Efficacy of self-perception after traumatic brain injury.

Background: Anosognosia is a lack of awareness of personal deficits that is commonly observed in people with a traumatic brain injury (TBI).

Objective: The purpose of this paper is to examine whether self-appraisal of executive functioning differs for students with and without TBI.

Methods: Students who had survived a TBI and those who had never had a TBI filled out the Behavior Rating Inventory of Executive Functioning from three different perspectives. Each participant was paired with an observer who was familiar with the person's behavior. Self-appraisal ratings, observer ratings of the participant, and reflective appraisal of how the participant thought the observer would rate them were compared.

Results: For the students without TBI, reflective appraisal was significantly correlated with self-appraisal but observer appraisal was not. For students with TBI, neither reflected appraisal nor observer appraisal correlated with self-appraisal. Both TBI and non-TBI participants overestimated their problems on measures of Inhibition, Shifting, Emotional Control, Initiation, and Planning/Organizing. TBI participants underestimated their problems on measures of Working Memory, Organization, and Task Monitoring relative to the non-TBI group.

Conclusions: Students with TBI do not accurately perceive how others perceive their behavior.