Assessing the biopsychosociospiritual model in primary care: development of the biopsychosociospiritual inventory (BioPSSI)

Int J Psychiatry Med. 2007;37(4):393-414. doi: 10.2190/PM.37.4.d.


Objective: There is growing evidence in support of the Biopsychosociospiritual Model. However, a cohesive instrument to measure each dimension in terms of its dimension-specific symptoms and functional status does not exist, serving as an obstacle to future research in this area. The purpose of this study was to develop and validate an instrument to measure each dimension in terms of its dimension-specific symptoms, appraisals, and functional status in an unselected group of primary care patients.

Method: An instrument that assessed biopsychosociospiritual symptoms and function and health outcomes was administered to 289 patients attending two primary care clinics. Responses were analyzed using principal component factor analysis with Equimax rotation. This led to the development of five Biopsychosociospiritual Inventory scales (impaired functional status, physical symptoms, psychological symptoms, social symptoms, and spiritual symptoms). Demographic differences in mean scale scores were sought. In addition to internal consistency, construct validity was assessed based upon dimension-specific health care utilization, life satisfaction, and perceived health status.

Results: All five scales had excellent internal consistency (alpha > 0.8) and construct validity. Differences were strongly related to income, marital status, and employment in a manner consistent with previous research.

Conclusions: This study developed and validated the Biopsychosociospiritual Inventory which could potentially provide a holistic estimate of the impact of disease and its treatment, support research in this area, and lead to the expansion of classification systems that include spirituality. Further validation of this instrument in other primary care sites using diverse patient populations as well as its function over time is needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology
  • Adolescent
  • Adult
  • Comorbidity
  • Female
  • Holistic Health
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology
  • Mental Disorders / therapy
  • Middle Aged
  • Outcome Assessment, Health Care
  • Personality Inventory / statistics & numerical data*
  • Primary Health Care*
  • Psychometrics / statistics & numerical data
  • Quality of Life / psychology
  • Reproducibility of Results
  • Social Adjustment*
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / psychology
  • Somatoform Disorders / therapy
  • Spirituality*
  • Texas
  • Treatment Outcome