Self-awareness after acquired brain injury -: Predictors and rehabilitation

Objective To investigate the factors contributing to deficit in self-awareness following acquired brain injury and to study change in self-awareness during a group support program. Methods Sixty-two patients ( mean age: 35.4 +/- 15.3 years) attending our Service ( 295 +/- 525 days after injury) were included in the study ( 41 of them had sustained a head injury). Thirty-six patients were admitted to a multidisciplinary rehabilitation program including a group support program designed to improve self-awareness deficits. All patients were assessed with the Patient Competency Rating Scale as a measure of self-awareness and with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales. Results Thirty patients showed high levels of self-awareness while 32 showed impaired self-awareness. Patients with appropriate perception of their deficits showed less psychopathological symptoms, better neuropsychological function and higher functional independence than those with impaired SA ( Student's t test, p< 0.05). Both groups improved, but with different patterns, after rehabilitation ( MANOVA, p< 0.05). Multiple regression analysis revealed that cognitive status was predictive of level of self-awareness. Conclusion The level of self-awareness after acquired brain injury is a useful prognostic index of the neuropsychological, psychopathological and functional status of the patient. We recommend the evaluation of this symptom after acquired brain injury due to its clinical relevance.