Lack of awareness and its impact in traumatic brain injury.

Research suggests that up to 45% of individuals with moderate to severe TBI demonstrate reduced awareness or complete lack of awareness of their deficits. We describe dimensions and distinctions within the concept of lack of awareness - including whether an individual has knowledge of a specific deficit, the emotional response an individual manifests to a specific deficit, the ability to comprehend the impact or consequences of the deficit on day to day life, and how an individual explains or accounts for any deficits - and various methods of assessing for lack of awareness in this population. Finally, a review of the literature studying lack of awareness in TBI, its relationship to injury severity, the impact of lack of awareness on outcome, and intervention approaches is presented.