Relationship Between Neurocognitive Function and Self-Discrepancy After Severe Traumatic Brain Injury

OBJECTIVE: Individuals with traumatic brain injury (TBI) often make unfavorable comparisons between their preinjury and postinjury selves. Although it is known that negative "self-discrepancy" is related to poorer emotional adjustment, the impact of neurocognitive function on self-discrepancy is unclear. This study aimed to investigate the relationship between current neurocognitive function (attention, memory, executive function, and self-awareness) and self-discrepancy after severe TBI. DESIGN: Fifty-four adults with severe TBI were recruited from outpatient and community rehabilitation services and completed measures of self-discrepancy (Head Injury Semantic Differential Scale-III) and self-awareness (Awareness Questionnaire) and a battery of standardized tests of attention, memory, and executive functions. RESULTS: More negative self-discrepancy was significantly associated with greater self-awareness (r = -0.40, P < .001) and better performance on tests of immediate memory (r = -0.43, P < .01), working memory (r = -0.35, P < .05), and verbal fluency (r = -0.34, P < .05). Self-awareness was the only neurocognitive factor significantly and uniquely related to self-discrepancy, accounting for 8.6% of the variance (P < .05). Furthermore, self-awareness was found to partially mediate the relationship between immediate memory and self-discrepancy. CONCLUSION: Better neurocognitive function is related to more negative self-discrepancy. These findings improve understanding of the process of identity reconstruction following TBI.