The Frontal Systems Behaviour Scale (FrSBe) as a predictor of community integration following a traumatic brain injury

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Abstract
Primary objective: This study examined the relationships between the Frontal Systems Behaviour Scale (FrSBe), neuropsychological tests and community integration outcomes among individuals with a history of TBI. Methods: Seventy-six individuals with a history of TBI were consecutively recruited from patients seen in a Neuropsychology clinic in an academic healthcare setting. Participants completed neuropsychological tests, the FrSBe and the Community Integration Questionnaire (CIQ) as part of a standard clinical neuropsychological evaluation. Results: The FrSBe was a significant predictor of community integration (CIQ) outcomes. Specifically, poorer executive functioning (FrSBe Executive Functioning) predicted lower CIQ Total Scores, while increased apathy (FrSBe Apathy) was associated with reduced CIQ Productivity. Regarding neuropsychological tests, only Delayed Memory remained as a predictor: higher scores were associated with enhanced CIQ Total Scores and CIQ Social Integration. Finally, female gender was associated with superior CIQ Total Scores, CIQ Home Integration and CIQ Productivity. Conclusions: While neuropsychological tests of executive functioning failed to add predictive power to models of community integration following TBI with this sample, the FrSBe, a measure of behavioural manifestations of frontal lobe dysfunction, did predict these important functional outcomes. This suggests that use of the FrSBe may enhance the ecological validity of information gathered during a clinical neuropsychological assessment.