Brief Screening for Mood Instability: Improving the Activation Scale of the Multidimensional Behavioral Health Screen

The Multidimensional Behavioral Health Screen (MBHS; McCord, 2020) is a brief, 29-item self-administered instrument designed for use in high-volume primary medical care settings. It includes nine 3-item scales tapping major core constructs of psychological dysfunction using a hierarchical-dimensional framework, with initial validation based on associations with related, primarily mid-level, scales of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3; Ben-Porath & Tellegen, 2020). A frequent challenge in primary medical care is evaluating for possible mood instability, including underlying hypomania or mania, in cases that present with primarily depressive symptomatology. For this reason, an Activation scale was included on the MBHS. Although the basic psychometric properties of the most recent version of the Activation scale were acceptable, convergent correlation with its target variable on the MMPI-3 (Activation) was the lowest amongst the nine MBHS scales, and discriminant validity was poor. In this paper we describe an effort to address these weaknesses in the development of a revised version of the 3-item Activation scale. Participants in this project were 288 college students with valid MMPI-3 protocols. The revised Activation scale exhibits substantially improved discriminant validity that should support a more precise screening-level indication of the possible presence of mood instability.