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Original Articles

Validating independent ratings of executive functioning following acquired brain injury using Rasch analysis

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Pages 874-889 | Received 01 Feb 2012, Published online: 17 Jul 2012
 

Abstract

Assessment of everyday problems with executive functioning following acquired brain injury (ABI) is greatly valued by neurorehabilitation services. Reliance on self-report measures alone is problematic within this client group who may experience difficulties with awareness and memory. The construct validity and reliability of independent ratings (i.e., ratings provided by a carer/relative) on the Dysexecutive Questionnaire (DEX-I) was explored in this study. Consistent with the results recently reported on the self-rated version of the DEX (DEX-S; Simblett & Bateman, Citation2011), Rasch analysis completed on 271 responses to the DEX-I revealed that the scale did not fit the Rasch model and did not meet the assumption of unidimensionality, that is, a single underlying construct could not be found for the DEX-I that would allow development of an interval-level measure as a whole. Subscales, based on theoretical conceptualisations of executive functioning (Stuss, Citation2007) previously suggested for the DEX-S, were able to demonstrate fit to the Rasch model and unidimensionality. Reliability of independent responses to these subscales in comparison to self-reported ratings is discussed. These results contribute to a greater understanding of how assessment of executive functioning can be improved.

Acknowledgments

This research was carried out as part of a PhD awarded to Sara Simblett by the National Institute of Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) and two doctoral degrees in Clinical Psychology undertaken by Rachel Badham and Kate Greening at the University of East Anglia (funded by Cambridge and Peterborough Foundation Trust). We are grateful to the staff and clients at the Oliver Zangwill centre for providing responses to the measure, making this research possible.

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