Impaired awareness following acquired brain injury : conceptual, emotional and treatment considerations
Acquired brain injury (ABI) frequently results in a characteristic spectrum of physical, cognitive, and behavioural consequences. Individuals with ABI are often unable to appreciate these consequences and comprehend the influence of these deficits on everyday life. These individuals are said to have impaired awareness. A selective overview of the literature on impaired awareness following ABI is presented. Emphasis is placed on terminology, theories, measurement, treatment, and the relationship between impaired awareness and emotional distress. It was established that the relationship between impaired awareness and aspects of neuropsychological and mood functioning is still unclear. In addition, relatively few empirical studies have investigated treatment techniques for impaired awareness. This study investigated the association between impaired awareness and executive functioning, and the relationship between impaired awareness and emotional distress with a sample of 30 adults with ABI. A sub-sample of 17 individuals with impaired awareness participated in an intervention where they received feedback of their brain scan findings. The main finding of the study was that measures of impaired awareness and emotional distress decreased following the feedback intervention. No evidence of a statistically significant relationship between impaired awareness and mood, or impaired awareness and executive functioning was found. There was a trend towards poor planning ability being related to unrealistic goal setting. Recommendations for further research in this area of neuropsychology and neurorehabilitation are made.