Factor analysis of the Mayo-Portland Adaptability Inventory: structure and validity

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Psychometrics

Background:

• Acquired brain injury (ABI) significantly impacts patient outcomes.
• Understanding the multifactorial nature of ABI is crucial for effective rehabilitation.
• The Mayo-Portland Adaptability Inventory (MPAI) is a key assessment tool.

Purpose of the Study:

• To determine if outcomes following acquired brain injury (ABI) are unifactorial or multifactorial.
• To evaluate the factor structure of the Mayo-Portland Adaptability Inventory (MPAI) in an ABI outpatient sample.
• To propose a refined subscale structure for improved clinical utility.

Main Methods:

• Principal-components (PC) factor analysis was applied to MPAI data from 189 outpatients with ABI.
• Factor scores for 'Cognition' were correlated with neuropsychological measures for validation.
• Patient self-rating scores were used to validate the 'Impaired-Self-awareness/Distress' factor.

Main Results:

• An eight-factor model was derived, explaining 64.4% of the total variance.
• Factors included Activities of Daily Living, Social Initiation, Cognition, Impaired-Self-awareness/Distress, Social Skills/Support, Independence, Visuoperceptual, and Psychiatric domains.
• Validation supported the 'Cognition' and 'Impaired-Self-awareness/Distress' factors, the latter capturing diminished self-awareness or enhanced distress.

Conclusions:

• Acquired brain injury (ABI) outcomes are multifactorial, not unifactorial.
• A new MPAI subscale structure offers enhanced clinical utility for understanding ABI manifestations.
• The proposed reorganization can improve treatment strategy implementation and outcome measurement for ABI patients.