Having accurate insight and self-awareness of one's own abilities and challenges is important for recovery, daily functioning, and return to work or school after a traumatic brain injury. Impaired self-awareness is frequently associated with a self-reported high quality of life, satisfaction and mood. When comparing the traumatic brain injury survivor's self-ratings to their significant other's, however, it is clear that these self-reports are a result of an inaccurate understanding of the challenges they actually face.
It is thought that self-awareness will improve over time, and past studies have found that as the person becomes more aware of their situation, their mood and perception of life often worsens. A recent long-term study of self-awareness after traumatic brain injury found that self-awareness impairments can last even more than five years after the injury. A significant number of participants in the study underreported their neurological symptoms and overreported their functional abilities at home and work. Additionally, those that showed greater self-awareness were more likely to by employed. The participants' self-ratings frequently did not agree with their significant other's ratings.
Clinicians and family members should understand that self-awareness problems can last for years after a traumatic brain injury. As the likelihood of returning to work is associated with greater self-awareness, recovery of awareness may be an important target for rehabilitation.
Kelley E, Sullivan C, Loughlin JK, et al. Self-awareness and neurobehavioral outcomes, 5 years or more after moderate to severe brain injury. Journal of Head Trauma Rehabilitation. (April 2014).