Neuropsychological assessment techniques as a means to modify denial of cognitive deficits in brain injured individuals

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Paul H. Blaney - Committee Chair

Second Committee Member

Perry C. Goldstein - Committee Member


Thirty-six subjects, 18 experimental and 18 control, participated in a study examining the effects of the feedback component of neuropsychological assessment, using a computerized cognitive retraining task, on the expression of denial and emotional distress. Subjects had documented brain injuries due to cerebrovascular accidents or closed head injuries. Denial was measured in a number of different ways: (1) difference scores between staff and subject ratings of ability to function on two psychosocial measures; (2) the MMPI K-scale; (3) difference scores between experimental subject's estimated and actual reaction time on a computerized reaction time test; and (4) experimental subject's indirect denial language in response to the experimental treatment. Pretreatment and posttreatment measures of denial and emotional distress were obtained. Groups were found to be comparable on all demographic measures, as well as on type of injury, hemisphere of injury, and level of neuropsychological impairment. No significant differences were found between experimental and control groups, or between measurement periods, on level of denial or level of reported emotional distress. However, as hypothesized, denial was generally found to be inversely related to the level of emotional distress. Other significant findings included: (1) positive correlations between the level of denial and level of neuropsychological impairment; (2) support for the importance of external raters in the judgement of subject's ability to function, i.e. staff ratings were significantly correlated with average neuropsychological impairment, whereas subject ratings were not; and (3) the finding that no significant differences in denial or expressed emotional distress was found between those with predominantly right hemisphere injuries and those with predominantly left hemisphere injuries.


Psychology, Clinical

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