B-61 Single-Item Reporting on the Neurobehavioral Symptom Inventory to Determine Clinical Levels of Depression: How Brief is too Brief?

Abstract

Abstract Objective The Neurobehavioral Symptom Inventory (NSI) is frequently used in the Department of Veterans Affairs as a self-report measure to assess for a variety of medical and mental health concerns in veterans who have suffered traumatic brain injury (TBI). Only one item on the NSI (item 20) relates to depressive symptoms (i.e., feeling depressed or sad). The purpose of the study was to compare responses on the Beck Depression Inventory-II (BDI-II) with item 20 of the NSI to determine classification for mild depressive symptomatology. Method Retrospective data collected from veteran patients (N = 325) of a polytrauma outpatient clinic were used in the analysis. Veterans were excluded if cutoff scores exceeded an embedded validity scale (i.e., NSI Validity-10) or had missing data. Receiver Operating Curve (ROC) analysis was conducted to determine which item score (i.e., score of 0-4) on the NSI best classified the presence of depressive symptoms as measured by a BDI-II cut-off score greater than 13 (i.e., mild depression). Results There were 55 subjects who tested positive for depression based on a cut-off score of 3 on the NSI. The ROC analysis was significant (AUC = .822, p < .001; 95% CI = .774 - .871). A cut-off score of greater than 13 on the BDI-II yielded a sensitivity rate of .982 and a specificity rate of .607. Conclusions These results indicate that item 20 of the NSI is indicative of a positive screen for depressive symptomatology with scores of 3 or greater indicating that further evaluation for depression is warranted.