Insight in Progressive Supranuclear Palsy (PSP): A study of Intra-individual awareness
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Deficits in awareness challenge patient’s health and safety and can decrease not only the patient’s quality of life but also that of the people around them (Rymer et al., 2002) Despite the frequency of awareness deficits in neurological diseases and its clinical relevance, the study of awareness in neurological conditions is still not fully understood. Moreover, it is not clear whether impaired awareness is a unitary concept or it can dissociate across different functional domains (Vasterling, Seltzer, Foss and Vanderbrook 1995). Due to the frontal pathology present in Progressive Supranuclear Palsy (PSP), many patients suffer from awareness deficits. However, the study of awareness in PSP has only recently been studied (O’Keeffe, et al., 2007). Following O’Keeffe et al’s (2007) multidimensional approach to awareness, the present study examines differences in awareness types (metacognitive, anticipatory and emergent awareness), the specificity of awareness deficits across cognitive domains and the effects of mood on awareness estimations across PSP patients, their primary carers and a group of controls. Results show that PSP patients have a specific pattern of awareness with not only general differences between emergent, anticipatory and metacognitive awareness (emergent being better than anticipatory and metacognitive awareness), but also domain-specific differences across different cognitive areas (with patients making more mistakes in executive tests than in any other types of tests). Moreover, the study also shows that the estimations made by the primary carers on the patients’ as well as on their own performance are inaccurate.