Awareness problems following moderate to severe traumatic brain injury: Prevalence, assessment methods, and injury correlates

We examined the degree to which individuals with a history of moderate to severe traumatic brain injury (TBI) are unaware of their postinjury deficits. We also examined correlates between awareness problems and injury acuteness and severity and whether awareness problems differed across behavioral domains. Self- and significant other (family member) ratings on the Key Behaviors Change Inventory (KBCI) were examined in 36 individuals an average of 2 years post-TBI. Family members reported greater problems postinjury than patients did, depending on the behavior in question and the level of patient awareness overall. Postinjury awareness problems were as prevalent as other behavioral problems measured by the KBCI but were not universally present. Some patients exhibited no awareness problems, others emergent awareness, and a minority poor awareness. Correlations revealed that as time postinjury increased, patients showed more accurate self-awareness than those whose injuries were more recent. Family members and patients agreed about preinjury functioning.