Executive functions, self-awareness and quality of life in chronic moderate-to-severe TBI

Abstract: BACKGROUND: Moderate-to-severe traumatic brain injury (TBI) leads to significant neuropsychological impairment, further affecting quality of life (QOL). OBJECTIVE: Investigate the effects of chronic moderate-to-severe TBI on Executive Functions (EF), Self-awareness (SA), QOL, and the associations between them. METHODS:33 males with moderate-to-severe TBI (ages 18–51; time since injury 1–19 years) were compared to 24 non-injured males, matched on age and education. EF measures included the Rey Complex Figure Test (copy), the Trail Making Test A & B, the Symbol Digits Modalities Test, and the Control Oral Word Association Test. SA was assessed using the Dysexecutive Questionnaire Revised, and the Self-Regulation Skills Interview. QOL and health-related QOL were assessed using the WHOQOL-BREF and the QOL after Brain Injury, respectively. RESULTS: TBI participants scored lower on EF, and SA, reported less satisfaction regarding physical health and greater satisfaction with environmental support, than controls. TBI survivors scoring lower on EF, exhibited lower SA. Lower SA correlated with greater satisfaction regarding cognitive skills, self-perception, and overall HRQOL. Lower EF performance correlated with greater satisfaction in social relationships. CONCLUSIONS: The long-term effects of TBI on EF, SA and QOL seem to support the role of EF and SA on QOL, and therefore, the need for personalized interventions in improving recovery outcome.