptom groupings and scales.

The MHI runs under our CogShell™ Assessment Environment, an easy-to-use computer interface which allows for the administration and scoring of CogniSyst’s instruments or batteries of our instruments. The CogShell/MHI scoring and administration software provides all of the features and outcome assessment support outlined in the sidebar to the left. The unlimited-use CogShell software includes a patient database which houses demographic data and patient assessment records.

Using repeated administrations of the MHI, our reports calculate, recount and graphically display changes in patients’ scaled scores—excellent for charting patient progress in treatment.