Form Structure: NIH ToolBox Emotion Domain Anger Survey Parent Report Ages 3-7
This form structure is an organized set of data definitions for a copyrighted form
Title:
NIH ToolBox Emotion Domain Anger Survey Parent Report Ages 3-7
Short Name:
NIHTBAngerSurvyPrntRpt3to7
Description:
The NIH Toolbox Anger Survey parent-report version for ages 3-7 is a 9-item fixed-length form. It assesses angry mood and aggression (verbal and physical).
Disease:
Traumatic Brain Injury
General (For all diseases)
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-06-21
Owner:
Number of Data Elements:
39
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 | Vital status | Status of participant/subject as alive or dead | VitStatus | Optional | CDE |
| 5 | Visit date | Actual interview or visit date | VisitDate | Recommended | CDE |
| 6 | Site name | The name of the site for the study | SiteName | Recommended | CDE |
| 7 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE |
| 8 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE |
| 9 | General notes text | General notes | GeneralNotesTxt | Optional | CDE |
Additional Element Groups
Listed below are your additional element groups.
Form Administration (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Language form administration ISO code | Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration | LangCRFAdministratISOCode | Recommended | CDE |
| 2 | Language form administration ISO code other text | The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. | LangCRFAdministratISOCodeOTH | Recommended | CDE |
| 3 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE |
| 4 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE |
| 5 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE |
| 6 | 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 |
NIH Toolbox Administration (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox - Test domain battery type | Type of domain battery for the NIH Toolbox test being administered, as a part of the NIH Toolbox | NIHTBTestDomainBattryTyp | Recommended | CDE |
| 2 | NIH Toolbox - Test domain battery type other | The free-text related to NIHTBTestDomainBatteryTyp specifying other text, as part of the NIH Toolbox | NIHTBTestDomainBatteryTypOTH | Recommended | CDE |
| 3 | NIH Toolbox - Test name type | Type of NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestNameTyp | Recommended | CDE |
| 4 | NIH Toolbox - Test name type other | The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox | NIHTBAdminTestNameTypOTH | Recommended | CDE |
| 5 | NIH Toolbox - Test administration language type | Type of language for test being administrated, as part of the NIH Toolbox | NIHTBTestAdminLanguageTyp | Recommended | CDE |
| 6 | NIH Toolbox - Test administration language type other | Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox | NIHTBTestAdminLanguageTypOTH | Recommended | CDE |
| 7 | NIH Toolbox - Form administered type | Type of NIH Toolbox form being administered, as part of the NIH Toolbox | NIHTBFormAdminTyp | Recommended | CDE |
| 8 | NIH Toolbox - Test administration flag type | Type of flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagTyp | Recommended | CDE |
| 9 | NIH Toolbox - Test administration flag indicator | Indicator of a flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagInd | Recommended | CDE |
NIH Toolbox Anger Survey Parent Report Ages 3-7 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Temper scale | Scale of parent reported truth of statement: Has temper trantrums or hot temper, for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7TemperScl | Recommended | CDE |
| 2 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Argues adults scale | Scale of parent reported truth of statement: Argues a lot with adults, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7ArguesAdultsScl | Recommended | CDE |
| 3 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Argues with peers scale | Scale of parent reported truth of statement: Argues a lot with peers, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7ArguesPeersScl | Recommended | CDE |
| 4 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Blames scale | Scale of parent reported truth of statement: Blames others for his/her own mistakes, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7BlamesScl | Recommended | CDE |
| 5 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Easily annoyed by others scale | Scale of parent reported truth of statement: Is easily annoyed by others, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7EasilyAnnoyOthScl | Recommended | CDE |
| 6 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Angry and resentful scale | Scale of parent reported truth of statement: Is angry and resentful, for the parent report for childen ages 3 to 7 as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7AngryResentfulScl | Recommended | CDE |
| 7 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Gets back scale | Scale of parent reported truth of statement: Gets back at people, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7GetsBackScl | Recommended | CDE |
| 8 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Swears scale | Scale of parent reported truth of statement: Swears or uses curse words, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7SwearsScl | Recommended | CDE |
| 9 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Does things to annoy others scale | Scale of parent reported truth of statement: Does things that annoy others, for the parent report for children ages , as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7DosThngAnoyOthScl | Recommended | CDE |
NIH Toolbox Anger Survey Parent Report Ages 3-7 Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Raw score | Raw score, as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7RawScore | Recommended | CDE |
| 2 | NIH Toolbox Emotion Domain Anger Parent Report 3 to 7 - Theta score | Theta score, as a part of the NIH Toolbox Emotion Domain Battery Anger Parent Report assessment | NIHTBAPR3to7ThetaScore | Recommended | CDE |
| 3 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted scale score | Age-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROAgeAdjSclScore | Recommended | CDE |
| 4 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted national percentile value | Value of age-adjusted national percentile, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROAgeAdjNationalPctVal | Recommended | CDE |
| 5 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Fully-adjusted scale score | Fully-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROFullyAdjSclScore | Recommended | CDE |
| 6 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Unadjusted scale score | Unadjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROUnadjSclScore | Recommended | CDE |
Keywords
