Neuropsychology of self-awareness in young adults

Self-caught methodologies for measuring mind wandering with meta-awareness: A systematic review

Mind wandering, also known as task-unrelated thought, refers to the drift of attention from a focal task or train of thought. Because self-caught measures of mind wandering require participants to spontaneously indicate when they notice their attention drift, self-caught methodologies provide a way to measure mind wandering with meta-awareness. Given the proposed role of meta-awareness in mental health and psychological interventions, an overview of existing self-caught methodologies would help clinicians and researchers make informed decisions when choosing or adapting a mind wandering or meta-awareness measure. This systematic review included 39 studies after 790 studies were assessed for eligibility. All studies operationalised mind wandering as instances of attention drift from a primary task. Three types of primary task were identified: (1) tasks adapted from computerised continuous performance tests (CPT) of sustained attention, (2) tasks involving focusing on the breath or a stream of aural beats, akin to in-vivo mindfulness meditation, (3) tasks involving an everyday life activity such as reading. Although data on mind wandering without meta-awareness (e.g., measured with probe-caught measures) was also obtained in many studies, such data was not always used in conjunction with self-caught mind wandering data to determine level of mind wandering meta-awareness. Few studies reported both reliability and validity of the measures used. This review shows that considerable methodological heterogeneity exists in the literature. Methodological variants of self-caught mind wandering methodologies are documented and examined, and suggestions for future research and clinical work are suggested.

Impaired awareness: Why people with multiple sclerosis continue using cannabis despite evidence to the contrary

BACKGROUND

With widespread moves toward legalization of cannabis, increasing numbers of people with multiple sclerosis (pwMS) are using the drug. Emerging MS-related data show that cannabis can cause or exacerbate cognitive dysfunction.

OBJECTIVE

To understand why people with MS continue using cannabis despite adverse cognitive consequences. It was hypothesized that lack of awareness, a component of metacognition, could explain this decision, in part.

METHOD

Forty pwMS who smoked cannabis almost daily were assigned by odd-even case number selection to either a cannabis continuation (CC) or cannabis withdrawal (CW) group. Both groups were followed for 28 days. All participants completed, at baseline and day 28, the brief repeatable battery of neuropsychological tests (BRNB) in MS for measures of processing speed, memory and executive function; Modified fatigue impact scale (mFIS) for self-report indices of cognitive functioning.

RESULTS

No significant baseline differences between the groups on the BRNB and mFIS. At day 28, significant improvement within group was seen on all measures of the BRNB, but only in the CW group (p = .0001 for all indices). A repeat measure ANOVA did not find any significant group (CC vs. CW) × time (baseline and day 28) interactions for the self-report cognitive measures on the mFIS. Cannabis abstainers did report less ability to function away from home. All 19 participants in the CW group reverted to using cannabis on study completion despite being informed individually of their cognitive improvement.

CONCLUSIONS AND RELEVANCE

The inability of pwMS to accurately appraise their memory and executive function can help explain, in part, why they continue to smoke cannabis despite objective evidence of the deleterious cognitive side effects of this behavior.

Patient Competency Rating Scale-Brazilian Revised Version (PCRS-R-BR): Normative and Psychometric Data in 154 Healthy Individuals

Background Patient Competency Rating Scale (PCRS-R-BR) is a clinical tool to evaluate the degree of competence in cognitive skills perceived by patients with brain injuries. However, no studies have investigated the influence of sociodemographic variables on self-report and self-awareness of healthy individuals.Aim This study aimed to (1) present normative data from the PCRS-R-BR in a healthy adult Brazilian sample; and (2) investigate psychometric properties of the scaleMethod One hundred and fifty-four adults that were divided in three age groups and two education groups and their informants completed the PCRS-R-BR.Results Score on the PCRS-R-BR Patient's Form differed as a function of age with younger adults reporting less competency than older individuals. An education effect was found on Attention/Working memory Factor on the Informant's PCRS-R-BR with informants of higher education adults reporting better competency than lower education individuals. A gender effect was observed on the Informant's Form. The Informant's Form scores of informants of women were higher than the scores provided by the informants of men. PCRS-R-BR showed adequate consistency coefficients and six factors.Conclusion PCRS-R-BR scores showed acceptable validity evidence and provides information regarding how age and gender effects may influence ratings in a Brazilian sample.

Pre-injury assessment of everyday executive function in moderate to severe traumatic brain injury

Executive dysfunction is frequently observed in moderate to severe traumatic brain injury (TBI) and is commonly assessed with objective measures or subjective rating scales. Given the variability in executive function in the normal population, a reliable measure of pre-injury executive function would be of considerable value. In this study we examined pre-injury self and collateral (relative or friend) ratings on the Frontal Systems Behavior Rating Scale (FrSBe). Fifty-one persons with moderate to severe TBI and their collaterals provided before- and after-TBI ratings at 3 months post injury. A subset of 36 dyads were retested at 6 and 12 months; 26 neurologically intact controls and their collaterals also provided FrSBe ratings. At 3 months post injury, the difference between patient and collateral ratings of current status was larger than the difference relating to premorbid status, suggesting that patients were able to rate themselves from a pre-injury perspective. However, pre-injury ratings from collaterals were more reliable over time compared with patients' self-ratings. For all sets of ratings - before injury, after injury, and status of healthy controls - collateral ratings indicated more abnormality, overall, than comparable self-ratings. Evaluating one's own executive behaviour may be a difficult task even without TBI, with the difficulty exacerbated by the effects of injury.

Self-reported measures of mindfulness in meditators and non-meditators: A cross-sectional study

Context:

Mindfulness forms an important component of meditation practice and has been increasingly popular around the world. There has been growing interest in studying the mindful component of various meditation techniques. One of the various forms of mindfulness is the practice of a unique technique called cyclic mediation (CM). We aimed at ascertaining the level of mindfulness in experienced practitioners of CM using a Mindfulness Attention Awareness Scale (MAAS).

Materials and Methods:

MAAS was administered anonymously in a classroom setup and two of the project coordinators were present to supervise the administration and to assist the participants where necessary. We executed a cross sectional design. One hundred and thirty-three (n = 133) healthy male volunteers (66 meditators and 67 non-meditators) with ages ranging from 25 to 35 years participated in the study. Meditators had a minimum 3 years experience of meditation.

Results:

Data were analyzed using IBM SPSS 20. The data were checked for normality and an independent samples t-test was employed to compare the means of both the groups. MAAS scores were significantly higher in meditators as compared with the non-meditators (P < 0.001). We found a positive correlation (r = 0.620) between the years of meditation practice and the levels of trait mindfulness.

Conclusions:

CM can lead to development of higher levels of mindfulness and may have the ability to positively impact mental states and attention, thereby offering the potential for prevention of clinical levels of psychopathology and improving overall psychological well-being in healthy individuals.

Preliminary validation of the Spanish version of the Frontal Systems Behavior Scale (FrSBe) using Rasch analysis

PRIMARY OBJECTIVE

To explore the construct validity of the Spanish version of the Frontal Systems Behavioral Scale (FrSBe) using Rasch modelling.

METHODS

Item responses of 245 Spanish subjects were analysed using Rasch analysis: self-rating of 65 participants with TBI or stroke (sample A), family-rating of the same 65 participants (sample B) and self-rating of 115 healthy individuals (sample C).

RESULTS

After removing or grouping several problematic items, the Apathy and the Executive Dysfunction sub-scales were found to be valid measures for samples A and B and the Disinhibition sub-scale was valid for samples B and C. Person Separation Index of reliability of sub-scales was greater than 0.83 for sample B and ∼0.72 for A and C. All items showed disordered threshold categories in samples A and B and five items were ordered in sample C.

CONCLUSIONS

With a few modifications, the sub-scales of the FrSBe-Spanish version are adequate measures for the assessment of the behavioural syndromes derived from frontal systems dysfunction in persons with brain injury. The family-rating form is preferable to the self-rating form. Only the Disinhibition scale is a valid measure for the behavioural assessment of the normal population. A reduction of response categories is suggested.

Ecologically valid assessment of executive dysfunction using a novel virtual reality task in patients with acquired brain injury

The current investigation sought to further establish the psychometric properties and ecological validity of the Multitasking in the City Test (MCT) in a clinical population. Ecological validity was addressed via correlational analyses between performance on this test and a subjective measure of everyday executive functioning (Frontal Systems Behavior Scale; FrSBe). The sample was composed of 13 individuals (11 males) who suffered a stroke or traumatic brain injury. A neuropsychological test battery consisting of the MCT and common executive and nonexecutive measures was administered. The only executive function tests that were significantly related to the FrSBe were the MCT and a semantic fluency test. Compared with a sample of normal participants, the patient group produced better plans but completed fewer tasks on the MCT. Patients made similar types of errors as normals, although some of these errors occurred more frequently in the patient sample. This study demonstrated the ecological validity of the MCT and suggested that patients can be differentiated from healthy individuals by quantitative (i.e., number of errors) rather than qualitative (i.e., type of errors) aspects of performance. Further interpretation of MCT performance and comparison with existing executive function tests is discussed.

Factors contributing to impaired self-awareness of cognitive functioning in an HIV positive and at-risk population

PURPOSE

To examine the association between self-awareness of cognitive impairment and age, selected mood disorders, and type and severity of cognitive impairment in a sample of individuals with HIV/AIDS and at risk for HIV.

METHOD

75 subjects, 52 HIV+ and 23 at risk for HIV completed a psychosocial interview, the Patient's Assessment of Own Functioning (PAOF) questionnaire, and a battery of neuropsychological tests. Based upon the differences between their clinical impairment and self-reported impairment, subjects were classified as being "Underestimators", "Good Awareness", or "Impaired Awareness" with regard to self-awareness.

RESULTS

Those with more severe cognitive impairment were less aware than those with normal or borderline cognitive impairment. A one-way ANOVA suggested that the Impaired Awareness group differed significantly from the Underestimators on the Rey Figure Immediate and Delayed Recall tasks, and from both the Underestimators and Good Awarenesss groups on the Digit Symbol Substitution Task. There were significant differences among all awareness groups on the test of Simple Reaction Time. Furthermore there is some suggestion that age may contribute to impaired self-awareness. The role of HIV in self-awareness remains unclear, as both, individuals with HIV and at risk, demonstrated impaired self-awareness.

CONCLUSIONS

Overall, impaired awareness was associated with poorer test performance, suggesting a relationship between awareness and sustained complex attention and visual spatial processing. This research has implications for understanding factors contributing to poor awareness among individuals with cognitive impairment.

Metacognition in animals

Metacognition is thinking about thinking. There is considerable interest in developing animal models of metacognition to provide insight about the evolution of mind and a basis for investigating neurobiological mechanisms of cognitive impairments in people. Formal modeling of low-level (i.e., alternative) mechanisms has recently demonstrated that prevailing standards for documenting metacognition are inadequate. Indeed, low-level mechanisms are sufficient to explain data from existing methods. Consequently, an assessment of what is 'lost' (in terms of existing methods and data) necessitates the development of new, innovative methods for metacognition. Development of new methods may prompt the establishment of new standards for documenting metacognition.