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Development and validation of a tool for the assessment of psychiatric disability in patients with traumatic brain
Deenu Chacko1, Sandeep Alex2, K Vidhukumar3
1Department of Psychiatry, Government Medical College, Ernakulam, Kerala, India.
Background:
Generic instruments recommended for disability assessment are not useful in delineating the exact contribution of psychiatric disability to total disability following traumatic brain injury (TBI).
Aim:
To develop and validate a tool to assess psychiatric disability due to the behavioral and cognitive impairments following TBI, named the Cognitive and Behavioral Inventory (CBI).
Methods:
The study was conducted in a tertiary care hospital in South India. The development of the tool was performed after a thorough literature search and discussions with experts. The face, content, and linguistic validity of the tool were established. Criterion validity was established by correlation with the Montreal Cognitive Assessment (MoCA) and Neuropsychiatry Inventory Questionnaire (NPI-Q) for cognitive and behavioral domains, respectively. The Intraclass correlation was calculated to assess the inter-rater reliability.
Results:
The item-level content validity index of the tool ranged from 1 to 0.86. The scale-level content validity index, calculated using the averaging and universal agreement method, was 0.97 and 0.88, respectively. The point estimate of criterion validity assessed using Pearson's correlation coefficient for the cognitive domain of the tool with MoCA was 0.87, and the behavioral domain of the tool with NPI-Q was 0.79. The intraclass correlation coefficients for the full scale, behavioral domain, and cognitive domain were all 0.99.
Conclusion:
CBI is a tool with high face, content, linguistic, and criterion validity, as well as good interrater reliability. It can be used to assess the behavioral and cognitive impairments following TBI, and thus psychiatric disability, in a very short time by a clinician.
