Impaired sustained attention and error awareness in traumatic brain injury: implications for insight

The processes of error awareness and sustained attention were investigated in 18 traumatic brain injury (TBI) individuals and 16 matched control participants. In Experiment 1, we found that: (1) in comparison to controls, TBI participants displayed reduced sustained attention and awareness of error during the Sustained Attention to Response Task; (2) degree of error awareness was strongly correlated with sustained attention capacity, even with severity of injury partialed out; and (3) that error feedback significantly reduced errors. We replicated the finding of a correlation between error awareness and sustained attention capacity in Experiment 2 with a separate sample of 19 TBI participants and 20 controls. We conclude that TBI leads to impaired sustained attention and error awareness. The finding of a significant relationship between these two deficits in TBI suggests there may be a link between these two processes. Feedback on error improves sustained attention performance of control and TBI participants.