title: Impaired self-awareness after traumatic brain injury: inter-rater reliability and factor structure of the Dysexecutive Questionnaire (DEX) in patients, significant others and clinicians.
abstract: OBJECTIVE
  This study sought to address two questions: (1) what is the inter-rater reliability of the Dysexecutive Questionnaire (DEX) when completed by patients, their significant others, and clinicians; and (2) does the factor structure of the DEX vary for these three groups?
  
  
  METHODS
  We obtained DEX ratings for 113 patients with an acquired brain injury from two brain injury services in the UK and two services in Ireland. We gathered data from two groups of raters-"significant others" (DEX-SO) such as partners and close family members and "clinicians" (DEX-C), who were psychologists or rehabilitation physicians working closely with the patient and who were able to provide an opinion about the patient's level of everyday executive functioning. Intra-class correlation coefficients and their 95% confidence intervals were calculated between each of the three groups (self, significant other, clinician). Principal axis factor (PAF) analyses were also conducted for each of the three groups.
  
  
  RESULTS
  The factor analysis revealed a consistent one-factor model for each of the three groups of raters. However, the inter-rater reliability analyses showed a low level of agreement between the self-ratings and the ratings of the two groups of independent raters. We also found low agreement between the significant others and the clinicians.
  
  
  CONCLUSIONS
  Although there was a consistent finding of a single factor solution for each of the three groups, the low level of agreement between significant others and clinicians raises a question about the reliability of the DEX.
authors.affiliation: School of Psychology, National University of Ireland Galway Galway, Ireland.
authors.forename: Brian E
authors.initials: BE
authors.lastname: McGuire
authors.affiliation: Department of Psychology, University of Saskatchewan Saskatoon, SK, Canada.
authors.forename: Todd G
authors.initials: TG
authors.lastname: Morrison
authors.affiliation: Department of Psychology, Sheffield Hallam University Sheffield, UK.
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Barker
authors.affiliation: Neurorehabilitation Services, Doncaster Rotherham and South Humber NHS Foundation Trust Doncaster, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Morton
authors.affiliation: School of Psychology, National University of Ireland Galway Galway, Ireland.
authors.forename: Judith
authors.initials: J
authors.lastname: McBrinn
authors.affiliation: Regional Acquired Brain Injury Unit, Musgrave Park Hospital Belfast, UK.
authors.forename: Sheena
authors.initials: S
authors.lastname: Caldwell
authors.affiliation: Regional Acquired Brain Injury Unit, Musgrave Park Hospital Belfast, UK.
authors.forename: Colin F
authors.initials: CF
authors.lastname: Wilson
authors.affiliation: Regional Acquired Brain Injury Unit, Musgrave Park Hospital Belfast, UK.
authors.forename: John
authors.initials: J
authors.lastname: McCann
authors.affiliation: National Rehabilitation Hospital Dublin, Ireland.
authors.forename: Simone
authors.initials: S
authors.lastname: Carton
authors.affiliation: National Rehabilitation Hospital Dublin, Ireland.
authors.forename: Mark
authors.initials: M
authors.lastname: Delargy
authors.affiliation: School of Psychology, National University of Ireland Galway Galway, Ireland.
authors.forename: Jane
authors.initials: J
authors.lastname: Walsh
keywords: brain injury; care giver; dysexecutive; factor analysis; reliability