Metacognitive unawareness correlates with executive function impairment after severe traumatic brain injury

Abstract

A neuropsychological battery was used to evaluate attention, memory and executive functions. SA was assessed by the PCRS, which was administered to patients and close family members. Patients were divided into two groups representing those with and without SA. Patients with poor SA had more problems than those with good SA in some components of the executive system, as indicated by the high percentage of perseverative errors and responses they made on the Wisconsin Card Sorting Test. Moreover, a decrease in metacognitive SA correlated significantly with time to follow commands (TFC). This study suggests the importance of integrating an overall assessment of cognitive functions with a specific evaluation of SA to treat self-awareness and executive functions together during the rehabilitation process.

Metamemory following childhood brain injury: A consequence of executive impairment

“…In accordance with previous findings in adults (e.g., Bogod et al, 2003;Ciurli et al, 2010;Morton & Barker, 2010), statistical analyses carried out on the memory selfawareness measure indicate that children with TBI who have a reduced level of executive functioning seem to underestimate the frequency of their memory problems (impaired selfawareness), while those with preserved executive functions appear to understand their own memory functioning as accurately as control children. As with knowledge of memory tasks and strategies, our results seem to confirm that high-level cognitive functions are involved in children's perception and understanding of their own memory strengths and limitations.…”

“…In accordance with previous findings in adults (e.g., Ciurli et al, 2010;Morton & Barker, 2010), the second aim of this research was to explore whether differences in executive impairment can influence the accuracy of the representations that children have of their own memory functioning after a TBI. For this purpose, a one-way ANOVA was carried out to compare the two TBI groups (TBI-High vs. TBI-Low) on the self-other discrepancy score for the memory questionnaire.…”

“…This hypothesis is supported by several neuropsychological studies carried out on adult patients with TBI that highlighted significant (negative) correlations between patients' level of executive functioning and both types of metamemory measures. Specifically, the results of these studies indicated that patients with poor executive functioning underestimate the frequency of their deficits and demonstrate less general knowledge of memory tasks and strategies than patients with good executive functioning (Bivona et al, 2008;Bogod et al, 2003;Ciurli et al, 2010;Morton & Barker, 2010;Ownsworth et al, 2002). Surprisingly however, despite the obvious clinical and theoretical value of this "executive" hypothesis and the fact that its corroboration could improve memory rehabilitation programs, few studies have examined this question from a developmental perspective.…”

Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment in acceptance-based therapies: A conceptual review

“…Impaired self-awareness has a complex, multifaceted relationship with the recovery process after TBI involving neurocognitive, psychological and socio-environmental factors (Ownsworth, Clare, & Morris, 2006;Ownsworth et al, 2007;Prigatano, 2005;Toglia & Kirk, 2000). A positive relationship has been established between impaired cognitive flexibility and impaired self-awareness using a range of self-awareness measures and neuropsychological tests of cognitive flexibility (Bivona et al, 2008;Bogod, Mateer, & Macdonald, 2003;Ciurli et al, 2010;Trudel, Tryon, & Purdum, 1998). This association between cognitive flexibility and self-awareness appears noteworthy and will be discussed further in the section, "Implications for psychological treatment after TBI".…”

Quality of life after traumatic brain injury: The clinical use of the QOLIBRI, a novel disease-specific instrument

“…For example, anosognosia can be measured by the PCRS [102] or by comparing the patient's and the significant other's responses or to the pre-traumatic situation [103][104][105]. This was done in the French, German and Italian samples.…”