CDE Detailed Report

Disease: NeuroRehab
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
C21040 Frontal Systems Behavior Scale (FrSBE) - Impulsiveness frequency scale FrSBeImpulsitiveFreq Frequency of doing things impulsively as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of doing things impulsively as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Does things impulsively 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 NeuroRehab Supplemental-Highly Recommended 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

C20994 Frontal Systems Behavior Scale (FrSBE) - Fabrication incredible story when unable remember frequency scale FrSBeMakeUpStoriesFreq Frequency of making up fantastic stories when unable to remember something as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of making up fantastic stories when unable to remember something as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Makes up fantastic stories when unable to remember something 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 NeuroRehab Supplemental-Highly Recommended 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

C21065 Frontal Systems Behavior Scale (FrSBE) - Lack initiative motivation frequency scale FrSBeLacksInitiativeFreq Frequency of having difficulty starting an activity, lacking initiative, motivation as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of having difficulty starting an activity, lacking initiative, motivation as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Has difficulty starting an activity, lacks initiative, motivation 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 NeuroRehab Supplemental-Highly Recommended 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

C21018 Frontal Systems Behavior Scale (FrSBE) - Childish humor frequency scale FrSBeChildishHumorFreq Frequency of being overly silly, has childish sense of humour as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of being overly silly, has childish sense of humour as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Is overly silly, has childish sense of humor 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 NeuroRehab Supplemental-Highly Recommended 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

C21092 Frontal Systems Behavior Scale (FrSBE) - Missing answer total count FrSBeMissingItemsTtlCount Total count of unanswered or missing questions as part of Frontal Systems Behavior Scale (FrSBE) form Total count of unanswered or missing questions as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions total 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.

Adult NeuroRehab Supplemental-Highly Recommended 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) Behavioral Function Outcomes and End Points

Free-Form Entry

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C20970 Frontal Systems Behavior Scale (FrSBE) - Personal hygience neglect frequency scale FrSBeNeglectPersonlHygieneFreq Frequency of neglecting personal hygiene as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of neglecting personal hygiene as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Neglects personal hygiene 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 NeuroRehab Supplemental-Highly Recommended 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

C21041 Frontal Systems Behavior Scale (FrSBE) - Benefit accept criticism frequency scale FrSBeAcceptFeedbackFreq Frequency of benefitting from feedback, accepting constructive criticism from others as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of benefitting from feedback, accepting constructive criticism from others as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Benefits from feedback, accepts constructive criticism from others 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.

Adult NeuroRehab Supplemental-Highly Recommended 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

C20996 Frontal Systems Behavior Scale (FrSBE) - Lack interest fun important frequency scale FrSBeDisinterestedInThingsFreq Frequency of losing interest in things that used to be fun or important to him/her as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of losing interest in things that used to be fun or important to him/her as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Has lost interest in things that used to be fun or important to him/her 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 NeuroRehab Supplemental-Highly Recommended 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

C21067 Frontal Systems Behavior Scale (FrSBE) - Inappropriate sexual comment frequency scale FrSBeInnapropriateSexJokesFreq Frequency of making inappropriate sexual comments and advances, is too flirtatious as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of making inappropriate sexual comments and advances, is too flirtatious as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Makes inappropriate sexual comments and advances, is too flirtatious 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 NeuroRehab Supplemental-Highly Recommended 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

C21020 Frontal Systems Behavior Scale (FrSBE) - Food lack smell taste complaint frequency scale FrSBeFoodHasNoSmellTasteFreq Frequency of complaining that food has no taste or smell as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of complaining that food has no taste or smell as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Complains that food has no taste or smell 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 NeuroRehab Supplemental-Highly Recommended 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

C21094 Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale A count FrSBeMissingItemsScaleACount Count of unanswered or missing questions for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) form Count of unanswered or missing questions for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions subscale A 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.

Adult NeuroRehab Supplemental-Highly Recommended 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
C20973 Frontal Systems Behavior Scale (FrSBE) - Hyperactivity frequency scale FrSBeHyperactiveFreq Frequency of being unable to sit still, is hyperactive as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of being unable to sit still, is hyperactive as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Can't sit still, is hyperactive 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 NeuroRehab Supplemental-Highly Recommended 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

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.

Adult NeuroRehab Supplemental-Highly Recommended 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