Affiliations: Department of Psychiatry, Neuropsychiatry Section, Dartmouth Medical School, Lebanon, NH and New Hampshire Hospital, Concord, NH, USA | Dartmouth Medical School, Department of Psychiatry, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. Tel.: +1 603 650 5824; Fax: +1 603 650 5842; E-mail: [email protected]
Correspondence:
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Address for correspondence: Laura A. Flashman, Ph.D., Department of Psychiatry, Neuropsychiatry Section, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. Tel.: +1 603 650 8524; Fax: +1 603 650 5842; E-mail: [email protected]
Abstract: Research suggests that up to 45% severe TBI demonstrate reduced awareness or complete lack of awareness of their deficits. We describe dimensions and distinctions within the concept of lack of awareness – including whether an individual has knowledge of a specific deficit, the emotional response an individual manifests to a specific deficit, the ability to comprehend the impact or consequences of the deficit on day to day life, and how an individual explains or accounts for any deficits – and various methods of assessing for lack of awareness in this population. Finally, a review of the literature studying lack of awareness in TBI, its relationship to injury severity, the impact of lack of awareness on outcome, and intervention approaches is presented.
Keywords: unawareness, lack of insight, traumatic brain injury, frontal-parietal circuitry
