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): Parent Version
Short Name:
IBQParentVersion
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.References: 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:
Traumatic Brain Injury , General (For all diseases)
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 Parent Version (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Interaction Behavior Questionnaire - Son daughter indicators  Indicates whether the child in question is the son or daughter of the individual filling out the form, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerSonDaughterInd Recommended CDE
2 Interaction Behavior Questionnaire - Joke often indicator  Indicator related to if the child and parent joke around often, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerJkOfInd Recommended CDE
3 Interaction Behavior Questionnaire - Activity together parent often indicator  Indicator related to if the child and parent do a lot of things together, parent version, as part of the Interaction Behavior Questionnaire. InBhvQsPrtVerThTgthInd Recommended CDE
4 Interaction Behavior Questionnaire - Never agree indicator  Indicator related to if the child and parent never seem to agree, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerNvAgInd Recommended CDE
5 Interaction Behavior Questionnaire - Enjoy talks indicator  Indicator related to If the child and parent enjoy talks they have, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerEnTlkInd Recommended CDE
6 Interaction Behavior Questionnaire - Angry often indicator  Indicator related to the child and the parent being angry at each other at least three times a week, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerThTmAnInd Recommended CDE
7 Interaction Behavior Questionnaire - Argue bad apologize indicator  Indicator related to the child and the parent having an argument which turns out badly resulting in an apology, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerArBdApInd Recommended CDE
8 Interaction Behavior Questionnaire - Argue dinner table often indicator  Indicator related to the child and the parent having arguments at the dinner table half the time, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerArDnTbHlfTmInd Recommended CDE
9 Interaction Behavior Questionnaire - Compromise argue indicator  Indicator related to the child and parent compromising during an argument, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerCmprArInd Recommended CDE
10 Interaction Behavior Questionnaire - Angry once day indicator  Indicator related to the child and parent being angry at each other at least once a day, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerAngOnDyInd Recommended CDE
11 Interaction Behavior Questionnaire - Frustrate talk indicator  Indicator related to the child and parents feeling frustrated after talking, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerFrsTlkInd Recommended CDE
12 Interaction Behavior Questionnaire - Speak only necessary time indicator  Indicator related to the child and parent only speaking to each other when they have to, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerSpOnWhHvToInd Recommended CDE
13 Interaction Behavior Questionnaire - Get along general indicator  Indicator related to the child and parent not getting along in general, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerGtAlGnInd Recommended CDE
14 Interaction Behavior Questionnaire - Argue dinner every time indicator  Indicator related to the child and parent arguing at dinner every night, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerAgDnEvTmInd Recommended CDE
15 Interaction Behavior Questionnaire - Fun together indicator  Indicator related to the child and parent never having fun together, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerHvFnTgInd Recommended CDE
16 Interaction Behavior Questionnaire - Big argument little thing indicator  Indicator related to the child and the parent having big arguments over little things, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerBgArgLtThInd Recommended CDE
17 Interaction Behavior Questionnaire - Enjoyable talk daily indicator  Indicator related to the child and the parent having an enjoyable talk at least once a day, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerEnTlkOnDyInd Recommended CDE
18 Interaction Behavior Questionnaire - Easy get along indicator  Indicator related to the child being easy to get along with, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerEsyInd Recommended CDE
19 Interaction Behavior Questionnaire - Receptive criticism indicator  Indicator related to the child being receptive to criticism, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerRcptvInd Recommended CDE
20 Interaction Behavior Questionnaire - Curse use indicator  Indicator related to the child cursing at the parent, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerCrsInd Recommended CDE
21 Interaction Behavior Questionnaire - Enjoy parent indicator  Indicator related to the child enjoying being with the parent, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerEnjyInd Recommended CDE
22 Interaction Behavior Questionnaire - Well behave indicator  Indicator related to the child being well behaved in discussions, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerWllBhvInd Recommended CDE
23 Interaction Behavior Questionnaire - Listen parent indicator  Indicator related to the child usually listening to what the parent tells them, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerLstnPrntInd Recommended CDE
24 Interaction Behavior Questionnaire - Approach parent thought indicator  Indicator related to the child approaching the parent when something is on their mind, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerApprchMndInd Recommended CDE
25 Interaction Behavior Questionnaire - Child scream indicator  Indicator related to the child screaming, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerChldScrmInd Recommended CDE
26 Interaction Behavior Questionnaire - Several hour argument indicator  Indicator related to the child being mad several hours after an argument, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerSvHrArInd Recommended CDE
27 Interaction Behavior Questionnaire - Pay attention indicator  Indicator related to the child paying attention when having discussions with the parent, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerPyAttnInd Recommended CDE
28 Interaction Behavior Questionnaire - Parent lack child consideration indicator  Indicator related to the child feeling like the parent has no consideration for him/her, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerNoCnsChldInd Recommended CDE
29 Interaction Behavior Questionnaire - Seek out indicator  Indicator related to the child seeking out the parent, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerSkOutInd Recommended CDE
30 Interaction Behavior Questionnaire - Disobedient indicator  Indicator related to the child not doing with the parent asks, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerDsbInd Recommended CDE
31 Interaction Behavior Questionnaire - Seem angry indicator  Indicator related to the child seeming angry, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerSmAngInd Recommended CDE
32 Interaction Behavior Questionnaire - Cry when question indicator  Indicator related to the child crying when questioned, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerCrWhnQstnInd Recommended CDE
33 Interaction Behavior Questionnaire - Impatience parent talk indicator  Indicator related to the child acting impatient when the parent is talking, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerChldImptInd Recommended CDE
34 Interaction Behavior Questionnaire - Perception unloved indicator  Indicator related to the child perceiving a parent does not love them, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerUnlvChldInd Recommended CDE
35 Interaction Behavior Questionnaire - Contradict indicator  Indicator related to a child contradicting everything a parent says, parent version, as part of the Interaction Behavior Questionnaire InBhvQSPrtVerContrInd Recommended CDE
36 Interaction Behavior Questionnaire - Never understand argument indicator  Indicator related to the child never understanding the parent's side of an argument, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerNvrUndArgInd Recommended CDE
37 Interaction Behavior Questionnaire - Lie often indicator  Indicator related to the child often lying to the parent, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerLieInd Recommended CDE
38 Interaction Behavior Questionnaire - Hit parent indicator  Indicator related to the child trying to hit a parent in a heated discussion, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerChldHtInd Recommended CDE
39 Interaction Behavior Questionnaire - Defensive behavior indicator  Indicator related to the child being defensive when talked to, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerDfnsivInd Recommended CDE
40 Interaction Behavior Questionnaire - Argument provoke parent often indicator  Indicator related to if the child provoking the parent into an argument at least twice a week, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerChldPrvkArgInd Recommended CDE
41 Interaction Behavior Questionnaire - No follow through agreement indicator  Indicator related to the child not following through on their end of the bargain made with the parent, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerEndBrgnInd Recommended CDE
42 Interaction Behavior Questionnaire - Unfair parent indicator  Indicator related to the child calling the parent unfair, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerUnfrInd Recommended CDE
43 Interaction Behavior Questionnaire - Blow up no reason indicator  Indicator related to the child blowing up without reason, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerBlowUpNoReasonInd Recommended CDE
44 Interaction Behavior Questionnaire - Angry discussion indicator  Indicator related to the parent being angry when having a discussion with the child, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerAngDisInd Recommended CDE
45 Interaction Behavior Questionnaire - Something else attention parent indicator  Indicator related to the parent doing something else when the child tries to talk with them, parent version, as part of the Interaction Behavior Questionnaire InBhvQsPrtVerSmthElsInd Recommended CDE

IBQ Parent Version Scoring (Appears Up To 1 Time)

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

(Draft)

Score for the appraisal of adolescent, parent version, as a part of the Interaction Behavior Questionnaire(IBC) InBhvQsPrtVerApprAdolescScore Recommended UDE
2 Interaction Behavior Questionnaire - Parent version appraisal of dyad score 

(Draft)

Score for the appraisal of dyad, parent version, as a part of the Interaction Behavior Questionnaire(IBC) InBhvQsPrtVerApprDyadScore Recommended UDE

 Change History

 Administrative Change History