The Katz Adjustment Scale: modification for use with victims of traumatic brain and spinal injury

Abstract

Although the assessment of the social, emotional and personality sequelae of traumatic injury is of central clinical and medico-legal importance, no satisfactory standard assessment device for this purpose has yet been developed. A multicentered study of a mixed group of head and spinally injured patients is reported. Factor analysis of a modified version of the relatives' form of the Katz Social Adjustment Scale (KAS-R) yielded 30 first-order factors under three main domains of emotional/psychosocial, physical/intellectual and psychiatric changes, together with seven second-order factors which were readily identifiable in terms of syndromes accompanying traumatic injury. Discriminant function analyses indicated that prediction of patient group using KAS-R data was most accurate using the current study's first-order factors as compared with the original factor structure proposed by Katz and Lyerly or the second-order factors from the current analyses. The modified KAS-R shows considerable promise as an instrument for measuring the complex social, emotional and personality changes following traumatic injury, with special significance for assessing brain-injury victims. The representativeness of the current patient sample and implications for future development of the method are discussed.