Rasch analysis of the postconcussive symptom questionnaire: Measuring the core construct of brain injury symptomatology

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Study used Rasch analysis to assess the psychometric properties of the Postconcussive Symptom Questionnaire (PCSQ) and to derive a revised PCSQ to target the core construct of subjective symptoms reported by people with traumatic brain injury (TBI). The PCSQ is purported to measure psychological, cognitive, somatic, and infrequency (i.e., items intended to reflect negative impression management) symptoms. A total of 133 people with mild to severe TBI completed the 45-item PCSQ. Items were scored dichotomously, as symptom present or absent. Rasch analysis was used to derive the revised PCSQ. The initial analysis of the 45-item scale revealed that several items did not fit with model expectations. Misfitting and redundant items were removed and a second model containing 19 items was fitted. The revised PCSQ-19 had superior psychometric qualities; reliability was 0.81. The PCSQ-19 provides a more targeted, unidimensional assessment of subjective symptoms following brain injury. Findings also revealed information related to symptom hierarchy which can further the understanding of PCS.

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