Executive function and metacognitive self-awareness after Severe Traumatic Brain Injury

Abstract

The objective of this study is to identify the clinical, neuropsychological, neuropsychiatric, and functional variables that correlate with metacognitive self-awareness (SA) in severe traumatic brain injury (TBI) outpatients and to assess the influence of the same variables on the sensory-motor, cognitive, and behavioral-affective indicators of SA. This cross-sectional observational study evaluated 37 outpatients from May 2006 to June 2007 in a neurorehabilitation hospital on the basis of the following inclusion criteria: (1) age Ն 15 years; (2) diagnosis of severe TBI (Glasgow Coma Scale, GCS Յ 8); (3) posttraumatic amnesia (PTA) resolution; (4) capacity to undergo formal psychometric evaluation despite cognitive and sensory-motor deficits; (5) absence of aphasia; (6) availability of informed consent. A neuropsychological battery was used to evaluate attention, memory, and executive functions. SA was assessed by the awareness questionnaire (AQ), administered to both patients and relatives. Decreased metacognitive self-awareness is significantly correlated with increased problems in some components of executive system, even when the AQ subscales were considered separately. The significant correlation found between some components of executive system and metacognitive self-awareness confirmed the importance of addressing this issue to treat SA contextually in the rehabilitation of executive functions. (JINS, 2008, 14, 862-868.)

Predictors of performance monitoring abilities following traumatic brain injury: The influence of negative affect and cognitive sequelae

“…Such awareness abilities are often correlated with executive functions (e.g., Bivona et al, 2008). Current results generally support the idea that Pe amplitude is associated with cognitive processing abilities and may indicate that Pe amplitude could serve as an index of cognitive impairment following TBI.…”

Assessment of impulsivity after moderate to severe traumatic brain injury

“…Indeed, lack of insight/self-awareness is frequently described after TBI, in particular in patients with executive disturbances (e.g., Bivona et al, 2008). Interestingly, although the correlation analysis indicated that there is some inter-observer agreement on individual differences within the group, self-report versus informant-report comparisons showed that patients tend to underestimate their impulsivity.…”

Anosognosia and self-correction of naming errors in aphasia

“…Finally, we examined the role of executive functioning in performance on the two measures of awareness. Metacognitive awareness (in domains of cognition other than language) has typically been described as conscious (McGlynn & Schacter, 1989;Koriat, 2007) and dependent on executive functioning (Bivona et al, 2008;Goverover et al, 2014;Shimamura, 2000). An association between tests of metacognitive awareness and tests of executive function has not, however, been clearly established by experimental studies (e.g., Gasquoine, 2016).…”