The problem checklist PCL Cavallo, Kay,

1
Efficacy and Base Rates of the Problem
Checklist and Competency Ratings of the Head
Injury Family Interview in Assessing Personal
Injury Claimants Sharron Dawes, B.Sc. (Hons).,
University of Southern Queensland, Australia,
Graeme J. Senior, Ph.D., University of Southern
Queensland, Australia, Rael T. Lange, Ph.D.,
Riverview Hospital, Canada
INTRODUCTION The problem checklist (PCL
Cavallo, Kay, Ezrachi, 1992) and competency
ratings (CRS Prigatano et al., 1986) form part
of the Head Injury Family Interview. While
developed primarily for use in rehabilitation
settings, we have found them to be valuable in
characterising the types of difficulties reported
by personal injury claimants (with and without
TBI) and the impact they have upon their daily
living. The objective of the current study was to
examine the underlying factor structure of these
measures in the medicolegal setting and generate
standardised subscales to better characterise
self-reports on these measures.
PARTICIPANTS Normative Sample 189
Community volunteers Mean Age 35.7 (SD
13.4) Mean Education 12.5 (SD 2.2)
Gender Male (n 84) Female (n 105)
Participants were excluded from the study if they
self-reported any history of
psychiatric or neurological disorders.
Clinical Sample 138 personal injury
claimants (82 with TBI) from a private
practice in Brisbane, Queensland. Mean Age
37.8 (SD 13.7) Mean Education 11.5 (SD
2.6) Gender Male (n 97) Female (n
41) MEASURES The PCL and CRS were derived
from Version 1.0 of the New York University
Head Injury Family Interview (Cavallo, Kay,
Ezrachi, 1992). Administration instructions
were modified only to remove references to
head injury and Australian spelling was
utilised instead of American. The PCL
consists of 34 problems likely to be
experienced by a person with a TBI (see Table
1a) PCL ratings are made on a 7 point scale 1
No problem to 7- Severe problem The CRS
consists of 30 items which query aspects of
daily living (see Table 1b). CRS ratings
are made on a 5-point scale 1- Cant do
2 Very Difficult to do 3 - Can do with
some difficulty 4 Fairly easy to do and
5 Can do with ease.
RESULTS (cont.) Competency Ratings PCA with
oblique rotation was conducted on the combined
normative and clinical samples. Five
components were retained with eigenvalues of
greater than 1 (46.6, 6.7, 4.4, 4.0, 3.6
of the total variance accounted for
respectively). 1 component included only one
item (Item 30. controlling my laughter)
with a factor loading greater than 0.4, and
was dropped from consideration. The
characteristics of the CRS and its four
subscales for both samples are presented in
Table 2b. No significant differences between
TBI and non-TBI.
RESULTS (cont.)
Table 2a. Problem Checklist Characteristics
Table 2b. Competency Rating Characteristics
Table 1a. Problem Checklist Items
USING THE SCALES Linear T-Scores can be
readily computed for each of the scales and
their respective subscales using the means
and standard deviations from the normative
sample. For PCL T (PCL - Mean)/SD x 10
50 For CRS T (Mean CRS)/SD x 10 50
(The sign is reversed in order to retain the
convention of higher T-scores indicating
greater difficulty. Note that higher raw scores
on the CRS indicate greater ability.) A
cut-score of T65 is recommended for
indicating as with the current samples this
results in the greatest overall predictive
power. No significant differences between TBI
and non-TBI cases on the PCL and CRS
suggests that the item content is not
specific to TBI and may have equal salience
in other conditions. In the personal injury
claimant setting more subscales were
generated for the PCL (four compared to
three) than in prior research (Kay et al.,
1995). Less subscales (four compared to
six) were derived for the CRS than in a
normative study conducted by Heilbronner et
al. (1993). REFERENCES Cavallo, M.M., Kay, T.,
Ezrachi, O. (1992). Problems and changes
after traumatic brain injury Differing
perceptions within and between families. Brain
Injury, 6(4), 327-335. Heilbronner, R.L.,
Milsaps, C., Azrin, R., Mittenberg, W.
(1993). Psychometric properties of the patient
competency rating scale. Journal of Clinical
and Experimental Neuropsychology, 15, 67. Kay,
T., Cavallo, M.M., Ezrachi, O., Vavagiakis, P.
(1995). The Head Injury Family Interview A
clinical and research tool. Journal of Head
Trauma Rehabilitation, 10 (2),
12-31. Prigatano, G., Fordyce, D., Zeiner, H.,
Roueche, J., Pepping, M., Wood, B.C. (1986).
Neuropsychological Rehabilitation After Brain
Injury. Baltimore, Md Johns Hopkins.
Table 1b. Competency Ratings Items
RESULTS Problem Checklist
Principle components analysis (PCA) with oblique
rotation was conducted on the combined
samples. Six components were retained with
eigenvalues of greater than 1 (48.7, 5.9,
3.8, 3.8, 3.2, 3.0 of total variance
accounted for respectively). 1 component
included only one item (Item 33. high sex
drive) with a factor loading greater than 0.4
and was dropped from consideration. The
characteristics of the full scale and the five
derived components for both normative and
clinical samples are presented in Table 2a.
No significant differences were found between PCL
scores for those with or without TBI.