Self-awareness and theory of mind in acquired brain injury

Self-awareness deficits are common sequelae of acquired brain injury (ABI) (i.e., stroke and traumatic brain injury). Currently there is converging evidence to suggest that the frontal lobes play an important part in mediating higher-level thinking skills, including self-awareness. It has also been suggested that the frontal lobes may play a critical role when making inferences about other people’s mental states, known traditionally as Theory of Mind (ToM). While the relationship between self-awareness and ToM has been studied in the psychiatric literature, only one study (Bach & David, 2006) to date, has examined this relationship within a neurological population. The present study investigated the relationship between ToM and self-awareness deficits in an ABI population. Twenty-three participants (15 with stroke and 8 with traumatic brain injury) were administered verbal and nonverbal ToM tasks. Self-awareness was measured using discrepancy scores between patient and relative ratings on the Patient Competency Rating Scale (Prigatano et al, 1986). Preliminary results suggest that participants with self-awareness deficits after ABI perform more poorly on both verbal and non-verbal ToM measures; however, these greater difficulties most likely reflect more general difficulties.