Assessing distress in caregivers of people with a traumatic brain injury (TBI): a psychometric study of the Head Injury Behaviour Scale

This study examined the psychometric properties of the Head Injury Behaviour Scale (HIBS) using responses from 242 caregivers. The HIBS is a 20-item, scale describing common behavioural problems following traumatic brain injury (TBI), which are typical of dysexecutive syndrome. A principal components analysis was conducted on caregiver distress ratings for the 20 items comprising the HIBS and produced a two-factor solution with 10 items loading on each factor. Consequently, two sub-scales were derived and labelled Emotional Regulation and Behavioural Regulation. The sub-scales were found to have good internal-consistency reliability. It is suggested that the Emotional Regulation sub-scale assesses behaviours reflecting impaired emotional control, occurring during interactions with caregivers. The Behavioural Regulation sub-scale assesses problems typical of dysexecutive syndrome, but which carry less emotional valence for caregivers. The clinical implications of these findings are discussed and normative data provided for the two sub-scales.