Search tips
Search criteria 


Logo of jnnpsycJournal of Neurology, Neurosurgery and PsychiatryVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Neurol Neurosurg Psychiatry. 1987 February; 50(2): 183–193.
PMCID: PMC1031490

The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician.


To investigate the inter-rater reliability and validity of the Neurobehavioural Rating Scale at various stages of recovery after hospitalisation for closed head injury, we studied 101 head trauma patients who had no antecedent neuropsychiatric disorder. The results demonstrated satisfactory inter-rater reliability and showed that the Neurobehavioural Rating Scale reflects both the severity and chronicity of closed head injury. A principal components analysis revealed four factors which were differentially related to severity of head injury and the presence of a frontal lobe mass lesion. Although our findings provide support for utilising clinical ratings of behaviour to investigate sequelae of head injury, extension of this technique to other settings is necessary to evaluate the distinctiveness of the neurobehavioural profile of closed head injury as compared with other aetiologies of brain damage.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.5M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Levin HS, Grossman RG. Behavioral sequelae of closed head injury. A quantitative study. Arch Neurol. 1978 Nov;35(11):720–727. [PubMed]
  • Lishman WA. The psychiatric sequelae of head injury: a review. Psychol Med. 1973 Aug;3(3):304–318. [PubMed]
  • Schnaper N. The psychological implications of severe trauma: emotional sequelae to unconsciousness; A preliminary study. J Trauma. 1975 Feb;15(2):94–98. [PubMed]
  • Brooks DN, McKinlay W. Personality and behavioural change after severe blunt head injury--a relative's view. J Neurol Neurosurg Psychiatry. 1983 Apr;46(4):336–344. [PMC free article] [PubMed]
  • Fordyce DJ, Roueche JR, Prigatano GP. Enhanced emotional reactions in chronic head trauma patients. J Neurol Neurosurg Psychiatry. 1983 Jul;46(7):620–624. [PMC free article] [PubMed]
  • Livingston MG, Brooks DN, Bond MR. Three months after severe head injury: psychiatric and social impact on relatives. J Neurol Neurosurg Psychiatry. 1985 Sep;48(9):870–875. [PMC free article] [PubMed]
  • Livingston MG, Brooks DN, Bond MR. Patient outcome in the year following severe head injury and relatives' psychiatric and social functioning. J Neurol Neurosurg Psychiatry. 1985 Sep;48(9):876–881. [PMC free article] [PubMed]
  • Oddy M, Coughlan T, Tyerman A, Jenkins D. Social adjustment after closed head injury: a further follow-up seven years after injury. J Neurol Neurosurg Psychiatry. 1985 Jun;48(6):564–568. [PMC free article] [PubMed]
  • van Zomeren AH, van den Burg W. Residual complaints of patients two years after severe head injury. J Neurol Neurosurg Psychiatry. 1985 Jan;48(1):21–28. [PMC free article] [PubMed]
  • Weddell R, Oddy M, Jenkins D. Social adjustment after rehabilitation: a two year follow-up of patients with severe head injury. Psychol Med. 1980 May;10(2):257–263. [PubMed]
  • Cassileth BR, Lusk EJ, Strouse TB, Miller DS, Brown LL, Cross PA, Tenaglia AN. Psychosocial status in chronic illness. A comparative analysis of six diagnostic groups. N Engl J Med. 1984 Aug 23;311(8):506–511. [PubMed]
  • Gronwall D, Wrightson P. Delayed recovery of intellectual function after minor head injury. Lancet. 1974 Sep 14;2(7881):605–609. [PubMed]
  • Rutherford WH. Sequelae of concussion caused by minor head injuries. Lancet. 1977 Jan 1;1(8001):1–4. [PubMed]
  • Walker AE. Long term evaluation of the social and family adjustment to head injuries. Scand J Rehabil Med. 1972;4(1):5–8. [PubMed]
  • Dikmen S, Reitan RM. Emotional sequelae of head injury. Ann Neurol. 1977 Dec;2(6):492–494. [PubMed]
  • Dikmen S, Reitan RM. MMPI correlates of adaptive ability deficits in patients with brain lesions. J Nerv Ment Dis. 1977 Oct;165(4):247–254. [PubMed]
  • Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975 Mar 1;1(7905):480–484. [PubMed]
  • Levin HS, Grossman RG, Rose JE, Teasdale G. Long-term neuropsychological outcome of closed head injury. J Neurosurg. 1979 Apr;50(4):412–422. [PubMed]
  • Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 Jul 13;2(7872):81–84. [PubMed]
  • Levin HS, O'Donnell VM, Grossman RG. The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis. 1979 Nov;167(11):675–684. [PubMed]
  • Nauta WJ. The problem of the frontal lobe: a reinterpretation. J Psychiatr Res. 1971 Aug;8(3):167–187. [PubMed]
  • Stuss DT, Benson DF. Neuropsychological studies of the frontal lobes. Psychol Bull. 1984 Jan;95(1):3–28. [PubMed]
  • Gandy SE, Snow RB, Zimmerman RD, Deck MD. Cranial nuclear magnetic resonance imaging in head trauma. Ann Neurol. 1984 Aug;16(2):254–257. [PubMed]
  • Adams JH, Graham DI, Murray LS, Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Ann Neurol. 1982 Dec;12(6):557–563. [PubMed]
  • STRICH SJ. Diffuse degeneration of the cerebral white matter in severe dementia following head injury. J Neurol Neurosurg Psychiatry. 1956 Aug;19(3):163–185. [PMC free article] [PubMed]
  • Marshall LF, Becker DP, Bowers SA, Cayard C, Eisenberg H, Gross CR, Grossman RG, Jane JA, Kunitz SC, Rimel R, et al. The National Traumatic Coma Data Bank. Part 1: Design, purpose, goals, and results. J Neurosurg. 1983 Aug;59(2):276–284. [PubMed]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group