Form Structure: Frontal Systems Behavior Scale (FrSBe)
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Frontal Systems Behavior Scale (FrSBe)
Short Name:
FrSBe
Description:
The FrSBe assesses frontal systems behavioral syndromes by providing a means to identify and quantify disordered natural behavior so that problems may be targeted for treatment.
Disease:
Traumatic Brain Injury
Organization:
NINDS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-08-11
Version:
1.0
Date Created:
2015-05-20
Owner:
Number of Data Elements:
75
eForms:
N
Logically grouped data elements with defined frequency at which they repeat.
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | GUID | Global Unique ID which uniquely identifies a subject | GUID | Required | CDE |
| 2 | Subject identifier number | An identification number assigned to the participant/subject within a given protocol or a study. | SubjectIDNum | Optional | CDE |
| 3 | Age in years | Value for participant's subject age recorded in years. | AgeYrs | Recommended | CDE |
| 4 | Visit date | Actual interview or visit date | VisitDate | Recommended | CDE |
| 5 | Site name | The name of the site for the study | SiteName | Recommended | CDE |
| 6 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE |
| 7 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE |
| 8 | General notes text | General notes | GeneralNotesTxt | Optional | CDE |
Additional Element Groups
Listed below are your additional element groups.
Form Administration (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE |
| 2 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE |
| 3 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE |
| 4 | Data source other text | The free-text field related to Data source specifying other text. Source of the data provided on the case report form | DataSourceOTH | Recommended | CDE |
FrSBe Administration (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Frontal Systems Behavior Scale (FrSBE) - Form type | Type of the Frontal Systems Behavior Scale (FrSBE) form | FrSBeFormTyp | Recommended | CDE |
Apathy (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Frontal Systems Behavior Scale (FrSBE) - Speech only with verbal prompt frequency | Frequency of speaking only when spoken to as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeSpeakOnlyWhenSpokenToFreq | Recommended | CDE |
| 2 | Frontal Systems Behavior Scale (FrSBE) - Lack initiative motivation frequency | Frequency of having difficulty starting an activity, lacking initiative, motivation as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeLacksInitiativeFreq | Recommended | CDE |
| 3 | Frontal Systems Behavior Scale (FrSBE) - Personal hygience neglect frequency | Frequency of neglecting personal hygiene as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeNeglectPersonlHygieneFreq | Recommended | CDE |
| 4 | Frontal Systems Behavior Scale (FrSBE) - Sits around doing nothing frequency | Frequency of sitting around doing nothing as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeSitDoNothingFreq | Recommended | CDE |
| 5 | Frontal Systems Behavior Scale (FrSBE) - No concern urine bowel control loss frequency | Frequency of losing control of urine or bowels and seems unconcerned as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeNoConcrnLosCntrlBowelFreq | Recommended | CDE |
| 6 | Frontal Systems Behavior Scale (FrSBE) - Lack interest in fun or important frequency | 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 | FrSBeDisinterestedInThingsFreq | Recommended | CDE |
| 7 | Frontal Systems Behavior Scale (FrSBE) - Unable finish task frequency | Frequency of starting things but failing to finish them as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeStartNotFinishThingsFreq | Recommended | CDE |
| 8 | Frontal Systems Behavior Scale (FrSBE) - Lack emotion concern frequency | Frequency of showing little emotion, is unconcerned and unresponsive as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeShowLittleEmotionFreq | Recommended | CDE |
| 9 | Frontal Systems Behavior Scale (FrSBE) - Inactive lack energy frequency | Frequency of being slow moving, lacking energy, inactive as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeSlowMoveLackEnergyFreq | Recommended | CDE |
| 10 | Frontal Systems Behavior Scale (FrSBE) - Sexual intimacy interest frequency | Frequency of being interested in sex as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeInterestedInSexFreq | Recommended | CDE |
| 11 | Frontal Systems Behavior Scale (FrSBE) - Appearance grooming interest frequency | Frequency of caring about his/her appearance as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeCaresAboutAppearanceFreq | Recommended | CDE |
| 12 | Frontal Systems Behavior Scale (FrSBE) - Activity spontaneous involvement frequency | Frequency of getting involved with activities spontaneously as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeSpontaneousActivitiesFreq | Recommended | CDE |
| 13 | Frontal Systems Behavior Scale (FrSBE) - Action without other people request frequency | Frequency of doing things without being requested to do so as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeDoesWithoutRequestFreq | Recommended | CDE |
| 14 | Frontal Systems Behavior Scale (FrSBE) - Begin spontaneous conversation frequency | Frequency of starting conversations spontaneously as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale | FrSBeSpontaneousConversatnFreq | Recommended | CDE |
| 15 | Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale A count | Count of missing answer for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) form | FrSBeMissingItemsScaleACount | Recommended | CDE |
| 16 | Frontal Systems Behavior Scale (FrSBE) - Apathy subscale invalid score indicator | Indicator if Apathy subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeScaleAInvalidInd | Recommended | CDE |
| 17 | Frontal Systems Behavior Scale (FrSBE) - Apathy subscale raw score | Raw score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeApathyRawScore | Recommended | CDE |
| 18 | Frontal Systems Behavior Scale (FrSBE) - Apathy subscale T score | T score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeApathyTScore | Recommended | CDE |
Disinhibition (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Frontal Systems Behavior Scale (FrSBE) - Anger easily frequency | Frequency of being easily angered or irritated, having emotional outbursts without good reason as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeAngeredEasilyFreq | Recommended | CDE |
| 2 | Frontal Systems Behavior Scale (FrSBE) - Impulsiveness frequency | Frequency of doing things impulsively as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeImpulsitiveFreq | Recommended | CDE |
| 3 | Frontal Systems Behavior Scale (FrSBE) - Laugh cry easily frequency | Frequency of laughing or crying too easily as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeCriesLaughsTooEasilyFreq | Recommended | CDE |
| 4 | Frontal Systems Behavior Scale (FrSBE) - Inappropriate sexual comment frequency scale | Frequency of making inappropriate sexual comments and advances, is too flirtatious as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeInnapropriateSexJokesFreq | Recommended | CDE |
| 5 | Frontal Systems Behavior Scale (FrSBE) - Action speech embarassment frequency | Frequency of doing or saying embarrassing things as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeSayEmbarrassingThingsFreq | Recommended | CDE |
| 6 | Frontal Systems Behavior Scale (FrSBE) - Hyperactivity frequency | Frequency of being unable to sit still, is hyperactive as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeHyperactiveFreq | Recommended | CDE |
| 7 | Frontal Systems Behavior Scale (FrSBE) - Interrupt conversation frequency | Frequency of talking out of turn, interrupts others in conversations as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeTalkOutOfTurnFreq | Recommended | CDE |
| 8 | Frontal Systems Behavior Scale (FrSBE) - Law authority difficulty frequency | Frequency of getting in trouble with the law or authorities as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeTroubleWithAuthorityFreq | Recommended | CDE |
| 9 | Frontal Systems Behavior Scale (FrSBE) - Risk taker frequency | Frequency of doing risky things just for the heck of it as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeDoesRecklessThingsFreq | Recommended | CDE |
| 10 | Frontal Systems Behavior Scale (FrSBE) - Childish humor frequency | Frequency of being overly silly, has childish sense of humour as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeChildishHumorFreq | Recommended | CDE |
| 11 | Frontal Systems Behavior Scale (FrSBE) - Food lack smell taste complaint frequency | Frequency of complaining that food has no taste or smell as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeFoodHasNoSmellTasteFreq | Recommended | CDE |
| 12 | Frontal Systems Behavior Scale (FrSBE) - Expletives use frequency | Frequency of swearing as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeSwearingFreq | Recommended | CDE |
| 13 | Frontal Systems Behavior Scale (FrSBE) - Sensitive other people need frequency | Frequency of being sensitive to the needs of other people as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeSensitiveToOthrsNeedsFreq | Recommended | CDE |
| 14 | Frontal Systems Behavior Scale (FrSBE) - Get along well with others frequency | Frequency of getting along well with others as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeGetsAlongWithOthersFreq | Recommended | CDE |
| 15 | Frontal Systems Behavior Scale (FrSBE) - Age appropriate behavior frequency | Frequency of acting appropriately for his/her age as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale | FrSBeActsAppropriatAgeFreq | Recommended | CDE |
| 16 | Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale D count | Count of missing answer for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) form | FrSBeMissingItemsScaleDCount | Recommended | CDE |
| 17 | Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale invalid score indicator | Indicator if Disinhibition subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeScaleDInvalidInd | Recommended | CDE |
| 18 | Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale raw score | Raw score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeDisinhibitionRawScore | Recommended | CDE |
| 19 | Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale T score | T score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeDisinhibitionTScore | Recommended | CDE |
Executive Dysfunction (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Frontal Systems Behavior Scale (FrSBE) - Action idea repetition frequency | Frequency of repeating certain actions or getting stuck on certain ideas as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeRepeatsActionsFreq | Recommended | CDE |
| 2 | Frontal Systems Behavior Scale (FrSBE) - Action sequence error frequency | Frequency of mixing up a sequence, getting confused when doing several things in a row as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeMixesUpSequencesFreq | Recommended | CDE |
| 3 | Frontal Systems Behavior Scale (FrSBE) - Repeat mistakes frequency scale | Frequency of making the same mistakes over and over, not learning from past experience as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeRepeatsMistakesFreq | Recommended | CDE |
| 4 | Frontal Systems Behavior Scale (FrSBE) - Problem deny unaware frequency | Frequency of denying having problems or is unaware of problems or mistakes as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeDeniesHavingProbsFreq | Recommended | CDE |
| 5 | Frontal Systems Behavior Scale (FrSBE) - Disorganized frequency scale | Frequency of being disorganized as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeDisorganizedFreq | Recommended | CDE |
| 6 | Frontal Systems Behavior Scale (FrSBE) - Not able multi-task frequency | Frequency of being unable to do two things at once as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeCantMultitaskFreq | Recommended | CDE |
| 7 | Frontal Systems Behavior Scale (FrSBE) -Poor judgment problem solver frequency | Frequency of showing poor judgment, is a poor problem solver as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBePoorJudgementFreq | Recommended | CDE |
| 8 | Frontal Systems Behavior Scale (FrSBE) - Fabrication incredible story when unable remember frequency | Frequency of making up fantastic stories when unable to remember something as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeMakeUpStoriesFreq | Recommended | CDE |
| 9 | Frontal Systems Behavior Scale (FrSBE) - Action not agree with description frequency | Frequency of saying one thing, then doing another thing as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeSayOneThingDoAnotherFreq | Recommended | CDE |
| 10 | Frontal Systems Behavior Scale (FrSBE) - Forgetful until prompted frequency | Frequency of forgetting to do things but then remembering when prompted or when it is too late as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeForgetUnlessPromptedFreq | Recommended | CDE |
| 11 | Frontal Systems Behavior Scale (FrSBE) - Inflexible frequency | Frequency of being inflexible, unable to change routines as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeInflexibleFreq | Recommended | CDE |
| 12 | Frontal Systems Behavior Scale (FrSBE) - Misbehavior apology frequency | Frequency of apologizing for misbehaviour as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeApologizeWhenMisbehavFreq | Recommended | CDE |
| 13 | Frontal Systems Behavior Scale (FrSBE) - Concentration continue with distraction frequency | Frequency of paying attention, concentrates even when there are distractions as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBePayingAttentionFreq | Recommended | CDE |
| 14 | Frontal Systems Behavior Scale (FrSBE) - Action thoughtful frequency | Frequency of thinking things through before acting as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeThinkBeforeActingFreq | Recommended | CDE |
| 15 | Frontal Systems Behavior Scale (FrSBE) - Memory strategy use frequency | Frequency of using strategies to remember important things as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeUseMemoryStrategiesFreq | Recommended | CDE |
| 16 | Frontal Systems Behavior Scale (FrSBE) - Planning ability frequency | Frequency of being able to plan ahead as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeAblePlanAheadFreq | Recommended | CDE |
| 17 | Frontal Systems Behavior Scale (FrSBE) - Benefit accept criticism frequency | Frequency of benefitting from feedback, accepting constructive criticism from others as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale | FrSBeAcceptFeedbackFreq | Recommended | CDE |
| 18 | Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale E count | Count of missing answer for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) form | FrSBeMissingItemsScaleECount | Recommended | CDE |
| 19 | Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale invalid score indicator | Indicator if Executive Dysfunction subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeScaleEInvalidInd | Recommended | CDE |
| 20 | Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale raw score | Raw score for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeExecutiveDysfunctRawScore | Recommended | CDE |
| 21 | Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale T score | T score for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeExecutiveDysfunctTScore | Recommended | CDE |
Total Scoring (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Frontal Systems Behavior Scale (FrSBE) - Missing answer total count | Total count of answered or missing questions as part of Frontal Systems Behavior Scale (FrSBE) form | FrSBeMissingItemsTtlCount | Recommended | CDE |
| 2 | Frontal Systems Behavior Scale (FrSBE) - Invalid score indicator | Indicator if Frontal Systems Behavior Scale (FrSBE) is invalid (has more than 5 questions missing) | FrSBeInvalidInd | Recommended | CDE |
| 3 | Frontal Systems Behavior Scale (FrSBE) - Total raw score | Total raw score as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeTotalRawScore | Recommended | CDE |
| 4 | Frontal Systems Behavior Scale (FrSBE) - Total T score | T score for all scales as part of Frontal Systems Behavior Scale (FrSBE) | FrSBeTotalTScore | Recommended | CDE |
Keywords
