Clinical Scales and Indexes Development and Reliability of a Revised Behavior Rating Inventory of Executive Function (BRIEF®-2) Melissa A. Messer1, MHS, Jennifer A. Greene1, MSPH, Peter K. Isquith2, PhD, and Gerard Gioia3, PhD Overview of the BRIEF-2 Development Inter-Rater Reliability The Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) is the first revision of the BRIEF, originally published in 2000 (Gioia, Isquith, Guy & Kenworthy, 2000). It is a rating scale designed to assess everyday behaviors associated with executive functions in the home and school environments. The BRIEF-2 Parent and Teacher Forms each contain 63 items within nine clinical scales; the Self-Report Form contains 55 items within seven clinical scales. The majority of items are parallel across forms. All three forms have three validity scales. In revising the BRIEF, item-total correlations, and item behavior were examined in over 5000 normative and clinical cases (see below for the demographic breakdown of each sample). Weaker items were removed; no new clinical items were added, and a new validity scale (Infrequency) was developed. Sample Pair n BRI ERI CRI GEC Parent/Parent Clinical 287 .63* .61* .57* .56* Standardization 149 .75* .73* .88* .86* Teacher/Teacher 583 .70** .52** .58** .62** 115 .45** .27** .47** Parent/Teacher 1,426 .32** .36** .30** 632 .72** .60** Parent/Self 458 .33 .28* .35* .25* 472 .62* .59* .74* .71* Teacher/Self 343 .24* .14* .20* .13* 372 .51* .42* Characteristic Parent Form Teacher Form Self-Report Form C S n 2,892 1,400 1,889 473 803 Gender Male 68.5 49.1 67.5 48.6 59.6 49.3 Female 31.5 51.0 32.5 51.4 40.4 50.7 Age M 11.23 11.51 11.03 14.76 14.50 SD 3.51 4.00 3.46 2.07 2.29 Range 5-18 11-18 Clinical Scales and Indexes Inhibit Control impulses; appropriately stop own behavior at the proper time. Self-Monitor Keep track of the effect of own behavior on others. Shift Move freely from one situation, activity, or aspect of a problem to another as the situation demands; transition; solve problems flexibly. Emotional Control Modulate emotional responses appropriately. Initiate Begin a task or activity; independently generate ideas. Working Memory Hold information in mind for the purpose of completing a task; stay with, or stick to, an activity. Plan/ Organize Anticipate future events; set goals; develop appropriate steps ahead of time to carry out an associated task or action; carry out tasks in a systematic manner; understand and communicate main ideas or key concepts. Task-Monitor Check work; assess performance during or after finishing a task to ensure attainment of goal. Organization of Materials Keep workspace, play areas, and materials in an orderly manner. Task Completion Completes schoolwork or chores in timely fashion; finishes tests within time limits; works at a satisfactory pace. Behavior Regulation Index (BRI) Regulate and monitor behavior effectively, reflecting inhibitory control and self-monitoring. Emotion Regulation Index (ERI) Regulate emotional responses, adapt to changes and shift set appropriately reflecting the Shift and Emotional Control scales. Cognitive Regulation Index (CRI) Control and manage cognitive processes; to initiate, plan, organize and monitor problem solve effectively, holding goals and plans in working memory. Global Executive Composite (GEC) Overall summary incorporating all aspects of executive functioning captured on the BRIEF-2. Note. C = Clinical sample; S = Standardization sample Reliability Reliability refers to a test’s stability, consistency, and accuracy. Reliability was studied on the BRIEF-2 through examining internal consistency, inter-rater reliability, and test-retest reliability. Internal consistency reliabilities (below) ranged from .80 to .98 across forms in the standardization samples and from .71 to .97 in the clinical samples, comparable to original BRIEF reliabilities. Inter-rater reliabilities (above right) were examined in subsamples of paired raters in both the standardization and clinical samples. Parent/Parent, Parent/Teacher, and Parent/Self raters had the strongest correlations in the standardization sample. Teacher/Teacher, Parent/Parent raters had moderate correlations in the clinical sample. Test-Retest Reliability Test-retest reliabilities were examined in a subset of the standardization sample (Parent: n =163; Teacher: n =173; Self: n =190). Test-retest correlations (below) ranged from .67 to .92 on the Parent Form, from .76 to .90 on the Teacher Form and from .61 to .85 on the Self-Report Form, comparable to original BRIEF reliabilities. Development Scale/Index Parent Form Teacher Form Self-Report Form Inhibit .84 .83 .79 Self-Monitor .67 .76 .61 BRI .75 Shift .77 .87 .73 Emotional Control .82 .71 ERI .88 Initiate -- Task Completion Working Memory .92 Plan/Organize .81 .78 Task-Monitor Organization of Materials CRI .89 GEC .90 .85 Internal Consistency Scale/Index Parent Form Teacher Form Self-Report Form C S Inhibit .90 .86 .93 .92 .78 .84 Self-Monitor .83 .80 .89 .71 .81 BRI .91 .95 Shift .88 .85 Emotional Control .94 ERI Initiate .76 .82 .87 -- Task Completion Working Memory Plan/Organize Task-Monitor Organization of Materials CRI .96 .98 GEC .97 Conclusion Validity scales Infrequency Extent to which the respondent endorses unlikely events. Inconsistency Extent to which the respondent answers similar BRIEF-2 items in an inconsistent manner. Negativity Extent to which the respondent answers selected BRIEF-2 items in an unusually negative manner. The BRIEF-2 is a more concise revision of the original BRIEF with several enhancements. Clinical and standardization data provide strong evidence of reliability including internal consistency, inter-rater, and test-retest reliability. 1Psychological Assessment Resources; 2Geisel School of Medicine at Dartmouth College; 3Children’s National Medical Center