Research Reports - Self-awareness and traumatic brain injury outcome

Brain Inj. 2015 Apr 27:1-11

Robertson K(1), Schmitter-Edgecombe M

PRIMARY OBJECTIVE: Impaired self-awareness following a traumatic brain injury
(TBI) can reduce the effectiveness of rehabilitation, resulting in poorer
outcomes. However, little is understood about how the multi-dimensional aspects
of self-awareness may differentially change with recovery and impact outcome.
Thus, this study examined four self-awareness variables represented in the
Dynamic Comprehensive Model of Awareness: metacognitive awareness, anticipatory
awareness, error-monitoring and self-regulation.
RESEARCH DESIGN: This study evaluated change of the self-awareness measures with
recovery from TBI and whether the self-awareness measures predicted community
re-integration at follow-up.
METHODS AND PROCEDURES: Participants were 90 individuals with moderate-to-severe
TBI who were tested acutely following injury and 90 age-matched controls.
Forty-nine of the TBI participants and 49 controls were re-tested after 6 months.
MAIN OUTCOME AND RESULTS: Results revealed that the TBI group's error-monitoring
performance was significantly poorer than controls at both baseline and
follow-up. Regression analyses revealed that the self-awareness variables at
follow-up were predictive of community re-integration, with error-monitoring
being a unique predictor.
CONCLUSIONS: The results highlight the importance of error-monitoring and suggest
that interventions targeted at improving error-monitoring may be particularly
beneficial. Understanding the multi-dimensional nature of self-awareness will
further improve rehabilitation efforts and understanding of the theoretical basis
of self-awareness.

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