Factor analysis of the adolescent version of the behavioural assessment screening tool (BAST-A) in adolescents with concussion

ABSTRACT

Objective: Develop and validate the Behavioral Assessment Screening Tool for Adolescents with brain injury.

Setting: Concussion clinics

Participants: Adolescents with mild traumatic brain injury 3 months after initial concussion clinic visit (n = 138).

Design: Assessment development and validation (cross-sectional cohort) study

Main Measures: Behavioral Assessment Screening Tool – Adolescent

Results: Expert panel members added or modified items specific to adolescents to the original Behavioral Assessment Screening Tool for adults. The Content Validity Index was 97.2%. Exploratory factor analysis of the Behavioral Assessment Screening Tool – Adolescent reduced the initial 70 items to 46 primary items with a 3-factor solution: Negative Affect & Fatigue, Executive & Social Function, and Risk Behaviors. Internal consistency reliabilities ranged from good to excellent for all factors (Cronbach’s α =.80-.95). We retained four secondary maladaptive coping items (from an initial six), though these require further modification and testing (Cronbach’s α =.67).

Conclusion: The Behavioral Assessment Screening Tool for Adolescents, a measure of neurobehavioral symptoms after mild traumatic brain injury in adolescents, has a multidimensional factor structure with evidence of good internal consistency reliabilities. Future work will further evaluate its convergent and discriminant validity and employ item response theory analyses for validation in a new sample of adolescents with concussion.

KEYWORDS:

• concussion
• brain injuries
• neurobehavioral
• measurement
• psychometrics
• adolescents

Acknowledgments

We would like to acknowledge the contributions of our expert panel members and the adolescents and their families who are part of our ConTex registry.

Declaration of interest

The authors report no conflicts of interest.

Additional information

Funding

This work was supported in part by a grant from the Texas Institute for Brain Injury and Repair (TIBIR), a state-funded initiative as part of the Peter J. O’Donnell Jr. Brain Institute at The University of Texas Southwestern Medical Center and by CTSA NIH Grant UL1TR001105.