Insight in TBI: What is its role in the relationship between cognition and vocational outcomes?

Impaired self-awareness (ISA), among other metacognitive deficits, frequently occurs after a Traumatic Brain Injury (TBI). Research has shown that ISA is often observed with executive functioning deficits in TBI and is also linked to poor vocational outcomes post-injury. Metacognition literature has largely focused on offline measures of self-awareness (i.e., the report of symptoms as per different sources’ response on questionnaires), or focused on on-line measures of self-awareness (i.e., in-the-moment prospective or retrospective judgment of own performance). Past research has not merged these two methodologies to assess ISA in TBI to better understand the relationship to specific functional outcomes in TBI. The current proposal sought to compare offline (global) measures and on-line (local) measures to establish their relation to executive functioning deficits, as well as certain vocational outcomes. Findings from this project suggested that the offline measure utilized in this study (DEX) better captured ISA in this sample, though it was not related to executive functioning or vocational outcomes in TBI. Limitations and areas of future research, specifically in the context of rehabilitation, are discussed. Given that findings support that unemployment is a challenge for individuals who have experienced a TBI, continued research is warranted to better understand the role that insight and executive functioning play, and any relevant mediational relationships, within a larger and more representative sample to inform tailored vocational and self-awareness interventions.M.S., Psychology -- Drexel University, 201