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1.3.1.2. Indirect assessments

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Several questionnaires allow for the indirect assessment of cognitive flexibility. One of the first to be proposed was the Cognitive Flexibility Scale (Martin and Ruben 1995). This scale consists of 12 items, to which the participant responds using a five-point Likert scale. Example of an item: “I am willing to work on problems that require a creative solution”.

The next three correspond to three versions of the Behavioral Assessment of Executive Functions Inventory, depending on the population. These three scales were constructed on an ecological basis and propose to evaluate the consequences of executive deficits in daily life, by adapting the situations to the three age groups targeted (preschoolers, children/adolescents, adults).

The BRIEF-A (Behavioral Assessment of Executive Function Inventory; Roth et al. (2005)), adult version, can be used to assess all executive functions, including flexibility. This questionnaire can be used in self or hetero-assessment.

It is composed of 75 questions grouped into nine scales: inhibition, flexibility, emotional control, self-control, initiation, working memory, planning/organization, task control and material organization. This tool was designed from an ecological perspective and allows the identification of executive deficits in adults (aged 18–93 years old) through their consequences in daily life.

Two other versions have been proposed, one for children and another for adolescents: the BRIEF (Behavioral Assessment of Executive Functions Inventory), child and adolescent version calibrated from 5 to 18 years of age (Gioia et al. 2000); the other for preschoolers: the BRIEF-P (Gioia et al. 2003). These two versions are proposed in hetero-assessment.

The BRIEF consists of 86 questions that can be grouped into eight scales: inhibition, flexibility, emotional control, initiation, material organization, working memory, planning/organization and control.

For each of the first two versions (BRIEF and BRIEF-A), two indices – a behavioral regulation index (BRI) and a metacognition index (MCI) – can be calculated, as well as a global executive composite score (ECS).

The BRIEF-P assesses behaviors in the school and/or family context of young preschoolers (aged 2–5 years and 11 months). It is composed of 63 questions (grouped into five scales: inhibition, flexibility, emotional control, working memory, planning/organization). In particular, three indices can be calculated:

 1) the inhibitory control index (ICI), which combines inhibition and emotional control;

 2) the flexibility index (FI), which combines flexibility and emotional control;

 3) the emerging metacognition index (EMI), which combines working memory and planning/organization.

The Cognitive Flexibility Inventory (CFI) (Dennis and Vander Wal 2010) provides a quick measure of cognitive flexibility. It is composed of 20 items in all. It is offered in a self-report format. Three aspects of cognitive flexibility can be measured through the following three subscales:

 1) the tendency to perceive difficult situations as controllable;

 2) the ability to perceive multiple alternative explanations for life events and human behavior;

 3) the ability to generate multiple alternative solutions to difficult situations.

On the basis of observation that cognitive flexibility may be particularly involved in emotion regulation, as a deficit in cognitive flexibility may be observed in mood and anxiety disorders; Gabrys et al. (2018) proposed the Cognitive Control and Flexibility Questionnaire (CCFQ).

This questionnaire was constructed to assess cognitive flexibility in the specific context of stressful situations. The CCFQ is a quick, self-report measure of cognitive flexibility with 18 items, all of which focus on stress management.

Table 1.2 summarizes the examples of indirect measures of flexibility presented in this chapter.

Table 1.2. Examples of indirect measures of flexibility

Authors Population Number of items
Cognitive Flexibility Scale Martin and Rubin (1995) Adults 12
BRIEF-A: Behavioral Assessment of Executive Function Inventory Roth et al. (2005) Adults 75
BRIEF Gioia et al. (2000) Children and teenagers (aged 5 to 18 years old) 86
BRIEF-P Gioia et al. (2003) Preschoolers (aged 2–5 years old) 63
Cognitive Flexibility Inventory Dennis and Vander Wal (2010) Adults 20
Cognitive Control and Flexibility Questionnaire (CCFQ) Gabrys et al. (2018) Adults 18
Cognitive Flexibility

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