Self-awareness, distress, and postacute rehabilitation outcome

James F. Malec, Anne M. Moessner

Research output: Contribution to journalArticle

68 Scopus citations


Objective: To examine changes in impaired self-awareness (ISA) and distress with participation in a brain injury comprehensive day treatment program (CDTP) and their relationship to treatment outcomes at program end and 1-year follow-up. Study Design and Participants: Ratings of ISA and distress by rehabilitation staff and their relationship to other outcome measures were examined for 62 consecutive program graduates. Measures: Ratings of ISA and distress from the Mayo-Portland Adaptability Inventory (MPAI); outcome measures included Raschtransformed MPAI score, goal attainment scaling T score, the Vocational Independence Scale, and the Independent Living Scale. Results: Nonparametric analyses of change scores showed that ISA and distress diminished after program participation. Nonparametric correlational analysis indicated that reduced ISA did not correlate with increased distress at program end. Linear and logistic regression analyses revealed that lower ISA and distress correlated with more positive outcomes on most measures (i.e., independent living, goal attainment scaling, and other ratings of disability on the MPAI) but did not predict vocational outcome. Conclusions: Participation in a CDTP reduces ISA and distress. Lower ISA and distress are associated with positive behavioral changes and more independent living but are neither necessary nor sufficient conditions for employment.

Original languageEnglish (US)
Pages (from-to)227-241
Number of pages15
JournalRehabilitation Psychology
Issue number3
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health

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