Awareness, emotional adjustment, and injury severity in postacute brain injury

Objective: Relationships among awareness of deficits, injury severity, and emotional adjustment in patients with traumatic brain injury were explored. Participants: One hundred sixty-six individuals were referred for postacute neurocognitive assessment. Design: Retrospective file analysis identified injury severity, and data from the Patient Competency Rating Scale and Katz Adjustment Scale-Revised, utilizing self-ratings and significant others' ratings, were gathered. Results: Significant others described emotional adjustment difficulties, regardless of the severity of injury. A positive association was noted between patients' acknowledgment of neurobehavioral problems and ratings of their emotional adjustment. Conclusions: Severity of TBI appeared less important than emotional adjustment in the awareness of deficit; mildly injured patients were more likely to report neurobehavioral deficits than were moderately and severely injured patients, relative to the reports of significant others.