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Form Structure: NIH Toolbox Emotion Domain Sadness Survey Parent Report CAT Ages 8-12

This form structure is an organized set of data definitions for a copyrighted form
Title:
NIH Toolbox Emotion Domain Sadness Survey Parent Report CAT Ages 8-12
Short Name:
NIHTBSadSrvyPrtRpt8to12
Description:
The parent-report measures for ages 8-12 using a CAT format; each survey version. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx assesses negative mood, negative views of the self, and negative social cognition.
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:
2016-06-28
Owner:
Number of Data Elements:
42
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.

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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 administration language type  Type of language for test being administrated, as part of the NIH Toolbox NIHTBTestAdminLanguageTyp Recommended CDE
4 NIH Toolbox - Test administration language type other  Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox NIHTBTestAdminLanguageTypOTH Recommended CDE
5 NIH Toolbox - Test name type  Type of NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestNameTyp Recommended CDE
6 NIH Toolbox - Test name type other  The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox NIHTBAdminTestNameTypOTH 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 Sadness Survey Parent Report CAT 8-12 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Miserable scale  Scale of parent reported truth of statement:My child felt miserable or unhappy, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12MiserableScl Recommended CDE
2 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Lonely scale  Scale of parent reported truth of statement: My child felt lonely, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12LonelyScl Recommended CDE
3 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Not as good scale  Scale of parent reported truth of statement:My child felt miserable or unhappy, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12NotAsGoodScl Recommended CDE
4 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Wrong scale  Scale of parent reported truth of statement: My child felt s/he did everything wrong, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12WrongScl Recommended CDE
5 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Enjoy scale  Scale of parent reported truth of statement: My child didn't enjoy anything at all, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12EnjoyScl Recommended CDE
6 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - No good scale  Scale of parent reported truth of statement: My child felt s/he was no good anymore, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12NoGoodScl Recommended CDE
7 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Cried scale  Scale of parent reported truth of statement: My child cried a lot, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12CriedScl Recommended CDE
8 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Think scale  Scale of parent reported truth of statement: My child found it hard to think properly or concentrate, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12ThinkScl Recommended CDE
9 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Hated self scale  Scale of parent reported truth of statement: My child hated him/herself, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12HatedSelfScl Recommended CDE
10 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Bad person scale  Scale of parent reported truth of statement: My child felt s/he was a bad person, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12BadPersonScl Recommended CDE
11 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Loved scale  Scale of parent reported truth of statement: My child thought nobody really loved him/her, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12LovedScl Recommended CDE

NIH Toolbox Sadness Survey Parent Rpt 8-12 Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Raw score  Raw score, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12RawScore Recommended CDE
2 NIH Toolbox Emotion Sadness Parent Report CAT 8 to 12 - Theta score  Theta score, during the past two weeks, for the parent report, for children ages 8 to 12 as part of the NIH Toolbox Emotion Sadness Parent Report CAT NIHTBSPRCAT8to12ThetaScore 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

Change History