Self-awareness following acquired brain injury: measurement and relationship to executive functioning

Impaired self-awareness (ISA) is common following acquired brain injury (ABI) and is related to functional outcome variables. This study examines two questionnaires currently used in clinical and research settings, which measure ISA by comparing patient reports with those of clinicians and significant others. This study also attempts to identify sensitive neuropsychological tests which may be used to predict ISA. A multivariate cross-sectional design is employed, including regression analyses and correlations. Fifty-four participants with ABI completed the Awareness Questionnaire (AQ), the Dysexecutive Questionnaire (DEX) and a battery of neuropsychological tests. Clinicians and significant others of each participant completed the AQ and the DEX. Findings support convergent validity of the two questionnaires; however, there were differences in the response patterns on each questionnaire. Regression analyses indicated that estimated IQ and in particular verbal IQ scores accounted for a greater amount of the variance in awareness than executive functioning test scores. The variance accounted for by executive functioning test scores was low and only partial support for current cognitive neuropsychological models of self-awareness was observed. The value of obtaining multiple informant reports when assessing patient self-awareness is highlighted.