Changes in psychosocial functioning following traumatic brain injury : a confirmatory factor analysis of the Katz Adjustment Scale (KAS-R)
The measurement of psychosocial functioning following traumatic brain injury has received very little attention, despite the fact that it has important applications in a variety of clinical, medico-legal and theoretical contexts. In the absence of well validated, standardised measures of psychosocialf unctioning, clinicians and researchersin this field have tendedt o employ measures which are designed for use in non-brain injury populations. The Katz Adjustment Scale (KAS-R; Katz & Lyerly, 1963) is one measure which has been widely used in brain injury studies despite the fact that it has questionable validity when applied to brain injury populations. In an attempt to resolve this problem, Jackson, Hopewell, Glass, Warburg, Dewey & Ghadiali (1992) conducted an exploratory factor analysis of a modified version of the KAS-R using a mixed sample of individuals who had a traumatic brain injury and\or spinal cord injury. The present study is an attempt to confirm the validity of the factors obtained by Jackson et al and where necessary revise the factor structure of the modified KAS-R. r1be present study represents a significant advance upon the work of Jackson et al in that it employs confirmatory factor analysis techniques and is based upon a new sample consisting solely of brain injured individuals. The results of this study provide support for the validity of the main first-order factors obtained by Jackson et al., and a number of post hoc modifications were made which appear to represent improvements upon the Jackson et al factors in terms of their relevance to brain injury. Preliminary analyses indicate that the modified factors may discriminate between different groups of brain injured individuals. Recommendations are made re further revision and validation of the KAS-R sub-scales and the potential research applications of the scales are discussed.