Department of Psychiatry, University of Cambridge, UK.
Neuropsychol Rehabil. 2012;22(6):874-89. doi: 10.1080/09602011.2012.703956. Epub 2012 Jul 17.
Assessment of everyday problems with executive functioning following acquired brain injury (ABI) is greatly valued by neurorehabilitation services. Reliance on self-report measures alone is problematic within this client group who may experience difficulties with awareness and memory. The construct validity and reliability of independent ratings (i.e., ratings provided by a carer/relative) on the Dysexecutive Questionnaire (DEX-I) was explored in this study. Consistent with the results recently reported on the self-rated version of the DEX (DEX-S; Simblett & Bateman, 2011 ), Rasch analysis completed on 271 responses to the DEX-I revealed that the scale did not fit the Rasch model and did not meet the assumption of unidimensionality, that is, a single underlying construct could not be found for the DEX-I that would allow development of an interval-level measure as a whole. Subscales, based on theoretical conceptualisations of executive functioning (Stuss, 2007 ) previously suggested for the DEX-S, were able to demonstrate fit to the Rasch model and unidimensionality. Reliability of independent responses to these subscales in comparison to self-reported ratings is discussed. These results contribute to a greater understanding of how assessment of executive functioning can be improved.
脑损伤后(ABI)执行功能日常问题的评估在神经康复服务中非常重要。在这个患者群体中,仅依赖自我报告的措施是有问题的,因为他们可能存在意识和记忆方面的困难。本研究探讨了独立评估者(即照顾者/亲属)对行为执行能力测验(DEX-I)的评定的结构效度和可靠性。与最近报告的 DEX 自评版本(DEX-S;Simblett 和 Bateman,2011)的结果一致,对 DEX-I 的 271 个响应进行的 Rasch 分析表明,该量表不符合 Rasch 模型,也不符合单维性的假设,即无法为 DEX-I 找到一个单一的潜在结构,从而无法整体开发一个区间水平的测量。基于先前为 DEX-S 提出的执行功能理论概念化(Stuss,2007)的子量表,能够符合 Rasch 模型和单维性。讨论了与自我报告评分相比,这些子量表对独立反应的可靠性。这些结果有助于更好地理解如何改进执行功能评估。