PT  - JOURNAL ARTICLE
AU  - Barzman, Drew
AU  - Mossman, Douglas
AU  - Sonnier, Loretta
AU  - Sorter, Michael
TI  - Brief Rating of Aggression by Children and Adolescents (BRACHA): A Reliability Study
DP  - 2012 Sep 01
TA  - Journal of the American Academy of Psychiatry and the Law Online
PG  - 374--382
VI  - 40
IP  - 3
4099  - http://jaapl.org/content/40/3/374.short
4100  - http://jaapl.org/content/40/3/374.full
SO  - J Am Acad Psychiatry Law2012 Sep 01; 40
AB  - The Brief Rating of Aggression by Children and Adolescents (BRACHA) is a 14-item instrument scored by emergency room staff members to assess aggression risk during an upcoming psychiatric hospitalization. In this study, we investigated the inter-rater reliability of the BRACHA 0.9, the latest version of the instrument. After receiving training based on the BRACHA 0.9 manual, 10 intake workers viewed 24 ten-minute videos in which child and adolescent actors portrayed pediatric emergency room patients with low, moderate, or high levels of risk for aggression during an upcoming hospitalization. We then evaluated inter-rater reliability for individual BRACHA items, using three measures of agreement, and reliability for total BRACHA 0.9 scores, using conventional (frequentist) methods and Bayesian techniques for calculating the intraclass correlation coefficient ICC (2,1). Inter-rater reliability for individual items ranged from good to almost perfect, with Kendall's W exceeding 0.75 for eight of 14 BRACHA items. The ICC (2,1) for the total BRACHA 0.9 score was 0.9099, with both conventional and Bayesian methods (95% credible interval 0.8530–0.9533), suggesting an excellent level of overall agreement. The BRACHA appears to be an accurate, highly reliable instrument for assessing the risk of aggression by children and adolescents who are about to undergo psychiatric hospitalization.