Awareness of Deficits and On-Road Driving Performance

Abstract

This study examined the relationship of neuropsychological and on-road driving evaluations among adults with acquired brain injury (ABI), and the extent to which that relationship is moderated by awareness of deficit. Participants were 62 pairs of adults with ABI and significant-other informants and 40 healthy controls (N = 102). Adults with ABI and controls completed neuropsychological and on-road evaluations. Multiple regression indicated that neuropsychological performance and the interaction between awareness of deficit and neuropsychological performance each explained significant variance in driving performance (i.e., the relationship between neuropsychological performance and on-road outcome depends on level of awareness). The moderation effect was illustrated by different relationships between neuropsychological and on-road performances among awareness groups: Among adults with impaired awareness (n = 21), neuropsychological functioning was substantially related to driving outcomes; in contrast, driving outcome showed weak relation to neuropsychological functioning among those with intact awareness (n = 24) or hypervigilance (n = 17) toward deficits. An exception was that processing speed showed modest relation to on-road outcome for all groups, including controls. Awareness of deficit has a considerable influence on driving outcomes both directly and as a moderator between the relationship of neuropsychological functioning and driving performance. When adults with ABI lack appreciation for their impairments, their neuropsychological status is especially important in predicting driving outcomes.

Keywords:

• Driving
• Awareness of deficit
• Acquired brain injury

Acknowledgments

This research was supported by grants from the US Department of Education – National Institute of Disability Research and Rehabilitation (H133G050134, L.J. Rapport) and Wayne State University (J.A. Griffen).

The authors thank Cherisse McKay, Christine Paradee, Laura Hill, Kaja Telmet Harper, Tanya Ergh Sherman, and Carolyn Scott for their invaluable assistance in data collection.