A – 130 Cognitive Frustration, Not Cognitive Ability, Predicts Self-Rated Functional Outcomes in Moderate-to-Severe Traumatic Brain Injury

Abstract Objective Individuals with moderate-to-severe traumatic brain injury (TBI) are often unaware of their cognitive deficits, although they often report frustration when completing neuropsychological tests. We evaluated the role of frustration and objective cognition in the ratings of functional abilities in individuals with moderate to severe TBI. Method This study included 22 moderate-to-severe TBI survivors and 31 healthy comparisons. NASA Task Load Index ratings of frustration were taken following completion of each neuropsychological measure in a brief test battery. Composite scores were calculated for attention, memory, and executive performances as well as frustration ratings. Functional outcomes were measured using the Mayo-Portland Adaptive Inventory, Fourth Edition (MPAI-4). Results Hierarchical regressions were conducted on frustration and each composite score separately to predict MPAI-4 ratings. In the TBI group, neither attention, memory, nor executive function composite scores predicted MPAI-4 self-ratings, while frustration regarding attention, memory, and executive performances did (R2 = .26, R2 = .28, R2 = .23, respectively). We found the opposite trend in HC, frustrations scores did not predict MPAI-4 self-ratings, but attention, memory, and executive composite scores did (R2 = .12, R2 = .18, R2 = .15, respectively). Conclusion Our findings demonstrate that frustration regarding cognitive performances, rather than object test scores, are most predictive of self-rated everyday abilities in people with TBI. These findings indicate that while individuals with TBI may be less aware of their objective cognitive deficits, their affective responses to cognitive performances may provide a window for them to understand the association between their cognitive abilities and functional difficulties.