Long-term outcome following traumatic brain injury: A comparison of subjective reports by those injured and their relatives

Many long-term outcome studies have documented changes following injury using subjective reports from TBI patients and close others. It is known that factors such as self-awareness and emotional adjustment can influence subjective reports, but there has been limited research comparing reports by those injured with those of their close others at longer periods post-injury. The aims of the present study were to compare TBI participants' and close others' subjective reports of cognitive and behavioural problems 10 years following TBI and to investigate the relationship between subjective reports of cognitive impairments and TBI participants' performances on cognitive tests. Fifty-four participants who had sustained mild to very severe TBI were followed up a mean of 10 years post-injury and 54 close others also participated. Measures included the Neurobehavioural Functioning Inventory (NFI), the Hospital Anxiety and Depression Scale (HADS), and cognitive measures of attention, memory and executive function. TBI participants and close others showed strong agreement in their reporting of problems on the NFI. However, there was no strong relationship between subjective reports of cognitive problems and test performances. Much stronger relationships were found between subjective reports of cognitive change and emotional state. This study highlights the importance of assessing emotional state when utilising subjective report data, as well as the need to use objective measures of cognitive impairment.