Lack of Awareness of Deficits in Traumatic Brain Injury

Lack of awareness of deficits is often seen in neurological and psychiatric disorders. Clues to the etiology of awareness deficits in these disorders can increase our understanding of the lack of awareness in traumatic brain injury (TBI). Research suggests that up to 45% of individuals with moderate to severe TBI have reduced awareness or complete lack of awareness of their deficits. The authors describe dimemsions and distinctions within the concept of lack of awareness-including whether an individual has knowledge of a specific deficit, the emotional response an individual manifests to a specific deficit, the ability to comprehend the impact or consequences of the deficit on day-to-day life, and how an individual explains or accounts for any deficits-and suggest that these discriminations have clinical, research, and theoretical value. These different aspects of lack of awareness have distinct neurological underpinnings as well as important treatment implications.