title: Self-Awareness and Self-Ratings of On-Road Driving Performance After Traumatic Brain Injury.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: School of Psychological Sciences, Monash University, Victoria, Australia (Drs Gooden, Ponsford, and Stolwyk); Monash Epworth Rehabilitation Research Centre, Victoria, Australia (Dr Ponsford); Monash University Accident Research Centre, Monash University, Victoria, Australia (Dr Charlton); Epworth Rehabilitation, Victoria, Australia (Ms Ross); Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada (Dr Marshall); School of Psychology, University of Ottawa, Ottawa, Ontario, Canada (Dr Gagnon); Centre for Research and Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada (Dr Bédard).
authors.forename: James R
authors.initials: JR
authors.lastname: Gooden
authors.forename: Jennie L
authors.initials: JL
authors.lastname: Ponsford
authors.forename: Judith L
authors.initials: JL
authors.lastname: Charlton
authors.forename: Pamela E
authors.initials: PE
authors.lastname: Ross
authors.forename: Shawn
authors.initials: S
authors.lastname: Marshall
authors.forename: Sylvain
authors.initials: S
authors.lastname: Gagnon
authors.forename: Michel
authors.initials: M
authors.lastname: Bédard
authors.forename: Renerus J
authors.initials: RJ
authors.lastname: Stolwyk
mesh_terms: D000328:Adult; D001315:Australia; D001334:Automobile Driving / Q000523:psychology*; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000628:therapy; D002170:Canada; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057566:Self Report; D012647:Self-Assessment; D017741:Survivors; D013647:Task Performance and Analysis
references.citation: J Head Trauma Rehabil. 2006 Sep-Oct;21(5):375-8
references.pmid: 16983222
references.citation: Brain Inj. 2007 Oct;21(11):1175-81
references.pmid: 17952716
references.citation: J Trauma. 2011 Sep;71(3):538-42
references.pmid: 21427610
references.citation: J Neurotrauma. 2014 Sep 1;31(17):1515-20
references.pmid: 24731076
references.citation: J Neurotrauma. 2012 Jan 1;29(1):96-100
references.pmid: 22026424
references.citation: N Engl J Med. 1973 Jun 14;288(24):1272-5
references.pmid: 4703316
references.citation: Intensive Care Med. 2015 May;41(5):823-32
references.pmid: 25643903
references.citation: J Neurotrauma. 2010 Nov;27(11):1945-50
references.pmid: 21028988
references.citation: Semin Neurol. 2008 Nov;28(5):716-25
references.pmid: 19115177
references.citation: Brain Inj. 2011;25(10):925-32
references.pmid: 21812584
references.citation: Stroke. 2008 Nov;39(11):3029-35
references.pmid: 18723420