A - 167 Neuropsychological Correlates of Challenging Behavior in Moderate to Severe ABI.

Abstract

Cognitive and behavioral changes, common after severe acquired brain injury (ABI), are important predictors of functional recovery, independence, and quality of life. The Overt Behavior Scale (OBS) is a standardized measure of challenging behaviors following ABI, and has been associated with pre-injury risk factors and psychosocial stressors. Information about the neuropsychological underpinnings of OBS scores is unknown, however. The current study is a preliminary analysis of relationships among OBS scores and neuropsychological data associated with behavioral dysregulation in adults with chronic moderate to severe ABI in a residential neurorehabilitation setting. Participants were 81 adults, ages 27-71 (SD = 10.46), 55 males, with average education of 12.6years, and average time since injury of 26.34 (SD = 13.35). Participants were administered neuropsychological tests (including NAB Screening Module Memory, Executive Functioning, and Attention Index and subtests, NAB Judgment, and Trails B). The OBS was administered by the psychology provider with input from the treatment team. Exploratory correlations examined the relationship between neuropsychological tests and OBS scores. Results found a significant relationship between the number of challenging behaviors on the OBS and NAB delayed story recall (p < 0.040, r = -0.266). Other correlations between OBS and the NAB and Trails B were not significant. The results raise the possibility that the OBS captures unique aspects of behavioral change that are not measured by traditional neuropsychological tests. Other possible explanations of the data include that the severity of cognitive impairment and physical limitations may be moderating factors, which will be examined in future studies.