Self-awareness following traumatic brain injury and implications for rehabilitation

Many studies investigating self-awareness following traumatic brain injury (TBI) have been conducted more than 2 years post-injury, thereby providing limited information regarding the implications of insight for rehabilitation. The present study aimed to investigate awareness of deficits in a group of patients who were less than 2 years post-injury and still involved in rehabilitation.

Thirty patients with a history of moderate or severe TBI and their significant other (SO) were studied in a cross-sectional analysis. A sub-group also participated in an interdisciplinary Memory Group at the Bethesda Rehabilitation Centre.

Level of insight was measured by the degree of agreement between self and significant other (SO) report on the Awareness of Deficit questionnaire (ADQ), assessing various domains of daily functioning.

There was substantial agreement between patients and their SO, although the patients with TBI were less likely to acknowledge executive problems. Interestingly, both groups reported only low-to-moderate levels of difficulty.

The data indicate that SO's awareness may also be limited in the early recovery stages. A sub-group of the patients obtained benefit from participation in the Memory Group in a rehabilitation setting.