6.2 Assessment of Aggressive and Agitated Behaviour

 What test is available to assess for agitated and aggressive behavior? 

Agitated Behaviour Scaleis designed to assess agitation in patients by those working with them.  14 item scale, with each item scoring 1-4 (total range 14-56). 

Click here to view the Agitated Behavior Scale: http://www.tbims.org/combi/abs/absrat.html

What are its strengths and weaknesses?


  1. The scale consists of 14 questions.
  2.  It can be completed in 30 minutes.
  3. Its availability makes the scale very practical.


  1. There is a risk of over diagnosis.
  • To measure agitation post-injury the Agitated Behavior Scale was developed 3.
  • The ABS was designed to assess agitation in patients by those working with them
  • According to Levy et al. 4, despite the availability of the scale, agitation remains unmeasured by most who work with the TBI population.  
  • The scale, which began as a 39 item scale, was reduced to 14 items, with each item scoring 1 to 4, (from absent to present to an extreme degree).
  • Thescale which was originally tested by nurses, occupational therapists (OT), physiotherapists (PT) and other hospital staff, was designed to be used by allied health professionals 5.

What are some of the practical advantages of using an objective scale for assessing agitation?

  1. Assess pattern of agitation;
  2. Assess the level of agitation, which then can dictate treatment;
  3. Assess the response of agitation to interventions;
  4. Numbers mean something; ABS >21 = agitation, <23 unlikely to be violent, >28 = treatment with pharmacological agents.