Evaluation of the Neurobehavioral Functioning Inventory as a Depression Screening Tool After Traumatic Brain Injury
Is the Neurobehavioral Functioning Inventory (NFI) a useful tool for diagnosing depression?
Past Studies have found that it is common for individuals with traumatic brain injury (TBI) to have psychiatric disturbance as a result of their injury. Review of the literature on diagnosing psychiatric dysfunction showed that TBI frequently caused a number of psychiatric disorders (major depression,
Use of structured interviews based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) to assess psychiatric disorders has been a widely accepted tool. DSM-IV utilizes a set of five criteria to accurately diagnose depression; the first including a list of nine symptoms of depression, of which five must be present. Time requirements have made using this tool impractical for use with individuals with TBI. The depression rating scales developed for the general population, as an alternative, have not been recommended for routine use as diagnostic tools for individuals with TBI. The Neurobehavioral Functioning Inventory (NFI), developed specifically for individuals with TBI, has been the assessment tool that includes characteristics suitable to assess depression in patients with TBI. It is a brief self-reporting tool which measures neurobehavioral functioning (nervous system
This Study attempts to address the issue of whether
Seventy-eight individuals with TBI were selected for this study. They were three months
Who May Be Affected By These Findings
Individuals with brain injury, their families, caregivers, health professionals, community providers, researchers.
Limitations of this study were a small sample size, self-reporting by individuals with TBI which may have precluded accurate reporting, diagnosis of depression by counting the number of symptoms without determining the etiology of the depression, and that certain questions on the NFI did not seem necessary for diagnosing depression. Further studies need to address these issues.
Study findings support the use of NFI as a potentially valuable assessment tool with good predictive value for determining major depression in individuals with TBI. The NFI scores, thought to be indicative of depression, were noticeably higher among individuals with a diagnosis of MDD than those without MDD. NFI was found to be particularly useful in rehabilitation settings for assessment of multiple neurobehavioral functioning areas, including
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Kennedy, R.E., Livingston, L. Riddick, A., Marwitz, H.., Kreutzer, J.S., Zasler, N.D. (2005).Evaluation of the Neurobehavioral Functioning Inventory as a Depression Screening Tool After Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 20 (6); 512-526.