Gp. Prigatano et al., A CROSS-CULTURAL-STUDY ON IMPAIRED SELF-AWARENESS IN JAPANESE PATIENTS WITH BRAIN-DYSFUNCTION, Neuropsychiatry, neuropsychology, and behavioral neurology, 10(2), 1997, pp. 135-143
Japanese patients with brain dysfunction (21 with severe traumatic bra
in injury [TBI], 21 with right, and 21 with left cerebral vascular acc
idents [CVA]) were asked to make behavioral ratings regarding their co
mpetencies in several areas, Relatives of patients and physical therap
ists who treated them also rated each patient's behavioral competency.
Japanese patients with TBI overestimated their behavioral competencie
s compared with therapists' ratings, but not relatives' ratings. Japan
ese patients with TBI overestimated self-care skills but not their abi
lity to interact in socioemotional situations. Patients who had right
and left CVA did not differ in their mean ratings of behavioral compet
ency. Among all patient groups, there was no correlation between self-
reported competencies and performance on a neuropsychological test. Fa
mily ratings of patients' behavioral competencies correlated with the
patients' neuropsychological test performance. Post hoc analyses of pa
tients with TBI suggest that speed of finger tapping related to an imp
aired self-awareness. Whereas cultural factors may influence self repo
rts of behavioral competency, patients across cultures with brain dysf
unction seem to have reduced insight into their actual level of neurop
sychological functioning.