Research Reports - Self-awareness and self-ratings of on-road driving performance after traumatic brain injury

J Head Trauma Rehabil. 2016 Jan 29. [Epub ahead of print]

Gooden JR(1), Ponsford JL, Charlton JL, Ross PE, Marshall S, Gagnon S, Bédard M,
Stolwyk RJ.

OBJECTIVE: To examine self-rated, clinician-rated, and self-awareness of on-road
driving performance in individuals with traumatic brain injury (TBI) deemed fit
and unfit to resume driving and healthy controls, and to explore their
associations with demographic, injury, cognitive, and mood variables.
METHODS: Participants included 37 individuals with moderate to severe TBI, and 49
healthy age, sex, and education-matched controls from Australia and Canada.
Participants completed an on-road assessment, the Brain Injury Driving
Self-Awareness Measure (BIDSAM), and a comprehensive neuropsychological
assessment.
RESULTS: Awareness scores on the BIDSAM were significantly different between
groups, F(2, 83) = 28.44 (P < .001; η = 0.41), with post hoc tests indicating TBI
participants who failed the on-road assessment had worse scores compared with
those who passed and controls. Poor self-awareness was significantly correlated
with reduced psychomotor speed (rs = -0.37; P < .01) and attentional switching
(rs = 0.28; P < .01). Worse self-ratings of driving were associated with
depression (rs = 0.42; P < .01) and anxiety (rs = 0.38; P < .01).
CONCLUSIONS: Individuals with TBI who failed an on-road assessment significantly
overestimated their driving ability. Impaired cognitive function was associated
with reduced self-awareness of driving. These findings suggest impaired awareness
of driving may need to be addressed as part of driver rehabilitation programs. 

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