Brain Injury Sense of Self Scale: psychometric development of a new measure of strength of self-identity after traumatic brain injury.
Emily J Thomas, William J Taylor, Richard J Siegert and 1 others
PMID 40271541WHAT IT FOUND
The new BISOSS scale identifies three distinct areas of self-identity trouble after brain injury: personal, societal, and relational.
It helps clinicians pinpoint exactly where a patient feels lost, rather than just noting general low self-esteem. This allows for targeted conversation and care planning.
Key findings
01The scale was reduced to 36 items across three subscales: Egocentric (personal), Sociocentric (place in the world), and Relational (how others treat me).
02Participants who had resumed work or reported no family disruption scored significantly higher on all three subscales than those who had not.
03The scale correlates with a single global question about having problems with self-identity, supporting its validity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The Relational subscale has poor precision and ceiling effects, meaning it cannot accurately measure moderate levels of identity disturbance in this domain. The study lacked ethnic diversity, with 89.7% of participants identifying as White British or NZ European, limiting generalizability to other cultural contexts. Data was collected only once, so test-retest reliability and responsiveness to change over time are unknown. The Sense of Coherence scale was difficult for participants to complete, which may have affected the validity testing against this comparator. No normative data exists for people without brain injury, so scores cannot be compared to a general population baseline.
Declared interests
The authors certify no conflict of interest with any financial organization. Funding was provided by a University of Otago doctoral scholarship.
The easy way to misread this
Do not assume the Relational subscale is as robust as the other two. It showed poor precision and ceiling effects, meaning it may fail to detect significant identity issues in this domain for many patients. Use it with caution until further items are developed.