Form Structure: NIH Toolbox Emotion Domain Perceived Stress CAT (Parent Report for children ages 8-12)
This form structure is an organized set of data definitions for a copyrighted form
Title:
NIH Toolbox Emotion Domain Perceived Stress CAT (Parent Report for children ages 8-12)
Short Name:
NIHTBPSCATPR8to12
Description:
The NIH Toolbox Perceived Stress Survey Pediatric (8-12) Parent Report is a CAT comprised of items modified from the Perceived Stress Scale-10. (Cohen, S., Kamarck, T., & Mermelstein, R. (1983). It assesses how unpredictable, uncontrollable, and overloaded respondents find their lives. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx
Disease:
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:
2016-07-07
Owner:
Number of Data Elements:
41
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 indicator | Indicator of a flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagInd | Recommended | CDE |
| 9 | 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 |
NIH Toolbox Perceived Stress CAT Parent Report 8-12 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Irritation scale | Scale of parent report of how often their child seems able to control life's irritations in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12IrritationScl | Recommended | CDE |
| 2 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Well scale | Scale of parent report of of how often it seemed that life was going well for their child in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12WellScl | Recommended | CDE |
| 3 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Angered scale | Scale of parent report of of how often did your child appear angered by things that happened outside of his/her control in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress CAT Parent Report. | NIHTBPSCATPR8to12AngeredScl | Recommended | CDE |
| 4 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Difficulties scale | Scale of parent report ofof how often difficulties piled up so high that their child did not seem able to overcome them in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress CAT Parent Report. | NIHTBPSCATPR8to12DffcltsScl | Recommended | CDE |
| 5 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Upset scale | Scale of parent report of of how often their child was upset because of something that happened unexpectedly, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12UpsetScl | Recommended | CDE |
| 6 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Frustrated scale | Scale of parent report of of how often their child appeared frustrated by being unable to control or do something, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12FrustratedScl | Recommended | CDE |
| 7 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Nervous scale | Scale of parent report of of how often their child appeared nervous and "stressed", in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12NervousScl | Recommended | CDE |
| 8 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Confident scale | Scale of parent report of how often their child appeared confident about his or her ability to handle personal problems, in the past month, for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress CAT Parent Report. | NIHTBPSCATPR8to12ConfidentScl | Recommended | CDE |
| 9 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Things well scale | Scale of parent report of of how often their child seemed to feel things were going well, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12ThngsWellScl | Recommended | CDE |
| 10 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Cope scale | Scale of parent report ofy of how often their child seemed unable to cope with all the things that had to be done, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12CopeScl | Recommended | CDE |
NIH Toolbox Perceived Stress CAT Prt Rpt 8-12 Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Raw score | Raw score, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12RawScore | Recommended | CDE |
| 2 | NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Theta score | Theta score, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. | NIHTBPSCATPR8to12ThetaScore | 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 |
| 7 | NIH Toolbox - Standard error | Standard error (a statistical measure of variance that represents the margin of error for the Tscore), as part of the NIH Toolbox Web, Cat and iPad Cognition measures such as: Picture Vocabulary Test and Oral Reading Recognition Test. | NIHTBStandardError | Optional | CDE |
Keywords
