Efficacy of self-perception after traumatic brain injury.

Abstract

Anosognosia is a lack of awareness of personal deficits that is commonly observed in people with a traumatic brain injury (TBI). The purpose of this paper is to examine whether self-appraisal of executive functioning differs for students with and without TBI. Students who had survived a TBI and those who had never had a TBI filled out the Behavior Rating Inventory of Executive Functioning from three different perspectives. Each participant was paired with an observer who was familiar with the person's behavior. Self-appraisal ratings, observer ratings of the participant, and reflective appraisal of how the participant thought the observer would rate them were compared. For the students without TBI, reflective appraisal was significantly correlated with self-appraisal but observer appraisal was not. For students with TBI, neither reflected appraisal nor observer appraisal correlated with self-appraisal. Both TBI and non-TBI participants overestimated their problems on measures of Inhibition, Shifting, Emotional Control, Initiation, and Planning/Organizing. TBI participants underestimated their problems on measures of Working Memory, Organization, and Task Monitoring relative to the non-TBI group. Students with TBI do not accurately perceive how others perceive their behavior.