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Neurobehavioral Symptom Inventory

Neurobehavioral Symptom Inventory

What is NSI

The NSI is a 22-item self-report measure of postconcussive symptoms. On this measure, respondents rate the degree of symptom severity on a five-point scale that ranges from zero (none; symptom is rarely ever present/not a problem at all) to four (very severe; symptom is almost always present/impairs performance at work, school, or home/individual probably cannot function without help).

NSI Printable PDF

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NSI Scoring and Interpretation

The severity of each symptom on the Neurobehavioral Symptom Inventory (NSI) is measured using a 5-item scale (0-none to 4-very severe) that asks patients to indicate the extent to which each symptom has disturbed them in the previous 2 weeks.

The NSI total score is the sum of severity ratings of the 22 symptoms (range 0 to 88).

Raw scores can be calculated for the three domains (Somatic/Sensory, Affective and Cognitive) and for the Total Score.

Descriptive statistics for the combined sample and subsamples of previously braininjured patients (TBI+) and non-brain-injured controls (TBI–)

Table 4
Combined SampleTBI–TBI+


Mean ± SD

Mean ± SD

Mean ± SD

NSI Total

32.23 ± 17.85

25.84 ± 15.99

40.46 ± 16.75


11.51 ± 7.80

8.72 ± 6.68

15.10 ± 7.69


13.86 ± 7.25

11.47 ± 6.87

16.94 ± 6.56


6.92 ± 4.52

5.65 ± 4.28

8.55 ± 4.29

No. of items in each Scale/Subscale (Caplan et al.’s suggested symptom groupings)

Table 5
Scale/SubscaleNo. of items

NSI Total








PsyPack can automatically score the NSI assessment and prepare corresponding tables and graphs.

NSI sample result

Further, PsyPack automatically plots a graph to help you easily track progress over time.

NSI track progress

Sample Report of NSI


Trauma, TBI (Traumatic Brain Injury)

What does NSI measure

The purpose of the evaluation is to:

  • measure of postconcussive symptoms, and
  • track symptoms over time.



Type of outcome tool


Assessment modes


Age and eligibility


Estimated time

5 to 10 minutes


Since the questionnaire relies on client self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the client understood the questionnaire, as well as other relevant information from the client.

The purpose of this inventory is to track symptoms over time.

Research suggests that the NSI is sensitive to increasing diagnostic burden in a roughly additive way. That is, the NSI total scores tend to increase as additional diagnostic thresholds are crossed.

Cicerone and Kalmar grouped patient endorsed symptoms into four distinct categories: affective, cognitive, somatic, and sensory. Symptoms such as headaches, difficulty sleeping, numbness, difficulty hearing, and change in taste or smell did not cluster into any category and were excluded from their follow-up analyses, though they remain listed as items on the measure. A more recent study by Caplan and colleagues show that a three-factor model composed of somatic/sensory, affective, and cognitive symptoms provided a better fit for symptom groupings.

Attribution and References