The aim of this study was to investigate cognitive and emotional factors associated with the presence and clinical course of confabulation.24 confabulating participants were compared with 11 brain injured and 6 healthy controls on measures of temporal context confusions, mood state (elation, depression) and lack of insight.Measures of autobiographical memory and executive function were also available. Changes in confabulation and these other measures were monitored over 9 months in the confabulating group.We found that temporal context confusions were more common in confabulating patients than in healthy controls, and that the decline in these errors paralleled the recovery from confabulation.However, temporal context confusions were not specific to the presence of confabulation in brain injury; and their decline was not correlated with change in confabulation scores over 9 months.We found that elated mood and lack of insight discriminated between confabulating and nonconfabulating patients, but these measures did not correlate with either the severity of confabulation or change in confabulation scores through time. What seems to have been most strongly associated with the severity of confabulation scores at 'baseline' and changes through time (over 9 months) were the severity of memory impairment (especially on autobiographical memory) and errors on executive tests (particularly in making cognitive estimates). Greater autobiographical memory and executive impairment were associated with more severe confabulation.The findings were consistent with the view that confabulation results from executive dysfunction where autobiographical memory is also impaired; and that it resolves as these impairments subside.

There is disagreement regarding the underlying basis of confabulation and, in particular, whether emotional mechanisms influence the presence or the content of confabulations. In this study, we have examined the emotional content of confabulations and "true" memories given by 24 memory-disordered patients on two autobiographical memory tasks. Two judges made pleasant/neutral/unpleasant ratings. Although many of the "memories" were evaluated as "neutral", there was an enhanced level of statements rated as having affective content (either pleasant or unpleasant) amongst these patients' confabulations, compared with their "true" memories. This affective bias was present irrespective of whether patients had suffered focal pathology extending to the ventro-medial frontal cortex (VMFC) or other pathology. There was also a correlation between participants' self-evaluated mood-states and both true and false memories' affective content, suggestive of a mood congruency effect in both types of memory. In summary, there was an enhanced tendency to produce memories with affective content (pleasant and unpleasant) amongst confabulations (whether or not there was VMFC pathology). The affective content of both confabulations and true memories produced may relate, in part, to an individual's current mood-state.

Patient characteristics may well determine individual benefits from particular rehabilitation programmes. However, few studies have attempted to provide evidence about this. As health provision focuses on needs-led services, it becomes paramount to investigate effectiveness from the client's perspective.

Functional Independence Measure + Functional Assessment Measure (FIM+ FAM) measures were taken for 38 clients on admission to and at discharge from an inpatient rehabilitatio n unit for people with cognitive and behavioural problems following acquired, single incident, brain injury. Over the course of the admission there was a significant improvement in FAM scores and cognitive and social items of the FIM+FAM. These improvements were not related to the amount of time elapsed between injury and admission to the rehabilitatio n unit. There was no significant change in FIM scores and neurophysical items of the FIM+FAM. Ceiling effects appear to have limited the scope for some of the FIM scales to detect change.