CDE Detailed Report

Disease: Sport-Related Concussion
Subdomain Name: Behavioral Function
CRF: Frontal Systems Behavioral Scale (FrSBe)

Displaying 51 - 63 of 63
CDE ID CDE Name Variable Name Definition Short Description 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 / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C21044 Frontal Systems Behavior Scale (FrSBE) - Activity spontaneous involvement frequency scale FrSBeSpontaneousActivitiesFreq Frequency of getting involved with activities spontaneously (such as hobbies) as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of getting involved with activities spontaneously (such as hobbies) as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Gets involved with activities spontaneously (such as hobbies) 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C20998 Frontal Systems Behavior Scale (FrSBE) - Action not agree with description frequency scale FrSBeSayOneThingDoAnotherFreq Frequency of saying one thing, then doing another thing as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of saying one thing, then doing another thing as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Says one thing, then does another thing 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21069 Frontal Systems Behavior Scale (FrSBE) - Apathy subscale raw score FrSBeApathyRawScore Raw score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) Raw score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) Apathy subscale raw score Numeric Values

Transfer each circled item score from the Before Illness or injury column to the corresponding shaded box in the BEFORE column. Transfer each circled item score from the After illness or injury column to the corresponding shaded box in the AFTER column. Sum the scores for each subscale (A, D, and E) and enter the total in the space provided at the bottom of each column.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Free-Form Entry

14 70
C21022 Frontal Systems Behavior Scale (FrSBE) - Swearing frequency scale FrSBeSwearingFreqScl Frequency of swearing as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of swearing as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Swears 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21097 Frontal Systems Behavior Scale (FrSBE) - Missing answer D count FrSBeMissingItemsScaleDCount Count of unanswered or missing questions for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) form Count of unanswered or missing questions for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions subscale D count Numeric Values

Examine the scoring sheet and circle the item number of each item that was left unanswered. An item should be counted as unanswered (missing) if either one or both of the responses (i.e., "Before illness or injury" or "After illness or injury") is missing. Count the number of circled item numbers and write the total number of missing items in the space provided at the bottom of page 3 of the scoring sheet.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Free-Form Entry

0 46
C20974 Frontal Systems Behavior Scale (FrSBE) - Problem deny unaware frequency scale FrSBeDeniesHavingProbsFreq Frequency of denying having problems or is unaware of problems or mistakes as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of denying having problems or is unaware of problems or mistakes as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Denies having problems or is unaware of problems or mistakes 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21046 Frontal Systems Behavior Scale (FrSBE) - Action without other people request frequency scale FrSBeDoesWithoutRequestFreq Frequency of doing things without being requested to do so as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of doing things without being requested to do so as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Does things without being requested to do so 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21002 Frontal Systems Behavior Scale (FrSBE) - Unable finish task frequency scale FrSBeStartNotFinishThingsFreq Frequency of starting things but failing to finish them as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of starting things but failing to finish them as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Starts things but fails to finish them, "peters out" 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21071 Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale raw score FrSBeDisinhibitionRawScore Raw score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) Raw score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) Disinhibition subscale raw score Numeric Values

Transfer each circled item score from the Before Illness or injury column to the corresponding shaded box in the BEFORE column. Transfer each circled item score from the After illness or injury column to the corresponding shaded box in the AFTER column. Sum the scores for each subscale (A, D, and E) and enter the total in the space provided at the bottom of each column.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Free-Form Entry

15 75
C21024 Frontal Systems Behavior Scale (FrSBE) - Misbehavior apology frequency scale FrSBeApologizeWhenMisbehavFreq Frequency of apologizing for misbehaviour (for example, apologizes for swearing) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of apologizing for misbehaviour (for example, apologizes for swearing) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Apologizes for misbehavior (for example, apologizes for swearing) 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21099 Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale E count FrSBeMissingItemsScaleECount Count of unanswered or missing questions for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) form Count of unanswered or missing questions for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions subscale E count Numeric Values

Examine the scoring sheet and circle the item number of each item that was left unanswered. An item should be counted as unanswered (missing) if either one or both of the responses (i.e., "Before illness or injury" or "After illness or injury") is missing. Count the number of circled item numbers and write the total number of missing items in the space provided at the bottom of page 3 of the scoring sheet.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Free-Form Entry

0 46
C20975 Frontal Systems Behavior Scale (FrSBE) - Sits around doing nothing frequency FrSBeSitDoNothingFreq Frequency of sitting around doing nothing as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of sitting around doing nothing as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Sits around doing nothing 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

C21049 Frontal Systems Behavior Scale (FrSBE) - Sensitive other people need frequency scale FrSBeSensitiveToOthrsNeedsFreq Frequency of being sensitive to the needs of other people as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of being sensitive to the needs of other people as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Is sensitive to the needs of other people 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult Exploratory 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Single Pre-Defined Value Selected

CSV