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Self-awareness after traumatic brain injury: A comparison of measures and their relationship to executive functions

Published online by Cambridge University Press:  25 February 2003

Bogod Nicholas M.*
Affiliation:
Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
Mateer Catherine A.
Affiliation:
Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
Macdonald Stuart W.S.
Affiliation:
Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
*
Reprint requests to: Nicholas M. Bogod, c/o Department of Psychology, University of Victoria, PO Box 3050 STN CSC, Victoria, BC V8W 3P5, Canada.

Abstract

Poor awareness of deficit is common after brain injury. Recent literature has examined various tools for measurement of this phenomenon; the most widely used being self–other rating scales. Although self–other scale measures have face validity, their criterion-related validity has not been adequately demonstrated, and there is little information as to whether and how they relate to other neuropsychological measures. The present study compared measurement of awareness by the Dysexecutive (DEX) Questionnaire self–other rating scale with the Self-Awareness of Deficits Interview (SADI), a semistructured interview measure. Evaluation of awareness by these measures was compared to tests of executive functioning and IQ. Results indicated significant, albeit marginal relationships between the two measures, and better correlation of the SADI with measures of frontal lobe functioning. The SADI also predicted injury severity. (JINS, 2003, 9, 450–458.)

Type
Research Article
Copyright
Copyright © The International Neuropsychological Society 2003

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References

Allen, C.C. & Ruff, R.M. (1990). Self-rating versus neuropsychological performance of moderate versus severe head-injured patients. Brain Injury, 4, 7–17.10.3109/02699059009026143CrossRefGoogle Scholar
Bergquist, T.F. & Jacket, M.P. (1993). Awareness and goal setting with the traumatically brain injured. Brain Injury, 7, 275–282.10.3109/02699059309029680CrossRefGoogle Scholar
Cavello, M.M., Kay, T., & Ezrachi, O. (1992). Problems and changes after traumatic brain injury: Differing perceptions within and between families. Brain Injury, 6, 327–335.10.3109/02699059209034947CrossRefGoogle Scholar
Cicerone, K.D. & Tanenbaum, L.N. (1997). Disturbance of social cognition after traumatic orbitofrontal brain injury. Archives of Clinical Neuropsychology, 12, 173–188.10.1093/arclin/12.2.173CrossRefGoogle Scholar
Damasio, A.R. & Anderson, S.W. (1993). The frontal lobes. In K.M. Heilman & E. Valenstein (Eds.), Clinical neuropsychology (3rd ed., pp. 409–460). New York: Oxford University Press.Google Scholar
de Zubicaray, G.I., Chalk, J.B., Rose, S.E., Semple, J., & Smith, G.A. (1997). Deficits on self ordered tasks associated with hyperostosis frontalis interna. Journal of Neurology, Neurosurgery and Psychiatry, 63, 309–314.10.1136/jnnp.63.3.309CrossRefGoogle Scholar
Diamond, A. (1991). Guidelines for the study of brain–behavior relationships during development. In H.S. Levin, H.M. Eisenberg, & A.L. Benton (Eds.), Frontal lobe function and dysfunction (pp. 189–211). New York: Oxford University Press, Inc.Google Scholar
Eslinger, P.J. (1999). Orbital frontal cortex: Behavioral and physiological significance. Neurocase, 5, 299–300.10.1080/13554799908411983CrossRefGoogle Scholar
Evans, J.J., Chua, S.E., McKenna, P.J., & Wilson, B.A. (1997). Assessment of the dysexecutive syndrome in schizophrenia. Psychological Medicine, 27, 1–12.10.1017/S0033291797004790CrossRefGoogle Scholar
Fleming, J. & Strong, J. (1995). Self-awareness of deficits following acquired brain injury: Considerations for rehabilitation. British Journal of Occupational Therapy, 58, 55–60.10.1177/030802269505800204CrossRefGoogle Scholar
Fleming, J.M., Strong, J., & Ashton, R. (1996). Self-awareness of deficits in adults with traumatic brain injury: How best to measure? Brain Injury, 10, 1–15.Google Scholar
Fleming, J.M., Strong, J., & Ashton, R. (1998). Cluster analysis of self-awareness levels in adults with traumatic brain injury and relationship to outcome. Journal of Head Trauma Rehabilitation, 13, 39–51.10.1097/00001199-199810000-00006CrossRefGoogle Scholar
Fordyce, D.J. & Roueche, J.R. (1986). Changes in perspectives of disability among patients, staff, and relatives during rehabilitation of brain injury. Rehabilitation Psychology, 31, 217–229.Google Scholar
Gans, J.S. (1983). Hate in the rehabilitation setting. Archives of Physical Medicine and Rehabilitation, 64, 176–179.Google Scholar
Goldman-Rakic, P.S. (1996). The prefrontal landscape: Implications of functional architecture for understanding human mentation and the central executive. Philosophical Transactions of the Royal Society, Series B, 35(1346), 1445–1453.Google Scholar
Lam, C.S., McMahon, B.T., Priddy, D.A., & Gehrud-Shultz, A. (1988). Deficit awareness and treatment performance among traumatic head injury adults. Brain Injury, 2, 235–242.10.3109/02699058809150947CrossRefGoogle Scholar
LaPierre, D., Braun, C.J., & Hodgins, S. (1995). Ventral frontal deficits in psychopathy: Neuropsychological test findings. Neuropsychologia, 33, 139–151.10.1016/0028-3932(94)00110-BCrossRefGoogle Scholar
Lezak, M.D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.Google Scholar
Malloy, P., Bihrle, A., Duffy, J., & Cimino, C. (1993). The orbitomedial frontal syndrome. Archives of Clinical Neuropsychology, 8, 185–201.10.1093/arclin/8.3.185CrossRefGoogle Scholar
McGlynn, S.M. & Schacter, D.L. (1989). Unawareness of deficits in neuropsychological syndromes. Journal of Clinical and Experimental Neuropsychology, 11, 143–205.10.1080/01688638908400882CrossRefGoogle Scholar
Norris, G. & Tate, R.L. (2000). The behavioural assessment of the dysexecutive syndrome (BADS): Ecological, concurrent and construct validity. Neuropsychological Rehabilitation, 10, 33–45.10.1080/096020100389282CrossRefGoogle Scholar
Ownsworth, T.L., McFarland, K., & Young, R. (2000). Development and standardization of the self-regulation skills interview (SRSI): A new clinical assessment tool for acquired brain injury. Clinical Neuropsychologist, 14, 76–92.10.1076/1385-4046(200002)14:1;1-8;FT076CrossRefGoogle Scholar
Ownsworth, T.L., McFarland, K., & Young, R. (2002). The investigation of factors underlying deficits in self-awareness and self-regulation. Brain Injury, 16, 291–309.10.1080/02699050110103986CrossRefGoogle Scholar
Petrides, M. (1994). Frontal lobes and behavior. Current Opinion in Neurobiology, 4, 207–211.10.1016/0959-4388(94)90074-4CrossRefGoogle Scholar
Petrides, M. (1995). Impairments on nonspatial self-ordered and externally ordered working memory tasks after lesion of the mid-dorsal part of the lateral frontal cortex in the monkey. Journal of Neuroscience, 15, 359–375.10.1523/JNEUROSCI.15-01-00359.1995CrossRefGoogle Scholar
Petrides, M. (1996). Specialized systems for the processing of mnemonic information within the primate frontal cortex. Philosophical Transactions of the Royal Society, Series B, 35(1346), 1455–1462.Google Scholar
Petrides, M., Alivisatos, B., Myers, E., & Evans, A.C. (1993). Functional activation of the human frontal cortex during the performance of verbal working memory tasks. Proceeding of the National Academy of Science, USA, 90, 878–882.10.1073/pnas.90.3.878CrossRefGoogle Scholar
Petrides, M. & Milner, B. (1982). Deficits on subject ordered tasks after frontal- and temporal-lobe lesions in man. Neuropsychologia, 20, 263–274.10.1016/0028-3932(82)90100-2CrossRefGoogle Scholar
Prigatano, G.P. (1987). Neuropsychological deficits, personality variables and outcome. In M. Ylvisaker & E.M.R. Gobble (Eds.), Community re-entry for head injured adults (pp. 1–23). Boston: College Hill Press.Google Scholar
Prigatano, G.P., Klonoff, P.S., & Bailey, I. (1987). Psychosocial adjustment associated with traumatic brain injury: Statistics BNI neurorehabilitation must best. BNI Quarterly, 3, 18–21.Google Scholar
Purdon, S.E. (1998). Olfactory identification and Stroop interference converge in schizophrenia. Journal of Psychiatry and Neuroscience, 23, 163–171.Google Scholar
Regard, M. (1991). Stroop Test: Victoria Version–Manual of instructions and norms. Victoria, British Columbia, Canada: Psychology Clinic, University of Victoria.Google Scholar
Robbins, T.W. (1996). Dissociating executive functions of the prefrontal cortex. Philosophical Transactions of the Royal Society, Series B, 35(1346), 1463–1471.Google Scholar
Rolls, E.T. (1996). The orbitofrontal cortex. Philosophical Transactions of the Royal Society, Series B, 35(1346), 1433–1444.Google Scholar
Sattler, J.M. (1992). Assessment of children (3rd ed.). San Diego, CA: J.M. Sattler.Google Scholar
Shallice, T. (1982). “Specific impairments of planning”. Philosophical transactions of the Royal Society of London, Series B, 298, 199–209.Google Scholar
Sherer, M., Bergloff, P., Levin, E., High_Jr., W.M., Oden, K.E., & Nick, T.G. (1998a). Impaired awareness and employment outcome after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 52–61.10.1097/00001199-199810000-00007CrossRefGoogle Scholar
Sherer, M., Boake, C., Levin, E., Silver, B.V., Ringholz, G., & High_Jr., W.M. (1998b). Characteristics of impaired awareness after traumatic brain injury. Journal of the International Neuropsychological Society, 4, 380–387.10.1017/S1355617798003804CrossRefGoogle Scholar
Sherer, M., Oden, K., Bergloff, P., Levin, E., & High, W.M. (1998c). Assessment and treatment of impaired awareness after brain injury: Implications for community reintegration. Neurorehabilitation, 10, 25–37.10.3233/NRE-1998-10104CrossRefGoogle Scholar
Shimamura, A.P. (1995). Memory and the prefrontal cortex. Annals of the New York Academy of Sciences, 769, 151–159.10.1111/j.1749-6632.1995.tb38136.xCrossRefGoogle Scholar
Stuss, D.T. (1991). Self, awareness, and the frontal lobes: A neuropsychological perspective. In J. Strauss & G.R. Goethals (Eds.), The self: Interdisciplinary approaches (pp. 255–278). New York: Springer-Verlag.Google Scholar
Stuss, D.T. & Benson, D.F. (1986). The frontal lobes. New York: Raven Press.Google Scholar
Toglia, J. & Kirk, U. (2000). Understanding awareness deficits following brain injury. Neurorehabilitation, 15, 57–70.10.3233/NRE-2000-15104CrossRefGoogle Scholar
Tranel, D., Anderson, S.W., & Benton, A. (1994). Development of the concept of ‘executive function’ and its relationship to the frontal lobes. In F. Boller & J. Grafman (Eds.), Handbook of neuropsychology, Vol. 9 (pp. 125–148). Amsterdam: Elsevier Science.Google Scholar
Trudel, T.M., Tryon, W.M., & Purdum, C.M. (1998). Awareness of disability and long-term outcome after traumatic brain injury. Rehabilitation Psychology, 43, 267–281.10.1037/0090-5550.43.4.267CrossRefGoogle Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised manual. New York, NY: The Psychological Corporation.Google Scholar
Wheeler, M.A., Stuss, D.T., & Tulving, E. (1995). Towards a theory of episodic memory. The frontal lobes and autonoetic consciousness. Psychological Bulletin, 121, 331–354.10.1037/0033-2909.121.3.331CrossRefGoogle Scholar
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J.J. (1996). Behavioural assessment of the dysexecutive syndrome. Bury St Edmunds, UK: Thames Valley Test Company.Google Scholar
Zajano, M.J. & Gorman, A. (1986). Stroop interference as a function of percentage of congruent items. Perceptual and Motor Skills, 63, 1087–1096.10.2466/pms.1986.63.3.1087CrossRefGoogle Scholar