The Awareness Questionnaire: factor structure and internal consistency

Abstract

Patients with traumatic brain injuries often show impaired awareness of their impairments. This impaired awareness can decrease motivation for treatment and limit eventual functional outcome. The importance of this phenomenon has led to the development of multiple techniques and scales for measuring impaired awareness. The present paper briefly reviews the various methods of operationalizing impaired awareness and describes a new scale (the Awareness Questionnaire) designed to incorporate all these methods. Findings of previous studies supporting the validity of the Awareness Questionnaire are presented. The present investigation examined the factor structure and internal consistency of the Awareness Questionnaire with samples of 126 traumatic brain injury survivors and 75 family members/significant others. Principal components factor analysis with varimax rotation indicated three factors: cognitive, behavioural/affective, and motor/sensory. Investigation of internal consistency (Cronbach Coefficient Alpha) in both the patient and family sample yielded satisfactory results. These findings are supportive of continued use and investigation of the Awareness Questionnaire.

Awareness of deficits in traumatic brain injury: A multidimensional approach to assessing metacognitive knowledge and online-awareness

“…Methods include comparing self-ratings to significant other or clinician ratings, such as the Patient Competency Rating Scale (PCRS) (Fleming et al, 1996;Sherer et al, 1998a), interviews (Fleming et al, 1996;Ownsworth et al, 2000), observation of actual task performance (Hart et al, 1998), comparison of patients' reports to neuropsychological performance (Allen & Ruff, 1990;Anderson & Tranel, 1989), comparison between patients' predictions of performance and actual performance (Gauggel et al, 2002;Fischer et al, 2004a) and more recently onlinemonitoring of errors (McAvinue et al, 2005;O'Keeffe et al, 2004). A number of researchers have highlighted the importance of using a number of different measures to assess the multi-faceted concept of self-awareness of deficits (Fischer et al, 2004a;Fleming et al, 1996).…”

Executive function and metacognitive self-awareness after Severe Traumatic Brain Injury

“…Factor analysis of the AQ (Sherer et al, 1998) revealed three subscales: motor-sensory (four items), cognition (seven items), and behavioral-affective (six items).…”

“…As an alternative to these scales, Sherer et al (1998) developed the Awareness Questionnaire (AQ), consisting of 17 items that evaluate patients'current functional abilities compared with their preinjury abilities. AQ items are rated on a Likert scale ranging from 1 (much worse) to 5 (much better).…”

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.…”

“…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. Usually, assessment of anosognosia for amnesia in focal patients is based on questionnaires consisting in a series of questions about various possible deficits, including amnesia (e.g., the Patient Competency Rating Scale - Prigatano et al, 1986; the Awareness Questionnaire - Sherer et al, 1998). These represent a valuable approach to evaluate lack of awareness across different deficits, but they are clearly limited to the most evident aspects of memory deficits.…”