Predictions of episodic memory following moderate to severe traumatic brain injury during inpatient rehabilitation

Abstract

We examined memory self-awareness and memory self-monitoring abilities during inpatient rehabilitation in participants with moderate to severe traumatic brain injury (TBI). Twenty-nine participants with moderate to severe TBI and 29 controls matched on age, gender, and education completed a performance prediction paradigm. To assess memory self-awareness, participants predicted the amount of information they would remember before completing list-learning and visual-spatial memory tasks. Memory self-monitoring was assessed by participants' ability to increase accuracy of their predictions after experience with the tests. Although the TBI participants performed more poorly than controls on both episodic memory tasks, no significant group differences emerged in memory self-awareness or memory self-monitoring. The TBI participants predicted that their memory performances would be poorer than that of controls, accurately adjusted their predictions in accordance with the demands of the tasks, and successfully modified their predictions following experience with the tasks. The results indicate that moderate to severe TBI individuals in the early stages of recovery can competently assess the demands of externally-driven metamemorial situations and utilize experience with task to accurately update their knowledge of memory abilities. Keywords traumatic brain injury; memory awareness; memory monitoring; metamemory; metacognition Accurate self-awareness and self-monitoring of memory abilities are important to everyday memory functioning. Individuals are more likely to successfully learn and retain information if they can accurately assess the demands of metamemorial situations. For example, if an individual is aware that they may experience difficulty learning important information, compensatory strategies can be initiated to help aid learning (Kennedy, 2004). After studying the material, the individual can also monitor their memory to determine whether the material was successfully learned or additional study time is needed. While memory self-awareness involves having accurate knowledge about one's memory abilities (Fleming, Strong, & Ashton, 1995), memory self-monitoring involves attending to and having an understanding about the (Hertzog, Saylor, Fleece, & Dixon, 1994;Koriat, 2000).A growing body of literature suggests that individuals with traumatic brain injury (TBI) who are more than one year post injury demonstrate accurate memory self-awareness and memory self-monitoring abilities (e.g., Kennedy, 2004;Schmitter-Edgecombe & Anderson, 2007;Schmitter-Edgecombe & Woo, 2004). However, few studies have explored impairment of metamemorial abilities during the early stages of recovery from TBI. This is an important area of study because, as past research has suggested, the more individuals with TBI are aware of deficits, the more they benefit from rehabilitation following injury (Lam, McMahon, Priddy, & Gehred-Schulz, 1988). In this study, we used a performance prediction paradigm to investigate memory self-aware...

Assessment of memory self-awareness following traumatic brain injury

“…After being read descriptions of verbal and visual memory tasks, participants provided an estimate of how well they thought they would perform on the memory tasks. Consistent with previous findings, participants with TBI were expected to perform more poorly on the memory tasks than control participants [4,5,18]. Based on prior literature showing intact self-awareness of memory using performance-prediction paradigms [5], it was hypothesized that individuals with TBI would be as accurate as control participants predicting their memory performance when assessed with a specific, temporally proximal online assessment technique.…”

“…These self-report judgements require participants to provide estimates of their memory functioning in close temporal proximity to memory tests. In contrast to offline assessment techniques, the majority of studies using online assessment methodologies have found intact memory self-awareness in individuals after TBI [5,14,15]. For example, using a global performance-prediction paradigm, Anderson and Schmitter-Edgecombe [5] found that individuals with moderate-to-severe TBI who were less than 3 months post-injury demonstrated preserved metamemorial abilities.…”

“…In contrast to offline assessment techniques, the majority of studies using online assessment methodologies have found intact memory self-awareness in individuals after TBI [5,14,15]. For example, using a global performance-prediction paradigm, Anderson and Schmitter-Edgecombe [5] found that individuals with moderate-to-severe TBI who were less than 3 months post-injury demonstrated preserved metamemorial abilities. In this study, prior to completing verbal and visual episodic memory tasks, participants estimated the amount of verbal and visual information they would recall.…”

“…Therefore, understanding metamemorial abilities in persons with traumatic brain injury (TBI) can have important implications for rehabilitation and compensatory strategy training. While multiple measurement techniques have been used to evaluate metamemory in populations with TBI [1,5,6], few studies have investigated more than one technique within the same sample [7]. This is important because studies using different methodologies have found conflicting results.…”

“…feelingof-knowing, judgement-of-learning) to assess metamemory abilities in participants with TBI [5,14,15]. These self-report judgements require participants to provide estimates of their memory functioning in close temporal proximity to memory tests.…”