B - 71 Behavior Rating Inventory of Executive Function, Second Edition—Adult Version (BRIEF2A) Scale Elevations in Adults with Mild and Moderate/Severe Traumatic Brain Injury

Abstract

Abstract Objective Adults with persisting symptoms after mild (mTBI) or moderate-to-severe (msTBI) TBI may show problems with executive functions (EF) on testing and, in some studies, in everyday life. We examined self- and informant-report EF in mTBI and msTBI using the BRIEF2A. Method Participants were 62 patients with persisting symptoms after mTBI (57 self-, 22 informant report) and 31 with msTBI (28 self, 17 informant) seen for neuropsychological evaluation at least one-year post-injury, compared to demographically-matched healthy adults (HA) from the standardization sample. BRIEF2A scales are Inhibit (INHIB), Self-Monitor (SM), Shift (SHFT), Emotional Control (EC), Initiate (INIT), Working Memory (WM), Plan/Organize (P/O), Task-Monitor (TM), and Organization of Materials (OM). Results mTBI self-ratings were higher than HA on all scales, especially WM, SM, INHIB, and SHFT. The majority of patients had elevated scores on 6/9 scales, most notably WM (82.5%) and P/O (64.9%). Informants also scored higher than HA on all scales, most commonly elevating on WM (77.3%), INIT (54.5%), SHFT and P/O (50%). In msTBI, greater self-rated difficulty than HA on all scales except OM, most common elevations being WM and INHIB (46.4%). msTBI Informant report was higher for the same 8/9 scales, especially elevating on WM (82%), P/O (76.5%), EC and SM (70.6%). Conclusions Patients and informants of those with persisting symptoms after mTBI and msTBI commonly endorse executive dysfunction in their everyday lives. Those persons with msTBI self-endorsed fewer problems with EF than seen in mTBI, contrasting with msTBI informants who observe a broader range of challenges than self-report, possibly related to reduced self-awareness.