Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Quality Improvement and Implementation Science
People with traumatic brain injury (TBI) are at risk for negative attribution bias (e.g. disproportionate assignment of hostile intent regarding others’ behaviors), which is associated with elevated anger and aggression. However, best assessment tools for the TBI population are unknown. The goal was to examine convergent validity (attribution-anger and attribution-aggression associations) in two negative attribution measures in participants with TBI and controls.
Design : Criterion Standard.
Setting : Two rehabilitation hospitals that treat TBI.
Participants (or Animals, Specimens, Cadavers) : Eighty-five to105 adults with TBI (minimum of one-year post-injury) and 85-105 healthy controls (HC) frequency matched for age and gender.
Interventions : Not applicable.
Main Outcome Measure(s) :
Attributions (i.e., intent, hostility, blame) and emotional response (i.e. anger) to hypothetical situations were measured with the Ambiguous Intention Hostility Questionnaire (AIHQ) and the Epps’ Scenarios. Trait aggression was assessed with the Buss-Perry Aggression questionnaire (BPAQ).
For the AIHQ measure (n=85/group), attribution-anger associations ranged from .39-.65 (p's
Conclusions : Valid measures for assessing negative attributions are critical due to related anger and aggression after TBI. To-date, the AIHQ has been the recommended measure in non-TBI samples; however, findings from this study suggest that in the TBI population, the Epps measure has stronger convergent validity than the AIHQ. Advantages and disadvantages for research and clinical utility will be discussed.
Noelle Witwer– Medical Student, Indiana University School of Medicine, Indianapolis, Indiana
Darby Dyar– Clinical Study Technician, Indiana University School of Medicine, Indianapolis, Indiana
Susan Perkins– Professor, Indiana University, Indianapolis, Indiana
Flora Hammond– Professor & Chair, Indiana University School of Medicine, Indianapolis, Indiana
Angelle Sander– Associate Professor, Baylor College of Medicine, Houston, Texas
Surya Sruthi Office– Biostatician, IU School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
Dawn Neumann– Associate Professor and Research Director, Indiana University and Rehab Hospital of Indiana, Indianapolis, Indiana