title: The trajectory of awareness across the first year after traumatic brain injury: the role of biopsychosocial factors.
abstract: OBJECTIVE
  To examine self-awareness over the first year following traumatic brain injury (TBI) and the association of demographic, biological, cognitive, psychological and social-environmental factors with change in awareness.
  
  
  METHODS
  Using a longitudinal design the progression of awareness and association of demographic and biopsychosocial factors with its trajectory were analysed using random effects regression.
  
  
  METHODS
  Sixty individuals with mainly moderate-to-severe TBI completed assessments at 3, 6 and/or 12 months post-injury. Measures of awareness (Self-Awareness of Deficits Interview; SADI), demographic (age at time of injury and gender), injury severity (post-traumatic amnesia duration), cognitive (Trails Making Test-Part B), psychological (Hospital Anxiety and Depression Scale) and social-environmental (return to pre-injury activities) factors were administered.
  
  
  RESULTS
  Awareness improved over the first year post-injury. Analysis of SADI sub-scales revealed that females had greater awareness in terms of setting more realistic goals early in recovery compared to males. Models including demographic, biological, cognitive, psychological and social-environmental factors did not contribute significantly to prediction of awareness on the SADI above the influence of time.
  
  
  CONCLUSIONS
  Time post-injury had the strongest influence on the development of awareness. This understanding may be important in determining the optimal timing of rehabilitative intervention.
authors.affiliation: School of Psychology and Psychiatry, Monash University , Melbourne , Australia .
authors.forename: Cally
authors.initials: C
authors.lastname: Richardson
authors.forename: Adam
authors.initials: A
authors.lastname: McKay
authors.forename: Jennie L
authors.initials: JL
authors.lastname: Ponsford
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D001364:Awareness; D001930:Brain Injuries / Q000523:psychology*; D005260:Female; D006040:Goals; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012649:Self Concept; D012647:Self-Assessment
keywords: Acute; Self-awareness; biopsychosocial; model; self-awareness of deficits interview (SADI); traumatic brain injury