An investigation into the relationship between executive function, psychological distress and awareness following acquired brain injury

Variations in awareness, psychological distress and executive function have been shown to impact on rehabilitation potential. In addition, following an acquired brain injury (ABI) risk of suicide is increased. Recently there has been an emphasis on improving awareness of disability as it has been shown to improve rehabilitation potential. However, increased awareness has been associated with increased psychological distress. If focus is on improving awareness following an ABI, increased psychological distress is likely to be observed, increasing the risk of disengagement and also suicide. In this study, the interaction of psychological distress, awareness and executive function was investigated with 64 participants who had sustained an ABI. Measures used included the BADS; DEX; HADS; and PCRS (for 19 out of the 64 participants). Awareness was positively correlated with psychological distress, depression and anxiety. It was also negatively correlated with behavioural ratings of the dysexecutive syndrome and with two of the subtests from the BADS. No significant correlation was found between psychological distress and executive function. Finally, a model is proposed suggesting how behavioural ratings of executive function and self report of psychological distress can predict awareness. It was concluded that for some individuals with poor awareness, focusing on improving awareness can be helpful. For those with good awareness, this approach may be detrimental to their emotional well being. In addition, it is concluded that awareness can not be predicted by test of executive function.