Neurobehavioral disorders after severe acquired brain injury: discrepancies between patients and caregivers’ perception

Objective: Neurobehavioral disturbances often follow acquired brain injuries. Patients and family members may perceive these anomalies differently, and these discrepancies are difficult to interpret due to methodological constraints. We explored the differing perceptions of behavioral alterations in patients with severe acquired brain injury (sABI) and their caregivers using the Latent Difference Score (LDS) analysis. We also examined the relation between the behavioral ratings and demographic, injury, and functional variables. Method: Data from 154 patients with sABI in the post-acute phase and their caregivers were retrospectively analyzed. The BIRT Personality Questionnaire was used to assess behavioral disorders. Results: We examined four subscales: Lack of Motivation (LoM), Lack of Emotion Regulation (LoER), Negative Emotionality/Reactivity (NE), and Lack of Social Skills (LoSS). Patients generally tended to underestimate their problematic behaviors compared to their family members. Sex predicted patient/caregiver discrepancies in the LoM and LoER subscales, with male patients perceiving themselves as higher functioning than female patients. The scale measuring physical disability was not associated with patient/caregiver discrepancies, except for LoER, with family members’ judgments of greater severity correlated with lower functional scores. Conclusions: Notable gaps emerged between subjective and family perceptions, particularly in motivation and social skills. The discrepancies were associated with sex differences. LDS is a promising tool for examining patient/caregiver discrepancies in patients with ABI.