Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-08T08:18:38.415Z Has data issue: false hasContentIssue false
  • English
  • Français

Awareness of activity limitations and prediction of performance in patients with brain injuries and orthopedic disorders

Published online by Cambridge University Press:  01 March 2004

SONJA FISCHER ,
LANCE E. TREXLER  and
SIEGFRIED GAUGGEL
SONJA FISCHER
Affiliation:
Department of Psychology, University of Technology Chemnitz, Chemnitz, Germany and Praxis fuer Neuropsychologische Rehabilitation Prof. Fries, Munich, Germany
LANCE E. TREXLER
Affiliation:
Hook Rehabilitation Center, Community Hospitals Indianapolis, Indiana, and Indiana University School of Medicine, USA
SIEGFRIED GAUGGEL
Affiliation:
Department of Psychology, University of Technology Chemnitz, Chemnitz, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this study was to compare the accuracy of performance predictions in experimental tasks with patients' awareness of activity limitations. Participants were 24 patients with brain injuries (i.e., traumatic brain injury and cerebrovascular disorders) and 22 patients with orthopedic disorders. Prediction of performance was examined in a memory task (word list learning) and a motor task (finger tapping). Awareness of activity limitations was measured by comparing patients' self-ratings and staff ratings in the Patient Competency Rating Scale (PCRS). Results for the PCRS showed that patients with orthopedic disorders underestimated and patients with brain injuries (i.e., patients with TBI) overestimated their level of functioning in the total scale and the social/emotional subscale in comparison to staff ratings. Both patient groups agreed with staff ratings in physical/basic self-care items. In the predicted performance tasks a similar pattern could be observed: None of the groups showed an overestimation of performance in the motor task, whereas patients with brain injuries overestimated their competency in the memory task. However, the agreement between both awareness measures (PCRS, predicted performance) was only low, which indicates that they might measure different aspects or levels of self-awareness. (JINS, 2004, 10, 190–199.)

Keywords

AwarenessActivity limitationsPredicted performanceBrain injury
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 10 , Issue 2 , March 2004 , pp. 190 - 199
Copyright
© 2004 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alfano, M.S. & Satz, P. (2000). Commentary and perspectives on R.M. Allen's “The test performance of the brain injured.” Journal of Clinical Psychology, 56, 975–997.Google Scholar
Anderson, S.W. & Tranel, D. (1989). Awareness of disease states following cerebral infarction, dementia, and head trauma: Standardized assessment. Clinical Neuropsychologist, 3, 327–339.Google Scholar
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). BDI-II manual. San Antonio, TX: The Psychological Corporation.
Buschke, H. (1973). Selective reminding for analysis of memory and learning. Journal of Verbal Learning and Verbal Behavior, 12, 543–550.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.
Dunlap, W.P., Cortina, J.M., Vaslow, J.B., & Burke, M.J. (1996). Meta-analysis of experiments with matched groups or repeated measures designs. Psychological Methods, 1, 170–177.Google Scholar
Ezrachi, O., Ben-Yishay, Y., Kay, T., Diller, L., & Rattok, J. (1991). Predicting employment in traumatic brain injury following neuropsychological rehabilitation. Journal of Head Trauma Rehabilitation, 6, 71–84.Google Scholar
Fischer, S. & Trexler, L.E. (1999). The CNR model of levels of functioning in brain injury rehabilitation. Zeitschrift für Neuropsychologie, 10, 103–114.Google Scholar
Fleming, J.M. & Strong, J. (1995). Self-awareness of deficits following acquired brain injury: considerations for rehabilitation. British Journal of Occupational Therapy, 58, 55–60.Google Scholar
Fleming, J.M., Strong, J., & Ashton, R. (1996). Self-awareness of deficits in adults with traumatic brain injury: How best to measure? Brain Injury, 10, 1–15.Google Scholar
Gasquoine, P.G. (1992). Affective state and awareness of sensory and cognitive effects after closed head injury. Neuropsychology, 6, 187–196.Google Scholar
Gauggel, S., Hoop, M., & Werner, K. (2002). Assigned vs. self-set goals and their impact on the performance of brain-damaged patients. Journal of Clinical and Experimental Neuropsychology, 24, 1070–1080.Google Scholar
Gauggel, S., Peleska, B., & Bode, R.K. (2000). Relationship between cognitive impairments and rated activity restrictions in stroke patients. Journal of Head Trauma Rehabilitation, 15, 710–723.Google Scholar
Godfrey, G.F.D., Partridge, F.M., Knight, R.G., & Bishara, S. (1993). Course of insight disorder and emotional dysfunction following closed head injury: A controlled cross sectional follow-up study. Journal of Clinical and Experimental Neuropsychology, 15, 503–515.Google Scholar
Halstead, W.C. (1947). Brain and intelligence; A quantitative study of the frontal lobes. Chicago: University of Chicago Press.
Hart, T., Giovannetti, T., Montgomery, M.W., & Schwartz, M.F. (1998). Awareness of errors in naturalistic action after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 16–28.Google Scholar
Heilbronner, R.L., Rouche, J.R., Everson, S.A., & Epler, L. (1989). Comparing patient perspectives of disability and treatment effects with quality of participation in a post-acute brain injury rehabilitation programme. Brain Injury, 3, 387–395.Google Scholar
Mazzoni, G. & Nelson, T.O. (1998). Metacognition and cognitive neuropsychology. Mahwah, NJ: Lawrence Erlbaum Associates.
McGlynn, S.M. & Schacter, D.L. (1989). Unawareness of deficits in neuropsychological syndromes. Journal of Clinical and Experimental Neuropsychology, 11, 143–205.CrossRefGoogle Scholar
Prigatano, G.P. (1996). Behavioral limitations TBI patients tend to underestimate: A replication and extension to patients with lateralized cerebral dysfunction. Clinical Neuropsychologist, 10, 191–201.Google Scholar
Prigatano, G.P., Altman, I.M., & O'Brien, K.P. (1990). Behavioral limitations that traumatic-brain-injured patients tend to underestimate. Clinical Neuropsychologist, 4, 163–176.Google Scholar
Prigatano, G.P., Bruna, O., Mataro, M., Munoz, J.M., Fernandez, S., & Junque, C. (1998). Initial disturbances of consciousness and resultant impaired awareness in Spanish patients with traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 29–38.Google Scholar
Prigatano, G.P., Fordyce, D., Zeiner, H.K., Roueche, J.R., Pepping, M., & Wood, B.C. (1986). Neuropsychological rehabilitation after brain injury. Baltimore: The Johns Hopkins University Press.
Prigatano, G.P. & Leathem, J.M. (1993). Awareness of behavioural limitations after traumatic brain injury: A cross-cultural study of New Zealand Maoris and non-Maoris. Clinical Neuropsychologist, 7, 123–143.Google Scholar
Prigatano, G.P. & Schacter, D.L. (Eds). (1991). Awareness of deficit after brain injury: Clinical and theoretical issues. New York: Oxford University Press.
Robins, R.W. & John, O.P. (1997). The quest for self-insight. Theory and research on accuracy and bias in self-perception. In R. Hogan, J. A. Johnson, & S.R. Briggs (Eds.), Handbook of personality psychology (pp. 649–679). San Diego, CA: Academic Press.
Sbordone, R.J., Seyranian, G.D., & Ruff, R.M. (1998). Are the subjective complaints of traumatically brain injured patients reliable? Brain Injury, 12, 505–515.Google Scholar
Sherer, M., Bergloff, P., Levin, E., High, W.M., Oden, K.E., & Nick, T.G. (1998b). Impaired awareness and employment outcome after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 52–61.Google Scholar
Sherer, M., Boake, C., Levin, E., Silver, B.V., Ringholz, G., & High, W.M. (1998c). Characteristics of impaired awareness after traumatic brain injury. Journal of the International Neuropsychological Society, 4, 380–387.Google Scholar
Sherer, M., Oden, K., Bergloff, P., Levin, E., & High, W.M. (1998a). Assessment and treatment of impaired awareness after brain injury: Implications for community re-integration. NeuroRehabilitation, 10, 25–37.Google Scholar
Trexler, L.E., Eberle, R., & Zappala. G. (2000). Models and programs of the Center for Neuropsychological Rehabilitation: Fifteen years experience. In A. Christensen & B.P. Uzzell (Eds.), International handbook of neuropsychological rehabilitation (pp. 215–229). Dordrecht, The Netherlands: Kluwer Academic Publishers.
Wagner, M.T. & Cushman, L.A. (1994). Neuroanatomic and neuropsychological predictors of unawareness of cognitive deficit in the vascular population. Archives of Clinical Neuropsychology, 9, 57–69.Google Scholar
Walker, D.E., Blankenship, V., Ditty, J.A., & Lynch, K.P. (1987). Prediction of recovery for closed-head-injured adults: an evaluation of the MMPI, the Adaptive Behavior Scale, and a ‘Quality of Life’ rating scale. Journal of Clinical Psychology, 43, 699–707.Google Scholar
Wallston, K.A. & Wallston, B.S. (1978). Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Education Monographs, 6, 160–170.Google Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised. New York: The Psychological Corporation.
Wilkinson, G.S. (1993). The Wide-Range Achievement Test 3: Administration manual. Wilmington, DE: Wide Range Inc.
Wyller, T.B., Sveen, U., & Bautz-Holter, E. (1996). The Frenchay Activities Index in stroke patients: agreement between scores by patients and by relatives. Disability and Rehabilitation, 18, 454–459.Google Scholar