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Journal of the Australasian Society for the Study of Brain Impairment
RESEARCH ARTICLE

Convergent, discriminant, and known-groups validity of the Behavioural Assessment Screening Tool (BAST) in chronic traumatic brain injury

Shannon Juengst https://orcid.org/0000-0003-4709-545X A B * , Brittany Wright B , Leia Vos C D , Gabriel Rodriguez E , Michael Conley F and Lauren Terhorst G
+ Author Affiliations
- Author Affiliations

A TIRR Memorial Hermann, Brain Injury Research Center, 1333 Moursund Street, Houston, TX 77030, USA.

B Department of Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA.

C Department of Neurosciences, CoreWell Health Medical Group, Grand Rapids, MI, USA.

D Division of Clinical Neurosciences, College of Human Medicine at Michigan State University, Grand Rapids, MI, USA.

E Department of Psychology and Neuropsychology, TIRR Memorial Hermann, Houston, TX, USA.

F Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.

G Department of Occupational Therapy, SHRS Data Center, University of Pittsburgh, Pittsburgh, PA, USA.


Handling Editor: Cynthia Honan

Brain Impairment 26, IB24064 https://doi.org/10.1071/IB24064
Submitted: 26 June 2024  Accepted: 16 January 2025  Published: 6 February 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment.

Abstract

Background

The Behavioural Assessment Screening Tool (BAST), which measures self-reported neurobehavioural symptoms experienced by adults with traumatic brain injury (TBI), was specifically developed as a self-reported measure for remote symptom reporting. Our aim was to assess the convergent, discriminant, and known-groups validity of the BAST among community-dwelling adults with TBI.

Methods

We assessed correlations and group differences with previously validated measures in two existing datasets (n = 111, n = 134). Other measures were the Patient Health Questionnaire-9 (depression), Generalized Anxiety Disorder-7 (anxiety), Positive and Negative Affect Schedule, Frontal Systems Behavior Scale (Executive Dysfunction, Apathy, Disinhibition), Modified Fatigue Impact Scale, Patient-Reported Outcomes Measurement Information System (Fatigue), Aggression Questionnaire (anger, hostility, physical and verbal aggression), and Alcohol Use Disorders Identification Test (alcohol misuse).

Results

BAST subscales had stronger correlations with measures of similar (|r| = 0.602–0.828, P < 0.001) and related (|r| = 0.364–0.589, P < 0.001) constructs and weaker correlations (|r| < 0.300) with measures of dissimilar/unrelated constructs. Statistically significant BAST subscale differences (ps < 0.001) were found (Cohen’s d = 1.2–1.9) for known groups with moderate–severe depression, moderate-severe anxiety, fatigue, problematic disinhibited and frontal executive behaviours, and alcohol misuse. Results support the construct validity of the BAST subscales.

Conclusion(s)

The BAST demonstrated good convergent, discriminant, and known-groups validity, supporting its use for remote self-reported symptom reporting to improve chronic symptom monitoring in community-dwelling adults with TBI.

Keywords: affect, fatigue, impulsivity, measurement, neurobehavioural, psychometrics, substance use, traumatic brain injury, validity.

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