The Effects of Early Impaired Self-Awareness After Traumatic Brain Injury

Past Studies

Past Studies confirm that traumatic brain injury can cause neurobehavioral problems. “Neurobehavior” refers to an individual’s ability to process thoughts or to think, behave socially, communicate, and control emotions. Individuals with neurobehavior problems commonly experience difficulty paying attention, concentrating, remembering things, and originating activities. They can experience a decrease in self-awareness. This means that they are unable to accurately assess their current level of function. Past studies show that individuals with brain injuries tend to err on the side of overestimating their abilities, especially in the areas of thinking skills and behavior. For instance, an individual with a memory problem may not realize or perceive that indeed, he or she has a memory problem. This can cause them to be unsuccessful at what they set out to accomplish and interfere with their interactions with others. Lack of awareness can cause individuals to overestimate their abilities, which can create difficulties with employment, family life, and socialization. Most studies have focused on self-awareness issues after individuals have completed rehabilitation. Studies are lacking regarding the early predictors of self-awareness following traumatic brain injury.

This Study

This Study included 129 individuals with traumatic brain injuries from 2 inpatient rehabilitation centers. The majority of the subjects were men with severe traumatic brain injuries. The researchers obtained information by reviewing the individual’s medical records and by interviewing the individuals and their family members. The researchers used formal testing measures to evaluate how independently the individuals could take care of their basic daily needs, their levels of self-awareness, and their likelihood to be employed at the time of discharge. The researchers examined how independently the individuals could take care of their basic daily needs at the time of admission to inpatient rehabilitation. This included self-care tasks, such as dressing, toileting, and eating; body movements, such as walking; the ability to think, such as remembering things and problem solving; and social skills. The researchers assessed the individuals for impaired self-awareness by having the individuals, their family members or significant others, and their clinicians complete an awareness rating survey and by comparing the results. At the time of discharge from inpatient rehabilitation, the researchers determined the individuals’ degrees of disability or the extent to which they could be employed. The researchers compared and statistically analyzed the results.The researchers found that the individuals with traumatic brain injuries rated themselves as having higher abilities in the areas of thinking skills and behavior than their clinicians and significant others. Individuals that were older and who could complete their basic daily needs more independently at inpatient rehabilitation admission were more likely to have accurate levels of self-awareness. The researchers suspect that older individuals may have established better coping skills prior to injuries, although this warrants further research. Overall, higher self-awareness scores were associated with higher levels of functioning. Individuals with higher levels of education at the time of their brain injuries and those with more accurate self-awareness were more likely to be rated as employable at their time of discharge from rehabilitation. Individuals with 13 years of education were 1.55 times more likely to be rated as employable than those with 10 years of education. Individuals with more accurate self-awareness were nearly twice as likely to be rated employable than those with less accurate self-awareness.

Who May Be Affected By These Findings

Individuals with traumatic brain injury and their significant others, health care providers, discharge planners, vocational rehabilitation specialists, and researchers

Caveats

The researcher’s findings were similar to previous studies in that individuals with brain injuries tended to rate themselves as having better abilities than their clinicians and significant others rated them; however, the researchers found that significant others tended to rate the individual’s abilities a bit higher than the clinicians did. The researchers state that this may indicate the need for increased communication and education between clinicians and significant others, and additional research in this area.

Bottom Line

Individuals that were older and who could complete their basic daily needs more independently at inpatient rehabilitation admission were more likely to have accurate levels of self-awareness. Individuals with traumatic brain injuries rated themselves as having higher abilities in the areas of thinking skills and behavior than their clinicians and significant others thought they did. Individuals with higher levels of education at the time of their brain injuries and those with more accurate self-awareness were more likely to be rated as employable at their time of discharge from rehabilitation.

 

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