Use of a modified version of the Overt Aggression Scale in the measurement and assessment of aggressive behaviours following brain injury.

Aggressive behaviour creates a significant challenge in neurorehabilitation. Despite the success in using behaviour modification principles in the treatment of post-acute behavioural problems, psychopharmacological approaches to the management of aggression are more frequently reported. However, inconsistencies apparent in the literature hinder inter-study comparisons of treatment methods. These include severity of brain injury, neuropsychological status and rigour of experimental methodology used. Data about aggression is also inconsistently reported, especially with regard to classification and severity. Descriptions of how aggressive behaviour responded to pre-treatment is also generally absent. In this paper an observational rating scale is described in an attempt to address these inconsistencies. The Overt Aggression Scale has been modified by increasing the range of interventions to reflect current practice in neurorehabilitation, and by changing the language to make it suitable for UK users. A range of antecedents has also been added to make the scale useful in behavioural analysis. Preliminary results indicate inter-rater reliability is good, and it is a valid indicator of type and severity of aggression. Antecedents and interventions used in the management of aggressive behaviours in neurorehabilitation are also illustrated. Clinical use of the scale is also discussed.