"I Couldn't Be Better": Assessing Self-Awareness With the Mayo-Portland Adaptability Inventory-4 Following TBI

Factors Influencing Objective and Subjective Prospective Memory Measures in Traumatic Brain Injury

OBJECTIVE

To accurately assess prospective memory (PM) functioning in patients who sustained a traumatic brain injury (TBI), it is important to use both subjective (questionnaires) and objective (tests) measures. However, which factors have the most significant effect on each PM measure remains unknown. This observational study aims to verify whether TBI severity or psychological status has the most influence on patients' objective and subjective PM measures.

METHOD

Fifteen healthy control (HC) participants (n = 15), 19 patients with a mild TBI (n = 19) and 30 patients with a moderate-to-severe TBI (n = 30) were recruited during the post-acute phase. For almost every participant, a relative was also recruited (n = 62). The Test écologique de mémoire prospective (TEMP), an objective computerized PM measure consisting of naturalistic stimuli, was administered to all participants along with anxiety (BAI) and depression inventories (BDI). Participants and their relatives also completed a questionnaire, the comprehensive assessment of PM (CAPM), a subjective PM measure assessing everyday failures.

RESULTS

Results on the objective PM measure were predicted by TBI severity, while psychological symptoms (BAI and BDI) predicted scores on the subjective PM measure. In addition, relatives in the moderate-to-severe TBI group reported more PM failures on the subjective measure and their perception was significantly correlated with results on the objective PM measure, which was not the case for the other two groups of relatives.

CONCLUSIONS

Objective PM measures are related to TBI severity and appear more robust against the influence of psychological factors than subjective PM measures.

Components of self-awareness affecting caregiver burden: a long-term follow-up study

OBJECTIVE

Studies utilizing the discrepancy model of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) have commonly used the cognitive and physical domains to estimate self-awareness. This study included other aspects of self-awareness such as awareness of one's social and emotional status and daily functioning to explore their effects on caregiver burden for ABI survivors.

METHODS

We studied 64 patient-caregiver pairs up to 29 years post-discharge from a holistic, milieu-oriented outpatient neurorehabilitation program. Discrepancy scores between ABI survivors' and caregivers' reports on the MPAI-4 subscales (i.e. Abilities, Adjustment, and Participation) and Total Score were used to determine self-awareness. Caregiver burden was measured using the Zarit Burden Interview (ZBI).

RESULTS

Exploratory linear regression analyses revealed that caregiver burden derived from the ZBI was predicted by the discrepancy scores generated from the Abilities (p < 0.0001), Adjustment (p < 0.01), Participation subscales (p = 0.01), and Total Score (p < 0.001), respectively. Among the exploratory models generated, the Total Score model had the highest predictive value (R2 = .33) for caregiver burden.

CONCLUSIONS

Measures of self-awareness should be comprehensive by considering diverse components of self-awareness. Increasing ABI survivors' self-awareness in different domains has the potential to effectively alleviate caregiver burden.