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Factor Analysis of the Frontal Systems Behavior Scale (FrSBe)

Julie C. Stout, Rebecca E. Ready, Janet Grace, Paul F. Malloy and Jane S. Paulsen
Assessment 2003 10: 79
DOI: 10.1177/1073191102250339

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ASSESSMENT Stout
ARTICLE
10.1177/1073191102250339
et al. / FrSBe FACTOR ANALYSIS

Factor Analysis of the Frontal

Systems Behavior Scale (FrSBe)

Julie C. Stout
Indiana University

Rebecca E. Ready
Janet Grace
Paul F. Malloy
Brown University

Jane S. Paulsen
University of Iowa

The Frontal Systems Behavior Scale (FrSBe), formerly called the Frontal Lobe Personality
Scale (FLOPS), is a brief behavior rating scale with demonstrated validity for the assess-
ment of behavior disturbances associated with damage to the frontal-subcortical brain cir-
cuits. The authors report an exploratory principal factor analysis of the FrSBeFamily
Version in a sample including 324 neurological patients and research participants, of which
about 63% were diagnosed with neurodegenerative diseases (Huntingtons, Parkinsons,
and Alzheimers diseases). The three-factor solution accounted for a modest level of vari-
ance (41%) and confirmed a factor structure consistent with the three subscales proposed on
the theoretical basis of the frontal systems. Most items (83%) from the FrSBe subscales of
Apathy, Disinhibition, and Executive Dysfunction loaded saliently on three corresponding
factors. The FrSBe factor structure supports its utility for assessing both the severity of the
three frontal syndromes in aggregate and separately.

Keywords: disinhibition; executive function; apathy; frontal

Damage to the prefrontal cortex is associated with a
wide range of behavioral changes, including disinhibition,
irritability, apathy, decreased initiation, emotional lability,
distractibility, irresponsibility, as well as problems with
executive functions, working memory, attention, abstract
thinking, mental flexibility, and recall (for a recent review,
see Lichter & Cummings, 2001b). These symptoms pose a
threat to personal autonomy and increase burden on fami-
lies and on society at large. Neuropsychological methods
for assessing cognitive changes associated with frontal
systems damage have been a focus of study for many
years, and neuropsychological tests are available that ef-
fectively address many of these cognitive disturbances
(Lezak, 1995; Spreen & Strauss, 1998). Fewer measures
are available to assess behavioral disturbances lying out-
side of the cognitive realm, although recent years have

Jessica Jones at Indiana University provided excellent assistance in preparation of this manuscript. We gratefully acknowledge the
contributions of Mary Wyman at Indiana University, who assisted in compiling data. We thank Drs. Guerry Peavy and David Salmon at
the University of California, San Diego Alzheimer Disease Research Center, for providing data from patients with Alzheimers disease.
Beth Turner and Laura Stierman provided assistance in data compilation at the University of Iowa. The project was supported by National
Institutes of HealthNational Institute of Aging AGO-5131 (UCSD-ADRC) and T32AG00214 (predoctoral fellowship to second au-
thor). Correspondence concerning this article should be addressed to Julie C. Stout, Department of Psychology, Indiana University, 1101
E. 10th St., Bloomington, IN 47405-7007; e-mail: jcstout@indiana.edu.
Assessment, Volume 10, No. 1, March 2003 79-85
DOI: 10.1177/1073191102250339
2003 Sage Publications

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80 ASSESSMENT
seen an increase in the availability of such measures (the
Neuropsychiatric Inventory, Cummings et al., 1994; the
Frontal Systems Behavior Scale [FrSBe], formerly re-
ferred to as the Frontal Lobe Personality Scale [FLOPS],
Grace, Stout, & Malloy, 1999; the Frontal Behavior In-
ventory, Kertesz, Davidson, & Fox, 1997; the Apathy
Evaluation Scale, Marin, Biedrzycki, & Firincioguliari,
1991). Accurate conceptualization and measurement of
frontal behavior disturbances are essential steps for de-
termining their prevalence and their impact on activities
of daily living. Furthermore, the precise measurement of
treatment efficacy depends on the availability of
psychometrically sound scales for measuring specific be-
havioral disturbances.
Of the scales listed above, the FrSBe is of particular in-
terest for characterizing behavior disturbances related to
frontal system dysfunction.1 The FrSBe is a behavior rat-
ing scale designed to provide a total frontal disturbance
score and three subscale scores made up of items devel-
oped to assess particular behavioral disturbances. Apathy,
disinhibition, and executive function were chosen by the
scales authors following an extensive search of the clini-
cal research literature that revealed these three categories
of behavior as the most frequently cited behavioral distur-
bances associated with damage to the frontal lobes and
frontal-subcortical brain circuitry. In fact, these three fron-
tal behavior syndromes have been linked to regional dis-
turbances in frontal lobe function. Specifically, damage to
the dorsolateral prefrontal cortex has been linked to prob-
lems with executive function, the mesial frontal and ante-
rior cingulate cortex with apathy and akinesia, and the
orbitofrontal cortex with disinhibited behavior and emo-
tional outbursts. These behavioral disturbances are found
in individuals who have frontal lobe damage and in indi-
viduals whose damage is at the subcortical levels in brain
structures known to be linked in a regionally specific fash-
ion to frontal cortex (Levin, Eisenberg, & Benton, 1991;
Lhermitte, Pillon, & Serdaru, 1986; Lichter & Cummings,
2001a; Mega & Cummings, 1994; Stuss & Benson, 1986).
The FrSBe is a 46-item behavior rating scale (Grace &
Malloy, 2001). Parallel forms exist for use by a family
member or close caregiver (Family Version), a staff mem-
ber caring for a patient in a professional setting (Staff Ver-
sion), and for self-ratings by the patient/subject (Self
Version). The FrSBe is designed to allow ratings to be
made of recent behavior, and for comparison, an optional
retrospective rating of behavior prior to accident, injury, or
treatment. The majority of the studies that have used the
FrSBe have focused on ratings only of recent (post-
accident, postinjury, or posttreatment) behavior (Hulver-
shorn, Stout, Paulsen, & Siemers, 1999; Norton, Malloy,
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& Salloway, 2001; Paulsen et al., 1996, 2000; Zawacki
et al., 2002). The Family Version of the FrSBe has been
used in the majority of the reports, including the primary
validity study of the FrSBe (Grace et al., 1999).
The FrSBe has been shown to have high internal consis-
tency reliability, and there is growing evidence for the
tests validity for assessing behavioral changes associated
with frontal systems damage (Boyle, Grace, Zawacki, Ott,
& Stout, 2001; Grace et al., 1999). The clinical utility of
the instrument is indicated by the fact that it measures
characteristics that are at least partly independent of cog-
nitive dysfunction and thus is not redundant with cognitive
measures (Paulsen et al., 1996; Stout, Wyman, Peavy, &
Salmon, 2001; Zawacki et al., 2002). Ratings on the FrSBe
also are associated with important outcome criteria, such
as functional status (Norton et al., 2001; Stout et al., 2001;
Zawacki et al., 2002).
Evidence is beginning to accrue that the FrSBe
subscales are differentially associated with clinical fea-
tures. For example, the Apathy Subscale of the FrSBe was
more strongly related to activities of daily living in vascu-
lar dementia (Zawacki et al., 2002) and mixed dementia
groups (Norton et al., 2001). Furthermore, Ready,
Stierman, and Paulsen (2001) reported evidence of eco-
logical validity for the various subscales in a healthy un-
dergraduate student sample; the Disinhibition Subscale
showed differential relationship to engaging in risky and
aggressive behaviors (Ready et al., 2001). Sufficient data
from neurological patients and research participants has
now accumulated so that it is possible to conduct a factor
analysis of the scale items and to determine if the factor
structure of the instrument corresponds to the hypothe-
sized three-subscale structure. This is an essential step for
determining whether the psychometric features of the
scale support the intended use of the measure for assessing
overall frontal behavior disturbance, as well as differential
presentation of the three frontal syndromes of apathy,
disinhibition, and executive dysfunction.
The goal of this study was to determine whether the fac-
tor structure of the FrSBe supports the subscale structure
of the scale. For this purpose, we evaluated data from a
mixed group of neurological patients and research partici-
pants regarding the frequency ratings of recent behaviors
on the FrSBeFamily Version. The study sample was de-
signed to include a wide range of neurological disorders
that is representative of those for whom the scale will be
used in clinical and research settings. Diagnostic heteroge-
neity in the sample ensured that a wide and comprehensive
range of FrSBe item scores would be represented in the
data, as is recommended for optimal factor analysis
(Gorsuch, 1997; Reise, Waller, & Comrey, 2000).
 Stout et al. / FrSBe FACTOR ANALYSIS 81

TABLE 1
Descriptive Statistics for Age, Education, and FrSBe Scales by Diagnosis (N = 324)
AD HD PD FLD Dem, NOS HI CVA
M SD M SD M SD M SD M SD M SD M SD

Age 75.4 7.8 46.5 12.2 68.2 7.8 69.9 8.8 70.7 11.8 41.8 17.5 60.0 19.2
Education 13.1 3.6 13.1 2.3 14.0 2.8 12.5 2.6 11.4 3.7 12.6 3.2
Apathy 41.6 10.7 39.0 11.8 34.8 10.7 48.6 7.9 35.6 12.2 32.3 10.3 36.0 11.5
Disinhibition 27.4 8.9 29.1 9.0 23.8 7.5 34.5 11.0 27.7 9.8 29.5 7.6 29.2 10.3
Executive dysfunction 55.9 12.9 46.1 14.3 40.0 11.1 57.8 13.5 48.8 16.3 41.3 10.4 44.3 15.6

Total 124.9 27.9 114.2 31.0 98.63 23.3 140.9 27.0 112.1 34.6 103.1 25.5 109.6 33.6
N 76 91 38 13 27 29 50

NOTE: AD = probable Alzheimers disease; HD = Huntingtons disease; PD = Parkinsons disease; FLD = frontal lobe dementia; Dem, NOS = dementia,
not otherwise specified, Lewy Body Variant, vascular dementia, traumatic dementia, dementia due to multiple sclerosis; HI = head injury; CVA = cerebral
vascular accident.

METHOD ticipants gave institutionally approved informed consent.

Sample
The sample consisted of 324 neurological outpatients
and research participants from eight diagnostic categories
(Table 1). Alzheimers disease was diagnosed according to
National Institutes of Neurological and Communicative
Disorders and Stroke criteria (McKhann et al., 1984). The
diagnosis of Huntington Disease was made by a senior
staff neurologist on the basis of chorea as screened on the
Unified Huntingtons Disease Rating Scale (Huntington
Study Group, 1996) and the presence of a confirmed fam-
ily history of Huntingtons disease. Parkinsons disease
was diagnosed using a clinical evaluation to document the
presence of symptoms (i.e., stooped posture, bradykinesia,
resting tremor, muscular rigidity) and to rule out other pos-
sible diagnoses (Bannister, 1992). Hoehn and Yahr (1967)
criteria were used to document the severity of the disorder.
Dementia patients with prominent changes in behavior
and personality at the onset of dementia and with major
frontal lobe impairments on neuropsychological testing
and single photon emission computed tomography
(SPECT) were diagnosed with frontotemporal dementia.
Dementia due to Lewy Bodies was diagnosed in dementia
patients with at least two of the following three character-
istics: visual hallucinations, parkinsonian symptoms, or
fluctuating cognitive ability. Patients with dementia and an
Hachinski ischemia score greater than or equal to 7
(Hachinski et al., 1975) were diagnosed with vascular de-
mentia. These data were obtained in clinical research set-
tings at the Indiana University Department of Psychology,
the Brown University Department of Psychiatry and Hu-
man Behavior, the University of California San Diego Alz-
heimer Disease Research Center and Genetically
Handicapped Persons Program, and the University of
Iowa Departments of Psychiatry and Neurology. All par-
Some of these data have appeared in prior publications
(Grace et al., 1999; Hulvershorn et al., 1999; Paulsen et al.,
1996; Stout et al., 2001).
Instrument
The FrSBe is a 46-item behavior rating scale that mea-
sures behaviors that are clinically and theoretically linked
to frontal lobe damage. The items on the scale were devel-
oped from a list of descriptors used in the neuropsycho-
logical, neurological, and psychiatric literatures. Next, a
panel of experts reviewed the items, and a set of items
judged to be redundant or poorly worded were eliminated.
Items were then assigned to three subscales. Q-sort of
these items by an expert on frontal-subcortical circuits and
behavior revealed an acceptable level of agreement ( =
.77, p < .001). Items from the scale were worded to assess
the frequency of problems related to three behavioral do-
mains: apathy/akinesia (Scale A, 14 items), disinhibition/
emotional dysregulation (Scale D, 15 items), and execu-
tive dysfunction (Scale E, 17 items). For all participants,
ratings of recent behavior were obtained from an infor-
mant (i.e., close family member or caregiver) using the fol-
lowing instructions:
Below is a list of phrases used to describe someone.
How well does each of these descriptions character-
ize the person you were asked to evaluate? Please
rate these items according to the persons behavior
in the past two weeks. Place a number in each box
that corresponds to your rating.
Below these instructions and reprinted at the top of each
page was a box containing the list of possible ratings with
descriptors. For the first 35 items, informants were asked
to rate each item according to the following 5-point scale:
1 = almost never, 2 = seldom, 3 = sometimes, 4 = frequently,

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82 ASSESSMENT

and 5 = almost always. The 5-point scale on the last page TABLE 2
(containing the final 11 positively stated scale items) was Pattern Matrix From Principal
reversed so that 1 = almost always, 2 = frequently, 3 = Factor Analysis With Oblique Rotation
sometimes, 4 = seldom, and 5 = almost never, and a rating to Simple Structure (N = 324)
scheme was maintained such that higher ratings corre- A Priori Factor 1 Factor 2 Factor 3
sponded to relatively more abnormal behavior. Item Abbreviation (number) Scale E D A

Shows poor judgment (19) E .73 .04 .04

Data Analysis Repeats same mistakes (7) E .70 .00 .08
Mixes up a sequence (5) E .67 .00 .00
We conducted exploratory principal component factor Is disorganized (15) E .65 .01 .13
analysis with iterated communalities on the 46 FrSBe Forgets to do things (25) E .57 .02 .11
Does not finish things (23) A .57 .02 .21
items. A three-factor solution was specified based on the
Is inflexible (26) E .54 .02 .11
theoretical conceptualization of the scale. Because we ex- Unaware of problems (13) E .54 .03 .06
pected the three factors to be correlated, as typically oc- Repeats certain actions (3) E .54 .03 .06
curs when the factors are components of a more general Says one thing, does another (22) E .53 .24 .07
a
construct (e.g., frontal system dysfunction), we used an Thinks things through (35) E .53 .00 .17
a
Pays attention (34) E .52 .11 .16
oblique rotation to simple structure as recommended by a
Is able to plan ahead (37) E .47 .06 .39
Reise and colleagues (2000). In this rotation, equal weight Cannot do two things at once (17) E .47 .01 .27
was given to the two criteria that enter into the oblique ro- Laughs or cries too easily (6)
b
D .37 .21 .10
b
tation, namely, orthogonal and correlated factors. Makes up stories (20) E .36 .25 .05
The fit of the resulting factor structure was evaluated Does embarrassing things (10) D .20 .67 .05
Makes sexual comments (9) D .05 .64 .02
using the following criteria: eigenvalues greater than or
Swears (32) D .03 .51 .02
equal to 1, scree test, and the interpretability of the factors Does things impulsively (4) D .33 .49 .17
with respect to the specific subscales proposed by the au- Is overly silly (30) D .30 .49 .10
a
thors in developing the FrSBe. We used a value greater Acts appropriately (45) D .18 .48 .14
than .40 as a criterion to define a salient factor loading as Talks out of turn (18) D .39 .47 .22
Neglects personal hygiene (11) A .02 .45 .43
recommended by Gorsuch (1997). A sample size of at a
Gets along with others (44) D .06 .42 .14
least 300 is recommended to identify item loadings of this b
Does risky things (28) D .08 .37 .03
magnitude in item-level data (Gorsuch, 1997). This rela- b
Is easily angered (2) D .24 .34 .06
b
tively large sample size also is recommended to ensure that Is hyperactive (12) D .23 .34 .16
b
the factors will emerge from error variance associated Trouble with the law (27) D .02 .27 .07
b
Loss of taste or smell (31) D .10 .24 .13
item-level data, which are known (in comparison to scales)
Lacks energy (29) A .25 .11 .61
to have relatively low intercorrelations, low reliability, Lost interest in things (21) A .24 .02 .60
varying distributions, and noncontinuous response for- Does nothing (14) A .31 .07 .60
a
mats (Gorsuch, 1997). Gets involved spontaneously (41) A .23 .14 .59
a
Starts conversations (46) A .04 .06 .51
a
Does things without reminders (42) A .22 .03 .50
Unconcerned and unresponsive (24) A .18 .06 .48
RESULTS Lacks initiative, motivation (8) A .40 .05 .48
a
Cares about appearance (39) A .04 .29 .46
a
Results of the factor analytic study supported the ex- Is sensitive to others (43) D .07 .22 .42
a, b
traction of three factors, which were consistent with the Benefits from feedback (40) E .22 .20 .37
a, b
Is interested in sex (38) A .10 .14 .36
subscales designed by the authors of the FrSBe. Below we b
Incontinence (16) A .12 .32 .36
describe the primary factor analysis results, followed by Uses memory strategies (36)
a, b
E .22 .09 .35
item-loading characteristics. a, b
Apologizes for misbehavior (33) E .04 .15 .30
b
Speaks only when spoken to (1) A .10 .07 .30
Primary Factor Analysis NOTE: E = Executive Dysfunction; A = Apathy; D = Disinhibition. Fac-
tor loadings of .40 or greater are in italics.
The three-factor solution accounted for 40.7% of the a. Reverse-keyed item.
b. Items with no salient loading on any of the three factors.
common variance among the 46 items (see Table 2). Three
lines of evidence supported the extraction of the three fac-
tors. First, the eigenvalues for the factors were all greater extracting factors beyond three in regard to accounting for
than 1. Second, the factors were above the elbow on the additional variance. Third, items from each of the three
scree plot, indicating significantly diminishing returns for FrSBe subscales tended to have primary loadings on the

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same factor, and thus, it was possible to make substantive
interpretations of the factors based on item loadings.
The first factor, which we labeled Executive Dysfunc-
tion, accounted for 29.1% of the variance. Twelve of the
original 16 Executive Dysfunction subscale items as well
as 1 item developed for the Apathy subscale had salient
loadings on the Executive Dysfunction factor. The second
factor, which we labeled Disinhibition, accounted for
7.2% of the common variance. It included salient loadings
by 8 of the original 15 items from the Disinhibition
subscale as well as 1 item from the Apathy subscale. The
third factor, which we labeled Apathy, accounted for 4.4%
of the common variance, and 9 of the 15 items proposed in
the original Apathy subscale loaded saliently on this fac-
tor, as did one item from the Disinhibition subscale.
Consistent with the notion that the three factors were
related to a similar underlying construct (i.e., frontal sys-
tems abnormality), the three factors were significantly (p <
.01) correlated (Executive Dysfunction with Disinhibition
r = .43, Executive Dysfunction with Apathy r = .43,
Disinhibition with Apathy r = .22). Such correlations can
be troubling when they are a result of a high level of item
cross-loadings, because this indicates that items in the
scale have such a high degree of overlap as to be ineffective
for distinguishing the constructs targeted by the factors.
However, only 2 of the 46 items had salient cross-loadings
as defined by .40 or greater, so item cross-loadings do
not account for a significant portion of the factor
intercorrelations.
Item Loading Characteristics
Using the criterion of > .40 to indicate salient loading,
29 of the 46 FrSBe items performed as predicted, loading
saliently and solely on the expected factor. An additional 9
items showed strongest loadings on the expected factor,
but at a value lower than the criterion of .40. Thus, 38 of the
original 46 items loaded on the expected factor in the fac-
tor analysis. For the remaining 8 items, 6 had their highest
loading on a factor other than the one corresponding
subscale to which they were assigned, and 2 had salient
cross-loadings both on the factor corresponding to their
subscale assignment and an additional subscale (see Ta-
ble 2).
Of the six items that loaded most highly on factors other
than the one expected, only two had salient loadings, in-
cluding Starts things but fails to finish them, which was
assigned to the Apathy subscale but which loaded saliently
on the Executive Dysfunction factor, and Is sensitive to
the needs of other people, which was assigned to the
Disinhibition subscale but instead loaded saliently on the
Executive Dysfunction factor and the Apathy factor, re-
spectively. The two items that failed to show specificity to
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Stout et al. / FrSBe FACTOR ANALYSIS 83
the subscale to which they were theoretically assigned
were Neglects personal hygiene from the Apathy sub-
scale, which cross-loaded on the Apathy and Disinhibition
factors, and Has difficulty starting an activity, lacks ini-
tiative, motivation, which cross-loaded on the Apathy and
Executive Dysfunction factors.
DISCUSSION
The exploratory principal factor analysis of the FrSBe
confirmed a factor structure consistent with the three
subscales that were proposed on the basis of frontal sys-
tems behavioral theory. That is, items from the individual
FrSBe subscales tended to load together on each of three
corresponding factors, Apathy, Disinhibition, and Execu-
tive Dysfunction. The Executive Dysfunction factor ac-
counted for the largest portion of the variance, but the
Apathy and Disinhibition factors also emerged as impor-
tant in accounting for the patterns of responses. Thus, the
factor structure, in conjunction with the previous studies
that have indicated construct validity of the scale, suggests
that the FrSBe is useful for assessing the severity of the
three frontal syndromes in aggregate, as well as for assess-
ing these syndromes separately. Additional evidence of
subscale utility has been obtained in clinical and research
settings. For example, in several studies, FrSBe subscales
were related to measures of independence in activities of
daily living (Norton et al., 2001; Stout et al., 2001;
Zawacki et al., 2002).
The FrSBe has significant intercorrelations between
the factors, ranging from r = .22 to r = .43, a finding that is
expected when the constructs underlying the subscales are
related to a broader construct such as behavioral character-
istics of frontal system dysfunction. Despite the interrela-
tionships, a significant level of unshared variance remains
in the factors, supporting the use of FrSBe subscales for
differentiating specific patterns of behavior disturbances
in individuals with frontal systems damage. Also of note,
only about 41% of the variance was accounted for by the
factor structure of the FrSBe. Thus, there is a substantial
amount of variance in FrSBe scores that is also independ-
ent of the three factors. Further studies will be necessary to
determine whether that variance contributes to the mea-
surement of more general frontal syndromes.
Only two of the items in the FrSBe cross-loaded
strongly on more than one factor. Although these items
were written to measure part of a single construct, it ap-
pears that more than one process underlies the behaviors
tapped by these two items. Relatively more of the items
performed below optimal levels in the factor analysis be-
cause they loaded less saliently (less than .40) on any of the
three factors (17 items) or loaded saliently only on a factor
84 ASSESSMENT
other than the one corresponding to the subscale for which
they were proposed (2 items). There are several possible
reasons for such findings. For example, a few items had
very low endorsement rates and restricted variance in our
sample (e.g., trouble with the law, does risky things, un-
concerned about incontinence), which may account for
their failure to covary with other items in a manner that
would have resulted in a salient factor loading. Although
their psychometric properties are not ideal, they may be
useful for clinical purposes. For example, trouble with
the law is infrequently endorsed and could alert a clini-
cian to the potential involvement of the legal process in the
patients outcome. Similarly, incontinence is a particularly
burdensome problem for caregivers and is associated with
higher rates of nursing home placement.
Ratings may differ depending on features of the rater
and his or her relationship with the person being rated. In
this sample, we did not systematically classify the type and
extent of the relationships between raters and the individu-
als they rated. However, all raters considered themselves
to be close family members or caregivers, and the majority
were cohabiting with the person whom they rated. None-
theless, some items may be too difficult for the caregiver or
family member to rate because the items require informa-
tion about the patients experience that is typically avail-
able only on self-reflection rather than by observation by
another individual (i.e., interest in sex, food has no taste or
smell, uses memory strategies). Finally, some items may
have been ambiguous or confusing (i.e., apologizes for
misbehavior), leading respondents to interpret the items
differently than intended by the authors of the FrSBe. In
fact, idiosyncratic interpretation of items has been identi-
fied as a major source of discrepancy between self and in-
formant personality ratings (McCrae, Stone, Fagan, &
Costa, 1998). For several of the remaining items that did
not load highly on any of the factors, there does not appear
to be any systematic reason for their failure to load sa-
liently on their corresponding factor. These items simply
may not have adequately captured the construct that they
were written to assess.
In summary, the results from the present study are con-
sistent with the use of the FrSBe subscales in the assess-
ment of behavioral disturbances associated with
neurological dysfunction. In addition, the item character-
istics revealed by the factor analysis provide initial indica-
tions regarding which items perform best in terms of the
goals of the FrSBe. This exploratory factor analysis re-
quires replication with confirmatory factor analysis to
avoid capitalization on chance findings (Finch & West,
1997). Such further studies are essential prior to any modi-
fications in the use of the FrSBe, such as eliminating items.
The finding of the three factors provides psychometric
support for the subscale structure of the FrSBe and also
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points to the need for additional studies to determine the
predictive validity of the subscales.
NOTE
1. Throughout the article, we refer to the scale as the Frontal Systems
Behavior Scale (FrSBe). In publications prior to this, the scale has been
consistently referred to as the Frontal Lobe Personality Scale (FLOPS).
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Julie C. Stout, Ph.D., is an assistant professor at Indiana Univer-
sity. Her research interests are in the area of basal ganglia and
frontal diseases, especially Parkinsons and Huntingtons, and in
drug abuse.
Rebecca E. Ready, Ph.D., is a research fellow at Brown Univer-
sity. Her research focuses on neuropsychology and caregiving in
dementia.
Janet Grace, Ph.D., is an associate professor at Brown Univer-
sity. Her research interests include clinical neuropsychology, re-
habilitation, and frontal behavior disturbances.
Paul F. Malloy, Ph.D., is an associate professor at Brown Uni-
versity. His research interests are in the field of frontal-
subcortical brain systems, neuropsychology, and obsessive-
compulsive disorder.
Jane S. Paulsen, Ph.D., is a professor at the University of Iowa.
Her research focuses on frontal-subcortical brain systems, Hun-
tingtons disease, and schizophrenia.