Self-rating versus neuropsychological performance of moderate versus severe head-injured patients

Head-injured patients frequently appear to be inaccurate in judging their cognitive functioning. To examine this clinical impression, self-ratings were compared with neuropsychological test performances. The sample was comprised of 28 patients with severe and 28 with mild-moderate head injuries, and these two groups were further subdivided according to chronicity, i.e. less than or equal to 1 year versus greater than 1 year between the date of injury and the evaluation. The control group of 31 adults was matched according to age and education. Head-injured patients rated themselves lower than normals regardless of severity of injury. Chronicity affected only the self-rating of learning and memory. The severely head-injured were generally less accurate when comparing self-ratings to test performance. However, this was not uniform across cognitive domains. Recommendations for self-assessment in neuropsychology are discussed.