{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:30:51Z","timestamp":1787848251273,"version":"build-2784847793"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Int Neuropsychol Soc"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1355617722000340_as1\"><jats:title>Objectives:<\/jats:title><jats:p>To validate the two-factor structure (i.e., cognitive and somatic) of the Health and Behaviour Inventory (HBI), a widely used post-concussive symptom (PCS) rating scale, through factor analyses using bifactor and correlated factor models and by examining measurement invariance (MI).<\/jats:p><\/jats:sec><jats:sec id=\"S1355617722000340_as2\"><jats:title>Methods:<\/jats:title><jats:p>PCS ratings were obtained from children aged 8\u201316.99 years, who presented to the emergency department with concussion (n = 565) or orthopedic injury (OI) (n = 289), and their parents, at 10-days, 3-months, and 6-months post-injury. Item-level HBI ratings were analyzed separately for parents and children using exploratory and confirmatory factor analyses (CFAs). Bifactor and correlated models were compared using various fit indices and tested for MI across time post-injury, raters (parent vs. child), and groups (concussion vs. OI).<\/jats:p><\/jats:sec><jats:sec id=\"S1355617722000340_as3\"><jats:title>Results:<\/jats:title><jats:p>CFAs showed good fit for both a three-factor bifactor model, consisting of a general factor with two subfactors (i.e., cognitive and somatic), and a correlated two-factor model with cognitive and somatic factors, at all time points for both raters. Some results suggested the possibility of a third factor involving fatigue. All models demonstrated strict invariance across raters and time. Group comparisons showed at least strong or strict invariance.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617722000340_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>The findings support the two symptom dimensions measured by the HBI. The three-factor bifactor model showed the best fit, suggesting that ratings on the HBI also can be captured by a general factor. Both correlated and bifactor models showed substantial MI. The results provide further validation of the HBI, supporting its use in childhood concussion research and clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1355617722000340","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T08:55:38Z","timestamp":1659603338000},"page":"346-359","source":"Crossref","is-referenced-by-count":9,"title":["Factor structure and measurement invariance of post-concussion symptom ratings on the Health and Behaviour Inventory across time, raters, and groups: An A-CAP study"],"prefix":"10.1017","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-4922","authenticated-orcid":false,"given":"Cherri","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam H.","family":"Beauchamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Craig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh","family":"Doan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith Owen","family":"Yeates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"S1355617722000340_ref28","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.2900"},{"key":"S1355617722000340_ref36","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acu014"},{"key":"S1355617722000340_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617718000462"},{"key":"S1355617722000340_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617719000286"},{"key":"S1355617722000340_ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4635"},{"key":"S1355617722000340_ref38","doi-asserted-by":"publisher","DOI":"10.1037\/a0018112"},{"key":"S1355617722000340_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6494.2011.00739.x"},{"key":"S1355617722000340_ref33","volume-title":"Living guideline for diagnosing and managing pediatric concussion","author":"Reed","year":"2019"},{"key":"S1355617722000340_ref34","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2012.715555"},{"key":"S1355617722000340_ref20","doi-asserted-by":"publisher","DOI":"10.1037\/met0000075"},{"key":"S1355617722000340_ref8","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.5643"},{"key":"S1355617722000340_ref1","article-title":"Invariance of the Bifactor Structure of Mild Traumatic Brain Injury (mTBI) Symptoms on the Rivermead Postconcussion symptoms questionnaire across time, demographic characteristics, and clinical groups: A TRACK-TBI study","author":"Agtarap","year":"2020","journal-title":"Assessment"},{"key":"S1355617722000340_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617708090188"},{"key":"S1355617722000340_ref19","first-page":"1","article-title":"The structure of post-concussion symptoms in adolescent student athletes: confirmatory factor analysis and measurement invariance","author":"Karr","year":"2020","journal-title":"The Clinical Neuropsychologist"},{"key":"S1355617722000340_ref24","unstructured":"Medicine, AftAoA. 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