Awareness of memory loss after severe closed-head injury.

This study investigated unawareness of memory loss in 48 severe closed-head injury patients. Awareness was measured as the correlation of patients' memory test scores with their self-ratings on the Everyday Memory Questionnaire (EMQ). Patients who endorsed atypical memory failures on the EMQ were classified as invalid responders. Invalid responders had poorer memory test performances and a higher rate of focal left hemispheric lesions, but did not report greater emotional symptoms. Correlations between memory test scores and memory self-ratings were weaker among invalid responders or those classified as depressed, and stronger among valid responders, especially those classified as non-depressed. The results indicate that the validity of memory self-reports is influenced by both neurogenic and psychogenic factors, and suggest that invalid responding is an important problem with self-reports by brain-injured patients.