Diagnosis of developmental or congenital prosopagnosia (CP) involves self-report of everyday face recognition difficulties, which are corroborated with poor performance on behavioural tests. This approach requires accurate self-evaluation. We examine the extent to which typical adults have insight into their face recognition abilities across four experiments involving nearly 300 participants. The experiments used five tests of face recognition ability: two that tap into the ability to learn and recognize previously unfamiliar faces [the Cambridge Face Memory Test, CFMT; Duchaine, B., & Nakayama, K. (2006). The Cambridge Face Memory Test: Results for neurologically intact individuals and an investigation of its validity using inverted face stimuli and prosopagnosic participants. Neuropsychologia, 44(4), 576–585. doi:10.1016/j.neuropsychologia.2005.07.001; and a newly devised test based on the CFMT but where the study phases involve watching short movies rather than viewing static faces—the CFMT-Films] and three that tap face matching [Benton Facial Recognition Test, BFRT; Benton, A., Sivan, A., Hamsher, K., Varney, N., & Spreen, O. (1983). Contribution to neuropsychological assessment. New York: Oxford University Press; and two recently devised sequential face matching tests]. Self-reported ability was measured with the 15-item Kennerknecht et al. questionnaire [Kennerknecht, I., Ho, N. Y., & Wong, V. C. (2008). Prevalence of hereditary prosopagnosia (HPA) in Hong Kong Chinese population. American Journal of Medical Genetics Part A, 146A(22), 2863–2870. doi:10.1002/ajmg.a.32552]; two single-item questions assessing face recognition ability; and a new 77-item meta-cognition questionnaire. Overall, we find that adults with typical face recognition abilities have only modest insight into their ability to recognize faces on behavioural tests. In a fifth experiment, we assess self-reported face recognition ability in people with CP and find that some people who expect to perform poorly on behavioural tests of face recognition do indeed perform poorly. However, it is not yet clear whether individuals within this group of poor performers have greater levels of insight (i.e., into their degree of impairment) than those with more typical levels of performance.
The Benton Facial Recognition Test (BFRT) and Cambridge Face Memory Test (CFMT) are two of the most common tests used to assess face discrimination and recognition abilities and to identify individuals with prosopagnosia. However, recent studies highlighted that participant-stimulus match ethnicity, as much as gender, has to be taken into account in interpreting results from these tests. Here, in order to obtain more appropriate normative data for an Italian sample, the CFMT and BFRT were administered to a large cohort of young adults. We found that scores from the BFRT are not affected by participants' gender and are only slightly affected by participant-stimulus ethnicity match, whereas both these factors seem to influence the scores of the CFMT. Moreover, the inclusion of a sample of individuals with suspected face recognition impairment allowed us to show that the use of more appropriate normative data can increase the BFRT efficacy in identifying individuals with face discrimination impairments; by contrast, the efficacy of the CFMT in classifying individuals with a face recognition deficit was confirmed. Finally, our data show that the lack of inversion effect (the difference between the total score of the upright and inverted versions of the CFMT) could be used as further index to assess congenital prosopagnosia. Overall, our results confirm the importance of having norms derived from controls with a similar experience of faces as the "potential" prosopagnosic individuals when assessing face recognition abilities.
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