The Insight Interview: A new tool for measuring deficits in awareness after traumatic brain injury

Abstract

Objective: Awareness deficits are common after traumatic brain injury (TBI); however, relatively little is known of awareness deficits in the early stages post-injury. This study outlines the development of a new tool, ‘The Insight Interview’, designed to measure awareness across different domains (awareness of change, severity of deficits, current and future functional consequences) from 3 months post-TBI.

Methods: Forty-three patients with at least a severe TBI, their nominated family member and treating clinician were all administered different versions of the Insight Interview during the patient’s inpatient stay. Awareness was measured; (1) by calculating a discrepancy score between the patient’s and their family informant’s and/or clinician’s ratings of the patient’s abilities and (2) using interviewer-based ratings of the patients’ responses to interview questions.

Results: Awareness differed depending upon the domain being assessed, with patients demonstrating greatest awareness in the current functional consequences domain. Evidence for a distinction between awareness of current and future functional consequences of impairments was also seen. Discrepancy scores and interviewer-based ratings showed good concordance. Adequate reliability and validity was demonstrated.

Conclusion: The Insight Interview is a useful and valid tool for measuring awareness in the acute stages following TBI and highlights that awareness depends on domain assessed.

• Assessment
• psychometric assessment
• self-awareness
• traumatic brain injury

Acknowledgements

Special thanks must go to the patients, family and staff of the Royal Rehabilitation Centre, Sydney and the Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney. Thanks is also extended to Dr Andrew Baillie for his help in preparing this paper for publication.