{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:36:32Z","timestamp":1787841392103,"version":"build-2784847793"},"reference-count":33,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Huntington's Disease"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Objective<\/jats:title>\n                    <jats:p>This study extends prior clinimetric evaluations by examining the factor structure, internal consistency, and distributional properties of the Problem Behaviors Assessment \u2013 Short Form (PBA-s) in a large sample of people with Huntington's disease (pwHD) at various stages of progression using the Huntington's Disease Integrated Staging System (HD-ISS) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline PBA-s item total scores were analyzed from 14,371 Enroll-HD participants. Using HD-ISS criteria, participants were categorized as Stage 0\/1 (n\u2009=\u20093262; 23%), Stage 2 (n\u2009=\u20091722; 12%), or Stage 3 (n\u2009=\u20099387; 65%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Missing responses were low across items and stages. Item total score distributions demonstrated significant skew in Stages 0\/1 and 2. Within Stage 3, skewness was less prevalent but still present in most distributions. In all groups, the PBA-s demonstrated moderate internal consistency, though five items exhibited weak item-total correlations. Resultant factor structures differed from those previously reported and varied by HD-ISS stage. In Stages 0\/1 and 2, a three-factor model representing internalizing, externalizing, and cognitive control problems accounted for 39\u201342% of the total variance. In Stage 3, a five-factor solution explained 56% of the overall variance and consisted of internalizing, externalizing, cognitive control problems, suicidality, and cognitive dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While the PBA-s demonstrates adequate internal consistency, our results revealed high rates of non-endorsement (i.e., item total scores = 0) and a variable factor structure with disease progression. Thus, the PBA-s may not distinguish mild changes in behavioral symptoms that might occur in early HD-ISS stages of disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18796397261423978","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:17:23Z","timestamp":1773253043000},"page":"468-475","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A clinimetric evaluation of the problem behaviors assessment short form (PBA-s) within the context of the Huntington's disease integrated staging system (HD-ISS)"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5223-9262","authenticated-orcid":false,"given":"Docia L","family":"Demmin","sequence":"first","affiliation":[{"name":"the company that manages the scientific activities of CHDI Foundation, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9350-7499","authenticated-orcid":false,"given":"Matthew W","family":"Roch\u00e9","sequence":"additional","affiliation":[{"name":"the company that manages the scientific activities of CHDI Foundation, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jatin G","family":"Vaidya","sequence":"additional","affiliation":[{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas R","family":"Langbehn","sequence":"additional","affiliation":[{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6545-7376","authenticated-orcid":false,"given":"Rebecca LM","family":"Fuller","sequence":"additional","affiliation":[{"name":"the company that manages the scientific activities of CHDI Foundation, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Z","family":"Weingast","sequence":"additional","affiliation":[{"name":"the company that manages the scientific activities of CHDI Foundation, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Sampaio","sequence":"additional","affiliation":[{"name":"the company that manages the scientific activities of CHDI Foundation, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7905-9336","authenticated-orcid":false,"given":"Glenn T","family":"Stebbins","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences, Rush University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13413"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.2007.19.4.441"},{"key":"e_1_3_3_4_2","first-page":"69","volume-title":"Handbook of clinical neurology","author":"Paulsen JS","year":"2017","unstructured":"Paulsen JS, Miller AC, Hayes T, et al. 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