Abstract
People with severe traumatic brain injury (TBI) often make errors on everyday tasks that compromise their safety and independence. Such errors potentially arise from the breakdown or failure of multiple cognitive processes. This study aimed to investigate cognitive deficits underlying error behavior on a home-based version of the Cooking Task (HBCT) following TBI. Participants included 45 adults (9 females, 36 males) with severe TBI aged 18–64 years (M = 37.91, SD = 13.43). Participants were administered the HBCT in their home kitchens, with audiovisual recordings taken to enable scoring of total errors and error subtypes (Omissions, Additions, Estimations, Substitutions, Commentary/Questions, Dangerous Behavior, Goal Achievement). Participants also completed a battery of neuropsychological tests, including the Trail Making Test, Hopkins Verbal Learning Test-Revised, Digit Span, Zoo Map test, Modified Stroop Test, and Hayling Sentence Completion Test. After controlling for cooking experience, greater Omissions and Estimation errors, lack of goal achievement, and longer completion time were significantly associated with poorer attention, memory, and executive functioning. These findings indicate that errors on naturalistic tasks arise from deficits in multiple cognitive domains. Assessment of error behavior in a real life setting provides insight into individuals' functional abilities which can guide rehabilitation planning and lifestyle support.
Highlights
Impairments in error self-regulation are common to many neurological disorders, including traumatic brain injury (TBI) (Hart et al, 1998; O’Keeffe et al, 2007), stroke (Stemmer et al, 2004), and dementia (Giovannetti et al, 2002; Bettcher et al, 2008)
Nine variables were identified with problematic skew/kurtosis and/or univariate outliers (GCS, Trails A, Trails B-A, Zoo Map Part 1 errors, and home-based version of the Cooking Task (HBCT) Total Errors, Additions, Estimation errors, Commentary/Questions and completion time)
This study investigated cognitive deficits related to error behavior on a HBCT following severe TBI
Summary
Impairments in error self-regulation are common to many neurological disorders, including traumatic brain injury (TBI) (Hart et al, 1998; O’Keeffe et al, 2007), stroke (Stemmer et al, 2004), and dementia (Giovannetti et al, 2002; Bettcher et al, 2008). These impairments most typically arise from damage or disease processes disrupting the prefrontal cortex and connecting pathways which support the capacity to accurately reflect upon and regulate one’s own behavior. Error detection is usually accompanied by efforts to correct or avert the error, research indicates that people with TBI can show an awareness of errors (e.g., pausing midaction or verbalizing) without making appropriate performance adjustments (Hart et al, 1998; Larson et al, 2012)
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