Validating the Brain Injury Screening Index (BISI) and the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) as screening tools for head injury in a Scottish prison setting, and clinical research portfolio

• Main Author: McGinley, Abi
• Published: University of Glasgow 2017
• Subjects: 365; BF Psychology
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.724054

Background: Head injury (HI) has been linked with offending behaviour. Self-report studies indicate a high prevalence of HI amongst offenders. Routine screening for HI for offenders has been recommended, to inform triage towards needs-led assessment and intervention (NPHN, 2016). However, there is a need to validate a screening tool for HI that can be used with offenders in the Scottish Prison Service (SPS). Aims: To examine the sensitivity, specificity and construct validity of the BISI and the OSU TBI ID against the reference standards of evidence of neuropsychological or psychiatric impairment or disability. The practical usefulness of the tools will also be considered. A parallel study by a second trainee examined the prevalence of disability associated with HI using the same data. Methods: A retrospective, cross-sectional design was utilised to gather data from 82 male participants (aged >21) from a Scottish prison. The two screening measures were used alongside measures of disability, mental health, cognitive function, and effort. Results: Construct validity was better for the OSU TBI-ID than the BISI. The OSU TBI-ID was significantly associated with neuropsychological, mental health and disability outcomes (p<0.05). Both tools had measures with good sensitivity (BISI injury severity rating: 86-100%; OSU TBI-ID clinical rating: 100%), but specificity was low (BISI injury severity rating: 17-24%; OSU TBI-ID clinical rating: 11-17%). The tools were equally practical to use in the SPS, and any differences were not clinically meaningful. Conclusion: This study indicates that the OSU TBI-ID may be more useful than the BISI as a screening tool for HI-related impairment or disability in Scottish prisons. Limitations and implications for future research are discussed.