| dc.description.abstract | One of the most striking deficits following brain injury is an unawareness of injury-related
impairments (Anosognosia). It has been proposed that lack of awareness of impaired
ability may be classified according to whether it has an organic or psychological origin.
The purpose of this study was to investigate the utility of a test instrument, the Patient
Competency Rating Survey (PCRS), in determining whether the lack of awareness of
deficit exhibited by neurorehabilitation clients is organically based Anosognosia or a
manifestation of psychological denial. Consenting consecutive patients (n=49) admitted to
the neurorehabilitation unit of St. Joseph's General Hospital in Thunder Bay, Ontario were
selected as the target sample for this investigation. Each subject was assigned to a brain
injured (BI) or a non-brain injured (non-BI) group. The BI group (n=32) consisted of
individuals who had sustained central nervous system damage affecting brain activity, and
the non-BI group (n=17) consisted of individuals with neurological damage not directly
impacting on brain activity. Each subject’s level of awareness of deficits was assessed
using the PCRS, and his/her pre-morbid coping techniques were assessed using the
Revised Ways of Coping Questionnaire (WOC-R). Comparison of the responses of BI
(n=32) and non-BI individuals (n=17) on the PCRS revealed that the relative to the non-brain
injured group, the brain injured group overestimated its ability on the following
seven critical items; preparing own meals, dressing self, washing dishes, taking care of
finances, keeping appointments on time, handling arguments with people well known to
the individual, understanding new instructions. Correlations between these critical items
and WOC-R coping scales indicated that psychological denial was not responsible for impaired awareness on four of the critical items. These analyses revealed moderate
negative associations between; Positive Reappraisal and preparing meals; Positive
Reappraisal and washing dishes; Seeking Social Support and washing dishes; Distancing
and handling arguments with people well known to the individual. In addition, a moderate
positive association was found between Accepting Responsibility and impaired awareness
of deficit in taking care of finances. These results provide evidence that the critical items
differentiate between organically and psychologically based impairments of awareness. | |
