Children and adolescents with traumatic brain injury (TBI) can experience impaired self-awareness, or difficulty in accurately perceiving their personal abilities. This study aimed to identify the neuro-developmental and socio-environmental factors associated with self-awareness impairment and determine how self-awareness is associated with psychosocial functioning. Parents and their children age 8–16 years with TBI (n = 107, 65.4% male, mean [M] age = 12.66 years, standard deviation [SD] = 2.6 years) were consecutively recruited from an outpatient clinic over a 4-year period. Children completed the Paediatric Awareness Questionnaire (PAQ) to report their functional abilities, and the Beck Youth Inventories to report their self-concept, and anxiety and depression symptoms. Parents completed the PAQ and measures of family functioning, parenting style, and children's emotional and behavioral problems. Self-awareness impairments were defined as more negative parent-child discrepancy scores on the PAQ. Younger age at injury, more severe injury, and more family dysfunction were significantly associated with poorer self-awareness. Poorer self-awareness was associated with worse parent-rated child adaptive functioning and emotional and behavioral problems. However, poorer self-awareness was also significantly associated with more positive self-concept and fewer symptoms of depression and anxiety as rated by children. Overall, impaired self-awareness seems to be both a liability and a benefit depending on the reporter (parent or child) and outcome of interest (adaptive function/behavior or self-concept/mood).

中文翻译：

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小儿脑外伤后自我意识受损：保护因素还是责任？

患有创伤性脑损伤 (TBI) 的儿童和青少年可能会出现自我意识受损或难以准确感知个人能力的情况。本研究旨在确定与自我意识障碍相关的神经发育和社会环境因素，并确定自我意识如何与心理社会功能相关联。患有 TBI 的父母及其 8-16 岁的孩子（n = 107，65.4% 男性，平均 [M] 年龄 = 12.66 岁，标准差 [SD] = 2.6 岁）在 4 年内连续从门诊招募。儿童完成了儿科意识问卷 (PAQ) 以报告他们的功能能力，并完成贝克青年清单以报告他们的自我概念、焦虑和抑郁症状。父母完成了 PAQ 和家庭功能、养育方式以及儿童情绪和行为问题的测量。自我意识障碍被定义为 PAQ 上更负的亲子差异分数。受伤年龄越小、受伤越严重和家庭功能障碍越多，与较差的自我意识显着相关。较差的自我意识与较差的父母评定的儿童适应功能以及情绪和行为问题有关。然而，更差的自我意识也与更积极的自我概念和更少的抑郁和焦虑症状显着相关。总体而言，受损的自我意识似乎既是一种责任，也是一种好处，这取决于报告者（父母或孩子）和感兴趣的结果（适应性功能/行为或自我概念/情绪）。