Self‐awareness in multiple sclerosis: Relationships with executive functions and affect

Abstract

Background and objectives Deficits in self‐awareness can be observed in persons with multiple sclerosis (pwMS). The present study aimed to investigate two types of self‐awareness (intellectual and online) among pwMS, which will inform clinical care. Intellectual awareness refers to knowledge of one's own abilities; online awareness refers to real‐time monitoring and regulation of one's performance. Methods The study sample consisted of 95 pwMS and 65 healthy controls (HCs). Intellectual awareness was defined as discrepancy between participant's and informant's reports of participant's functioning. Online awareness was operationalized by change in self‐assessment of performance after engaging in a functional task. Results PwMS had significantly worse intellectual awareness than HCs regarding money management (confidence interval [CI] 0.44 to 1.99), task performance (CI −0.01 to 2.5), social interaction (CI 0.29 to 2.45), and problem solving (CI 0.87 to 2.8) abilities, but not sensory symptoms. Executive functioning was positively associated with intellectual awareness in HCs, while depressive and anxiety symptoms were negatively related to intellectual awareness in pwMS. In contrast, online awareness was not significantly different between groups; both groups were able accurately to assess their performance after engaging in a functional task. Conclusions Intellectual awareness, but not online awareness, is impaired in pwMS. Among pwMS, affective symptomatology may distort their perception of functional status. Persons with MS may benefit from actually performing a functional task during the assessment and treatment process, which may lead to a more accurate estimate of their own abilities.

Intrapsychic and Interpersonal Realms in Patients with Multiple Sclerosis and Their Comparison with Normal Individuals: A Look at Object Relations and Anger Management

“…According to Captu (2018), a phenomenological study of the experiences of patients with amyotrophic lateral sclerosis (ALS) shows that communications with the self and the outside world are impaired in patients and focusing on interpersonal relations could be an effective restorative strategy in rebuilding these relations ( 25 ). Defects in self-awareness ( 26 ), personality changes ( 9 ) and fragile relationships occur simultaneously with the development of physical symptoms ( 27 ) in patients with MS. Some other studies, such as the study by Mahmoudi et al (2018) have not shown a difference in the perception of social support and self-compassion between patients with MS and the general population ( 28 ).…”

Developing and Validating an Instrument to Assess Ninth-Grade Students’ Online Metacognitive Skills in Solving Chemistry Problems

“…In science education, current literature has not achieved a consensus regarding the construct of online metacognitive skills (Desoete, 2001;Desoete & Roeyers, 2002;Efklides, 2002;Lee et al, 2019). According to Chen and Goverover (2021), online metacognition skills comprise the abilities of monitoring (e.g., identifying mistakes) and regulation (e.g., correcting responses). Similarly, Quiles et al (2014; have identified two aspects of online metacognitive skills, including online metacognitive monitoring that involves the subjective self-assessment of confidence in answering the questions and online metacognitive control concerning the decision on whether to validate the answers.…”

“…In reference to previous studies (Chen & Goverover, 2021;Quiles et al, 2020;Sporer & Horry, 2011;Wong, 2007), this study defined online metacognitive skills as the ability to monitor, evaluate, regulate, and reflect on one's own performance in solving chemistry problems. In particular, four hierarchical levels comprise the construct of this study, which is hypothesized to delineate a set of complicated online metacognitive skills, from the least sophisticated (i.e., monitoring one's own thought processes) to the most advanced (i.e., making attributions about one's own cognitive performance), as shown in Figure 1.…”

Differences in metacognition between multiple sclerosis phenotypes: cognitive impairment and fatigue are key factors

“…Objectively measured cognitive performance often fails to match patients' subjective perceptions of their performance. This might be due to factors such as the discrepancy between laboratory tasks and everyday life cognitive demands as well as premorbid abilities, given that they can mask cognitive decline (Sumowski et al, 2018 ) and mood disturbances that can affect cognitive performance (Feinstein, 2006 ; Chen and Goverover, 2021 ). Deficit awareness issues may also be present in pwMS.…”

“…Fewer studies have explored metacognition in terms of consistency, either between self-evaluation and informant evaluation or between subjective and objective evaluation. Nonetheless, it seems that metacognitive knowledge may be impaired in pwMS, especially when compared with HC (Goverover et al, 2014 ; Mazancieux et al, 2019 ; Chen and Goverover, 2021 ; Feinstein et al, 2021 ). However, it is not clear which factors explain metacognitive impairments and to what extent.…”