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Informant Report of Financial Capacity for Individuals With Chronic Acquired Brain Injury

An Assessment of Informant Accuracy

Sunderaraman, Preeti, PhD; Cosentino, Stephanie, PhD; Lindgren, Karen, PhD; James, Angela, BA; Schultheis, Maria, PhD

The Journal of Head Trauma Rehabilitation: November/December 2018 - Volume 33 - Issue 6 - p E85–E94
doi: 10.1097/HTR.0000000000000382
Focus on Clinical Research and Practice

Objective: Primarily, to investigate the association between informant report and objective performance on specific financial capacity (FC) tasks by adults with chronic, moderate to severe acquired brain injury, and to examine the nature of misestimates by the informants.

Design: Cross-sectional design.

Setting: A postacute, community-based rehabilitation center.

Participants: Data were obtained from 22 chronic acquired brain injury (CABI) adults, mean age of 46.6 years (SD = 8.67), mean years of education of 13.45 years (SD = 2.15), with moderate to severe acquired brain injury (86% had traumatic brain injury), with a mean postinjury period of 17.14 years (SD = 9.5). Whereas the CABI adults completed the Financial Competence Assessment Inventory interview—a combination of self-report and performance-based assessment, 22 informants completed a specifically designed parallel version of the interview.

Results: Pearson correlations and 1-sample t tests based on the discrepancy scores between informant report and CABI group's performance were used. The CABI group's performance was not associated with its informant's perceptions. One-sample t tests revealed that informants both underestimated and overestimated CABI group's performance.

Conclusions: Results indicate lack of correspondence between self- and informant ratings. Further investigation revealed that misestimations by informants occurred in contrary directions with CABI adults' performance being inaccurately rated. These findings raise critical issues related to assuming that the informant report can be used as a “gold standard” for collecting functional data related to financial management, and the idea that obtaining objective data on financial tasks may represent a more valid method of assessing financial competency in adults with brain injury.

Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the G. H. Sergievsky Center (Drs Sunderaraman and Cosentino) and Department of Neurology (Dr Cosentino), Columbia University Medical Center, New York City, New York; Bancroft Brain Injury Services, Cherry Hill, New Jersey (Dr Lindgren); and Psychology Department, Drexel University, Philadelphia, Pennsylvania (Ms James and Dr Schultheis).

Corresponding Author: Preeti Sunderaraman, PhD, Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the G. H. Sergievsky Center, Columbia University Medical Center, 630 West 168th St, P&S Box 16, New York City, NY 10032 ( or

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The authors declare no conflicts of interest.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.