A Longitudinal Study of Self-Awareness: Functional Deficits Underestimated by Persons with Brain Injury

Abstract

Following brain injury, self-awareness of deficits tends to be most impaired for cognitive and socioemotional dysfunction, which may limit client participation in therapy. AbstractA longitudinal study of55 adults with severe traumatic brain injury (TBl) investigated the areas of function for which they lacked self-awareness of their level of competency. Data were collected at 3 and 12 months postinjury using the Patient Competency Rating Scale. Self-awareness was measured by comparing patient self-ratings with the ratings of an informant. The results were consistent with previous studies, indicating that self-awareness was most impaired for activities with a large cognitive and socioemotional component, and least impaired for basic activities of daily living, memory activities, and overtemotional responses. For most areas of function that were overestimated at 3 months post-injury, self-awareness subsequently improved during thefirst year after injury.

The development of awareness and the use of compensatory strategies for cognitive deficits

“…Furthermore, two of the three clients reported increased awareness associated with participation in functional tasks in a familiar environment. This supports previous research with similar results [8,11]. Fleming and Strong [11] found that`a number of individuals in the current study described greater understanding of their limitations after engaging in functional activities' (p. 300).…”

Occupational Therapy Outcomes for Clients With Traumatic Brain Injury and Stroke Using the Canadian Occupational Performance Measure

“…Right CVA has been associated more with impairments in selfawareness and insight than has left CVA (Arnadottir, 1990). Significant impairments with self-awareness have been associated with TBI, but this study did not show any significant differences in performance or satisfaction between the TBI and CVA groups (Fleming & Strong, 1999). Left CVA also has been more associated with depression than right CVA, which may explain why the left CVA group reported lower levels of satisfaction with their occupational performance than the right CVA group (Arnadottir, 1990).…”

“…TBI and right CVA have been associated more with impairments in self-awareness and insight than left CVA (Arnadottir, 1990;Fleming & Strong, 1999). Therefore, another objective of this study was to determine differences in performance and satisfaction between clients with TBI, right CVA, and left CVA.…”

A Review of the Stereotype Threat Literature and Its Application in a Neurological Population

“…Although identification with one's neurological group is important to measure, more relevant to this population is level of awareness. It is well documented that neurologically compromised individuals often have reduced insight and awareness into their cognitive difficulties (e.g., Fleming and Strong 1999;Graham et al 2005;Sbordone et al 1998). These individuals may lack understanding and knowledge of their deficits and their impact on day-to-day functioning.…”