Concordance between the Awareness Questionnaire and Self-Awareness of Deficits Interview for identifying impaired self-awareness in individuals with traumatic brain injury in the community

Abstract

Objective: To investigate concordance between the Awareness Questionnaire (AQ) and Self-Awareness of Deficits Interview (SADI) for identifying impaired self-awareness in the community after traumatic brain injury. Design: A retrospective file audit was conducted to retrieve data on the AQ and SADI for participants with traumatic brain injury involved in previous studies on community-based outcomes. Concordance between the AQ and SADI was examined using receiver operating characteristic curves for different scores on each measure. Participants: A total of 80 individuals with moderate-to-severe traumatic brain injury (81% male, mean age 2.25 years, standard deviation (SD) 11.5 years) living in the community. Methods: Participants were administered the AQ and SADI and their significant other completed the AQ and SADI checklist. Results: Consistency of classification of impaired self-awareness between the AQ and SADI was high (i.e. 80–84%) based on scores reflecting good sensitivity and specificity. Corresponding scores on the 2 measures and rates of impaired self-awareness were as follows: SADI > 3~AQ discrepancy > 4 (45–48% with impaired self-awareness); SADI > 4~AQ discrepancy > 9 (26–34% with impaired self-awareness); SADI > 5~AQ discrepancy >12 (13–26% with impaired self-awareness). Conclusion: The AQ and SADI yielded consistent information regarding the presence of impaired self-awareness in community-based individuals with traumatic brain injury. The choice of measure may depend on how the tool is being used to guide rehabilitation planning.

Keywords

• traumatic brain injury
• impaired self-awareness
• assessment
• concordance
• sensitivity
• specificity.