Abstract
Objectives
To develop, for versions completed by individuals with traumatic brain injury (TBI)
and an observer, a more precise metric for the Neuropsychiatric Inventory (NPI) Irritability
and Aggression subscales using all behavioral item ratings for use with individuals
with TBI and to address the dimensionality of the represented behavioral domains.
Design
Rasch and confirmatory factor analyses of retrospective baseline NPI data from 3 treatment
studies.
Setting
Postacute rehabilitation clinic.
Participants
NPI records (N = 525) consisting of observer ratings (n = 287) and self-ratings (n
= 238) by participants with complicated mild, moderate, or severe TBI at least 6 months
postinjury.
Interventions
Not applicable.
Main Outcome Measures
Frequency and severity ratings from NPI Irritability/Lability and Agitation/Aggression
subscales.
Results
Confirmatory factor analyses of both observer and participant ratings showed good
fit for either a 1-factor or a 2-factor solution. Consistent with this, the Rasch
model also fit the data well with aggression items indicating the more severe end
of the construct and irritability items populating the milder end.
Conclusions
Irritability and aggression appear to represent different levels of severity of a
single construct. The derived Rasch metric offers a measure of this construct based
on responses to all specific items that is appropriate for parametric statistical
analysis and may be useful in research and clinical assessments of individuals with
TBI.
Keywords
List of abbreviations:
CFI (comparative fit index), FXS (frequency times severity), NFI (Neurobehavioral Functioning Inventory), NPI (Neuropsychiatric Inventory), PCA (principal component analysis), RMSEA (root mean square error of approximation), TBI (traumatic brain injury), WRMR (weighted root mean square residual)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 13, 2017
Footnotes
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant nos. H133A20016, H133A080035, and 90DP0001-01-01). The NIDILRR is a center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.
Disclosures: F.M. Hammond has a financial relationship with Avanir Steering Committee outside the submitted work. The other authors have nothing to disclose.
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- Minimal Clinically Important Difference for the Rasch Neuropsychiatric Inventory Irritability and Aggression Scale for Traumatic Brain InjuryArchives of Physical Medicine and RehabilitationVol. 99Issue 3
