Review of the Neurobehavioral Symptom Inventory.

Abstract

Purpose/Objective: To describe the psychometrics and utility of the Neurobehavioral Symptom Inventory (NSI) and provide suggestions for clinical usage and future research. Research Method/Design: Thirty studies examining aspects of the NSI, published between 1995 and 2020, were reviewed. Results: The NSI is a 22-item self-report questionnaire of neurobehavioral symptoms. The NSI was first published in 1995 and has since been adopted by the Department of Defense and Department of Veterans affairs for traumatic brain injury (TBI) research and clinical evaluation. Most research on the NSI has been conducted in veteran and military samples with predominantly mild TBI. Cronbach’s alpha ranged from .81 to .96 for the total score and exceeded .80 for most scales. Test–retest values ranged from .78 to .94 for the total score and ranged from .52 to .91 for subscales. Item content overlaps with psychiatric disorders and is expectedly correlated with psychiatric measures and emotional distress. Although consensus about its factor structure is lacking, the 3- and 4-factor solutions have been replicated and have the strongest support. Subsequent researchers have published reliable change indices, embedded validity indices, and normative data using civilian and military samples. Conclusions/Implications: The NSI has acceptable reliability and some evidence supporting its validity in measuring neurobehavioral symptoms. Although not intended to diagnose TBI, the NSI has value for clinicians and researchers in characterizing the presence and severity of symptom complaints and tracking symptomatic change in persons with TBI.

Sex Differences in Behavioral Symptoms and the Levels of Circulating GFAP, Tau, and NfL in Patients With Traumatic Brain Injury

“…Postconcussive symptoms were measured using the Neurobehavioral Symptom Inventory (NSI), a 22-item questionnaire that includes somatosensory, affective, cognitive, and vestibular sub-scales. The questionnaire has been validated in the TBI population with an acceptable test-retest indices (r ranging 0.78-0.94) and good internal consistency (α ≥ 0.80) for NSI total, and test-retest reliability with r ranging 0.52 to 0.91 and α ≥ 0.80 for its subscales (Silva 2020). The items on the questionnaire are rated from 0 (none) to 4 (severe) with higher scores indicating worse symptoms.…”

Network Analysis of Neurobehavioral and Post-Traumatic Stress Disorder Symptoms One Year after Traumatic Brain Injury: A Veterans Affairs Traumatic Brain Injury Model Systems Study

“…45 Analyses of the NSI factor structure have yielded various solutions; the 3-factor (cognitive, affective, and somatosensory/vestibular) and 4-factor (cognitive, affective, somatosensory, and vestibular) solutions have tended to be stronger and replicable. 46 The NSI has demonstrated strong internal consistency and acceptable test-retest reliability. 46 The Cronbach α among the current sample was .94.…”

“…46 The NSI has demonstrated strong internal consistency and acceptable test-retest reliability. 46 The Cronbach α among the current sample was .94.…”

Evaluation of post-traumatic stress disorder (PTSD) and related comorbidities in clinical studies

“…To measure neurobehavioral symptoms in patients with TBI, several scales are available. One frequently used scale is the Neurobehavioral Symptom Inventory (NSI) which consists of a 22-item self-report questionnaire regarding neurobehavioral symptoms [ 55 ]. The first version of the NSI was first published as a symptom checklist in 1995 by Cicerone and Kalmar in the Journal of Head Trauma Rehabilitation.…”

“…The Department of Veterans Affairs (VA) uses the Neurobehavioral Symptom Inventory (NSI) to measure postconcussive symptoms (present within the last two weeks) in its comprehensive traumatic brain injury (TBI) evaluation; however, the scale domain is not limited to TBI [ 56 ]. It is also important to note that most of the research on the NSI was conducted in veteran and military samples with predominantly mild TBI [ 55 ]. Nevertheless, studies have demonstrated that this scale is a reliable and valid measure of postconcussive symptoms and helps differentiate veterans with TBI from those without TBI.…”