Screening and Assessment
Screening
Screening refers to a preliminary procedure, such as a test or examination, to detect the signs of a disorder that may require further evaluation. It can be helpful to consider integrating screening instruments to detect the possible presence of different health conditions, mental health symptoms, and unhealthy or problematic behaviors (e.g., substance misuse, suicidal thoughts or behavior). These measures are often brief and easy to administer (e.g., self-report).
In instances in which someone is determined to be at elevated risk, you should strongly consider consulting with a licensed provider for further assessment and, if warranted, intervention. Importantly, these measures should **NOT** serve as a substitute for a robust diagnostic clinical interview, but rather serve to inform who may benefit from further assessment. This is especially important as disentangling some of these factors, for example neurocognitive impact due to TBI versus depression, can be complex and require in-depth assessment (e.g., neuropsychological evaluation).
Screening & Assessment Tools
TBI History and Neurocognitive Impact
TBI can impact several Neurocognitive Domains. These brief measures can facilitate in identifying if a TBI occurred as well as acute and more chronic symptoms following the injury.
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Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID)
- First 5 items of the OSU TBI-ID asking for recall of blows to the head or neck in high velocity of forces.
- 5 minutes
- No fee for use.
- Health care and social service providers can be easily trained via web-based modules here
- Download PDF
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Brain Injury Screening Questionnaire (BISQ)
- Structured questionnaire that characterizes incidence and severity of lifetime exposure of TBI, as well as symptoms in attention/memory, depression, anxiety/
mood, aggression/ impulsivity, depression, and physical symptoms. - 10-15 minutes
- Fees
- There are costs associated obtaining the BISQ which includes access to it and training, as well as a system for scoring and clinical report. May be administered via interview or self-administration and can be conducted as self- or proxy-report assessment.
- More information
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Brain Check Survey (BCS)
- A parent-completed screening tool used to establish a credible history of brain injury, which, in turn, triggers a thorough evaluation of difficulties encountered by students in the classroom.
- 15-20 minutes
- No fee for use.
- More information
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Neuro-behavioral Symptom Inventory (NSI)
- A 22-item self-report measure of post-concussive (PC) symptoms that commonly occur after mild TBI, including affective, somatic, sensory and cognitive complaints.
- 15-20 minutes
- No fee for use.
- Download PDF
Substance Use
Substance use, including alcohol and drug (both misuse of prescription and those not prescribed), can impact functioning and exacerbate health conditions. Moreover, substance use may be driven, in part, by difficulties regulating emotions and interfere with treatment processes and therapeutic benefit. Screening for substance misuse can help to identify problematic alcohol and drug use and appropriate augmenting and tailoring care.
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AUDIT
- A 10-item screening questionnaire to identify persons whose alcohol consumption has become hazardous or harmful to their health.
- 3 minutes
- No fee for use
- *The AUDIT can be augmented to screen for substance misuse (DUDIT)
- Download Avaialble
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CAGE Questionnaire
- A 4-item questionnaire to detect problematic alcohol use.
- 2 minutes
- No fee for use
- *The CAGE can be augmented to also detect both problematic alcohol and substance use (CAGE-AID)
- Download PDF
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Drug Abuse Screening Test (DAST)
- A 28-item instrument to identify individuals who are potentially misusing drugs; and the degree of functional impact due to drug misuse.
- 5 minutes
- Minimal fee for use
- Download PDF
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Simple Screening Instrument for Substance Abuse (SSI-SA)
- A 16-item screening instrument that examines symptoms of both problematic alcohol and drug use.
- 10 minutes
- No fee for use
- Download PDF
Mental Health Conditions
Mental health conditions and symptoms can occur either independent of or related to one's TBI. Given this, determining the potential presence of psychiatric diagnosis to inform appropriate referral (e.g., pharmacotherapy; psychotherapy) can be helpful for a patient's functional recovery.
*We have discussed mental health conditions commonly associated with TBI below (i.e., depression, anxiety, posttraumatic stress disorder). It is important to note that several additional mental health conditions exist (e.g., bipolar and personality disorder), and that presentation may differ based on age (e.g., geriatric depression). Because of this, this list should be considered informative but not exhaustive.
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Beck Depression Inventory II (BDI-II)
- A 21-item questionnaire used to screen for the presence and rate the severity of depression symptoms.
- 10 minutes
- Fee for use
- *Differing from other screens for depression which mirror the DSM-5 symptom profile (e.g., PHQ-9; see below), the BDI-II screens for emotional, cognitive, motivational, and physiological domains of depression.
- Available at: Pearson Assessments (formerly PsychCorp)
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Patient Health Questionnare-9 (PHQ-9)
- A 9-item questionnaire used to screen for depression.
- 5 minutes
- No fee for use
- Available at: Patient Health Questionnare Screeners
- Patient Health Questionnare Screeners
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Generalized Anxiety Disorder scale (GAD-7)
- A 7-item questionnaire used to screen for generalized anxiety.
- 5 minutes
- Minimal fee for use
- Available at PHQ Screeners website
- Patient Health Questionnare Screeners
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Mental Health Screening Form-III (MHSF-III)
- An 17-item questionnaire to screen for present or past symptoms of most of the major mental disorders; yes/no responses.
- 10-15 minutes
- No fee for use
- Available in PDF format
- Download PDF
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PTSD Checklist for DSM 5 (PCL-5)
- A 20-item self-report measure that assesses the DSM-5 symptoms of PTSD.
- 5-10 minutes
- No fee for use
- Available at the VA PTSD website
- Download
Suicide Risk
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The Columbia-Suicide Severity Rating Scale (C-SSRS)
- A 6-item screening for recent suicidal thoughts and behaviors. This information can be used to inform those who may be at elevated acute risk for suicide (e.g., presence of suicidal intent, means, or plan).
- 5 minutes
- No fee for use.
- Health care and social service providers can be easily trained via web-based modules. The C-SSRS can be extended for a more in-depth assessment of lifetime and recent suicidal thoughts and behavior.
- TBI Modules
Assessment
Assessment refers to an evaluation of a condition based on the patient's subjective report of the symptoms and the examiner's objective findings, including data obtained through laboratory tests, physical examination, medical history, and information reported by family members and other health care team members. Assessment is a critical step in providing care to those who have a history of TBI by helping providers determine the extent of ones' TBI history, co-occurring mental health symptoms, and other sequelae. For information on interventions related to these screening and assessment areas please visit our Interventions page.
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Traumatic Brain Injury
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Approach
Synthesis of injury severity factors (i.e., posttraumatic amnesia, loss of consciousness, Glasgow Coma Scale), neuroimaging findings, and functional impairment (e.g., neuropsychological evaluation).
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Description
Comprehensive assessment often includes a neuropsychological battery and clinical interview to facilitate differential diagnosis of traumatic brain injury from other potential conditions (e.g., depression); review of health record data (e.g., medical records from emergency department; neuroimaging) and collateral can further inform diagnostic formulation.
*Please talk to your treatment team for additional information and potential referral for neuropsychological or rehabilitation services (including assessment).
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Mental Health and Substance Use
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Approach
Clinical interview augmented with structured measures for differential diagnosis (e.g., Structured Clinical Interview for DSM-5) or specific diagnoses (e.g., Clinician Administered PTSD Scale for DSM-5).
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Description
Combining information from a clinical interview with structured measures can help to identify psychiatric diagnoses or comorbidities. This can be especially beneficial when identifying diagnoses driving symptom presentation which are common across several diagnoses (e.g., insomnia due to mania, depression, or PTSD).
*Please see: The American Psychiatric Association for additional information (including training) for the Structured Clinical Interview for DSM-5
Please see: National Center for PTSD for additional information (including training) for the Clinician Administered PTSD Scale for DSM-5
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Suicide Risk
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Approach
In the presence of elevated acute risk for suicide (i.e., suicidal intent, means, or plan; recent suicide attempt), providers should conduct a comprehensive interview of current risk and resilience factors. This information can then inform necessary acute (e.g., Safety Planning, hospitalization) and longer-term (e.g., outpatient, evidence-based psychotherapy) recommendations.
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Description
Management of acute and chronic suicide risk can be complex. We recommend providers use a therapeutic risk management approach (Rocky Mountain MIRECC model of Therapeutic Risk Management (TRM) with Patients at Risk for Suicide) which is a clinically informed model for assessment and management of suicide risk.
In addition, we recommend providers consider integrating evidence-based suicide prevention approaches into their practice. Please consider clicking here for further information regarding suicide risk management
