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Frontal Behavioral Inventory - Modified by Heidler Gary
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Supplemental: Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument

Background: The Frontal Behavior Inventory Modified (FBI-Mod) is unique in two ways as compared with the original FBI: 1) Items are simplified to ask only one question per item, as opposed to two questions, and 2) the test is completed by the caregiver themselves as opposed to being completed as a staff-led interview.
Construct measured: FTD-Type Behavioral and Personality Change.
Generic vs. disease specific: Specific with regards to FTD-type dementia, but generic with regards to the presence of MND.
Means of administration: Caregiver self-administered interview. This self-administered questionnaire distinguishes it from the staff-led interview method used with the traditional FBI.
Intended respondent (e.g. patient, caregiver, etc): Caregiver.
# of items: 24 items.
# of subscales and names of sub-scales: Two subscales: Negative Score, and Disinhibition Score.
# of items per sub-scale: 12 each.
Administration time: 10 minutes.
Strengths: Simplified, shorter administration time. One study found good validity when using it to distinguish between AD and FTD. Not copyrighted.
Weaknesses: Not ALS specific. At least 15 items have overlap with MND symptoms, making it difficult to disentangle MND changes from behavioral changes due to frontotemporal deterioration. Because the caregiver is answering the questions without a staff member present, there may be reduced validity due to potential misinterpretation of items by a caregiver unfamiliar with complex nature of the personality/behavior constructs, and unaware of how the MND symptoms play a role in behavior.


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 because no staff are required.
Reliability: No tests of reliability have been completed for this version of the FBI.
Validity: In a study comparing AD with ALS-FTD patients, ALS-FTD patients were reported as having significantly more total behavioral problems and more negative behaviors in particular (F=6.5 p=.01). No study to date has tested the validity of this instrument on ALS-normals vs ALS-FTD.
Sensitivity to Change: Not yet studied.
Relationships to other variables: This measures a behavioral construct distinct from clinical depression, PBA, and neuropsychological function (e.g. executive dysfunction).

Heidler-Gary, J& Hillis, A (2007). Distinctions between the dementia in Amyotrophic Lateral Sclerosis with Frontotemporal Dementia and the dementia of Alzheimer's disease. Amyotrophic Lateral Sclerosis, 8, 276- 282.
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.


Document last updated July 2018