Psychometric Properties of the German Version of the Rivermead Post-Concussion Symptoms Questionnaire in Adolescents after Traumatic Brain Injury and Their Proxies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Ethical Approval
2.3. Sociodemographic and Injury-Related Data
2.4. Instruments
2.4.1. Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
2.4.2. Post-Concussion Symptom Inventory (PCSI)
2.4.3. Generalized Anxiety Disorder Scale 7 (GAD-7)
2.4.4. Patient Health Questionnaire 9 (PHQ-9)
2.5. Statistical Analyses
2.5.1. Item Characteristics
2.5.2. Reliability
2.5.3. Factorial Validity
2.5.4. Construct Validity
2.6. Agreement between Self-Report and Proxy Assessment
3. Results
3.1. Sample Characteristics
3.2. Item Characteristics
3.3. Reliability
3.4. Factorial Validity
3.5. Convergent and Divergent Validity
3.6. Agreement between Self-Report and Proxy Assessment
4. Discussion
Strengths and Limitations
5. Conclusions and Outlook
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Source | Symptom | Scale | M | SD | SK | KU | Floor | Ceiling | % Missing |
---|---|---|---|---|---|---|---|---|---|
Self-report | Headaches | S | 0.98 | 1.04 | 0.79 | −0.42 | 40 | 1 | 3.38 |
Feeling of Dizziness | S | 0.65 | 0.88 | 1.23 | 0.59 | 55 | 0 | 2.70 | |
Nausea and/or Vomiting | S | 0.37 | 0.75 | 2.36 | 5.79 | 73 | 1 | 2.03 | |
Noise Sensitivity, easily upset by loud Noise | S | 0.78 | 1.02 | 1.14 | 0.50 | 54 | 2 | 2.03 | |
Sleep Disturbance | S | 0.80 | 1.08 | 1.28 | 0.71 | 53 | 3 | 2.03 | |
Fatigue, tiring more easily | S | 1.06 | 1.10 | 0.92 | 0.08 | 37 | 3 | 2.03 | |
Being Irritable, easily angered | E | 1.12 | 1.16 | 0.87 | −0.13 | 37 | 5 | 2.03 | |
Feeling Depressed or Tearful | E | 0.78 | 1.18 | 1.45 | 1.05 | 59 | 5 | 2.03 | |
Feeling Frustrated or Impatient | E | 0.92 | 1.01 | 0.97 | 0.16 | 42 | 1 | 2.03 | |
Forgetfulness, poor memory | C | 1.06 | 1.14 | 0.92 | −0.04 | 40 | 4 | 2.03 | |
Poor Concentration | C | 1.23 | 1.18 | 0.55 | −0.88 | 34 | 3 | 2.03 | |
Taking Longer to Think | C | 0.72 | 0.94 | 1.30 | 1.21 | 52 | 1 | 2.70 | |
Blurred Vision | S | 0.49 | 0.86 | 1.83 | 2.76 | 68 | 1 | 2.03 | |
Light Sensitivity, easily upset by bright light | S | 0.46 | 0.92 | 2.28 | 4.66 | 72 | 2 | 2.03 | |
Double Vision | S | 0.21 | 0.59 | 2.91 | 8.06 | 84 | 0 | 2.03 | |
Restlessness | E | 0.55 | 0.85 | 1.73 | 3.07 | 61 | 1 | 2.03 | |
Proxy assessment | Headaches | S | 0.94 | 1.17 | 1.02 | −0.07 | 49 | 3 | 2.03 |
Feeling of Dizziness | S | 0.46 | 0.91 | 1.94 | 2.70 | 72 | 1 | 4.05 | |
Nausea and/or Vomiting | S | 0.29 | 0.73 | 3.10 | 10.37 | 79 | 1 | 3.38 | |
Noise Sensitivity, easily upset by loud Noise | S | 0.69 | 1.03 | 1.34 | 0.74 | 60 | 1 | 2.70 | |
Sleep Disturbance | S | 0.79 | 1.07 | 1.28 | 0.82 | 53 | 3 | 3.38 | |
Fatigue, tiring more easily | S | 0.93 | 1.16 | 0.97 | −0.32 | 49 | 2 | 2.70 | |
Being Irritable, easily angered | E | 1.06 | 1.18 | 1.07 | 0.25 | 39 | 6 | 2.03 | |
Feeling Depressed or Tearful | E | 0.51 | 1.01 | 2.21 | 4.21 | 70 | 4 | 3.38 | |
Feeling Frustrated or Impatient | E | 0.86 | 1.06 | 1.23 | 0.81 | 46 | 3 | 2.70 | |
Forgetfulness, poor memory | C | 1.03 | 1.26 | 0.89 | −0.48 | 49 | 5 | 2.70 | |
Poor Concentration | C | 1.14 | 1.25 | 0.72 | −0.70 | 43 | 5 | 2.70 | |
Taking Longer to Think | C | 0.67 | 1.06 | 1.48 | 1.12 | 63 | 2 | 2.03 | |
Blurred Vision | S | 0.29 | 0.74 | 3.03 | 9.82 | 80 | 1 | 2.03 | |
Light Sensitivity, easily upset by bright light | S | 0.46 | 0.85 | 1.88 | 2.57 | 70 | 0 | 2.70 | |
Double Vision | S | 0.12 | 0.55 | 5.49 | 32.81 | 91 | 1 | 2.03 | |
Restlessness | E | 0.37 | 0.77 | 2.24 | 4.79 | 75 | 1 | 2.70 |
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Variable | Group/Values | Adolescents (n = 148) | Proxies (n =147) |
---|---|---|---|
Gender † | Female | 62 (42%) | 121 (82%) |
Male | 85 (57%) | 26 (18%) | |
Diverse | 1 (1%) | 0 (0%) | |
Missing | 0 (0%) | 1 (1%) | |
Age | M (SD) | 15.24 (1.47) | 47.97 (5.64) |
Min–Max | 13.00–17.92 | 35.00–70.00 | |
TBI severity † | Mild | 109 (74%) | - |
Moderate | 9 (6%) | - | |
Severe | 30 (20%) | - | |
Presence of lesions † | No lesions | 100 (68%) | - |
At least one lesion | 43 (29%) | - | |
Missing | 5 (3%) | - | |
Years since injury † | <1 | 3 (2%) | - |
1–<2 | 20 (14%) | - | |
2–<4 | 36 (24%) | - | |
4–10 | 88 (59%) | - | |
Missing | 1 (13%) | - | |
KOSCHI Score † | 3a (lower severe disability) | 0 (0%) | - |
3b | 0 (0%) | - | |
4a | 5 (3%) | - | |
4b | 18 (12%) | - | |
5a | 25 (17%) | - | |
5b (full recovery) | 100 (68%) | - |
Source | RPQ | PCSI-SR13 | GAD-7 | PHQ-9 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
C | S | E | Total | C | P | E | F | Total | Total | Total | ||
Self-report | n | 145 | 145 | 145 | 145 | 123 | 123 | 123 | 123 | 123 | 143 | 143 |
M | 2.13 | 3.79 | 2.25 | 8.17 | 5.63 | 6.18 | 5.02 | 3.22 | 16.82 | 3.43 | 4.7 | |
SD | 3.03 | 5.22 | 3.43 | 9.96 | 5.47 | 6.66 | 5.52 | 3.52 | 15.39 | 3.57 | 4.19 | |
Mdn | 0 | 2 | 0 | 4 | 4 | 4 | 3 | 3 | 12 | 2 | 4 | |
W | 0.74 | 0.75 | 0.71 | 0.80 | 0.85 | 0.82 | 0.83 | 0.82 | 0.86 | 0.82 | 0.88 | |
Proxy assessment | n | 145 | 145 | 145 | 145 | 122 | 122 | 122 | 121 | 122 | 143 | 143 |
M | 2.29 | 3.57 | 1.84 | 7.7 | 3.3 | 3.75 | 3.34 | 2.04 | 10.38 | 3.44 | 4.71 | |
SD | 3.29 | 5.49 | 3.31 | 10.25 | 5.07 | 5.88 | 4.8 | 3.44 | 13.55 | 3.58 | 4.22 | |
Mdn | 0 | 0 | 0 | 2 | 1 | 2 | 1 | 0 | 6 | 2 | 4 | |
W | 0.73 | 0.70 | 0.63 | 0.77 | 0.70 | 0.69 | 0.73 | 0.65 | 0.76 | 0.82 | 0.88 |
Source | Scale | Cronbach’s α | Cronbach’s α When Item Omitted | McDonald’s ω | Corrected Item-Total Correlation Range | Correlations | ||
---|---|---|---|---|---|---|---|---|
(1) | (2) | (3) | ||||||
Self-report | (1) Cognitive | 0.84 | 0.74–0.83 | 0.84 | 0.70–0.81 | 1 | – | – |
(2) Somatic | 0.82 | 0.79–0.83 | 0.82 | 0.34–0.73 | 0.57 | 1 | – | |
(3) Emotional | 0.81 | 0.72–0.79 | 0.82 | 0.67–0.80 | 0.62 | 0.64 | 1 | |
(4) Total score | 0.90 | 0.89–0.90 | 0.93 | 0.40–0.76 | 0.80 | 0.91 | 0.86 | |
(1) | (2) | (3) | ||||||
Proxy assessment | (1) Cognitive | 0.90 | 0.82–0.92 | 0.91 | 0.77–0.91 | 1 | – | – |
(2) Somatic | 0.86 | 0.83–0.87 | 0.86 | 0.37–0.76 | 0.56 | 1 | – | |
(3) Emotional | 0.83 | 0.71–0.84 | 0.84 | 0.59–0.89 | 0.60 | 0.61 | 1 | |
(4) Total score | 0.91 | 0.90–0.92 | 0.95 | 0.30–0.76 | 0.80 | 0.91 | 0.83 |
Confirmatory Factor Analyses (CFA) | Model Comparison | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Source | Model | χ2 | df | χ2/df | p | CFI | TLI | RMSEA | CI90% | SRMR | ∆χ2 (∆df) | p |
Self-report | One factor | 225.89 | 104 | 2.50 | <0.001 | 0.98 | 0.98 | 0.09 | [0.07, 0.11] | 0.1 | 49.05 (3) | <0.001 |
Three factors | 141.04 | 101 | 1.86 | 0.005 | 0.99 | 1.00 | 0.05 | [0.03, 0.07] | 0.09 | – | – | |
Proxy assessment | One factor | 475.72 | 104 | 4.14 | <0.001 | 0.96 | 0.96 | 0.16 | [0.14, 0.17] | 0.16 | 89.68 (3) | <0.001 |
Three factors | 209.72 | 101 | 2.40 | <0.001 | 0.99 | 0.99 | 0.08 | [0.07, 0.10] | 0.12 | – | – |
Source | n | Total (RPQ, PCSI) | Somatic (RPQ), Physical (PCSI) | Emotional (RPQ, PCSI) | Cognitive (RPQ, PCSI) |
---|---|---|---|---|---|
Self-report | 123 | 0.80 | 0.70 | 0.70 | 0.71 |
Proxy assessment | 121 | 0.75 | 0.57 | 0.64 | 0.71 |
Source | PROM | Total | Somatic | Emotional | Cognitive |
---|---|---|---|---|---|
Self-report | GAD-7 | 0.36 | 0.34 | 0.38 | 0.25 |
PHQ-9 | 0.35 | 0.31 | 0.33 | 0.30 | |
Proxy assessment | GAD-7 | 0.53 | 0.37 | 0.59 | 0.42 |
PHQ-9 | 0.62 | 0.48 | 0.57 | 0.52 |
Variable | Scale | Group | n | M | Md | Cliff’s δ | W | p |
---|---|---|---|---|---|---|---|---|
Sex | Total score | Male | 83 | 6.41 | 3 | −0.19 | 2044 | 0.022 |
Female | 61 | 10.54 | 8 | |||||
Cognitive | Male | 83 | 1.82 | 0 | −0.13 | 2214.5 | 0.077 ☨ | |
Female | 61 | 2.59 | 0 | |||||
Emotional | Male | 83 | 1.55 | 0 | −0.23 | 1953 | 0.005☨ | |
Female | 61 | 3.23 | 2 | |||||
Somatic | Male | 83 | 3.04 | 2 | −0.15 | 2156.5 | 0.055 ☨ | |
Female | 61 | 4.72 | 2 | |||||
TBI severity | Total score | Mild | 107 | 7.80 | 4 | −0.12 | 1795 | 0.137 |
Moderate—Severe | 38 | 9.18 | 6 | |||||
Cognitive | Mild | 107 | 1.69 | 0 | −0.28 | 1473.5 | 0.003☨ | |
Moderate—Severe | 38 | 3.37 | 3 | |||||
Emotional | Mild | 107 | 2.24 | 0 | −0.02 | 1994 | 0.424 ☨ | |
Moderate—Severe | 38 | 2.26 | 0 | |||||
Somatic | Mild | 107 | 3.87 | 2 | −0.04 | 1961 | 0.368 ☨ | |
Moderate—Severe | 38 | 3.55 | 2 | |||||
KOSCHI score | Total score | 5b | 123 | 5.09 | 4 | −1.02 | 1534.5 | <0.001 |
<5b | 22 | 13.15 | 12.5 | |||||
Cognitive | 5b | 123 | 1.48 | 0 | −1.15 | 1703 | 0.002☨ | |
<5b | 22 | 3.98 | 3.5 | |||||
Emotional | 5b | 123 | 1.26 | 0 | −0.60 | 1718.5 | 0.003☨ | |
<5b | 22 | 3.06 | 2.5 | |||||
Somatic | 5b | 123 | 2.36 | 2 | −0.83 | 1505.5 | <0.001☨ | |
<5b | 22 | 6.11 | 3.5 | |||||
GAD-7 | Total score | <5 | 110 | 5.57 | 2 | −1.10 | 1034.5 | <0.001 |
≥5 | 37 | 15.26 | 14 | |||||
Cognitive | <5 | 110 | 1.45 | 0 | −0.97 | 1120.5 | <0.001☨ | |
≥5 | 37 | 4.17 | 5 | |||||
Emotional | <5 | 110 | 1.44 | 0 | −1.00 | 1090 | <0.001☨ | |
≥5 | 37 | 4.54 | 3 | |||||
Somatic | <5 | 110 | 2.68 | 0 | −0.82 | 1180.5 | <0.001☨ | |
≥5 | 37 | 6.54 | 5 | |||||
PHQ-9 | Total score | <5 | 89 | 5.45 | 2 | −0.69 | 1619 | <0.001 |
≥5 | 58 | 11.82 | 9 | |||||
Cognitive | <5 | 89 | 1.38 | 0 | −0.65 | 1769 | 0.001☨ | |
≥5 | 58 | 3.27 | 2 | |||||
Emotional | <5 | 89 | 1.41 | 0 | −0.62 | 1651 | <0.001☨ | |
≥5 | 58 | 3.43 | 2 | |||||
Somatic | <5 | 89 | 2.66 | 0 | −0.51 | 1785.5 | 0.002☨ | |
≥5 | 58 | 5.12 | 4 |
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Bockhop, F.; Zeldovich, M.; Greving, S.; Krenz, U.; Cunitz, K.; Timmermann, D.; Bonke, E.M.; Bonfert, M.V.; Koerte, I.K.; Kieslich, M.; et al. Psychometric Properties of the German Version of the Rivermead Post-Concussion Symptoms Questionnaire in Adolescents after Traumatic Brain Injury and Their Proxies. J. Clin. Med. 2023, 12, 319. https://doi.org/10.3390/jcm12010319
Bockhop F, Zeldovich M, Greving S, Krenz U, Cunitz K, Timmermann D, Bonke EM, Bonfert MV, Koerte IK, Kieslich M, et al. Psychometric Properties of the German Version of the Rivermead Post-Concussion Symptoms Questionnaire in Adolescents after Traumatic Brain Injury and Their Proxies. Journal of Clinical Medicine. 2023; 12(1):319. https://doi.org/10.3390/jcm12010319
Chicago/Turabian StyleBockhop, Fabian, Marina Zeldovich, Sven Greving, Ugne Krenz, Katrin Cunitz, Dagmar Timmermann, Elena M. Bonke, Michaela V. Bonfert, Inga K. Koerte, Matthias Kieslich, and et al. 2023. "Psychometric Properties of the German Version of the Rivermead Post-Concussion Symptoms Questionnaire in Adolescents after Traumatic Brain Injury and Their Proxies" Journal of Clinical Medicine 12, no. 1: 319. https://doi.org/10.3390/jcm12010319
APA StyleBockhop, F., Zeldovich, M., Greving, S., Krenz, U., Cunitz, K., Timmermann, D., Bonke, E. M., Bonfert, M. V., Koerte, I. K., Kieslich, M., Roediger, M., Staebler, M., Berweck, S., Paul, T., Brockmann, K., Rojczyk, P., Buchheim, A., & von Steinbuechel, N. (2023). Psychometric Properties of the German Version of the Rivermead Post-Concussion Symptoms Questionnaire in Adolescents after Traumatic Brain Injury and Their Proxies. Journal of Clinical Medicine, 12(1), 319. https://doi.org/10.3390/jcm12010319