Outcomes

Natalis clinicians may use the Health Dynamics Inventory (HDI) for outcomes measurement. The HDI is a self-report questionnaire for mental health screening and outcomes. It evaluates patients’ symptoms, emotional distress, and degree of impairment. The background questionnaire takes approximately 5 minutes and the core clinical questionnaire takes about 8-10 minutes to complete.

Information for Patients
The HDI is a psychological questionnaire we use to collect information to serve you better. This questionnaire helps us gather information about your personal and family history, previous treatments, and your current problems and functioning. Your responses to this form will be used to guide your treatment, so it is important that you respond to the questions frankly, giving your own opinion of your concerns.

If you are filling out the HDI for a child, the questionnaire will focus on the child’s problems from your point of view. If your adolescent 14 or older is receiving treatment, you will fill out an HDI from your observations (HDI-P), and your adolescent will fill out their own (HDI-S).

Information for Clinicians
The HDI is a 50 item, broadband self-report questionnaire for mental health screening and outcomes. Evaluates the three aspects of mental disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM): (1) experience of emotional or behavioral symptoms that define mental illness, such as dysphoria, worry, angry outbursts, low self-esteem, or excessive drinking, (2) level of emotional distress related to these symptoms, and (3) impairment or problems fulfilling the major roles of one’s life being exhibited.

Validation scale available. Versions for both children (HDI-Parent, normed from 4-19) and adults (HDI-Self Report, normed from 14 through adulthood). Clear comparison between multiple administrations demonstrates change. Teens can report on themselves and also be described with the parent form for comparison.

Reliability
HDI split half reliabilities values of .70 for the Substance Abuse Subscale to .91 for the Depression Subscale. (Alpha .reliabilities of .72 to .95 on all three major scales and all of the subscales).

Validity
The major scales (Distress, Global Symptoms and Global Impairment) distinguish patient and non-patient samples. HDI Morale correlated with MMPI-2 Demoralization at r=.-79 (the expected direction). HDI Depression scale correlated overall with the PHQ-9 scale at .r=52, items range from r=.27 to .66. Norms from a sample of over 2,161 patients and 1,574 nonpatients Factor Structure The three major subscales are associated but also independent. This supports the factor structure of the HDI as a reflection of the three major aspects of mental illness described as the Phase Model. Key Areas Measured Morale/Distress (4 items) Global Symptoms Depressive Symptoms (8 items) Anxiety Symptoms (6 items) Attention Problems (2 items) Psychotic Thinking (4 items) Eating Disorders (4 items) Substance Abuse (4 items) Behavioral Problems (4 items) Global Impairment Occupational/Task Impairment (4 items) Relationship and Social Impairment (4 items) Self-Care Impairment (4 items) Background Information Optional Background Information section collects treatment history, selected health problems, and family psychiatric and addictive history. Needed only at first contact.

Testing Time
Time to complete the Background Questionnaire is approximately 5 minutes. Time to complete the core clinical questionnaire is 8-10 minutes. Hand or computer administration and scoring. Scoring from computer administration is 5 seconds. Measured 6th grade reading level. Computer administered American Spanish version.