Symptom Checklist-90 Revised scores in persons with traumatic brain injury: Affective reactions or neurobehavioral outcomes of the injury?

The goal of this study was to examine the concurrent validity of the Symptom Checklist-90 Revised (SCL-90-R) as a measure of emotional distress among persons with traumatic brain injuries (TBI). Following previous studies, the scale was divided into a "Brain Injury Subscale" (BIS), composed of items that are confounded with the neurobehavioral outcomes of TBI, and a "Non Brain Injury Subscale" (NBIS), composed of items unrelated to the neurobehavioral outcomes. The scores of 94 persons with TBI were analyzed on the two subscales. Although more frequently endorsed, the BIS items were equally related to the cognitive and behavioral outcomes of the injury and to the respondents' affective dispositions. The same pattern of correlations was evident with the NBIS items. In addition, both scales were predicted by measures of emotional reactions to the injury. These results were interpreted as supporting the validity of the SCL-90-R as a measure of emotional distress among persons with brain injuries.