The Brief Symptom Inventory-18 (BSI-18: Derogatis, 2000) is an abbreviated version of the nine dimension, 53-item BSI (Derogatis, 1993) which is a shortened form of the 90-item Symptom Checklist-90-Revised (SCL-90-R: Derogatis, 1994). Criticism focused on factor structure (cf. Boulet & Boss, 1991; Ruipérez, Ibáñez, Lorente, Moro, & Ortet, 2001) and the two older versions' poor discriminant validity suggest the scales' usefulness is limited to global scores only. Using principal component analysis, the authors explore the three-dimension factor structure of the BSI - 18 with the understudied population of Central American immigrants to the U.S. (N = 100). Results suggest one underlying factor best used in aggregate as a general screening for overall levels of psychological distress. Cultural differences are discussed.