Metacognitive knowledge and online awareness in persons with multiple sclerosis

BACKGROUND: Recent models of self-awareness draw a distinction between intellectual awareness (metacognitive knowledge of disabilities) and online awareness of errors (emergent and anticipatory awareness). OBJECTIVE: The present study compared these two types of self-awareness (metacognitive knowledge of disabilities and online awareness) in individuals with multiple sclerosis (MS) and healthy participants. The relationship between self-awareness and functional performance was also examined. METHODS: Participants included 18 individuals with MS and 16 healthy controls (HC) between the ages of 27 and 60. Intellectual awareness was assessed via discrepancy scores on the Functional Behavior Profile (FBP) between participants and their informants. Online Awareness was examined using self-prediction and self-assessment of performance on a functional task. RESULTS: Participants with MS had significantly lower levels of intellectual awareness relative to HCs. The MS group demonstrated worse prediction online awareness than HCs. However, assessment online awareness did not differ between groups, indicating that experience with a task can improve online awareness in persons with MS. CONCLUSION: This study highlights the necessity of adopting a multidimensional approach to assessing the multifaceted phenomenon of self-awareness in MS. In addition, it provides initial evidence to support a self-awareness treatment model for persons with MS.