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Associations between self and informant ratings of executive functioning and driver behavior following acquired brain injury

Acquired brain injury (ABI) may cause impairment of executive functioning, which includes cognitive function, self-regulation and self-control, and awareness of potential deficits. Unfortunately, reduced executive functioning can limit a person’s ability to drive safely, and, as a result, many survivors of ABI do not resume driving after recovering from their injuries. Because awareness of one’s own deficits may be impaired by ABI, some research suggests that caregivers’ perceptions an accurate predictor of a patient’s driving capacity.

A recent Norwegian study investigated the relationship between self and informant ratings of executive function and driving behavior in people who experienced ABI. Researchers collected data from 24 adults who experienced a stroke and 10 who experienced a traumatic brain injury in the previous year. They administered the Behavior Rating of Executive Function (BRIEF-A) to determine participants’ degree of executive functioning. Next, they assessed ABI patients’ and their caregivers’ perceptions of driving capacity with the Swedish Driver Behavior Questionnaire (DBQ) and Sunnaas Driving Pattern Questionnaire (SDPQ). The researchers found that:

  • Patients’ ratings of executive function were significantly associated with their DBQ scores.
  • Caregivers’ ratings were not significantly associated with patients’ DBQ ratings, suggesting that caregiver reports are not a strong predictor of patients’ actual driving capacity.
  • Neither patients’ nor caregivers’ reports were associated with involvement in a vehicle accident.

Impairments to executive functioning are associated with reduced driving capacity in patients with ABI. Importantly, patients’ self-reporting is a more reliable predictor of their driving capacity than the perceptions and reports of their caregivers. Although patients with decreased awareness of deficits were more likely to drive greater distances and use fewer compensatory driving strategies than other ABI patients, these patients were equally as likely to use safe driving practices as other patients.

Rike P, Askdal Eriksen L, & Schanke A. Associations between self and informant ratings of executive functioning and driver behavior following acquired brain injury. Journal of Rehabilitation Medicine. (July 2018).


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