This form structure is an organized set of data definitions for a copyrighted form

 General Details

Title:
NIH Toolbox Emotion Domain Perceived Stress CAT (Parent Report for children ages 8-12)
Short Name:
NIHTBPSCATPR8to12
Description:
The NIH Toolbox Perceived Stress Survey Pediatric (8-12) Parent Report is a CAT comprised of items modified from the Perceived Stress Scale-10. (Cohen, S., Kamarck, T., & Mermelstein, R. (1983). It assesses how unpredictable, uncontrollable, and overloaded respondents find their lives. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx
Disease:
General (For all diseases)
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-07-07
Owner:
Number of Data Elements:
41
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

NIH Toolbox Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox - Test domain battery type  Type of domain battery for the NIH Toolbox test being administered, as a part of the NIH Toolbox NIHTBTestDomainBatteryTyp Recommended CDE
2 NIH Toolbox - Test domain battery type other  The free-text related to NIHTBTestDomainBatteryTyp specifying other text, as part of the NIH Toolbox NIHTBTestDomainBatteryTypOTH Recommended CDE
3 NIH Toolbox - Test name type  Type of NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestNameTyp Recommended CDE
4 NIH Toolbox - Test name type other  The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox NIHTBAdminTestNameTypOTH Recommended CDE
5 NIH Toolbox - Test administration language type  Type of language for test being administrated, as part of the NIH Toolbox NIHTBTestAdminLanguageTyp Recommended CDE
6 NIH Toolbox - Test administration language type other  Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox NIHTBTestAdminLanguageTypOTH Recommended CDE
7 NIH Toolbox - Form administered type  Type of NIH Toolbox form being administered, as part of the NIH Toolbox NIHTBFormAdminTyp Recommended CDE
8 NIH Toolbox - Test administration flag indicator  Indicator of a flag for the NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestFlagInd Recommended CDE
9 NIH Toolbox - Test administration flag type  Type of flag for the NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestFlagTyp Recommended CDE

NIH Toolbox Perceived Stress CAT Parent Report 8-12 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Irritation scale  Scale of parent report of how often their child seems able to control life's irritations in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12IrritationScl Recommended CDE
2 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Well scale  Scale of parent report of of how often it seemed that life was going well for their child in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12WellScl Recommended CDE
3 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Angered scale  Scale of parent report of of how often did your child appear angered by things that happened outside of his/her control in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress CAT Parent Report. NIHTBPSCATPR8to12AngeredScl Recommended CDE
4 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Difficulties scale  Scale of parent report ofof how often difficulties piled up so high that their child did not seem able to overcome them in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress CAT Parent Report. NIHTBPSCATPR8to12DffcltsScl Recommended CDE
5 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Upset scale  Scale of parent report of of how often their child was upset because of something that happened unexpectedly, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12UpsetScl Recommended CDE
6 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Frustrated scale  Scale of parent report of of how often their child appeared frustrated by being unable to control or do something, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12FrustratedScl Recommended CDE
7 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Nervous scale  Scale of parent report of of how often their child appeared nervous and "stressed", in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12NervousScl Recommended CDE
8 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Confident scale  Scale of parent report of how often their child appeared confident about his or her ability to handle personal problems, in the past month, for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress CAT Parent Report. NIHTBPSCATPR8to12ConfidentScl Recommended CDE
9 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Things well scale  Scale of parent report of of how often their child seemed to feel things were going well, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12ThngsWellScl Recommended CDE
10 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Cope scale  Scale of parent report ofy of how often their child seemed unable to cope with all the things that had to be done, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12CopeScl Recommended CDE

NIH Toolbox Perceived Stress CAT Prt Rpt 8-12 Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Raw score  Raw score, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12RawScore Recommended CDE
2 NIH Toolbox Emotion Perceived Stress Parent Report CAT 8 to 12 - Theta score  Theta score, in the past month for ages 8 to 12 as part of the NIH Toolbox Emotion Battery Perceived Stress Computerized Adaptive Test Parent Report. NIHTBPSCATPR8to12ThetaScore Recommended CDE
3 NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted scale score  Age-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROAgeAdjSclScore Recommended CDE
4 NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted national percentile value  Value of age-adjusted national percentile, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROAgeAdjNationalPctVal Recommended CDE
5 NIH Toolbox Patient Reported Outcome (PRO) Measures - Fully-adjusted scale score  Fully-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROFullyAdjSclScore Recommended CDE
6 NIH Toolbox Patient Reported Outcome (PRO) Measures - Unadjusted scale score  Unadjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROUnadjSclScore Recommended CDE
7 NIH Toolbox - Standard error  Standard error (a statistical measure of variance that represents the margin of error for the Tscore), as part of the NIH Toolbox NIHTBStandardError Optional CDE

 Change History

 Administrative Change History