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Self- and Informant Ratings of Executive Functioning After Mild Traumatic Brain Injury
Jacobus Donders1, Ye In Oh, Jessica Gable
1Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan (Dr Donders); Calvin College, Grand Rapids, Michigan (Ms Oh); and Hope College, Holland, Michigan (Ms Gable).
Objective:
To determine correlates of self- and informant reports on a standardized rating of executive functioning in persons with mild traumatic brain injury.
Setting:
Outpatient clinic at a rehabilitation hospital.
Participants:
One hundred referred persons who met criteria for mild traumatic brain injury (ie, time to follow commands <30 minutes, posttraumatic amnesia <24 hours, and Glasgow Coma Scale score >12).
Design:
Retrospective case series review.
Main Measures:
Participants and informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) during outpatient neuropsychological evaluations within 30 to 360 days postinjury.
Results:
Participant and informant BRIEF-A ratings were strongly correlated, but participants rated themselves as worse than informants did. Regression analysis revealed that higher levels of education and presence of intracranial neuroimaging findings were associated with better BRIEF-A ratings whereas worse BRIEF-A ratings were associated with longer time since injury and prior psychiatric treatment. BRIEF-A ratings were not correlated with laboratory measures of executive functioning.
Conclusions:
Subjective perceptions of executive dysfunction during the first year after mild TBI are driven primarily by premorbid factors and do not reflect acquired cerebral impairment.
