Cerebrovascular accidents, intracranial tumors, and urologic consequences
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Pettersen et al. assessed how functional status after a CVA relates to urinary symptoms and overall outcomes in stroke patients. The authors recorded the mental status, functional status, and urinary symptoms of 315 patients with acute stroke. Patients with impaired awareness were found to have the poorest outcomes and the least improvement in urinary function 3 months after their stroke.44 The authors attributed this impairment in awareness to anosognosia, which is unawareness or denial of a neurologic deficit. Other studies have attributed anosognosia to more severe overall disability, and this finding is an independent predictor of poor outcome in these patients.45 When patients with a CVA develop self-neglect, their inability to recognize basic needs, such as the need to void and perform hygiene, adds to their overall disability and leads to a worse outcome than those in whom these executive functions are intact.46
Anosognosia
Alexander R. Toftness in Incredible Consequences of Brain Injury, 2023
Anosognosia refers to a disorder wherein a person has a problem of some kind, such as an illness, but is unaware that the problem exists or otherwise greatly underestimates the severity of the problem (Nurmi & Jehkonen, 2014). Their brain fails to update their knowledge of themselves with the new problem that they are experiencing, so they do not realize that it is happening. The type of problems that people with anosognosia fail to acknowledge are extremely diverse, and the definition can be broad enough to potentially include all of the other conditions contained in this book. Because anosognosia modifies other conditions, you will see it written as “anosognosia for ______,” with the blank filled in by whatever condition the person has but of which they are unaware.
Recognising and engaging with spatial cognition problems
Ross Balchin, Rudi Coetzer, Christian Salas, Jan Webster in Addressing Brain Injury in Under-Resourced Settings, 2017
Anosognosia is a very strange disorder. Patients with clear psychological and/or physical problems (e.g. a paralysed arm) will tell you that there is nothing wrong with them. This demonstrates a lack of awareness or denial of deficit/s and the consequences of the deficit/s. Such patients are typically unconcerned about their health problems even when they are pointed out to them or when they admit to them themselves. This lack of concern is known as anosodiaphoria. Patients will usually regain awareness of their impairments with time.
Metacognitive Improvements Following Cognitive Stimulation Therapy for People with Dementia: Evidence from a Pilot Randomized Controlled Trial
Published in Clinical Gerontologist, 2023
Elodie Bertrand, Valeska Marinho, Renata Naylor, Iris Bomilcar, Jerson Laks, Aimee Spector, Daniel C. Mograbi
Lack of awareness for cognitive and/or behavioral deficits, also termed anosognosia, is a common characteristic of dementia (Mograbi et al., 2012). Both cross-sectional and longitudinal studies showed that awareness of deficits increases with disease severity (Starkstein et al., 2006; Turró-Garriga et al., 2016). Considering the association between anosognosia and cognitive decline, however, the results are inconsistent, with studies highlighting that awareness declined along with cognition (Turró-Garriga et al., 2016) and others showing that, despite increasing cognitive deficits, some individuals showed preserved awareness (Vogel et al., 2015). Another important aspect of awareness in dementia is its relationship with mood. Indeed, many studies exploring the clinical correlates of anosognosia in PwD highlighted a negative association between depression and anosognosia, with increased depression associated with better awareness (Clare et al., 2012; Harwood et al., 2000).
Conceptualization of self-awareness in adults with acquired brain injury: A qualitative systematic review
Published in Neuropsychological Rehabilitation, 2022
Danielle Sansonetti, Jennifer Fleming, Freyr Patterson, Natasha A. Lannin
The terminology used to describe “self-awareness” varied across papers, with 12 different definitions provided that described knowledge about self, impairments, and problems encountered or anticipated; and considered both past, present, and future experiences that inform self-awareness. Eight definitions of “impaired self-awareness” were provided, with descriptions being on a continuum of partial or complete loss of information or knowledge about deficits or problems. Papers included 20 different definitions of “anosognosia”, with description ranging from a total lack of, to diminished knowledge of, deficit or disability; difficulty acknowledging or recognizing abilities, and denial of illness. See Table 3 for a synthesis of the definitions found in the review.
How is carer strain related to the recovery of stroke survivors with right hemisphere dysfunction? Implications for practice
Published in Disability and Rehabilitation, 2022
Maria Stella Stein, Frances Ann Reynolds
Anosognosia presents important ethical, behavioural and management implications in affected RHS conditions [40,45] especially when it coexists with emotional dysregulation. Understanding the survivor’s ability to regulate emotions such as anger (reported by carers) could help develop therapeutic interventions and training aimed at supporting both carer and survivor overcoming some of the communication and behavioural challenges reported by carers in the qualitative survey. It is not clear how relational and behaviour-specific carer’s education and training is or if they receive any at all. However, appropriate support is important as carers of RHS survivors recognise the need for counselling and acknowledge their lack of skill to manage survivors who were “too demanding”, “difficult to reason with”, “angry and forgetful” and “in denial of his/her abilities” (2b, 2c), “fixing problems” when they occur. Carers felt that their skills were lacking in this area.
Related Knowledge Centers
- Denial
- Disability
- Parietal Lobe
- Stockholm Syndrome
- Dementia
- Schizophrenia
- Bipolar Disorder
- Post-Traumatic Stress Disorder
- Mental Disorder
- Neurology