Deficit awareness and cognitive performance in individuals with acquired brain injury

Abstract

Anosognosia is commonly reported after acquired brain injury (ABI) or stroke and often hinders an ABI survivor's ability to perceive the social consequences of their behavior and to modify it. This study concerned the question of whether awareness discrepancy scores could predict cognitive performance with a focus on the acquired brain injured (ABI) population. It was hypothesized that lack of awareness would predict performance on cognitive tasks. Archival data was assessed for a total of 21 patients; 10 learning disabled (LD) and 11 with a brain injury with each person having one "observer". Data consisted of patient and observer ratings on the Acquired Deficit Awareness Management System (ADAMS) profile, a 36-item survey that measured both patient self-report and observer assessment of awareness. These data yielded two discrepancy scores: deficit with awareness (DWA) and deficit without awareness (DWoA). The discrepancy scores were used to predict IQ scores from the Wechsler Adult Intelligence Scale, academic performance on the Woodcock-Johnson Psychoeducational Battery, memory functioning on the Wechsler Memory Scale, and a measure of fine motor skill. The DWoA measure correlated significantly with several cognitive variables and with finger tapping speed on the non-dominant hand. These correlations were not apparent in the LD group. Measures of lack of awareness predicted cognitive performance in the ABI population. Therapeutic interventions are discussed that address lack of awareness after ABI.