Awareness of behavioral limitations after traumatic brain injury: A cross-cultural study of New Zealand maoris and non-maoris

Forty-one New Zealand traumatic brain injury (TBI) patients were studied using the Patient Competency Rating Scale (PCRS) and selected neuropsychological tests. An attempt was made to replicate earlier reported findings in American TBI patients and determine if cultural factors influence self-perceptions (i.e., awareness) of impairments after brain injury. TBI patients with Maori ancestry were compared to New Zealanders with non-Maori (English) ancestry. Both groups showed no correlation between their actual neuropsychological status and self-reports of behavioral competency. In contrast, the ratings of their relatives concerning their behavioral competency were correlated with the patient\u27s neuropsychological test performance. Maori TBI patients reported less behavioral competency than non-Maori TBI patients. Non-Maori TBI patients\u27 performance on the PCRS replicated the findings obtained with American TBI patients. An earlier finding of slow speed of left-hand finger tapping in patients who overestimate their behavioral competency was not replicated, but a confounding of ethnicity and finger-tapping speed was observed. Brain damage may contribute to patients\u27 misperceptions of their behavioral competency, but cultural factors also seem to play an important role