The Katz Adjustment Scale: modification for use with victims of traumatic brain and spinal injury

Although the assessment of the social, emotional and personality sequelae of traumatic injury is of central clinical and medico-legal importance, no satisfactory standard assessment device for this purpose has yet been developed. A multicentered study of a mixed group of head and spinally injured patients is reported. Factor analysis of a modified version of the relatives' form of the Katz Social Adjustment Scale (KAS-R) yielded 30 first-order factors under three main domains of emotional/psychosocial, physical/intellectual and psychiatric changes, together with seven second-order factors which were readily identifiable in terms of syndromes accompanying traumatic injury. Discriminant function analyses indicated that prediction of patient group using KAS-R data was most accurate using the current study's first-order factors as compared with the original factor structure proposed by Katz and Lyerly or the second-order factors from the current analyses. The modified KAS-R shows considerable promise as an instrument for measuring the complex social, emotional and personality changes following traumatic injury, with special significance for assessing brain-injury victims. The representativeness of the current patient sample and implications for future development of the method are discussed.