Impaired Awareness of Deficits and Treatment Adherence Among People With Traumatic Brain Injury or Spinal Cord Injury

Abstract

These results confirm IAD's link to treatment adherence, and support the observation that IAD is a common clinical feature of brain injury that should be carefully considered when making prognoses and developing and applying interventions with this population.

Use of behavioural contracting to increase adherence with rehabilitation treatments on an inpatient brain injury unit: A case report

“…These socially unwanted post-injury behaviours often have their aetiology in the cerebral trauma itself, pre-morbid coping difficulties, environmental contingencies that (overtly or inadvertently) reinforce maladaptive responding and similar factors alone or in combination [1][2][3]. An important additional factor that has been highlighted in the literature as influencing a person's behavioural presentation and adherence with rehabilitation therapies is lowered self-awareness of post-injury deficits [4].…”

Driving difficulties of brain-injured drivers in reaction to high-crash-risk simulated road events: A question of impaired divided attention?

“…Findings show that on average, TBI individuals had a tendency to rate the temporal demand of the challenging events as being less than did the controls. This result is perhaps less surprising in the context of research showing that individuals frequently lack full awareness of their limitations following brain injury (Hoofien, Gilboa, Vakil, & Barak, 2004;Trahan, Pépin, & Hopps, 2006). Our findings imply that even highly functional moderate to severe TBI individuals may underestimate the time pressure generated by challenging events.…”

Assessing anosognosia: a critical review

“…However, several authors have pointed out that lack of awareness of memory impairment is a common occurrence also in patients suffering from traumatic brain injury (TBI -Prigatano et al, 1990;Sherer et al, 1998;Bach & David, 2006;Trahan et al, 2006;Malec et al, 2007;Sherer et al, 2003;Hart et al, 2009; see also Prigatano, this issue). Tinson and Lincoln (1987) maintained that unawareness of memory problems is frequent also in stroke patients; similarly, Wilson et al (2008) pointed out that these patients often show lack of insight.…”