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Título: ANOSOGNOSIA, MOOD AND PERSPECTIVE-TAKING IN MILD TO MODERATE ALZHEIMER S DISEASE
Autor: ELODIE BERTRAND
Instituição: PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO - PUC-RIO
Colaborador(es):  JESUS LANDEIRA FERNANDEZ - ADVISOR
DANIEL CORREA MOGRABI - CO-ADVISOR

Nº do Conteudo: 33345
Catalogação:  21/03/2018 Idioma(s):  ENGLISH - UNITED STATES
Tipo:  TEXT Subtipo:  THESIS
Natureza:  SCHOLARLY PUBLICATION
Nota:  Todos os dados constantes dos documentos são de inteira responsabilidade de seus autores. Os dados utilizados nas descrições dos documentos estão em conformidade com os sistemas da administração da PUC-Rio.
Referência [pt]:  https://www.maxwell.vrac.puc-rio.br/colecao.php?strSecao=resultado&nrSeq=33345@1
Referência [en]:  https://www.maxwell.vrac.puc-rio.br/colecao.php?strSecao=resultado&nrSeq=33345@2
Referência DOI:  https://doi.org/10.17771/PUCRio.acad.33345

Resumo:
Lack of awareness about cognitive deficits or illness, also named anosognosia, is a common feature of Alzheimer s disease (AD). However, there is variability in the presentation and severity of anosognosia in patients with AD. Based on the Cognitive Awareness Model (CAM), this thesis aims to explore experimentally two factors which could possibly influence the awareness of cognitive abilities in AD, namely current mood state and the perspective through which the information is presented. The first section of this thesis explores the impact of mood state on awareness of deficits. As it has been suggested in the CAM that emotional biases could influence the access to personal memories, consequently leading to anosognosia, a systematic literature review was conducted to understand better the mood-congruent memory effect in healthy adults (Article 1). Then, we present an experimental study investigating this hypothesis in AD (Article 2). In this study, negative and neutral mood states were experimentally induced using four Success-Failure Manipulation (SFM) tasks, two based on reaction time tasks and the other on memory tasks. The results showed an improvement of awareness of symptoms after negative mood induction, but only when the task used in the SFM was memory-based. The second section of this work investigates if the perspective through which the information is presented (self vs. other) has an influence on metacognitive abilities of patients with AD. Indeed, a literature review highlighted that studies exploring the impact of perspective taking on metacognition with different neurologic and psychiatric populations showed that patients are able to recognize deficits in others, despite lack of awareness of their own difficulties (Article 3). Then, an experimental study was conducted by asking AD patients and controls to evaluate their own performance on four different tasks, as well as the performance of a well-known person (caregiver/spouse/friend) (Article 4). Our findings highlight that overall both groups made higher overestimation when evaluating the performance of a well-known person. However, AD patients tended to overestimate more the performance compared to controls but only in the memory experiment. In summary, results of these studies give experimental support to three aspects suggested by the CAM as factors influencing awareness of deficits. First, the findings on the relationship between mood and awareness support the idea of emotional biases in memory as a partial explanation for anosognosia. Second, the results showing that AD patients appraise the evaluation of selfperformance differently than the evaluation of a well-known person s performance support the inclusion of different memory records for self- and otherinformation in the reformulated version of the CAM. Third, by presenting differences in results depending on the type of task used in the SFM (reaction time vs. memory), our findings reinforce the concept that awareness is multidimensional, on which is based the modular aspect of the CAM.

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