Agitated Behavior Scale

Objective

The Agitation Behavior Scale (ABS) was designed to assess agitation and other problem behaviors that typically occur during the acute recovery phase after traumatic brain injury. [1]

Intended Population

Patients with Traumatic brain Injury

Method of Use

ABS was used to assess agitation. This is a 14-item scale that includes different types of behaviors. Each item is rated from 1 (absent) to 4 (extremely present). A total score of 21 or less is normal behavior 22-28 is mild agitation 29-35 is moderate agitation, 36-56 is severe agitation.

Score 1: Absent

2 points: slight. Does not prevent the patient from engaging in otherwise appropriate behavior

3 points: Moderate. Need to move from agitation to appropriate behavior

Score 4: Extreme. The commotion persists despite trying to redirect

Procedure: Behavior (assign 1 to 4 points for each of the following 14 items)

1. Short attention span Easily distracted Difficulty concentrating
2. Impulsive impatience Low tolerance for pain or frustration
3. Uncooperative resisting care or requests
4. Violence and/or threats of violence against persons or property
5. Explosive or unpredictable anger
6. Shaking, rubbing, moaning, or other self-stimulating behavior
7. Pulling at tubes or restraints
8. Wandering from treatment areas
9. restless pacing or excessive movement
10. Repetitive behaviors (motor or verbal)
11. Rapid, loud or excessive talking.
12. Sudden changes of mood.
13. Excessive crying or laughing.
14. Self-abusiveness (physical or verbal)

Reliability

Test/Retest Reliability – (Corrigan 1989; 1=35; mean age=28.2; secondary education=12 years) Excellent correlation (r=70) of same-day scores between therapists and nurses[2]

Interater/interrater reliability – TBI: (Bogner et al. 1099; 17=45; admitted to acute rehab s/p TBI)

Total score (1=02) correlated well with factor correlations for disinhibition (r=00), aggression (1=91) and instability (1=73) when conducted by a research assistant

Sufficient correlation of booth and nursing ratings (range 1 = 304 to 004) based on the researcher’s 1-minute observation and the nursing staff’s entire shift rating

Validity

Traumatic brain injury: (Corrigan & Bogner 1994; N=212; mean age=31.2 (14-3) years; admitted to rehabilitation unit for acquired brain injury)

Confirmatory factor analysis supports a three-component subscale structure of aggressive disinhibition and instability, representing the structure of agitation[2]

Responsiveness

Agitation measured by ABS is best represented as a single structure. The results provide additional support for the reliability and effectiveness of ABS.