Impaired awareness of deficits in individuals with neuropsychiatric symptoms after acquired brain injury: Associations with treatment motivation and depressive symptoms

S.M.J. Smeets, R.W.H.M. Ponds, G. Wolters Gregório, C.G.J.G. Pouwels, A.J. Visscher, I. Winkens, C.M. van Heugten

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

Objective: The purpose of this study was to investigate impaired awareness of deficits in relation to treatment motivation and depressive symptoms in patients with neuropsychiatric symptoms after acquired brain injury. Method: The study had a Cross-sectional design with 93 outpatient brain injury patients with neuropsychiatric symptoms in the chronic phase after injury. Awareness was measured by the discrepancy in answers between patients and significant others and/or clinicians. Patients were divided into 3 awareness groups: underestimation, accurate estimation, and overestimation of competencies. Treatment motivation and depressive symptoms were measured with self-report questionnaires. Results: Average discrepancy scores suggested patients had accurate awareness of deficits. However, when dividing patients into 3 awareness groups, 30% underestimated, 38% accurately estimated, and 32% overestimated their competencies. Linear regression analysis with discrepancy scores showed overestimation of competencies (positive discrepancy scores) was associated with less depressive symptoms, whereas underestimation (negative discrepancy scores) was associated with more depressive symptoms (beta = -.28 to -.42, p < .05). Group analysis revealed that the underestimation group reported significantly more depressive symptoms than the overestimation group (beta = .43 to .44, p < .05). No significant difference between the accurate estimation and overestimation group was found (p > .05). An association between awareness and treatment motivation was not statistically confirmed. Conclusion: This study demonstrated that when considering awareness groups, more nuanced results arise than when only considering discrepancy scores. From a clinical and scientific standpoint, it is important to distinguish awareness groups in addition to considering mean discrepancy scores. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Original languageEnglish
Pages (from-to)717-725
Number of pages9
JournalNeuropsychology
Volume28
Issue number5
Early online date7 Apr 2014
DOIs
Publication statusPublished - Sep 2014

Keywords

  • awareness
  • brain injuries
  • neuropsychiatry
  • depression
  • treatment motivation
  • SELF-AWARENESS
  • REHABILITATION
  • INVENTORY
  • QUESTIONNAIRE
  • ADJUSTMENT
  • VALIDITY
  • SEQUELAE
  • STROKE
  • ADULTS

Cite this

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title = "Impaired awareness of deficits in individuals with neuropsychiatric symptoms after acquired brain injury: Associations with treatment motivation and depressive symptoms",
abstract = "Objective: The purpose of this study was to investigate impaired awareness of deficits in relation to treatment motivation and depressive symptoms in patients with neuropsychiatric symptoms after acquired brain injury. Method: The study had a Cross-sectional design with 93 outpatient brain injury patients with neuropsychiatric symptoms in the chronic phase after injury. Awareness was measured by the discrepancy in answers between patients and significant others and/or clinicians. Patients were divided into 3 awareness groups: underestimation, accurate estimation, and overestimation of competencies. Treatment motivation and depressive symptoms were measured with self-report questionnaires. Results: Average discrepancy scores suggested patients had accurate awareness of deficits. However, when dividing patients into 3 awareness groups, 30{\%} underestimated, 38{\%} accurately estimated, and 32{\%} overestimated their competencies. Linear regression analysis with discrepancy scores showed overestimation of competencies (positive discrepancy scores) was associated with less depressive symptoms, whereas underestimation (negative discrepancy scores) was associated with more depressive symptoms (beta = -.28 to -.42, p < .05). Group analysis revealed that the underestimation group reported significantly more depressive symptoms than the overestimation group (beta = .43 to .44, p < .05). No significant difference between the accurate estimation and overestimation group was found (p > .05). An association between awareness and treatment motivation was not statistically confirmed. Conclusion: This study demonstrated that when considering awareness groups, more nuanced results arise than when only considering discrepancy scores. From a clinical and scientific standpoint, it is important to distinguish awareness groups in addition to considering mean discrepancy scores. (PsycINFO Database Record (c) 2014 APA, all rights reserved).",
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author = "S.M.J. Smeets and R.W.H.M. Ponds and {Wolters Greg{\'o}rio}, G. and C.G.J.G. Pouwels and A.J. Visscher and I. Winkens and {van Heugten}, C.M.",
year = "2014",
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doi = "10.1037/neu0000068",
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journal = "Neuropsychology",
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Impaired awareness of deficits in individuals with neuropsychiatric symptoms after acquired brain injury: Associations with treatment motivation and depressive symptoms. / Smeets, S.M.J.; Ponds, R.W.H.M.; Wolters Gregório, G.; Pouwels, C.G.J.G.; Visscher, A.J.; Winkens, I.; van Heugten, C.M.

In: Neuropsychology, Vol. 28, No. 5, 09.2014, p. 717-725.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Impaired awareness of deficits in individuals with neuropsychiatric symptoms after acquired brain injury: Associations with treatment motivation and depressive symptoms

AU - Smeets, S.M.J.

AU - Ponds, R.W.H.M.

AU - Wolters Gregório, G.

AU - Pouwels, C.G.J.G.

AU - Visscher, A.J.

AU - Winkens, I.

AU - van Heugten, C.M.

PY - 2014/9

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N2 - Objective: The purpose of this study was to investigate impaired awareness of deficits in relation to treatment motivation and depressive symptoms in patients with neuropsychiatric symptoms after acquired brain injury. Method: The study had a Cross-sectional design with 93 outpatient brain injury patients with neuropsychiatric symptoms in the chronic phase after injury. Awareness was measured by the discrepancy in answers between patients and significant others and/or clinicians. Patients were divided into 3 awareness groups: underestimation, accurate estimation, and overestimation of competencies. Treatment motivation and depressive symptoms were measured with self-report questionnaires. Results: Average discrepancy scores suggested patients had accurate awareness of deficits. However, when dividing patients into 3 awareness groups, 30% underestimated, 38% accurately estimated, and 32% overestimated their competencies. Linear regression analysis with discrepancy scores showed overestimation of competencies (positive discrepancy scores) was associated with less depressive symptoms, whereas underestimation (negative discrepancy scores) was associated with more depressive symptoms (beta = -.28 to -.42, p < .05). Group analysis revealed that the underestimation group reported significantly more depressive symptoms than the overestimation group (beta = .43 to .44, p < .05). No significant difference between the accurate estimation and overestimation group was found (p > .05). An association between awareness and treatment motivation was not statistically confirmed. Conclusion: This study demonstrated that when considering awareness groups, more nuanced results arise than when only considering discrepancy scores. From a clinical and scientific standpoint, it is important to distinguish awareness groups in addition to considering mean discrepancy scores. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

AB - Objective: The purpose of this study was to investigate impaired awareness of deficits in relation to treatment motivation and depressive symptoms in patients with neuropsychiatric symptoms after acquired brain injury. Method: The study had a Cross-sectional design with 93 outpatient brain injury patients with neuropsychiatric symptoms in the chronic phase after injury. Awareness was measured by the discrepancy in answers between patients and significant others and/or clinicians. Patients were divided into 3 awareness groups: underestimation, accurate estimation, and overestimation of competencies. Treatment motivation and depressive symptoms were measured with self-report questionnaires. Results: Average discrepancy scores suggested patients had accurate awareness of deficits. However, when dividing patients into 3 awareness groups, 30% underestimated, 38% accurately estimated, and 32% overestimated their competencies. Linear regression analysis with discrepancy scores showed overestimation of competencies (positive discrepancy scores) was associated with less depressive symptoms, whereas underestimation (negative discrepancy scores) was associated with more depressive symptoms (beta = -.28 to -.42, p < .05). Group analysis revealed that the underestimation group reported significantly more depressive symptoms than the overestimation group (beta = .43 to .44, p < .05). No significant difference between the accurate estimation and overestimation group was found (p > .05). An association between awareness and treatment motivation was not statistically confirmed. Conclusion: This study demonstrated that when considering awareness groups, more nuanced results arise than when only considering discrepancy scores. From a clinical and scientific standpoint, it is important to distinguish awareness groups in addition to considering mean discrepancy scores. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

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KW - neuropsychiatry

KW - depression

KW - treatment motivation

KW - SELF-AWARENESS

KW - REHABILITATION

KW - INVENTORY

KW - QUESTIONNAIRE

KW - ADJUSTMENT

KW - VALIDITY

KW - SEQUELAE

KW - STROKE

KW - ADULTS

U2 - 10.1037/neu0000068

DO - 10.1037/neu0000068

M3 - Article

VL - 28

SP - 717

EP - 725

JO - Neuropsychology

JF - Neuropsychology

SN - 0894-4105

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ER -