Agitated Behavior Scale

Progressive dementia: (Bogner et al., 1999; n= 23; patients in long term care with progressive demetia)

• Excellent correlation for total score (r= .906) and factor scores (r=.860 to .886) when rated by research assistants

Progressive Dementia: (Bogner et al., 1999)

• Adequate to Excellent internal consistency (Chronbach’s alpha = .74-.808)

TBI, Dementia, and Anoxia: (Bogner et al., 2001; n=152 individuals with acute TBI on rehabilitation unit, n=102 individuals with dementia of Alzheimer’s type; n= 6 with anoxic encephalopathy)

• Rating scale analysis determined three misfit items: wandering, excessive crying/laughing, and self-abuse. Items among those were observed least often, but not associated with those most agitated.
• A stable item hierarchy was identified, with a calibration table to allow conversion of ABS scores to interval measures if desired.

Traumatic Brain Injury: (Bogner et al., 2001; n=340 consecutive admissions to TBI unit; mean age=33 years)

• For total or converted subscale scores:
  • Scores of 21 or below – within normal limits
  • Scores of 22-28 – mild agitation
  • Scores of 29-35 – moderate agitation
  • Scores greater than 35 – severe agitation

TBI: (Corrigan, 1989; n=35; mean age= 28.2; median education= 12 years)

• Excellent correlation of same day ratings by therapists and nurses (r=.70)

TBI: (Bogner et al., 1999; n=45; admitted to acute rehab s/p TBI)

• Excellent correlation for total score (r=.92), with factor correlations for Disinhibition (r=.90), Aggression (r=.91) and Lability (r=.73) when conducted by research assistants
• Adequate correlations for research staff and nursing ratings (range r=.364 to .604) based on a 10 minute observation from research staff and entire shift ratings by nursing

TBI: (Corrigan, 1989; n= 35; mean age= 28.5; currently patients in inpatient rehabilitation)

• Excellent internal consistency (Chronbach’s alpha values.83-.92)

TBI: (Bogner et al., 1999)

• Excellent internal consistency (Chronbach’s alpha = .921, .828, nd .801)

TBI, Dementia, and Anoxia: (Bogner et al., 2001; n=152 individuals with acute TBI on rehabilitation unit, n=102 individuals with dementia of Alzheimer’s type; n= 6 with anoxic encephalopathy)

• Rating scale analysis determined three misfit items: wandering, excessive crying/laughing, and self-abuse. Items among those were observed least often, but not associated with those most agitated.
• A stable item hierarchy was identified, with a calibration table to allow conversion of ABS scores to interval measures if desired.

TBI: (Corrigan, 1989)

• The ABS score was associated with 36% to 62% of the variance in 15 of 16 correlations with simultaneous, independent observations of agitation by experts

Predictive validity

TBI: (Bogner et al, 2001; n=340 consecutive admissions to TBI unit; mean age=33 years)

• Patients designated as having agitation (ABS >21) for more than 48 hours were compared to those who were not agitated
• Agitation was significantly associated with a longer length of rehabilitation and lower likelihood of being discharged to a private residence
• Agitation predicted cognitive FIM scores at discharge, but did not predict outcomes at one year (satisfaction with life, productivity)

Traumatic Brain Injury: (Corrigan & Bogner, 1994; n=212; mean age=31.2 (14.3) years; admissions to inpatient rehabilitation unit with acquired brain injury)

• Confirmatory factor analysis supported the subscale structure of three components of aggression, disinhibition and lability representing the construct of agitation

Aquired Brain Injury (TBI, aneurysm, brain tumor, anoxia, etc.): (Lequerica et al., 2007; n=69; mean age=42.2 (15.1) years; acute care stay 1-51 days; rehabilitation stay 4-69 days; admissions to TBI rehabilitation unit)

• Less than 10% of the patients were classified as “agitated” according to a previously described cutpoint of 22 on ABS, yet most patients had some level of behavioral expression of agitation
• Agitation measured by ABS was significantly correlated (p<.01) with injury severity, engagement in therapy and rehabilitation progress (measured by FIM efficiency ratios)
• Agitation predicted engagement in therapy to a greater degree (15.3% of variance) than injury severity (10.5%) in a 2-step regression model
• ABS values much below the suggested cutpoint for agitation may disrupt participation in rehabilitation.

Traumatic Brain Injury and Hypoxia: (Nott et al., 2010; n=8; mean age=34(13) years; median GCS 6; mean time from injury to data collection 37 (17) days)

• Ratings made over the course of 3 nursing shifts/day over 5 weeks post-injury demonstrated two patterns:
  • Patients beginning at Rancho level V, gradually decreased agitated behaviors over time, especially after emerging from PTA
  • Those patients in PTA with lower cognitive functioning demonstrated higher ABS scores, with higher scores on afternoon shifts, lowest scores at night

Acquired Brain Injury: (Corrigan, 1989)

• Items were selected from an initial 39-item pool based on their testability, differentiation of agitation, frequency of occurrence, and representation of the full domain of the construct