Awareness of Subjective Fatigue After Moderate to Severe Traumatic Brain Injury

Objective: As measurements of subjective fatigue after traumatic brain injury (TBI) rely on self-assessment, deficits in self-awareness after TBI may distort subjective fatigue reports. This study investigates awareness of subjective fatigue after TBI using self-and informant reports. Participants: Fourteen adults with moderate to severe TBI and 7 healthy controls (HCs). Measures: Modified Fatigue Impact Scale (MFIS) and battery of cognitive and emotional tests. Informants completed an "other-report," rating their perception of participant's fatigue. Subjective fatigue awareness was defined as discrepancy between self-and other-MFIS scores. Results: Adults with TBI showed greater discrepancies between self-and other-MFIS scores than did HCs. Negative relations were found between fatigue awareness and symptoms of depression, but there were no relationships between fatigue awareness and cognitive performance. Conclusions: Results indicate that adults with TBI have poorer awareness of subjective fatigue than HCs. Correlations between subjective fatigue awareness and depression support existing literature implicating strong emotional components in the experience of subjective fatigue postinjury. Findings suggest cautious interpretation of subjective fatigue, as responses may not reflect fatigue symptoms exclusively.