Self-awareness and traumatic brain injury outcome.
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.


METHODS
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
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.


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.
Department of Psychology, Washington State University , Pullman, WA , USA.
Kayela
K
Robertson
Maureen
M
Schmitter-Edgecombe
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D001364:Awareness; D001930:Brain Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation; D005500:Follow-Up Studies; D006801:Humans; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012649:Self Concept; D012647:Self-Assessment; D012931:Social Environment; D014481:United States / Q000453:epidemiology
Awareness; community integration; outcome; rehabilitation; self-awareness; traumatic brain injury