Measuring apathy after traumatic brain injury: Two assessment scales

Neural Networks

Apathy is defined as indifference, or a reduced emotional, cognitive, and behavioral state. Apathy is common after traumatic brain injury-somewhere between half and three-quarters of brain injury survivors show signs of it. Apathy is related to frontal lobe and limbic system damage, both of which are common areas of injury.

However, apathy can be difficult to detect. Cognitive impairment, depression, or fatigue can all mask symptoms of apathy. Two assessment scales that measure apathy have recently been evaluated: the Apathy Evaluation Scale and the Frontal Systems Behavior Scale. Although both have been used extensively in research, neither has been evaluated as a method of screening for apathy in traumatic brain injury.

The Apathy Evaluation Scale contains 18 statements that require an answer on a 4-point scale. Examples of statements on the Apathy Evaluation Scale are "Getting together with friends is important to them" and "When something good happens, s/he gets excited."

The Frontal Systems Behavior Scale contains 46 statements altogether, but only 14 that rate apathy. Statements such as " Speaks only when spoken to" and "Is slow moving, lacks energy, inactive" are rated by a 5-point scale.

Both assessment scales demonstrate reliability and consistency for measuring apathy in traumatic brain injury survivors, and can be a useful tool to differentiate apathy from other symptoms such as depression.

Lane-Brown AT & Tate RL. Measuring apathy after traumatic brain injury: Psychometric properties of the Apathy Evaluation Scale and the Frontal Systems Behavior Scale. Brain Injury. (December 2009).