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Frontal Behavioral Inventory - ALS Version (FBI-ALS)
Availability
Please email the authors for information about obtaining the instrument: Jennifer.Murphy@ucsf.edu
Classification
Supplemental:  Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument
Summary: This version of the FBI has one or two questions for each item, to help distinguish between MND symptoms and behavioral changes due to FTD. There are also instructions in parentheses to help disentangle the two. This effort to distinguish the physical MND from the behavioral/personality change makes this version ALS-specific yet lengthier as compared with the other two FBI versions.
 
Construct measured: FTD-Type Behavioral and Personality Change.
 
Generic vs. disease specific: ALS-specific and FTD specific.
 
Means of administration: Caregiver interview by research staff, by phone or in person, without patient present.
 
Intended respondent: Caregiver.
 
# of items: 24.
 
# of subscales and names of sub-scales: Two subscales: Negative Behavior and Disinhibition.
 
# of items per sub-scale: 12 each.
 
Administration time: 15-30 minutes.
 
Strengths: This ALS version of the FBI is currently being used widely in a multicenter study and has been shown to have good inter-rater reliability (N=10; r=.97). A training video has been created for the purpose of increasing reliability and validity. This is the only version of the FBI which distinguishes between MND symptoms and behavioral changes due to FTD.
 
Weaknesses: This ALS version of the scale has not yet been published. It is more time consuming than the FBI-mod, which is a self-administered questionnaire given to caregivers without requiring staff involvement.
Scoring
Scoring: Items are scored according to the extent of the behavioral change: 0 = None/never; 1 = Mild, occasional; 2 = Moderate/often; 3 = Severe, most of the time.
Psychometric Properties
Feasibility: Easy to use interview that can be completed by phone or in person, by any trained staff person.
 
Reliability: The original FBI has high inter-rater reliability (Cohen's kappa of .90) and item consistency (a Cronbach alpha of .89). The FBI-ALS version also has high interrater reliability (r=.986; N=10).
 
Validity: Using the original FBI, discriminant function correctly classified 92.7% versus all other patients (vascular dementia (VaD), Alzheimer's disease (AD), primary progressive aphasia (PPA), and depressive disorder (DD) patients.) The mean scores of FLD patients were significantly above all other groups.
 
Sensitivity to Change: The FBI has been shown to be sensitive to changes in behavior and personality in both the frontal variant and PPA variants of FTD (Marczinski CA, et al.).
 
Relationships to other variables: This measures a behavioral construct distinct from clinical depression, PBA, and neuropsychological function (e.g. executive dysfunction).
References
Kertesz, A., Davidson, W., & Fox, H. (1997). Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci, 24(1), 29-36.
 
Kertesz, A. (1998). The quantification of behavior in frontal lobe dementia. In A. Kertesz& D. G. Munoz (Eds.), Pick's disease and Pick complex (pp. 47-67). New York: Wiley & Sons, Inc.
 
Kertesz, A., Nadkarni, N., Davidson, W.,& Thomas, A. W. (2000). The Frontal Behavioral Inventory in the differential diagnosis of frontotemporal dementia. Journal of the International Neuropsychological Society, 6(4), 460-468.
 
Kertesz, A., Davidson, W., McCabe, P.,& Munoz, D. (2003). Behavioral quantitation is more sensitive than cognitive testing in frontotemporal dementia. Alzheimer Disease & Associated Disorders, 17(4), 223-229.
 
Marczinski, C. A., Davidson, W.,& Kertesz, A. (2004). A longitudinal study of behavior in frontotemporal dementia and primary progressive aphasia. Cogn Behav Neurol, 17(4), 185-190.