An investigation of awareness of everyday memory ability after traumatic brain injury
Background: Survivors of traumatic brain injury (TBI) may have to contend with changes in their abilities, yet some may be unaware of specific emotional, cognitive and behavioural
consequences of the injury. Unawareness of memory difficulties may impact on functional outcome and participation in rehabilitation following TBI. Objectives: This study aimed to examine whether people are aware of their everyday memory ability after TBI. Design: A between-subjects design was used to compare a group with TBI and a healthy comparison group. A within-subjects design compared informant and self memory ratings. Method: Twenty-six healthy people and 26 people with TBI participated. People with TBI were recruited from statutory and voluntary community services available to people with
TBI. Awareness was measured by calculating the difference between performance on the Rivermead Behavioural Memory Test - Extended version and the Memory Awareness Rating Scale.
Results: The discrepancies between memory test score and pre-test self-ratings were not significantly different between the TBI and comparison group. However, the discrepancy was significantly smaller for the comparison group on post-test ratings. This indicates that the TBI and comparison groups were similar in pre-test rating of their memory compared to memory test performance. However, healthy people were better able to adjust estimates based on performance. Informants' ratings were more strongly correlated to memory performance for part of the rating scale, though neither self nor informant-ratings were
significantly correlated to memory performance in the TBI group.
Conclusions: Neither people with TBI nor healthy people make accurate estimates of their memory ability. Developing measurement of awareness of memory for research and clinical
practice is discussed. Clinicians should endeavour to thoroughly assess awareness, being mindful that healthy people also make relatively poor estimates of memory ability.