Agitated Behavior Scale

Original Editor - Shreya Pavaskar

Top Contributors - Shreya Pavaskar  

Objective[edit | edit source]

The agitated behavior scale (ABS) was designed to evaluate agitation and other problematic behaviors that commonly occur during the acute recovery phase following traumatic brain injury.[1]

Intended Population[edit | edit source]

Patients with Traumatic brain Injury

Method of Use[edit | edit source]

The ABS was used for the assessment of agitated behavior. It is a 14-item scale comprising different types of behavior. Each item is rated from 1 (absent) to 4 (present to an extreme degree). Total scores of 21 points or below are classified as normal behavior, 22–28 as mild agitation, 29–35 as moderate agitation, and 36–56 as severe agitation.

Score 1: Absent

Score 2: Slight. Does not prevent patient from conducting other appropriate behavior

Score 3: Moderate. Requires redirection from agitated to appropriate behavior

Score 4: Extreme. Despite redirection attempts, Agitation persists


Protocol: Behaviors (assign a score of 1 to 4 to each of the following 14)[edit | edit source]

  1. Short attention span, easy distractibility, inability to concentrate
  2. Impulsive, impatient, low tolerance for pain or frustration
  3. Uncooperative, resistant to care or demanding
  4. Violent and or threatening Violence toward people or property
  5. Explosive or unpredictable anger
  6. Rocking, rubbing, moaning or other self-stimulating behavior
  7. Pulling at tubes or restraints
  8. Wandering from treatment areas
  9. Restlessness, 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[edit | edit source]

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

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

Excellent correlation for total score (1=02), with factor correlations for Disinhibition (r=00), Aggression (1=91) and Lability (1=73) when conducted by research assistants

Adequate correlations for research stall and nursing ratings (range 1=304 to ,004) based on a 1o minute obsèrvation from research staff and entire shift ratings by nursing

Validity[edit | edit source]

Traumatic Brain Injury: (Corrigan & Bogner, 1994; N=212; mean age=31.2 (14-3) years; admissions to inpatient rehabilitation unit with acquired brain injury)

Confirmatory factor analysis supported the subscale structure of three components of aggression, disinhibition and lability representing the construct of agitation[2]

Responsiveness[edit | edit source]

Agitation as measured by the ABS is best represented as a unitary construct. Results provide additional support for the reliability and validity of the ABS.

References[edit | edit source]

  1. Kreutzer JS, Caplan B, DeLuca J. Encyclopedia of Clinical Neuropsychology; With 199 Figures and 139 Tables. Springer; 2011.
  2. 2.0 2.1 Bogner JA, Corrigan JD, Bode RK, Heinemann AW. Rating scale analysis of the Agitated Behavior Scale. The Journal of head trauma rehabilitation. 2000 Feb 1;15(1):656-69.