Sherer, PhD, ABPP-Cn, The Institute for Rehabilitation Research
Citation Sherer, M. (2004). The
Awareness Questionnaire. The Center for Outcome Measurement
in Brain Injury. http://www.tbims.org/
combi/aq ( accessed
self-awareness of deficits is frequently observed in persons who
have suffered moderate or severe TBI. Such impaired self-awareness
can complicate rehabilitation by limiting patient motivation for
treatment or resulting in selection of inappropriate long-term goals.
Some authors have stated that degree of impaired self-awareness
is a major factor in determining outcome after TBI. Sherer, Bergloff,
and colleagues (1998b) found that degree of impaired self-awareness
was predictive of employment outcome after TBI. Given the apparent
importance of impaired self-awareness to employment outcome, it
is important to have reliable, valid measures of impaired self-awareness.
of methods have been used to measure self-awareness in various investigations.
The Patient Competency Rating Scale, developed by George Prigatano
and colleagues, is the most commonly used scale in studies of self-awareness
after TBI. The PCRS is also described on the COMBI. The AQ was developed
as an alternative to the PCRS. The AQ requires persons with TBI
to compare their post-injury abilities to their pre-injury abilities
while the PCRS only requires patients to rate their current abilities.
The significance of this difference as well as the overlap between
the two scales are being investigated as part of the Collaborative
Study of Impaired Self-awareness after TBI (Principal Investigators
- Mark Sherer and Tessa Hart, NIDRR Grant #H133A980067).
indices of self-awareness can be derived from the three forms of
the Awareness Questionnaire. Clients who have impaired self-awareness
will rate themselves as less impaired in cognitive, behavioral,
and motor functioning than will family members or clinicians. Two
indices of the degree of impaired self-awareness can be calculated
by subtracting the total for the 17 family/significant other ratings
from the total for the 17 client self-ratings and by subtracting
the total for the first 17 clinician ratings from the total for
the client self-ratings. The larger the difference scores, the greater
the impairment of self-awareness. In a method similar to that described
by Anderson and Tranel (1989), client self-ratings on cognitive
items can be compared to scores on neuropsychological tests to produce
a third index of impaired self-awareness. Finally, the direct clinician
rating of accuracy of self-awareness provides a fourth measure of
S.W., & Tranel, D. (1989). Awareness of disease states following
cerebral infarction, dementia, and head trauma: Standardized assessment.
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