Form Structure: NIH Toolbox Emotion Domain Perceived Stress Survey CAT Ages 13-17
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
NIH Toolbox Emotion Domain Perceived Stress Survey CAT Ages 13-17
Short Name:
NIHTBPercevdStrssCAT13to17
Description:
The NIH Toolbox Perceived Stress Survey is a self-report measure administered to ages 13-85, as well as a parent-report measure for ages 8-12. Both versions are administered as computer-adaptive tests. It assesses how unpredictable, uncontrollable, and overloaded respondents find their lives. Items administered use a 5-point scale, with options ranging from never to very often. 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)
Traumatic Brain Injury
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-07-05
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 Survey CAT 13-17 (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | NIH Toolbox Emotion Domain Perceived Stress CAT - Unexpected scale | Scale of participant report of when the participant has been upset because of something that happened unexpectedly in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATUnexpectedScl | Recommended | CDE |
2 | NIH Toolbox Emotion Domain Perceived Stress CAT - Control scale | Scale of participant report of when the participant felt they are unable to control the important things in their life in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATControlScl | Recommended | CDE |
3 | NIH Toolbox Emotion Domain Perceived Stress CAT - Nervous scale | Scale of participant report of when the participant felt nervous and stressed in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATNervousScl | Recommended | CDE |
4 | NIH Toolbox Emotion Perceived Stress CAT 13 to 17 - Manage scale | Scale of participant report of how often participant has found they cannot handle or manage all the things they had to do in the past month for ages 13 to 17 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCAT13to17ManageScl | Recommended | CDE |
5 | NIH Toolbox Emotion Domain Perceived Stress CAT - Angered scale | Scale of participant report of when the participant was angered because of things that happened that were outside of their control, in the past month,as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATAngeredScl | Recommended | CDE |
6 | NIH Toolbox Emotion Domain Perceived Stress CAT - Difficulties scale | Scale of participant report of when the participant felt difficulties were piling up so high they could not overcome them in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATDffcltsScl | Recommended | CDE |
7 | NIH Toolbox Emotion Domain Perceived Stress CAT - Confidence scale | Scale of participant report of when the participant felt confident in their ability to handle personal problems in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATConfidenceScl | Recommended | CDE |
8 | NIH Toolbox Emotion Domain Perceived Stress CAT - Your way scale | Scale of participant report of when the participant felt things were going their way in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATYourWayScl | Recommended | CDE |
9 | NIH Toolbox Emotion Domain Perceived Stress CAT - Irritations scale | Scale of participant report of when the participant has been able to control irritations in their life in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATIrritationsScl | Recommended | CDE |
10 | NIH Toolbox Emotion Domain Perceived Stress CAT - On top of things scale | Scale of participant report of when the participant felt they were on top of things in the past month, as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCATOnTopThngsScl | Recommended | CDE |
NIH Toolbox Perceived Stress Survey CAT 13-17 Scoring (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | NIH Toolbox Emotion Perceived Stress CAT 13 to 17 - Raw Score | Raw score, in the past month, for ages 13 to 17 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCAT13to17RawScore | Recommended | CDE |
2 | NIH Toolbox Emotion Perceived Stress CAT 13 to 17 - Theta Score | Theta score, in the past month, for ages 13 to 17 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test | NIHTBPSCAT13to17ThetaScore | 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