Benefits of Order: The Influence of Item Sequencing on Metacognition in Moderate and Severe Traumatic Brain Injury

Abstract

<jats:title>Abstract</jats:title><jats:p>The ability to appraise one's own ability has been found to have an important role in the recovery and quality of life of clinical populations. Examinee and task variables have been found to influence metacognition in healthy students; however the effect of these variables on the metacognitive accuracy of adults with neurological insult, such as traumatic brain injury (TBI), remains unknown. Twenty-two adults with moderate and severe TBI and a matched sample of healthy adults participated in this study examining the influence of item sequencing on metacognitive functioning. Retrospective confidence judgments were collected while participants completed a modified version of the Matrix Reasoning subtest. Significant influence of item sequence order was found, revealing better metacognitive abilities and performance when participants completed tasks where item difficulty progressed in order from easy to difficult. We interpret these findings to suggest that the sequencing of item difficulty offers “anchors” for gauging and adjusting to task demands. (<jats:italic>JINS</jats:italic>, 2012,<jats:italic>18</jats:italic>, 379–383)</jats:p>

Enhanced default mode connectivity predicts metacognitive accuracy in traumatic brain injury.

“…As a final caveat, our task manipulation for obtaining a value of metacognitive accuracy removes difficulty anchors, creating a task that is more sensitive to metacognitive deficits (Chiou et al, 2012; Grossner et al, 2018). We did not see this same association between network connectivity and metacognition using the “ordered” version of the matrix reasoning task, where the design of the task is retained and item difficulty increases incrementally over the course of the task ( p s > .342).…”

“…Each participant received both versions of this task, and the administration was counterbalanced across subjects to eliminate ordering effects. After answering each task question, participants were asked, “How confident are you of your choice?” and responded on a 6-point Likert scale ranging from completely certain to completely uncertain (Chiou, Carlson, Arnett, Cosentino, & Hillary, 2011; Chiou & Hillary, 2012; Grossner et al, 2018). The confidence ratings are shown in Figure 1…”

“…Deficits in metacognition are linked to a host of functional deficits in the areas of insight and planning, including disengagement in rehabilitation and problems understanding one’s own functional limitations (Flashman & McAllister, 2002; Ownsworth & Fleming, 2005). Metacognitive impairments have been consistently observed after TBI (Chiou & Hillary, 2012; Kennedy, 2001; O’Keeffe, Dockree, Moloney, Carton, & Robertson, 2007), but what is less clear is how the pathophysiology of TBI directly interacts with the neural substrates that give rise to metacognitive capacity. Previous literature has demonstrated a link between gray matter volume in frontal brain regions and metacognitive accuracy in both healthy individuals (Fleming, Weil, Nagy, Dolan, & Rees, 2010; McCurdy et al, 2013) as well as individuals who have experienced a TBI (Grossner, Bernier, Brenner, Chiou, & Hillary, 2018).…”

Enhanced default mode connectivity predicts metacognitive accuracy in traumatic brain injury.

“…As a final caveat, our task manipulation for obtaining a value of metacognitive accuracy removes difficulty anchors, creating a task that is more sensitive to metacognitive deficits (Chiou et al, 2012; Grossner et al, 2018). We did not see this same association between network connectivity and metacognition using the “ordered” version of the matrix reasoning task, where the design of the task is retained and item difficulty increases incrementally over the course of the task ( p s > .342).…”

“…Each participant received both versions of this task, and the administration was counterbalanced across subjects to eliminate ordering effects. After answering each task question, participants were asked, “How confident are you of your choice?” and responded on a 6-point Likert scale ranging from completely certain to completely uncertain (Chiou, Carlson, Arnett, Cosentino, & Hillary, 2011; Chiou & Hillary, 2012; Grossner et al, 2018). The confidence ratings are shown in Figure 1…”

“…Deficits in metacognition are linked to a host of functional deficits in the areas of insight and planning, including disengagement in rehabilitation and problems understanding one’s own functional limitations (Flashman & McAllister, 2002; Ownsworth & Fleming, 2005). Metacognitive impairments have been consistently observed after TBI (Chiou & Hillary, 2012; Kennedy, 2001; O’Keeffe, Dockree, Moloney, Carton, & Robertson, 2007), but what is less clear is how the pathophysiology of TBI directly interacts with the neural substrates that give rise to metacognitive capacity. Previous literature has demonstrated a link between gray matter volume in frontal brain regions and metacognitive accuracy in both healthy individuals (Fleming, Weil, Nagy, Dolan, & Rees, 2010; McCurdy et al, 2013) as well as individuals who have experienced a TBI (Grossner, Bernier, Brenner, Chiou, & Hillary, 2018).…”

Functional connectivity within lateral posterior parietal cortex in moderate to severe traumatic brain injury.

“…All participants were administered neuropsychological tests of attention and higher-order cognition including the Digit Span subtest from the Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, 2008), Visual Search and Attention Test (VSAT; Trennerry, Crosson, DeBoe, & Leber, 1990), Trail Making Tests A & B (TMT-A and TMT-B, respectively; Reitan & Wolfson, 1985), and a modified version of the Matrix Reasoning subtest from the WAIS-III (Chiou & Hillary, 2012). Neuropsychological performance in the TBI and control groups as well as information on modified test administrations are found in Table A1 in Appendix A.…”

Metacognition in Individuals Aging with Traumatic Brain Injury

“…Objective metacognitive performance evaluation was assessed using a modified Matrix Reasoning task adapted from Wechsler Adult Intelligence Scale -Third Edition (Wechsler, 1997) with retrospective confidence judgments served as the objective measure of metacognition (see Chiou et al, 2011;Chiou & Hillary, 2012;Grossner, Bernier, Brenner, Chiou, & Hillary, 2018;Grossner, Bernier, Brenner, Chiou, Hong, & Hillary, 2019). This perceptual reasoning task required participants to complete an abstract puzzle from one of five presented choices.…”

Enhanced default mode connectivity predicts metacognitive accuracy in traumatic brain injury.

“…As a final caveat, our task manipulation for obtaining a value of metacognitive accuracy removes difficulty anchors, creating a task that is more sensitive to metacognitive deficits (Chiou et al, 2012; Grossner et al, 2018). We did not see this same association between network connectivity and metacognition using the “ordered” version of the matrix reasoning task, where the design of the task is retained and item difficulty increases incrementally over the course of the task ( p s > .342).…”

“…Each participant received both versions of this task, and the administration was counterbalanced across subjects to eliminate ordering effects. After answering each task question, participants were asked, “How confident are you of your choice?” and responded on a 6-point Likert scale ranging from completely certain to completely uncertain (Chiou, Carlson, Arnett, Cosentino, & Hillary, 2011; Chiou & Hillary, 2012; Grossner et al, 2018). The confidence ratings are shown in Figure 1…”

“…Deficits in metacognition are linked to a host of functional deficits in the areas of insight and planning, including disengagement in rehabilitation and problems understanding one’s own functional limitations (Flashman & McAllister, 2002; Ownsworth & Fleming, 2005). Metacognitive impairments have been consistently observed after TBI (Chiou & Hillary, 2012; Kennedy, 2001; O’Keeffe, Dockree, Moloney, Carton, & Robertson, 2007), but what is less clear is how the pathophysiology of TBI directly interacts with the neural substrates that give rise to metacognitive capacity. Previous literature has demonstrated a link between gray matter volume in frontal brain regions and metacognitive accuracy in both healthy individuals (Fleming, Weil, Nagy, Dolan, & Rees, 2010; McCurdy et al, 2013) as well as individuals who have experienced a TBI (Grossner, Bernier, Brenner, Chiou, & Hillary, 2018).…”

Functional connectivity within lateral posterior parietal cortex in moderate to severe traumatic brain injury.

“…All participants were administered neuropsychological tests of attention and higher-order cognition including the Digit Span subtest from the Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, 2008), Visual Search and Attention Test (VSAT; Trennerry, Crosson, DeBoe, & Leber, 1990), Trail Making Tests A & B (TMT-A and TMT-B, respectively; Reitan & Wolfson, 1985), and a modified version of the Matrix Reasoning subtest from the WAIS-III (Chiou & Hillary, 2012). Neuropsychological performance in the TBI and control groups as well as information on modified test administrations are found in Table A1 in Appendix A.…”

Metacognition in Individuals Aging with Traumatic Brain Injury

“…Objective metacognitive performance evaluation was assessed using a modified Matrix Reasoning task adapted from Wechsler Adult Intelligence Scale -Third Edition (Wechsler, 1997) with retrospective confidence judgments served as the objective measure of metacognition (see Chiou et al, 2011;Chiou & Hillary, 2012;Grossner, Bernier, Brenner, Chiou, & Hillary, 2018;Grossner, Bernier, Brenner, Chiou, Hong, & Hillary, 2019). This perceptual reasoning task required participants to complete an abstract puzzle from one of five presented choices.…”

Enhanced default mode connectivity predicts metacognitive accuracy in traumatic brain injury.

“…As a final caveat, our task manipulation for obtaining a value of metacognitive accuracy removes difficulty anchors, creating a task that is more sensitive to metacognitive deficits (Chiou et al, 2012; Grossner et al, 2018). We did not see this same association between network connectivity and metacognition using the “ordered” version of the matrix reasoning task, where the design of the task is retained and item difficulty increases incrementally over the course of the task ( p s > .342).…”

“…Each participant received both versions of this task, and the administration was counterbalanced across subjects to eliminate ordering effects. After answering each task question, participants were asked, “How confident are you of your choice?” and responded on a 6-point Likert scale ranging from completely certain to completely uncertain (Chiou, Carlson, Arnett, Cosentino, & Hillary, 2011; Chiou & Hillary, 2012; Grossner et al, 2018). The confidence ratings are shown in Figure 1…”

“…Deficits in metacognition are linked to a host of functional deficits in the areas of insight and planning, including disengagement in rehabilitation and problems understanding one’s own functional limitations (Flashman & McAllister, 2002; Ownsworth & Fleming, 2005). Metacognitive impairments have been consistently observed after TBI (Chiou & Hillary, 2012; Kennedy, 2001; O’Keeffe, Dockree, Moloney, Carton, & Robertson, 2007), but what is less clear is how the pathophysiology of TBI directly interacts with the neural substrates that give rise to metacognitive capacity. Previous literature has demonstrated a link between gray matter volume in frontal brain regions and metacognitive accuracy in both healthy individuals (Fleming, Weil, Nagy, Dolan, & Rees, 2010; McCurdy et al, 2013) as well as individuals who have experienced a TBI (Grossner, Bernier, Brenner, Chiou, & Hillary, 2018).…”

Functional connectivity within lateral posterior parietal cortex in moderate to severe traumatic brain injury.

“…All participants were administered neuropsychological tests of attention and higher-order cognition including the Digit Span subtest from the Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, 2008), Visual Search and Attention Test (VSAT; Trennerry, Crosson, DeBoe, & Leber, 1990), Trail Making Tests A & B (TMT-A and TMT-B, respectively; Reitan & Wolfson, 1985), and a modified version of the Matrix Reasoning subtest from the WAIS-III (Chiou & Hillary, 2012). Neuropsychological performance in the TBI and control groups as well as information on modified test administrations are found in Table A1 in Appendix A.…”

Metacognition in Individuals Aging with Traumatic Brain Injury

“…Objective metacognitive performance evaluation was assessed using a modified Matrix Reasoning task adapted from Wechsler Adult Intelligence Scale -Third Edition (Wechsler, 1997) with retrospective confidence judgments served as the objective measure of metacognition (see Chiou et al, 2011;Chiou & Hillary, 2012;Grossner, Bernier, Brenner, Chiou, & Hillary, 2018;Grossner, Bernier, Brenner, Chiou, Hong, & Hillary, 2019). This perceptual reasoning task required participants to complete an abstract puzzle from one of five presented choices.…”