This form structure is an organized set of data definitions for a form that has not been copyrighted

 General Details

Title:
Conflict Behavior Questionnaire (CBQ) / Interaction Behavior Questionnaire (IBQ): Adolescent Version
Short Name:
IBQAdolescentVersion
Description:
The Conflict Behavior Questionnaire (CBQ) also known as the Interaction Behavior Questionnaire (IBQ) was designed to obtain evaluations of parent and adolescent behavior directly from mother and adolescent. The questionnaire reliably measures whether or not a family is experiencing distress. Administration takes about 5 minutes. Separate versions are available for parents and adolescents.Reference: Prinz, R. J., Foster, S., Kent, R. N. and O'Leary, K. D. (1979), MULTIVARIATE ASSESSMENT OF CONFLICT IN DISTRESSED AND NONDISTRESSED MOTHER-ADOLESCENT DYADS. Journal of Applied Behavior Analysis, 12: 691–700. doi:10.1901/jaba.1979.12-691
Disease:
General (For all diseases) , Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-11-04
Owner:
Number of Data Elements:
62
eForms:
N

 Documentation


 Groups & Attached Data Elements

Logically grouped data elements with defined frequency at which they repeat.

# Title Short Description Variable Name Required? Type
1 GUID   Global Unique ID which uniquely identifies a subject GUID Required CDE
2 Subject identifier number   An identification number assigned to the participant/subject within a given protocol or a study. SubjectIDNum Optional CDE
3 Age in years   Value for participant's subject age recorded in years. AgeYrs Recommended CDE
4 Vital status   Status of participant/subject as alive or dead VitStatus Optional CDE
5 Visit date   Actual interview or visit date VisitDate Recommended CDE
6 Site name   The name of the site for the study SiteName Recommended CDE
7 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
8 Case control indicator   Indicator of whether subject is in the case or control arm of the study CaseContrlInd Optional CDE
9 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

Form Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Language form administration ISO code  Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration LangCRFAdministratISOCode Recommended CDE
2 Language form administration ISO code other text  The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. LangCRFAdministratISOCodeOTH Recommended CDE
3 Context type  The context to which the questions were answered ContextType Recommended CDE
4 Context type other text  The free-text related to ContextType specifying other text ContextTypeOTH Recommended CDE
5 Data source  Source of the data provided on the case report form DataSource Recommended CDE
6 Data source other text  The free-text field related to Data source specifying other text. Source of the data provided on the case report form DataSourceOTH Recommended CDE

IBQ Adolescent Version (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Interaction Behavior Questionnaire - Adolescent version mother father indicator 

(Draft)

Indicator related to if the mother or father was being addressed, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerMotFatInd Recommended UDE
2 Interaction Behavior Questionnaire - Adolescent version joke often indicator  Indicator related to if the child and parent joke around often, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerJkOfInd Recommended CDE
3 Interaction Behavior Questionnaire - Adolescent version things together indicator  Indicator related to if the child and parent do a lot of things together, adolescent version, as part of the Interaction Behavior Questionnaire. InBhvQsAdlstVerThTgthInd Recommended CDE
4 Interaction Behavior Questionnaire - Adolescent version never agree indicator  Indicator related to if the child and parent never seem to agree, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerNvAgInd Recommended CDE
5 Interaction Behavior Questionnaire - Adolescent version enjoy talks indicator  Indicator related to If the child and parent enjoy talks they have, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerEnTlkInd Recommended CDE
6 Interaction Behavior Questionnaire - Adolescent version three time angry indicator  Indicator related to the child and the parent being angry at each other at least three times a week, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerThTmAnInd Recommended CDE
7 Interaction Behavior Questionnaire - Adolescent version argue bad apologize indicator  Indicator related to the child and the parent having an argument which turns out badly resulting in an apology, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerArBdApInd Recommended CDE
8 Interaction Behavior Questionnaire - Adolescent version argue dinner table half time indicator  Indicator related to the child and the parent having arguments at the dinner table half the time, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerArDnTbHlfTmInd Recommended CDE
9 Interaction Behavior Questionnaire - Adolescent version compromise argue indicator  Indicator related to the child and parent compromising during an argument, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerCmprArInd Recommended CDE
10 Interaction Behavior Questionnaire - Adolescent version angry once day indicator  Indicator related to the child and parent being angry at each other at least once a day, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerAngOnDyInd Recommended CDE
11 Interaction Behavior Questionnaire - Adolescent version frustrate talk indicator  Indicator related to the child and parents feeling frustrated after talking, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerFrsTlkInd Recommended CDE
12 Interaction Behavior Questionnaire - Adolescent version speak only when have to indicator  Indicator related to the child and parent only speaking to each other when they have to, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerSpOnWhHvToInd Recommended CDE
13 Interaction Behavior Questionnaire - Adolescent version get along general indicator  Indicator related to the child and parent not getting along in general, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerGtAlGnInd Recommended CDE
14 Interaction Behavior Questionnaire - Adolescent version argue dinner every time indicator  Indicator related to the child and parent arguing at dinner every night, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerAgDnEvTmInd Recommended CDE
15 Interaction Behavior Questionnaire - Adolescent version have fun together indicator  Indicator related to the child and parent never having fun together, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerHvFnTgInd Recommended CDE
16 Interaction Behavior Questionnaire - Adolescent version big argument little thing indicator  Indicator related to the child and the parent having big arguments over little things, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerBgArgLtThInd Recommended CDE
17 Interaction Behavior Questionnaire - Adolescent version enjoyable talk once day indicator  Indicator related to the child and the parent having an enjoyable talk at least once a day, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerEnTlkOnDyInd Recommended CDE
18 Interaction Behavior Questionnaire - Adolescent version right unrecognize by parent indicator  Indicator related to the child being right but not acknowledged by the parent as being so, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerRghtUnrcByPrInd Recommended CDE
19 Interaction Behavior Questionnaire - Adolescent version picked on by parent indicator  Indicator related to the child being picked on by parent, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPckOnPrInd Recommended CDE
20 Interaction Behavior Questionnaire - Adolescent version parent understanding indicator  Indicator related to the child being understood by the parent, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPrUndInd Recommended CDE
21 Interaction Behavior Questionnaire - Adolescent version argument remaining hour later indicator  Indicator related to the child and parent remaining in an argument an hour later, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerArRmHrLtInd Recommended CDE
22 Interaction Behavior Questionnaire - Adolescent version faults brought up indicator  Indicator related to the parent bringing up faults of the child in an argument, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerFlBrUpInd Recommended CDE
23 Interaction Behavior Questionnaire - Adolescent version parent like friend indicator  Indicator related to the parent liking the child's friends, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPrLkFrInd Recommended CDE
24 Interaction Behavior Questionnaire - Adolescent version parent slap when angry indicator  Indicator related to the parent slapping a child when angry, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPrSlWhAnInd Recommended CDE
25 Interaction Behavior Questionnaire - Adolescent version no consideration for parent indicator  Indicator related to the parent feeling like the child has no consideration for him/her, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerNoCnsPrInd Recommended CDE
26 Interaction Behavior Questionnaire - Adolescent version bad things to others indicator  Indicator related to if the parent says bad things to other people about the child, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerBdThOthInd Recommended CDE
27 Interaction Behavior Questionnaire - Adolescent version bossy parent indicator  Indicator related to the parent being bossy to child when talking, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerBossPrInd Recommended CDE
28 Interaction Behavior Questionnaire - Adolescent version unfinished thought indicator  Indicator related to whether the parent allows the child to finish a thought, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerUnfThInd Recommended CDE
29 Interaction Behavior Questionnaire - Adolescent version argument my fault indicator  Indicator related to the parent making the child feel like the argument is their fault, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerArMyFltInd Recommended CDE
30 Interaction Behavior Questionnaire - Adolescent version parent understand point of view indicator  Indicator related to the parent understanding the child's point of view, even when they don't agree, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPrUnPOVInd Recommended CDE
31 Interaction Behavior Questionnaire - Adolescent version on my mind perception indicator  Indicator related to the parent perceiving a child having something on their mind, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerOnMndPrcInd Recommended CDE
32 Interaction Behavior Questionnaire - Adolescent version interested thing indicator  Indicator related to the parent being interested in the things that the child does, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerInterstdThngInd Recommended CDE
33 Interaction Behavior Questionnaire - Adolescent version punish fair indicator  Indicator related to the parent being fair when punishing a child, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPnshFrInd Recommended CDE
34 Interaction Behavior Questionnaire - Adolescent version parent scream indicator  Indicator related to the parent screaming, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPrScInd Recommended CDE
35 Interaction Behavior Questionnaire - Adolescent version never apologize indicator  Indicator related to the parent never apologizes first, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerNvApInd Recommended CDE
36 Interaction Behavior Questionnaire - Adolescent version rare listen indicator  Indicator related to the parent rarely listening to the child during an argument, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerRrLstInd Recommended CDE
37 Interaction Behavior Questionnaire - Adolescent version put down indicator  Indicator related to the parent putting down the child, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPtDwnInd Recommended CDE
38 Interaction Behavior Questionnaire - Adolescent version childish opinion indicator  Indicator related to if the parent believes the child's opinions are childish, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerChldOpInd Recommended CDE
39 Interaction Behavior Questionnaire - Adolescent version state view indicator  Indicator related to the parent not allowing a child to state their views, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerSttVwInd Recommended CDE
40 Interaction Behavior Questionnaire - Adolescent version nag little thing indicator  Indicator related to the parent nagging the child about little things in an argument, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerNgLtThgInd Recommended CDE
41 Interaction Behavior Questionnaire - Adolescent version stupid indicator  Indicator related to the parent calling the child stupid, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerStpInd Recommended CDE
42 Interaction Behavior Questionnaire - Adolescent version listen indicator  Indicator related to the parent listening to the child even if they are not letting them do something, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerLstnInd Recommended CDE
43 Interaction Behavior Questionnaire - Adolescent version problem help indicator  Indicator related to the parent offering help to the child if problems arise, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerPrbHlpInd Recommended CDE
44 Interaction Behavior Questionnaire - Adolescent version angry discussion indicator  Indicator related to the parent being angry when having a discussion with the child, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerAngDisInd Recommended CDE
45 Interaction Behavior Questionnaire - Adolescent version something else indicator  Indicator related to the parent doing something else when the child tries to talk with them, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerSmthElsInd Recommended CDE

IBQ Adolescent Version Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Interaction Behavior Questionnaire - Adolescent version appraisal of parent score 

(Draft)

Score for the appraisal of parent, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerApprPrntScore Recommended UDE
2 Interaction Behavior Questionnaire - Adolescent version appraisal of dyad score 

(Draft)

Score for the appraisal of dyad, adolescent version, as part of the Interaction Behavior Questionnaire InBhvQsAdlstVerApprDyadScore Recommended UDE

 Change History

 Administrative Change History