BIS–15 cut-off scores 1

Cut-off scores for the Barratt Impulsiveness Scale–short form (BIS–15): sense and nonsense

Adrian Meule1,2

1
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich,

Germany

2
Schoen Clinic Roseneck, Prien am Chiemsee, Germany

Correspondence:

Adrian Meule, PhD

Schön Klinik Roseneck

Am Roseneck 6

83209 Prien am Chiemsee, Germany

Email: ameule@med.lmu.de
 BIS–15 cut-off scores 2

Introduction

The Barratt Impulsiveness Scale–short form (BIS–15) is a self-report questionnaire for

the assessment of impulsivity as a trait (Spinella, 2007). It is an abbreviated version of the 30-

item BIS–11 (Patton et al., 1995; Stanford et al., 2009). Note that the name of the BIS–15

refers to the number of items (i.e., 15 items) whereas the name of the BIS–11 refers to the

number of revisions (i.e., the 11th version of the BIS). Complicating matters, there are also

other short versions of the BIS–11 (e.g., the BIS–Brief; Steinberg et al., 2013) and even

another short version entitled BIS–15 (Maggi et al., 2022) although items of this version only

partially overlap with the BIS–15 by Spinella (2007).

The English item wordings can be found in Table 3 in the article by Spinella (2007)

and the German version can be accessed at https://adrianmeule.wordpress.com/resources. The

scale has also been translated into some other languages such as French, Spanish, Thai, and

Kannada (Bhat et al., 2018; Juneja et al., 2019; Orozco-Cabal et al., 2010; Ram et al., 2019;

Rousselle & Vigneau, 2016). Responses are recorded on a four-point scale with 1 =

rarely/never, 2 = occasionally, 3 = often, and 4 = almost always/always. Responses to six

items are inversely coded, that is, need to be recoded as 1=4, 2=3, 3=2, and 4=1.1 All items

are then summed up to a total score that can range between 15 and 60. Subscale scores can

also be calculated but I will focus only on the total score in this manuscript. I have received

several requests by researchers and practitioners that have asked me what cut-off score the

BIS–15 has. The answer is that is does not have one. In the following, I will try to answer

why that is, why it is probably not necessary to have one, and which scores may still be

considered as “high”.

Why does the BIS–15 not have a cut-off score?

A cut-off score usually is a score of a questionnaire that discriminates best between a

condition and the absence of this condition. For example, a researcher might have a sample of

1
Note that these items are “I plan for job security.”, “I plan for the future.”, “I save regularly.”, “I plan tasks carefully.”, “I am a careful
thinker.”, and “I concentrate easily.”. Endorsing these statements speaks for a low impulsivity and, thus, these item responses need
to be reverse coded. In Table 3 in the article by Spinella (2007), the item “I act on impulse.” is erroneously denoted as inverted item.
 BIS–15 cut-off scores 3

persons with and without depression (identified by a structured clinical interview) who

complete a self-report questionnaire that measures depressive symptoms. This researcher

might then use Receiver Operating Characteristic analysis (cf. Altman & Bland, 1994) for

determining sensitivity and specificity of different questionnaire scores for discriminating

between those with vs. without depression. A “cut-off score” can then be derived for which

both sensitivity and specificity are sufficiently high so when a person scores higher than this

score, it is quite likely that this person actually has depression.

Although higher impulsivity relates to a range of dysfunctional behaviors (e.g., binge

eating, substance use, suicidal and non-suicidal self-injury; Moeller et al., 2001; Stanford et

al., 2009), impulsivity itself is not a mental disorder. That is, being impulsive is not

pathological per se or, in other words, a person might have high scores on the BIS–15 but still

has no impairment or distress in daily life. Similarly, there is no objective, universal way to

classify persons into those with “clinically relevant” or “pathological” impulsivity and

“normal” impulsivity. Without such a clear categorization, it is not possible to determine a

cut-off score of an impulsivity questionnaire because there is no criterion variable that could

be predicted from the questionnaire’s scores.

Why is it not necessary to use a cut-off score?

Questionnaire scores are continuous in nature. For the BIS–15, higher scores indicate

higher impulsivity and lower scores indicate lower impulsivity but any categorization into

groups (e.g., persons with low vs. high impulsivity based on a certain score) would be

artificial and arbitrary. Although researchers are often tempted to categorize their sample that

way, it has been noted for decades that this has numerous disadvantages such as loss of

information about individual differences, loss of effect size and power or spurious statistical

significance and overestimation of effect size, the potential to overlook non-linear

relationships, and loss of measurement reliability (MacCallum et al., 2002; Maxwell &
 BIS–15 cut-off scores 4

Delaney, 1993; McClelland et al., 2015; Rucker et al., 2015). What researchers are usually

interested in is how impulsivity relates other variables of interest, for example, if certain

groups differ in impulsivity, if impulsivity correlates with another variable, if impulsivity

predicts changes of another variable over time, or if impulsivity itself changes over time. All

these research questions can be answered by using BIS–15 scores as continuous variable in

the statistical analyses—a categorization into certain groups with different levels of

impulsivity is not needed.

Which scores may be considered as “high”?

Although I strongly discourage researchers from artificially categorizing BIS–15

scores and instead strongly encourage using them as continuous variable, I realize that some

researchers might still be interested in which BIS–15 scores may be considered as indicating

“high impulsivity” and which represent “average impulsivity” for the purpose of describing

their sample. This might also be relevant for practitioners who use the BIS–15 at the

beginning of or during therapy and need to evaluate the score of a single patient. While a cut-

off score cannot be derived for the BIS–15 for the reasons described above, it might still be

helpful to examine the descriptive statistics (means and standard deviations) in different

samples. Table 1 lists 18 studies with 26 samples in which the BIS–15 was used. Mean sum

scores ranged between 29 and 42 in all samples. Of note, it seems that in samples for which it

would be expected that persons have at least some elevated impulsivity levels (i.e., persons

with bulimia nervosa/binge eating disorder, bipolar disorder, substance use disorder, and

suicide attempts), mean sum scores were 34 or higher while they were 34 or lower in all other

samples.

Does this indicate that 34 should be considered a possible cut-off score? Probably not

because the standard deviation needs to be considered as well. Averaging the numbers in

Table 1 results in an overall mean sum score of 33 and a mean standard deviation of 7.
 BIS–15 cut-off scores 5

Averaging the scores of the samples with persons with bulimia nervosa/binge eating disorder,

bipolar disorder, substance use disorder, and suicide attempts results in a mean sum score of

37 with a standard deviation of 7. Averaging the scores of all other samples results in a mean

sum score of 32 with a standard deviation of 7. So, it seems that a standard deviation of 7 is a

quite good estimate of the usual standard deviation of BIS–15 sum scores.

One approach to approximate a “threshold” for the BIS–15 may be to consider a score

that equals two standard deviations above the mean. When assuming that a score of M + 2SD

in the samples with “low” or “average” impulsivity (both terms make little sense here, of

course, but I’m referring to the samples other than those with persons with bulimia

nervosa/binge eating disorder, bipolar disorder, substance use disorder, and suicide attempts)

represents noticeably elevated impulsivity levels, this would be a score of 32 + (2 × 7) = 46.

Now recall that response categories range from 1 to 4, so a sum score of 45 indicates that a

person has, on average, selected “3 = often” for each statement (15 × 3 = 45) and, thus, has a

tendency to somewhat endorse each item. Therefore, it probably makes sense to denote such a

person as having impulsive tendencies.

Now, where do we go from here? My suggestion would be to interpret BIS–15 sum

scores higher than 39 (M + 1SD = 32 + 7), that is, scores of 40–45 as “moderately impulsive”

and scores higher than 45, that is, scores of 46–60 as “markedly impulsive”. Although scores

of, for example, 35–39 correspond to the mean sum scores in samples of persons with bulimia

nervosa/binge eating disorder, bipolar disorder, substance use disorder, and suicide attempts,

they should probably not be interpreted as high impulsivity (when interpreting such a score

for a single person) as they still fall within the range of M + 1SD from the other samples. This

again makes sense when considering the response categories of the scale. For example, a

person who has a total score of 37 may have somewhat endorsed seven items by selecting “3
 BIS–15 cut-off scores 6

= often” (7 × 3 = 21) but somewhat not endorsed eight items by selecting “2 = occasionally”

(8 × 2 = 16) and, thus, does not have an overall tendency to endorse the items.

Conclusions and caveats

I suggest that sum scores of the BIS–15 of approximately 40–45 may be interpreted as

“moderately impulsive” and scores higher than 45 as “markedly impulsive”. Now imagine a

fictitious example when a researcher might compare a group of persons A with a mean sum

score of 30 with a group of persons B with a mean sum score of 35 and let’s assume that these

values are significantly different based on an independent samples t-test. This researcher then

concludes that group B is more impulsive than group A. Or consider another example in

which higher BIS–15 total scores are significantly correlated with some other variable X but

the scores in this sample may only range between 15 and 39. In these examples, my

recommendation may be mistaken by stating that “while group B had higher impulsivity

scores than group A, they were still not really impulsive” or “although impulsivity correlated

with X, there actually were no impulsive persons in this sample”. Both of these statements

would be absurd as the absolute values of the BIS–15 do not really matter when interpreting

such analyses. Thus, I would like to reiterate that in almost all instances, it is preferable to use

BIS–15 scores as continuous variable and avoid any categorization of these scores into

persons with “low” or “high” impulsivity.

 BIS–15 cut-off scores 7

References

Altman, D. G., & Bland, J. M. (1994). Statistics Notes: Diagnostic tests 3: receiver operating

characteristic plots. BMJ, 309(6948), 188. https://doi.org/10.1136/bmj.309.6948.188

Bhat, N. A., Roopesh, B. N., Bhaskarapillai, B., & Benegal, V. (2018). Validation of the

Barratt Impulsiveness Scale- short form among Indian adolescents. Asian Journal of

Psychiatry, 37, 172–177. https://doi.org/10.1016/j.ajp.2018.10.009

de Vries, S.-K., & Meule, A. (2016). Food addiction and bulimia nervosa: New data based on

the Yale Food Addiction Scale 2.0. European Eating Disorders Review, 24, 518–

522. https://doi.org/10.1002/erv.2470

Juneja, R., Chaiwong, W., Siripool, P., Mahapol, K., Wiriya, T., Shannon, J. S., Petchkrua,

W., Kunanusont, C., & Marriott, L. K. (2019). Thai adaptation and reliability of three

versions of the Barratt Impulsiveness Scale (BIS 11, BIS-15, and BIS-Brief).

Psychiatry Research, 272, 744–755. https://doi.org/10.1016/j.psychres.2018.12.173

MacCallum, R. C., Zhang, S., Preacher, K. J., & Rucker, D. D. (2002). On the practice of

dichotomization of quantitative variables. Psychological Methods, 7, 19–

40. https://doi.org/10.1037//1082-989X.7.1.19

Maggi, G., Altieri, M., Ilardi, C. R., & Santangelo, G. (2022). Validation of a short Italian

version of the Barratt Impulsiveness Scale (BIS-15) in non-clinical subjects:

psychometric properties and normative data. Neurological Sciences, 43(8), 4719–

4727. https://doi.org/10.1007/s10072-022-06047-2

Maxwell, S. E., & Delaney, H. D. (1993). Bivariate median splits and spurious statistical

significance. Psychological Bulletin, 113, 181–190. https://doi.org/10.1037/0033-

2909.113.1.181

McClelland, G. H., Lynch, J. G., Irwin, J. R., Spiller, S. A., & Fitzsimons, G. J. (2015).

Median splits, Type II errors, and false–positive consumer psychology: Don't fight the
 BIS–15 cut-off scores 8

power. Journal of Consumer Psychology, 25, 679–

689. https://doi.org/10.1016/j.jcps.2015.05.006

Meule, A., Heckel, D., Jurowich, C. F., Vögele, C., & Kübler, A. (2014). Correlates of food

addiction in obese individuals seeking bariatric surgery. Clinical Obesity, 4(4), 228–

236. https://doi.org/10.1111/cob.12065

Meule, A., Hermann, T., & Kübler, A. (2014). A short version of the Food Cravings

Questionnaire—Trait: the FCQ-T-reduced. Frontiers in Psychology, 5(190), 1–

10. https://doi.org/10.3389/fpsyg.2014.00190

Meule, A., Hermann, T., & Kübler, A. (2015). Food addiction in overweight and obese

adolescents seeking weight-loss treatment. European Eating Disorders Review, 23(3),

193–198. https://doi.org/10.1002/erv.2355

Meule, A., Hofmann, J., Weghuber, D., & Blechert, J. (2016). Impulsivity, perceived self-

regulatory success in dieting, and body mass in children and adolescents: A moderated

mediation model. Appetite, 107, 15–20. https://doi.org/10.1016/j.appet.2016.07.022

Meule, A., & Kübler, A. (2014). Double trouble. Trait food craving and impulsivity

interactively predict food-cue affected behavioral inhibition. Appetite, 79, 174–

182. https://doi.org/10.1016/j.appet.2014.04.014

Meule, A., Mayerhofer, M., Gründel, T., Berker, J., Beck Teran, C., & Platte, P. (2015). Half-

year retest-reliability of the Barratt Impulsiveness Scale–Short Form (BIS-15). SAGE

Open, 5(1), 1–3. https://doi.org/10.1177/2158244015576548

Meule, A., Michalek, S., Friederich, H.-C., & Brockmeyer, T. (2020). Confirmatory factor

analysis of the Barratt Impulsiveness Scale–short form (BIS–15) in patients with

mental disorders. Psychiatry Research, 284,

112665. https://doi.org/10.1016/j.psychres.2019.112665

Meule, A., Müller, A., Gearhardt, A. N., & Blechert, J. (2017). German version of the Yale

Food Addiction Scale 2.0: Prevalence and correlates of ‘food addiction’ in students
 BIS–15 cut-off scores 9

and obese individuals. Appetite, 115, 54–

61. https://doi.org/10.1016/j.appet.2016.10.003

Meule, A., Reichenberger, J., & Blechert, J. (2018). Development and preliminary validation

of the Salzburg Stress Eating Scale. Appetite, 120, 442–

448. https://doi.org/10.1016/j.appet.2017.10.003

Meule, A., Vögele, C., & Kübler, A. (2011). Psychometric evaluation of the German Barratt

Impulsiveness Scale – Short Version (BIS-15). Diagnostica, 57, 126–

133. https://doi.org/10.1026/0012-1924/a000042

Moeller, F. G., Barratt, E. S., Dougherty, D. M., Schmitz, J. M., & Swann, A. C. (2001).

Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158, 1783–

1793. https://doi.org/10.1176/appi.ajp.158.11.1783

Orozco-Cabal, L., Rodríguez, M., Herin, D. V., Gempeler, J., & Uribe, M. (2010). Validity

and reliability of the abbreviated Barratt Impulsiveness Scale in Spanish (BIS-15S).

Revista Colombiana de Psiquiatría, 39, 93–109. https://doi.org/10.1016/S0034-

7450(14)60239-0

Paashaus, L., Forkmann, T., Glaesmer, H., Juckel, G., Rath, D., Schönfelder, A., & Teismann,

T. (2021). From decision to action: suicidal history and time between decision to die

and actual suicide attempt. Clinical Psychology & Psychotherapy, 28(6), 1427–

1434. https://doi.org/10.1002/cpp.2580

Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt

Impulsiveness Scale. Journal of Clinical Psychology, 51, 768–

774. https://doi.org/10.1002/1097-4679(199511)51:6<768::Aid-

jclp2270510607>3.0.Co;2-1

Ram, D., Chandran, S., Sadar, A., & Gowdappa, B. (2019). Correlation of cognitive

resilience, cognitive flexibility and impulsivity in attempted suicide. Indian Journal of

 BIS–15 cut-off scores 10

Psychological Medicine, 41(4), 362–

367. https://doi.org/10.4103/ijpsym.Ijpsym_189_18

Rousselle, P., & Vigneau, F. (2016). Adaptation and validation of a French-language short

version of the Barratt Impulsiveness Scale (BIS-15). European Review of Applied

Psychology, 66(6), 317–324. https://doi.org/10.1016/j.erap.2016.05.001

Rucker, D. D., McShane, B. B., & Preacher, K. J. (2015). A researcher's guide to regression,

discretization, and median splits of continuous variables. Journal of Consumer

Psychology, 25, 666–678. https://doi.org/10.1016/j.jcps.2015.04.004

Spinella, M. (2007). Normative data and a short form of the Barratt Impulsiveness Scale.

International Journal of Neuroscience, 117, 359–

368. https://doi.org/10.1080/00207450600588881

Stanford, M. S., Mathias, C. W., Dougherty, D. M., Lake, S. L., Anderson, N. E., & Patton, J.

H. (2009). Fifty years of the Barratt Impulsiveness Scale: An update and review.

Personality and Individual Differences, 47, 385–

395. https://doi.org/10.1016/j.paid.2009.04.008

Steinberg, L., Sharp, C., Stanford, M. S., & Tharp, A. T. (2013). New tricks for an old

measure: The developement of the Barratt Impulsiveness Scale–Brief (BIS-Brief).

Psychological Assessment, 25, 216–226. https://doi.org/10.1037/a0030550

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Table 1

Means and standard deviations of the BIS–15 total score in different studies

Reference Country Sample M SD

Description n Age (M) Sex (% female)
Bhat et al. (2018) India Adolescents 1806 17 48 34 7
de Vries and Meule (2016) Germany Convenience 341 26 100 31 6
Bulimia nervosa 115 26 100 36 8
Juneja et al. (2019) Thailand Convenience 305 33 50 29 6
Meule et al. (2011) Germany Convenience 752 23 77 30 6
Meule and Kübler (2014) Germany Students 55 24 100 33 6
Meule, Heckel, et al. (2014) Germany Bariatric surgery candidates with obesity 96 40 66 32 7
Meule, Hermann, et al. (2014) Germany Students 70 22 100 33 5
Meule, Hermann, et al. (2015) Germany Adolescents with obesity 50 17 62 34 10
Meule, Mayerhofer, et al. (2015) Germany Students 133 20 100 32 5
Meule et al. (2016) Austria Children/Adolescents 122 14 52 33 10
Meule et al. (2017) Germany Convenience 455 26 89 31 7
Bariatric surgery candidates with obesity 138 40 78 30 6
Meule et al. (2018) Germany/Austria Convenience 340 24 77 31 8
Meule et al. (2020) Germany Mental disorders (56% depression) 453 38 64 33 8
Orozco-Cabal et al. (2010) Colombia Students 283 20 N/A 31 6
Anorexia nervosa 33 22 N/A 31 7
Bulimia nervosa/Binge eating disorder 57 24 N/A 34 8
Anxiety disorders 27 31 N/A 32 8
Bipolar disorder 32 30 N/A 37 8
Substance use disorder 15 26 N/A 42 9
Paashaus et al. (2021) Germany Suicide attempters 118 39 63 36 8
Ram et al. (2019) India Suicide attempters 270 41 31 36 2
Rousselle and Vigneau (2016) Canada Students 366 20 65 31 5
Spinella (2007) USA Convenience (Study 1) 700 29 60 33 7
Convenience (Study 2) 100 27 49 33 7
Notes. Numbers are rounded to integers to facilitate readability.