Category: Measurement; Brain Injury; Pediatric Rehabilitation
Objective : To examine differences in the factor structure of the Behavioral Assessment Screening Tool (BAST) for adults and the BAST-A for adolescents with traumatic brain injury.
Design : Measurement development
Participants (or Animals, Specimens, Cadavers) : Adolescents (n= 147) with documented concussion and adults (n=110) with a self-reported history of mild to severe TBI.
Interventions : Not applicable
Main Outcome Measure(s) : BAST for adults (>18 years old) with 37 final primary items;1,2a modified BAST (BAST-A) for adolescents (12-20 years old) with 50 final primary items. Wording on select original BAST items was modified and additional items were added that were deemed relevant to adolescents by a panel of experts. Both the BAST and BAST-A underwent pilot testing in their target populations, and final items resulted from Exploratory Factor Analysis.
The BAST resulted in five distinct primary factors: Negative affect, Substance Abuse, Executive Function, Fatigue, and Impulsivity.1,2 The BAST-A for adolescents resulted in three distinct factors: Affect and Fatigue, Executive function, and Risk-taking. The Executive function subscale for both versions was generally composed of the same items. Items related to Substance abuse and Impulsivity in adults factored together in adolescents, indicating more general Risk-taking behaviors. In adolescents, Fatigue and Negative Affect did not differentiate into different factors, with items associated with Fatigue in adults interspersed with items associated with Negative affect.
Conclusions : Behavioral symptoms in adults and adolescents with a history of TBI may qualitatively differ, supporting the need for specifically adapted and validated assessments for behavioral symptoms in each population.
Brittany Wright– Student Researcher, UT Southwestern, Carrollton, Texas
Maria Kajankova– Assistant Professor, Icahn School of Medicine at Mount Sinai, New York, New York
Lauren Terhorst– Associate Professor and Biostatistician, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
Shannon Juengst– Assistant Professor, UT Southwestern, Dallas, Texas