CDE Detailed Report

Disease: Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage
Sub-Domain: [php]
CRF: Neurobehavioral Symptom Inventory (NSI)

Displaying 1 - 26 of 26
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C07334 Neurobehavioral Symptom Inventory (NSI) - Taste impairment score NSITastImprmntScore Score of subject's taste impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's taste impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Change in taste and or smell 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07345 Neurobehavioral Symptom Inventory (NSI) - Frustration impairment score NSIFrustrtnImprmntScore Score of subject's frustration tolerance, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's frustration tolerance, as part of the Neurobehavioral Symptom Inventory (NSI) Poor frustration tolerance feeling easily overwhelmed by things 0;1;2;3;4 None - rarely if ever present, not a problem at all;Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07324 Neurobehavioral Symptom Inventory (NSI) - Dizzy score NSIDizScore Score of subject's dizziness, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's dizziness, as part of the Neurobehavioral Symptom Inventory (NSI) Feeling Dizzy 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07335 Neurobehavioral Symptom Inventory (NSI) - Appetite impairment score NSIApptitImprmntScore Score of subject's appetite impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's appetite impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Loss of appetite or increased appetite 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07350 Neurobehavioral Symptom Inventory (NSI) - Total score NSITotalScore Total Score for the Neurobehavioral Symptom Inventory (NSI) (0-88) Total Score for the Neurobehavioral Symptom Inventory (NSI) (0-88) Numeric Values

Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Free-Form Entry

0 88
C07325 Neurobehavioral Symptom Inventory (NSI) - Balance impairment score NSIBalncImprmntScore Score of subject's loss of balance, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's loss of balance, as part of the Neurobehavioral Symptom Inventory (NSI) Loss of balance 0;1;2;3;4 None - rarely if ever present, not a problem at all;Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07336 Neurobehavioral Symptom Inventory (NSI) - Concentration impairment score NSIConctrtnImprmntScore Score of subject's concentration impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's concentration impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Poor concentration cant pay attention easily distracted 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C18489 Neurobehavioral Symptom Inventory (NSI) - Form completion name NSIFrmCompltNm Name of the person who completed the form, as part of the Neurobehavioral Symptom Inventory (NSI) Name of the person who completed the form, as part of the Neurobehavioral Symptom Inventory (NSI) Name Alphanumeric

Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Neurobehavioral Symptom Inventory (NSI) [php] [php_1] 255

Free-Form Entry

C07326 Neurobehavioral Symptom Inventory (NSI) - Coordination impairment score NSICoordntnImprmntScore Score of subject's coordination impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's coordination impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Poor coordination clumsy 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07337 Neurobehavioral Symptom Inventory (NSI) - Memory impairment score NSIMmryImprmntScore Score of subject's memory impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's memory impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Forgetfulness cant remember things 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C18490 Neurobehavioral Symptom Inventory (NSI) - Form completion date NSIFrmCompltDate Date of form completion, as part of the Neurobehavioral Symptom Inventory (NSI) Date of form completion, as part of the Neurobehavioral Symptom Inventory (NSI) Date Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Free-Form Entry

C07327 Neurobehavioral Symptom Inventory (NSI) - Headaches score NSIHdcheScore Score of subject's headache, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's headache, as part of the Neurobehavioral Symptom Inventory (NSI) Headaches 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07338 Neurobehavioral Symptom Inventory (NSI) - Decision impairment score NSIDecsnImprmntScore Score of subject's indecisiveness, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's indecisiveness, as part of the Neurobehavioral Symptom Inventory (NSI) Difficulty making decisions 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C18491 Neurobehavioral Symptom Inventory (NSI) - Medical record number NSIMedRecrdNum Medical record number of the form completion, as part of the Neurobehavioral Symptom Inventory (NSI) Medical record number of the form completion, as part of the Neurobehavioral Symptom Inventory (NSI) Medical Record Numeric Values

Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Free-Form Entry

C07328 Neurobehavioral Symptom Inventory (NSI) - Nausea score NSINausScore Score of subject's nausea, as part of the Neurobehavioral Symptom Inventory (NSI) Nausea Nausea 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07339 Neurobehavioral Symptom Inventory (NSI) - Slow thinking impairment score NSISlwThnkngImprmntScore Score of subject's slow thinking impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's slow thinking impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Slowed thinking difficulty getting organized cant finish things 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07329 Neurobehavioral Symptom Inventory (NSI) - Vision impairment score NSIVisnImprmntScore Score of subject's vision impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's vision impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Vision problem blurring troubling seeing 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07340 Neurobehavioral Symptom Inventory (NSI) - Fatigue impairment score NSIFatigImprmntScore Score of subject's fatigue, loss of energy and getting tired easily, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's fatigue, loss of energy and getting tired easily, as part of the Neurobehavioral Symptom Inventory (NSI) Fatigue loss of energy getting tired easily 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07330 Neurobehavioral Symptom Inventory (NSI) - Sensitive light score NSISenstvLgtScore Score of subject's sensitivity to light, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's sensitivity to light, as part of the Neurobehavioral Symptom Inventory (NSI) Sensitivity to light 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score.

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07341 Neurobehavioral Symptom Inventory (NSI) - Sleep impairment score NSISlpImprmntScore Score of subject's sleep impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's sleep impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Difficulty falling or staying asleep 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07331 Neurobehavioral Symptom Inventory (NSI) - Hearing impairment score NSIHearngImprmntScore Score of subject's hearing impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's hearing impairment, as part of the Neurobehavioral Symptom Inventory (NSI) Hearing difficulty 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07342 Neurobehavioral Symptom Inventory (NSI) - Anxiety impairment score NSIAnxtyImprmntScore Score of subject's anxiety , as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's anxiety , as part of the Neurobehavioral Symptom Inventory (NSI) Feeling anxious or tense 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07332 Neurobehavioral Symptom Inventory (NSI) - Sensitive noise score NSiSenstvNoisScore Score of subject's sensitivity to noise, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's sensitivity to noise, as part of the Neurobehavioral Symptom Inventory (NSI) Sensitivity to noise 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07343 Neurobehavioral Symptom Inventory (NSI) - Depression impairment score NSIDeprsnImprmntScore Score of subject's depression , as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's depression , as part of the Neurobehavioral Symptom Inventory (NSI) Feeling depressed or sad 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07333 Neurobehavioral Symptom Inventory (NSI) - Numbness impairment score NSINumbnssImprmntScore Score of subject's numbness or tingling on parts of the body, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's numbness or tingling on parts of the body, as part of the Neurobehavioral Symptom Inventory (NSI) Numbness or tingling on parts of my body 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

C07344 Neurobehavioral Symptom Inventory (NSI) - Irritability impairment score NSIIrrabltyImprmntScore Score of subject's irritability, as part of the Neurobehavioral Symptom Inventory (NSI) Score of subject's irritability, as part of the Neurobehavioral Symptom Inventory (NSI) Irritability easily annoyed 0;1;2;3;4 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help Numeric Values

See the instructions on the form

Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. Adult Supplemental 3.00 2013-07-19 21:21:51.533 Neurobehavioral Symptom Inventory (NSI) [php] [php_1]

Single Pre-Defined Value Selected

CSV