Category: Brain Injury; Measurement
Objective : To examine the relationship between impaired self-awareness and change in self-appraisal of domain-specific cognitive ability after performance on neuropsychological tests.
Design : Secondary analysis of a cross-sectional cohort study
Setting : Community
Participants (or Animals, Specimens, Cadavers) : Community-dwelling adults with moderate-severe TBI (n=58).
Interventions : Not Applicable
Main Outcome Measure(s) : Self-Awareness of Deficits Interview (SADI) scores indicating good awareness (total score >2 and >4); Visual Analog Scale (VAS) of ability in memory, attention, problem-solving, fluency, and self-awareness completed before and after neuropsychological tests; Neuropsychological test battery, including the California Verbal Learning Test (CVLT), Symbol Digit Modalities Test (SDMT), Wisconsin Card Sorting Test (WCST), and letter and category fluency (FAS and Animals).
Results : Participants were categorized as having good awareness (n=34), impaired awareness (n=16), and severely impaired awareness (n=8). On average, those with severely impaired awareness rated their ability as higher than those with good or impaired awareness. They also rated their self-appraisal of memory as higher after neuropsychological testing than before, despite testing indicating impairment in memory. Overall, participants who scored higher on tests of attention and problem-solving tended to rate their ability in these domains after testing as higher, while those scoring lower on these tests tended to rate their ability in these domains as lower after testing, regardless of self-awareness group.
Conclusions : Self-appraisal of cognitive ability in specific cognitive domains was highest in those with severely impaired awareness, despite poorer test performance. Though participants changed their self-appraisal of cognitive ability after testing in a direction consistent with test performance, this may not always be the case for those with more severely impaired awareness. Further research should replicate these findings new and larger sample.
Shannon Juengst– Assistant Professor, UT Southwestern, Dallas, Texas
Stephanie Neaves– Research Assistant, UT Southwestern Medical Center, Dallas, Texas
Andrew Nabasny– Doctoral Student, University of Texas Southwestern Medical Center, Dallas, Texas
Michael Kolessar– Clinical Neuropsychologist, University of Texas Southwestern Medical Center, Dallas, Texas