Preliminary validation of a checklist for lifetime exposure to sources of central nervous system compromise

Research Objectives: To develop a formal index from a checklist for lifetime exposure to sources of central nervous system compromise (CNSC) and provide preliminary evidence of validity with regard to neurobehavioral symptoms in a sample of Spanish-speakers. The CNSC was developed by the Ohio Valley Center for Brain Injury Prevention and Rehabilitation to be used as a covariate in traumatic brain injury research to control for other sources of neurological compromise.

Design: Cross-sectional

Setting: Online survey.

Participants: 709 individuals from a community sample of Spanish-speakers recruited from the U.S., Spain, and Latin America completed an online survey.

Interventions: Not Applicable.

Main Outcome Measures: The CNSC checklist was included in a web-based survey along with the Ohio State University Traumatic Brain Injury Identification Self-Administered-Brief (OSU TBI-ID SAB) and the Neurobehavioral Symptom Inventory.

Results: An initial index quantifying exposure to sources of CNS compromise demonstrated a significant relationship with neurobehavioral symptoms. However, the upper categories demonstrated little differentiation. These were collapsed to indicate endorsement of no sources, 1 source, or more than one source of CNS compromise. Controlling for history of exposure to traumatic brain injury, this index demonstrated a satisfactory relationship with neurobehavioral symptoms with a medium effect size [F(2,703)=37.0, p< 0.001, partial eta squared=0.095]. The NSI scores of those in with 1 source of CNS compromise were significantly greater than those in the group with no endorsement (p < 0.001), and significantly below those endorsing more than one source of CNS compromise (p < 0.001).

Conclusions: The CNSC index demonstrated preliminary evidence of validity with expected relationships with neurobehavioral symptoms. Additional validation may consider comparing self-report with medical records or other reliable sources for convergent validity. Nevertheless, this tool appears to be useful for survey research wishing to examine sources of CNS compromise apart from TBI either as a covariate or as a subject for further investigation of lifetime exposure and neurobehavioral outcomes.

Author(s) Disclosures: Authors have no conflicts of interest to disclose.