‘She might have what I have got’: The potential utility of vignettes as an indirect measure of awareness in early-stage dementia

Clare, Linda; Nelis, Sharon M.; Martyr, Anthony; Whitaker, Christopher J.; Marková, Ivana; Roth, Ilona; Woods, Bob; Morris, Robin G.

doi:10.1080/13607863.2011.652594

Cited by 20 publications

(35 citation statements)

References 30 publications

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“…Unawareness of illness or its consequences, such as the cognitive or behavioural changes, is a common feature of AD [12,13], and it is plausible that stimuli about AD would produce a greater emotional reaction only in those with preserved awareness and who identify with the content of the material. Indeed, in connection with this, it has been shown that people with AD who have greater awareness of their own illness are more likely to provide appropriate advice when attempting problem solving vignettes concerning dementia [14]. Alternatively, it has been suggested that reactivity to illness material can be driven by implicit processing of information, bypassing explicit awareness of the effects of dementia [12,15].…”

mentioning

confidence: 99%

Emotional Reactivity to Film Material in Alzheimer’s Disease

Mograbi

Brown²,

Morris³

2012

Dement Geriatr Cogn Disord

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Aims: To explore emotional reactivity in mild to moderate Alzheimer’s disease (AD) using film material, investigating the influence of dementia-related material and awareness of condition. Methods: Twenty-two patients with AD and 21 healthy older adults viewed films with positive, neutral or negative content, including a film about dementia. Reactivity was measured through a self-report questionnaire and filming of facial expressions. Awareness of condition was assessed contrasting patients’ versus informants’ versions of an anosognosia questionnaire. Results: The AD patients showed reduced self-reported reactivity to negative films, but exhibited a pattern of facial responses similar to controls for all films. Awareness was associated with frequency of negative facial expressions during the dementia film. Conclusions: AD patients may have impairments in self-reported reactivity to negative stimuli. Awareness may mediate responses to dementia-related material.

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mentioning

confidence: 99%

Emotional Reactivity to Film Material in Alzheimer’s Disease

Mograbi

Brown²,

Morris³

2012

Dement Geriatr Cogn Disord

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“…These findings were interpreted by the authors as the poor ability of people with AD to put themselves in someone else’s position. The authors explained that the different findings between their results and Clare et al (2012a) were attributable to methodological differences. Indeed, in Mograbi et al (2014), the cognitive demand of the task, where participants had to imagine themselves as someone else, was higher than in Clare et al (2012a), in which patients did have access to written vignettes.…”

Section: Relationship Between Metacognition and Perspective-takingmentioning

confidence: 86%

“…The authors explained that the different findings between their results and Clare et al (2012a) were attributable to methodological differences. Indeed, in Mograbi et al (2014), the cognitive demand of the task, where participants had to imagine themselves as someone else, was higher than in Clare et al (2012a), in which patients did have access to written vignettes. Altogether, these results suggest that patients with AD are more accurate when evaluating the performance of someone else (e.g., caregiver or fictional person) than they are for themselves.…”

Section: Relationship Between Metacognition and Perspective-takingmentioning

confidence: 86%

“…Using a vignette technique as an indirect method to assess awareness, Clare et al (2012a) explored the ability of PwD (including AD, vascular dementia and mixed Alzheimer’s and vascular dementia) to appreciate the deficits of a fictional person. PwD, their caregivers, and older adult controls were asked to identify and offer advice for the problems that were described in the vignettes.…”

Section: Relationship Between Metacognition and Perspective-takingmentioning

confidence: 99%

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Metacognition and Perspective-Taking in Alzheimer’s Disease: A Mini-Review

2016

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Metacognition refers to the monitoring and regulation of cognitive processes and its impairment can lead to a lack of self-awareness of deficits, or anosognosia. In the context of different neurological and psychiatric disorders (e.g., traumatic brain injury, dementia, and schizophrenia), studies have shown that patients who present impairments in metacognitive abilities may be able to recognize such difficulties in others and in themselves when exposed to material in a third-person perspective. Considering that metacognitive impairments are an important characteristic of dementia, especially in Alzheimer’s Disease (AD), studies of the relationship between metacognition and perspective-taking may be relevant to improve the quality of life of people with dementia. The current paper first briefly addresses the theme of metacognition and the impact of metacognitive deficits in people with AD. The focus then turns to the relationship between metacognition and perspective-taking in different neurological and psychiatric disorders, particularly AD. This relationship is also discussed based on theoretical models, particularly the Cognitive Awareness Model (CAM). Specifically, the CAM suggests the existence of distinct memory systems for self- and other-information, an idea which is supported by neuroimaging findings. We suggest that the Default Mode Network, as it has been shown to be implicated in self vs. other processing and is affected early in AD, could explain the impact of perspective-taking on awareness of deficits in AD. Finally, we present possible clinical implications of the relationship between metacognition and perspective-taking in AD. Indeed, we considered the possibility of improving patient’s awareness through the use of a third-person perspective, which, consequently, may decrease the negative impacts of anosognosia in AD.

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“…Using a vignette technique as an indirect method to assess awareness, Clare et al (2012) explored the ability of PwD (including AD, vascular dementia and mixed Alzheimer's and vascular dementia) to appreciate the deficits of a fictional person. PwD, their caregivers, and older adult controls were asked to identify and offer advice for the problems that were described in the vignettes.…”

Section: Metacognition and Perspective-taking In The Context Of Admentioning

confidence: 99%

Anosognosia, Mood and Perspective-Taking in Mild to Moderate Alzheimer S Disease

BERTRAND¹

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Ao meu co-orientador, Professor Daniel Mograbi. Estou profundamente grata por você ter confiado em mim e por ter me dado à oportunidade de realizar esse trabalho. Foi uma honra poder ter sido a sua primeira aluna de doutorado. Obrigada por ter me passado sua paixão pela pesquisa. Obrigada também pela qualidade da sua orientação, pelos seus conselhos e seu apoio ao longo dessa jornada. I am grateful to Professor Robin Morris for having provided the major theoretical framework on which this work has been built. Thank you for your collaboration. Aos Professores Jerson Laks e Marcia Dourado, pela colaboração e por ter me abrindo as portas do Centro da Doença do Alzheimer no IPUB (UFRJ). I would like to thank Professor Stephanie Cosentino for kindly welcoming me in her lab. Thank you for having always your door open, our exchanges have usefully nourished this work. A very special thanks to my labmates at the Taub Institute: Silvia, Martina, Preeti and Sara, for their friendship. Our personal and professional discussions made this work richer. A CAPES, pelo apoio financeiro. Aos meus colegas na PUC-Rio e todos os membros do Mograbilab. Ticiana, obrigada pela ajuda com a coleta de dados. Rodrigo, obrigada pelo seu apoio e sua amizade na reta final desse trabalho. Carol, a minha grande amiga, estou grata por ter tido você de meu lado, que seja no Brasil ou um pouquinho mais longe. A todos os funcionários do Departamento de Psicologia, especialmente Marcelina e Vera, pela grande ajuda. A todos os participantes dessa pesquisa, especialmente a todos os pacientes e seus cuidadores. Estou muito grata por ter aprendido tanto trabalhando com vocês. Aos meus sogros, Angela, Paulo José e Denise, às minhas cunhadas, Paula e Carolina, aos meus concunhados, Joel e Romulo, e a Catarina e Marco. Obrigada por ter me acolhido no Brasil com tanto carinho.

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‘She might have what I have got’: The potential utility of vignettes as an indirect measure of awareness in early-stage dementia

Cited by 20 publications

References 30 publications

Emotional Reactivity to Film Material in Alzheimer’s Disease

Emotional Reactivity to Film Material in Alzheimer’s Disease

Metacognition and Perspective-Taking in Alzheimer’s Disease: A Mini-Review

Anosognosia, Mood and Perspective-Taking in Mild to Moderate Alzheimer S Disease

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