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

 General Details

Title:
NIH Toolbox Emotion Domain Sadness Survey CAT 18-85
Short Name:
NIHTBSadnessCAT18to85
Description:
A self-report measure for ages 18-85 using a CAT format is available. Each survey version assesses negative mood, negative views of the self, and negative social cognition. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx
Disease:
Traumatic Brain Injury , 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:
2016-06-28
Owner:
Number of Data Elements:
58
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 Sadness Survey CAT 18-85 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Sadness CAT 18+ - Worthless scale  Scale of participant report of statement: I felt worthless, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18WorthlessScl Recommended CDE
2 NIH Toolbox Emotion Sadness CAT 18+ - Nothing scale  Scale of participant report of statement: I felt that I had nothing to look forward to, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18NothingScl Recommended CDE
3 NIH Toolbox Emotion Sadness CAT 18+ - Helpless scale  Scale of participant report of statement: I felt helpless, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18HelplessScl Recommended CDE
4 NIH Toolbox Emotion Sadness CAT 18+ - Withdrew scale  Scale of participant report of statement: I withdrew from other people, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18WithdrewScl Recommended CDE
5 NIH Toolbox Emotion Sadness CAT 18+ - Cheer up scale  Scale of participant report of statement: I felt that nothing could cheer me up, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18CheerUpScl Recommended CDE
6 NIH Toolbox Emotion Sadness CAT 18+ - Not good scale  Scale of participant report of statement: I felt that I was not as good as other people, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18NotGoodScl Recommended CDE
7 NIH Toolbox Emotion Sadness CAT 18+ - Felt sad scale  Scale of participant report of statement: I felt sad, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18FeltSadScl Recommended CDE
8 NIH Toolbox Emotion Sadness CAT 18+ - Give up scale  Scale of participant report of statement: I felt that I wanted to give up on everything, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18GiveUpScl Recommended CDE
9 NIH Toolbox Emotion Sadness CAT 18+ - Blame scale  Scale of participant report of statement: I felt that I was to blame for things, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18BlameScl Recommended CDE
10 NIH Toolbox Emotion Sadness CAT 18+ - Failure scale  Scale of participant report of statement: I felt like a failure, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18FailureScl Recommended CDE
11 NIH Toolbox Emotion Sadness CAT 18+ - Close scale  Scale of participant report of statement: I had trouble feeling close to people, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18CloseScl Recommended CDE
12 NIH Toolbox Emotion Sadness CAT 18+ - Disappointed scale  Scale of participant report of statement: I felt disappointmed in myself, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18DisappointedScl Recommended CDE
13 NIH Toolbox Emotion Sadness CAT 18+ - Not needed scale  Scale of participant report of statement: I felt that I was not needed, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18NotNeededScl Recommended CDE
14 NIH Toolbox Emotion Sadness CAT 18+ - Lonely scale  Scale of participant report of statement: I felt lonely, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18LonleyScl Recommended CDE
15 NIH Toolbox Emotion Sadness CAT 18+ - Depressed scale  Scale of participant report of statement: I felt depressed, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18DepressedScl Recommended CDE
16 NIH Toolbox Emotion Sadness CAT 18+ - Decisions scale  Scale of participant report of statement: I had trouble making decisions, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18DecisionsScl Recommended CDE
17 NIH Toolbox Emotion Sadness CAT 18+ - Discouraged scale  Scale of participant report of statement: I felt discouraged about the future, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18DiscouragedScl Recommended CDE
18 NIH Toolbox Emotion Sadness CAT 18+ - Overwhelming scale  Scale of participant report of statement: I found that things in my life were overwhelming, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18OverwhelmingScl Recommended CDE
19 NIH Toolbox Emotion Sadness CAT 18+ - Unhappy scale  Scale of participant report of statement: I felt unhappy, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18UnhappyScl Recommended CDE
20 NIH Toolbox Emotion Sadness CAT 18+ - Living scale  Scale of participant report of statement: I felt I had no reason for living, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18LivingScl Recommended CDE
21 NIH Toolbox Emotion Sadness CAT 18+ - Ignored scale  Scale of participant report of statement: I felt ignored by people, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18IgnoredScl Recommended CDE
22 NIH Toolbox Emotion Sadness CAT 18+ - Upset scale  Scale of participant report of statement: I felt upset for no reason, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18UpsetScl Recommended CDE
23 NIH Toolbox Emotion Sadness CAT 18+ - Interesting scale  Scale of participant report of statement: I felt that nothing was interesting, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18InterestingScl Recommended CDE
24 NIH Toolbox Emotion Sadness CAT 18+ - Pessimistic scale  Scale of participant report of statement: I felt pessimistic, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18PessimisticScl Recommended CDE
25 NIH Toolbox Emotion Sadness CAT 18+ - Empty scale  Scale of participant report of statement: I felt that my life was empty, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18EmptyScl Recommended CDE
26 NIH Toolbox Emotion Sadness CAT 18+ - Guilty scale  Scale of participant report of statement: I felt guilty, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18GuiltyScl Recommended CDE
27 NIH Toolbox Emotion Sadness CAT 18+ - Exhausted scale  Scale of participant report of statement: I felt emotionally exhausted, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18ExhaustedScl Recommended CDE

NIH Toolbox Sadness Survey CAT 18-85 Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Sadness CAT 18+ - Raw score  Raw score, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18RawScore Recommended CDE
2 NIH Toolbox Emotion Sadness CAT 18+ - Theta score  Theta score, in the past 7 days, for ages 18+ as part of the NIH Toolbox Emotion Sadness CAT NIHTBSCAT18ThetaScore 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