Disturbances of Self‐awareness and Rehabilitation of Patients With Traumatic Brain Injury: A 20‐Year Perspective

  title={Disturbances of Self‐awareness and Rehabilitation of Patients With Traumatic Brain Injury: A 20‐Year Perspective},
  author={George P. Prigatano},
  journal={Journal of Head Trauma Rehabilitation},
  • G. Prigatano
  • Published 1 January 2005
  • Psychology, Medicine
  • Journal of Head Trauma Rehabilitation
Over the last 20 years, numerous papers that are relevant to understanding the problem of impaired self-awareness after moderately severe to severe traumatic brain injury have appeared. This article reviews many of these papers and summarizes salient findings relevant to rehabilitation and future research. 

Impaired self-awareness after moderately severe to severe traumatic brain injury.

  • G. Prigatano
  • Psychology, Medicine
    Acta neurochirurgica. Supplement
  • 2005
A recent model for conceptualizing disturbances of self-awareness after various forms of brain injury is reviewed and indicates that patients may underreport cognitive and behavioral difficulties, which are the true residuals of their brain injury.

Understanding and adapting after head injury: Impact of awareness on rehabilitation

A sensitive team approach is advocated, with psychological support and clear goal-planning, to enable the patient to make use of critical incidents and ‘aha moments’ within rehabilitation to understand their problems better and therefore to start adjusting to life after head injury.

Psychiatric disorders and traumatic brain injury

The epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI are approached.

Self‐Reported Driving Difficulty in Veterans With Traumatic Brain Injury: Its Central Role in Psychological Well‐Being


A considerable amount of empirical support was found for a positive relationship between improved awareness and employability, although this was less consistent for depressive symptoms and psychosocial and emotional stability.

The trajectory of awareness across the first year after traumatic brain injury: The role of biopsychosocial factors

Analysis of SADI sub-scales revealed that females had greater awareness in terms of setting more realistic goals early in recovery compared to males, and time post-injury had the strongest influence on the development of awareness.

Patterns and Antecedents of the Development of Self-Awareness following Traumatic Brain Injury: The Importance of Occupation

The pattern of the development of self-awareness following traumatic brain injury was different between the two groups, and occupational therapists should consider the use of familiar occupations to assist in the recovery process.

Neuropsychological rehabilitation of self-awareness after brain injury: a review

The present review has the aim of showing the different approaches wit hin the neuropsychological model that are used in the treatment of self-awareness problems, from the holistic approach to the social integration of the patient.

Self-awareness, depression and neurocognitive functions in patients with moderate and severe traumatic brain injury

Patients who have suffered a moderate or severe TBI may have impaired self-awareness, a complex function that needs to use executive functions and episodic memory.



A Clinician's Rating Scale for Evaluating Impaired. Self-Awareness and Denial of Disability After Brain Injury

A distinction between impaired self-awareness versus denial of disability following brain injury seems clinically warranted and an experimental rating scale is presented to help clinicians evaluate these two interacting disturbances.

Cognitive retraining after traumatic brain injury and its role in facilitating awareness.

This article explores the nature and rationale of cognitive retraining activities in a neuropsychologically oriented outpatient rehabilitation program. Daily performance on tasks of speed of

The three vectors of consciousness and their disturbances after brain injury

Based on the recent review of Zeman (2001) three “vectors” of consciousness aredescribed. A model for understanding how they are related is outlined. Recentbehavioural and neuroimaging studies are

Training awareness and compensation in postacute head injury rehabilitation.

Deficits in awareness caused by brain Injury can be divided into three types: deficits in intellectual awareness, deficits in emergent awareness, and deficits in anticipatory awareness. The presence

Predicting employment in traumatic brain injury following neuropsychological rehabilitation

Employment outcome was predicted for fifty-nine clients with traumatic brain injury participating in a holistic neuropsychological rehabilitation program using data collected prior to and following

Deficit awareness and treatment performance among traumatic head injury adults.

Results lend qualified support to the hypothesis that head-injured clients who are aware of their deficits tend to have better treatment performance as rated by their therapists.

Comparing patient perspectives of disability and treatment effects with quality of participation in a post-acute brain injury rehabilitation programme.

High correlations among the patient measures were found, although little relationship appeared between patient and staff ratings, and implications for patient-staff interactions and overall psychosocial outcome after brain injury are discussed.

Self-awareness of deficits in adults with traumatic brain injury: how best to measure?

An approach which makes use of multiple measures to evaluate self-awareness of deficits is recommended, and an interviewer-rated semi-structured interview is proposed (the Self-Awareness of Deficits Interview).

Characteristics of impaired awareness after traumatic brain injury

The present paper presents the results of 2 new studies with a total of 111 traumatic brain injury patients conducted to bring further clarity to this area, confirming and extended many results of previous investigations.

Initial Disturbances of Consciousness and Resultant Impaired Awareness in Spanish Patients with Traumatic Brain Injury

Initial disturbances of consciousness, one measure of severity of brain injury, appeared to relate to later measures of impaired self-awareness in Spanish patients with TBI.