title: Gender differences in awareness and outcomes during acute traumatic brain injury recovery.
abstract: BACKGROUND
  Recent literature on traumatic brain injury (TBI), though mixed when reporting outcomes, seems collectively to suggest possible gender advantage for women in postinjury recovery, especially in executive functions. Hormonal neuroprotection, through female reproductive hormones, is often proposed as an underlying factor in these results. We explored potential gender differences in an aspect of executive functions, self-awareness (SA), which is often impaired after TBI, limits patient effort in critical rehabilitation, and increases caregiver burden.
  
  
  METHODS
  Within a prospective survey, repeated-measures design, 121 patients with moderate or severe TBI undergoing acute rehabilitation in a Level 1 trauma center, a family member or caregiver informant, and a treating clinician were asked to complete the Patient Competency Rating Scale (PCRS) and the Frontal Systems Behavior Scale (FrSBe) at admission and discharge.
  
  
  RESULTS
  Although overall, women and men with TBI showed generally similar levels of SA, women had significantly better awareness of their injury-related deficits at acute rehabilitation discharge, even when controlling for age, education, and injury severity.
  
  
  CONCLUSIONS
  Mixed findings in this study mirror the pattern of results that dominate the published literature on gender and TBI. Gender differences in executive dysfunction may not be as large or robust as some researchers argue. In addition, complex interplays of socialization, gender-role expectations, naturally occurring male and female ability differences, and differences in access to postinjury rehabilitation are understudied potential moderators.
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation , Charlotte, North Carolina.
authors.forename: Janet P
authors.initials: JP
authors.lastname: Niemeier
authors.forename: Paul B
authors.initials: PB
authors.lastname: Perrin
authors.forename: Megan G
authors.initials: MG
authors.lastname: Holcomb
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Rolston
authors.forename: Laura K
authors.initials: LK
authors.lastname: Artman
authors.forename: Juan
authors.initials: J
authors.lastname: Lu
authors.forename: Karine S
authors.initials: KS
authors.lastname: Nersessova
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D056344:Executive Function; D005260:Female; D005625:Frontal Lobe / Q000293:injuries / Q000503:physiopathology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012647:Self-Assessment; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D015599:Trauma Severity Indices