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Reliability and Validity of Neurobehavioral Symptom Inventory: A Psychometric Study

Explore the psychometric properties of the Neurobehavioral Symptom Inventory (NSI) in identifying symptoms related to traumatic brain injury (TBI). This study analyzes NSI's internal consistency, external validity, and differentiation ability in veterans. Results indicate NSI's reliability in assessing postconcussive symptoms, albeit influenced by affective disturbances.

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Reliability and Validity of Neurobehavioral Symptom Inventory: A Psychometric Study

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  1. Psychometric study of the Neurobehavioral Symptom Inventory Paul R. King, PhD; Kerry T. Donnelly, PhD; James P. Donnelly, PhD; Mina Dunnam, PhD; Gary Warner, PhD; C. J. Kittleson, PsyD; Charles B. Bradshaw, PhD; Michelle Alt, MA; Scott T. Meier, PhD

  2. Aim • Examine Neurobehavioral Symptom Inventory’s (NSI’s) psychometric properties. • Relevance • Recent studies raised questions about NSI’s ability to accurately identify symptoms uniquely associated with traumatic brain injury (TBI).

  3. Methods • Clarified NSI’s psychometric properties: • Item analysis; internal consistency; external validity relative to TBI, posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD). • Data from 500 Operations Iraqi/Enduring Freedom veterans in upstate NY. • Measures: • Neuropsychological interview, NSI, Beck Anxiety Inventory, Beck Depression Inventory-II, and PTSD Checklist-Military Version.

  4. Results • NSI demonstrated high internal consistency: • Total alpha = 0.95. • Subscale alpha = 0.88 to 0.92. • Subscale totals based on Caplan et al.’s factor analysis correlated highly with NSI total score: • r = 0.88 to 0.93. • NSI scores differentiated veterans with vs without TBI history. • Were strongly influenced by variance associated with probable PTSD, depression, and GAD.

  5. Conclusions • NSI appears to be reliable and valid measure of postconcussive symptoms. • However, significant affective disturbance has potential—if not likelihood—to inflate ratings of postconcussive symptoms in noninjured controls and veterans with history of TBI even many years after injury, long after we might expect true postconcussive symptoms to have resolved.

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