Awareness of Deficits and On-Road Driving Performance

• Published in: Clinical neuropsychologist Vol. 25; no. 7; pp. 1158 - 1178
• Main Authors: Griffen, Julie A., Rapport, Lisa J., Bryer, Renee Coleman, Bieliauskas, Linas A., Burt, Cynthia
• Format: Journal Article
• Language: English
• Published: Hove Psychology Press 01.10.2011
• Subjects: Acquired brain injury; Adult; Adult and adolescent clinical studies; Applied psychology; Attention; Automobile Driver Examination; Automobile Driving - psychology; Awareness - physiology; Awareness of deficit; Biological and medical sciences; Brain Injuries - complications; Brain Injuries - mortality; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognition Disorders - psychology; Driving; Female; Fundamental and applied biological sciences. Psychology; Humans; Male; Medical sciences; Middle Aged; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychomotor Performance - physiology; Psychopathology. Psychiatry; Regression Analysis; Surveys and Questionnaires; Transportation. City planning; Human; Nervous system diseases; Vehicle driving; Acquired brain injury; Awareness; Neuropsychological test; Driving; Psychometrics; Cognition; Cerebral disorder; Awareness of deficit; Central nervous system disease; Performance
• ISSN: 1385-4046; 1744-4144
• DOI: 10.1080/13854046.2011.609841

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.