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The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients’ ability to participate in work and social life and improving collaborative patient-clinician relationships.
The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S).
Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings.
The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.
Kraus’s book is both deep and wide-ranging. My comments focus on her account of Kant on self-awareness – both a priori and empirical apperception. Basic to her account is what she calls the hylomorphism of mental faculties in Kant. Kraus distinguishes her ‘reflexive’ account of apperception from both ‘logical’ and ‘psychological’ accounts. An inevitable question is: Does Kant think we have an empirical cognition of the self? Kraus seems to want to say yes, but I question this answer. Cognition requires both intuition and conception. My claim is that it requires intuition in both space and time, but inner empirical self-awareness is apparently in time only. Kant’s Refutation of Idealism in B, as developed later in the Kiesewetter essays, makes awareness of our body essential to time determination.
What does it actually mean to be professional? How can students develop their own sense of self, and how might this interact with their professional identify and performance? This chapter explains self-awareness and the importance of understanding your own values, beliefs and motivations in order to better understand the diverse experiences of others, and to nurture the therapeutic and professional relationships that are essential for quality nursing practice.
The role of emotional and social intelligence in understanding ourselves and others is also explored, as this concept is closely linked to self-awareness. Critical reflection and mindfulness are suggested as two strategies for fostering the development of greater self-awareness and better self-care, which may assist in caring for others with empathy, compassion and ‘intelligent kindness’. In essence, enhancing your self-awareness,self-care, understanding and compassion for others will help you interact and communicate more effectively, reconcile any differences or conflicts that may arise, and better cope with the emotional demands inherent in healthcare practice (Foster et al. 2015, Kelly, Runge & Spencer 2015).
A ‘nursing philosophy’ underpinning the curriculum is mandated by the accrediting body, the Australian Nursing and Midwifery Accreditation Council (ANMAC). We believe that a rigorous philosophical position underpinning nursing theory and practice can provide a focus for the discipline in terms of practical reasoning and moral commitment.
This chapter introduces the concept of gratitude as an example of a virtuous character trait. Aristotle recognised the importance of properly trained emotions for acquiring the virtues; thus his account is consistent with our emphasis on emotional intelligence and self-awareness. We show how excellent practice as a nurse aligns with doing well as a human being. The main point argued in this chapter is that Aristotle’s conception of virtue can provide a philosophical ‘basis for nursing that focuses on moral competence in a robust, coherent and systematic way, while at the same time accommodates the demand for discipline-specific knowledge and high levels of technical skill’ (Bliss et al. 2017, p. 1). We contend that this underpinning philosophy allows the knowledge and caring aspects of nursing to be united.
Analysis of problems arising in communication between parents and their children with disabilities is a part of biopsychological examination of disease.
The study was aimed at exploring the parent-child communication in children suffering from chronic neurological disorders in order to organize the optimal psychological rehabilitation.
The study consisted of two stages: 1) CAT (Bellak) and drawing tests, performed by child; 2) experiment involving both parent and child, making up a story together (CAT-H, parallel to the task performed by the child). Parents filled in a questionnaire on their communication with the child; its results were compared to the situations of real communication. Other methods used included: observation, analysis of family situation and child’s development; coding of communicative elements; analysis of the story by the method by N. Burlakova (Burlakova, 2001). The study involved 34 persons: 17 children (aged 7–10) + 17 parents (15 mothers, 2 fathers). The dyads were studied when the children received treatment in the hospital (resided in the hospital together with the parent).
1) Activity of the child together with the parent revealed several communicative patterns, which correlated differently to the estimation of communication by the parent. 2) The types of inner dialogues in children were discovered, which gave concrete expression to the inferiority feeling caused among others by the communication in the parent-child dyad. 3) The organization of the research enabled to follow the “production” of dialogues of self-awareness in children with chronical diseases.
The conducted research enables organization of individualized psychological and psychotherapeutical aid.
This chapter reviews five decades of research on reactions to mirrors and self-recognition in nonhuman primates, starting with Gallup’s (1970) pioneering experimental demonstration of self-recognition in chimpanzees and its apparent absence in monkeys. Taking a decade-by-decade approach, developments in the field are presented separately for great apes on the one hand, and all other primates on the other (prosimians, monkeys, and so-called lesser apes), considering both empirical studies and theoretical issues. The literature clearly shows that among nonhuman primates the most compelling evidence for something approaching human-like visual self-recognition is seen only in great apes, despite an impressive range of sometimes highly original procedures employed to study many monkey species. In the past decade, research has been shifting from simple questions about whether great apes can self-recognize (now considered beyond doubt), to addressing possible biological bases for individual and species differences in the strength of self-recognition, analysis of possible adaptive functions of the capacity for self-visualization, and searching for evidence of self-recognition in a range of nonprimate species.
Monitoring our progress is an important – yet oft-overlooked – aspect of goal pursuit. However, the need for setting achievable markers that benchmark progress in the short term is crucial to achieving long-term success. After all, goal pursuit is a dynamic (rather than static) process and maximizing that process over time requires a systematic effort to monitor our progress.
Agenesis of the corpus callosum (AgCC) is associated with a range of cognitive deficits, including mild to moderate problems in higher order executive functions evident in neuropsychological assessments. Previous research has also suggested a lack of self-awareness in persons with AgCC.
We investigated daily executive functioning and self-awareness in 36 individuals with AgCC by analyzing self-ratings on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), as well as ratings on the same instrument from close relatives. Discrepancies between self- and informant-ratings were compared to the normative sample and exploratory analyses examined possible moderating effects of participant and informant characteristics.
Significant deficiencies were found in the Behavioral Regulation and Metacognitive indices for both the self and informant results, with elevated frequency of metacognition scores in the borderline to clinical range. Informants also endorsed elevated frequency of borderline to clinically significant behavioral regulation scores. The proportion of AgCC participants whose self-ratings indicated less metacognitive impairment than informant-ratings was greater than in the normative sample. Self-ratings of behavioral regulation impairment decreased with age and informant-ratings of metacognition were higher in males than females.
These findings provide evidence that individuals with AgCC experience mild to moderate executive functioning problems in everyday behavior which are observed by others. Results also suggest a lack of self-understanding or insight into the severity of these problems in the individuals with AgCC, particularly with respect to their metacognitive functioning.
This chapter tells the fascinating story of how human motivational processes evolved from the humblest of creatures, starting with “primordial” goals and precursors of basic emotions. In addition to explaining how our capabilities for self-direction and self-regulation evolved, this chapter provides a way of understanding the complexly organized motivational systems we see in humans in a way that transcends specific motivation theories. It is thus a chapter about the fundamental properties of human nature as they relate to motivation and optimal functioning rather than a chapter about a particular theoretical approach to human motivation. That is an essential framing, as one of the basic premises of this book is that efforts to motivate self and others can best succeed if they are consistent with basic human nature.
Although parents and educators have identified student social and emotional development as an important educational outcome, this domain has not received as much emphasis in educational policy or practice as academic achievement. Recognition of the contributions of social and emotional learning (SEL) to students’ social and academic success, however, has increased interest in promoting SEL in schools over the last decade. This chapter begins with a brief introduction to SEL constructs and definitions, followed by a synopsis of current SEL assessment and intervention practices. We also highlight the current state of empirical evidence for these practices and then turn to several important necessary future directions to advance school-based SEL practices.
When a complex emergency (CE) overwhelms infrastructure, the ability of health-care providers to work efficiently under duress saves lives. The author uses her experience of providing mental health supports to humanitarian aid workers and the pieces of training conducted for internal medicine practitioners to offer guidance on how to manage severe job-related stresses during the response to the coronavirus disease 2019 (COVID-19) pandemic. This work reminds responders about their professional mission and purpose, but its extreme physical and mental demands can take a toll on their well-being and health. In CEs, the sheer volume of work and the emotional over-engagement tend to produce toxic fantasies (eg, rescuer or helper fantasies), acting upon which threatens integrity of care and increases risks for both patients and providers. Accumulated fatigue and exposure to mass suffering and mortality can change the perceived value of life and increase reckless, risk-taking, and suicidal behaviors. Introducing a self-awareness framework prioritizes the awareness of the available choices and making situation-appropriate and informed decisions about balancing one’s own and others’ needs. The COVID-19 response has demonstrated that fostering peer supports, changing organizational culture, addressing self-awareness within a training and supervisory context, and strengthening supports for managers are important parts of disaster preparedness. It also revealed that more research is needed to better understand and meet the special psychological needs of health-care responders.
In neurological diseases, metacognitive judgements have been widely used in order to assess the degree of disease awareness. However, as yet little research of this type has focused on multiple sclerosis (MS).
We here focused on an investigation of item-by-item metacognitive predictions (using feeling-of-knowing judgements) in episodic and semantic memory and global metacognitive predictions in standard neuropsychological tests pertinent to MS (processing speed and verbal fluency). Twenty-seven relapsing–remitting MS (RR-MS) patients and 27 comparison participants took part.
We found that RR-MS patients were as accurate as the group of comparison participants on our episodic and semantic item-by-item judgements. However, for the global predictions, we found that the MS group initially overestimated their performance (ds = .64), but only on a task on which performance was also impaired (ds = .89; processing speed). We suggest that MS patients, under certain conditions, show inaccurate metacognitive knowledge. However, postdictions and item-by-item predictions indicate that online metacognitive processes are no different from participants without MS.
We conclude that there is no monitoring deficit in RR-MS and as such these patients should benefit from adaptive strategies and symptom education.
Chapter 9 draws on a case study of a pilot project in two secondary schools, one in the United Kingdom and one in Colombia, to illustrate how ethical education spaces can be co-created, sustained and enriched. It regards ethical education practice to consist of at least three aspects: (1) exploring students’ self-awareness which is intimately connected to relationships with others; (2) experiencing one’s feelings, emotions and relations, and (3) inquiring into one’s own and others’ lived realities, and things in the world. These respond to the particular needs and challenges of adolescence and contribute to enriching students’ relationships with self and others, learning and goodness in the world. To present the case study, this chapter begins by considering the needs for relational development during adolescence. It then articulates the conceptual framework underpinning the above ethical education practices. Following a detailed description of each ethical space, the pedagogical intentions underlying it, and the learning processes that the students embarked on within each space, the case study discusses how the participating students have experienced these spaces, and reflects on teaching and learning practices that have enabled these experiences. Finally, this chapter makes suggestions on how ethical spaces might be integrated in secondary education.
Dietary salt intake may vary depending on different lifestyles. We aimed to estimate the different salt intakes and evaluate the knowledge and self-awareness about salt among people speaking the Teochew, Teochew–Hakka and Hakka dialects in the Chaoshan region of southern China.
The study followed a cluster sampling of residents in Chaoshan region. General characteristics, lifestyles, health status as well as knowledge and self-awareness related to salt intake were investigated using a questionnaire. Anthropometric variables as well as Na and K excretion in a 24-h urine collection were measured.
Chaoshan region of China.
Four hundred fifteen adults who spoke only one of these three dialects.
The salt intake of adults who spoke the Teochew, Teochew–Hakka and Hakka dialects was 7·19 (interquartile range (IQR) 5·29–10·17), 9·03 (IQR 6·62–11·54) and 10·12 (IQR 7·61–12·82) g/d, respectively, with significant differences between Teochew and Teochew–Hakka speakers and between Teochew and Hakka speakers (both P < 0·05). The Na:K ratio for adults who spoke the three dialects was 3·00 (IQR 2·00–4·11), 3·50 (IQR 2·64–4·82) and 4·52 (IQR 3·35–5·97), respectively, and differed significantly among the groups (all P < 0·05). Multiple linear regression analysis showed increased Na:K ratio associated with hypertension (β = 0·71, P = 0·043) in Hakka speakers. Knowledge and self-awareness about salt intake were poor in this population.
Salt intake was closely related to lifestyles and was higher than the upper limit (5 g/d) recommended by the WHO in adults of Chaoshan, especially those speaking the Hakka dialect.
Body image disturbances are core symptoms of Anorexia Nervosa (AN). This study investigated self-face recognition in cases of AN, and the influence of others factors associated with AN, such as massive weight loss.
Fifteen anorexic female patients and 15 matched Healthy Controls (HC) performed a self-face recognition task. Participants viewed digital morphs between their own face and a gender-matched, unfamiliar other face presented in a random sequence (Fig. 1). For each stimulus, subjects were asked if they recognized their own face, and respond by selectively pressing a button on a computer. Participants’ self-face recognition failures, cognitive flexibility, body concerns and eating habits were assessed, respectively, with the Self-Face Recognition Questionnaire (SFRQ), the Trail Marking Task (TMT), the Body Shape Questionnaire (BSQ) and the Eating Disorder Inventory-2 (EDI-2).
Examples of stimulus. For each subject, a photograph of an unfamiliar face was digitally morphed into a photograph of the subject's face in 10% increments.
Anorexic patients showed a significantly greater difficulty than healthy control in identifying their own face (P = 0.028, Fig. 2). No significant difference was observed between the two groups for TMT (all P > 0.1). However, analysis did not reveal significant correlations between behavioral data and the EDI-2 or BSQ (all P > 0.1). A correlation analysis revealed a significant, negative correlation with BMI (P < 0.001) and the SFRQ “self-face recognition” subscale (P = 0.015).
Self response rates per stimulus ranked in increasing order of familiarity (other to self) in both groups.
We observed a decrease in self-face recognition, correlated with BMI, suggesting this disturbance could be linked to massive weight loss. It thus supports the theory of a lack of ability to update body image by the central nervous system, underlying self-images distortion in AN patients.
Awareness of attention deficit hyperactivity disorder (ADHD) in adults has been growing over the last decade. One of the most interesting issues related to this topic is these adults’ self-awareness of their ADHD symptoms and their estimation of their own impairments. Our hypothesis while studying young adult ADHD populations was that there would be a significant difference between their self-report and their clinical assessment.
One hundred and three students volunteered for this study. In order to validate our ADHD screening questionnaire (ADHD-SQ), and to assess the level of awareness they have of their own symptoms, participants underwent a complete clinical assessment for ADHD. They were divided into a control group (n = 24), and an ADHD study group (n = 79), which in turn was composed of two sub-groups, one comprising 24 ADHD predominantly inattentive (ADHD-I) and the other 55 ADHD combined type (ADHD-C).
Factor analysis yielded two factors explaining 41% of the variance. The Inattention (IA) subscale score tended to be higher in both ADHD sub-groups as compared to the control group (6.5±2.1 vs. 2.34±2.3 with P<0.001), with no significant difference between the two ADHD sub-groups. Hyperactivity Impulsivity (HI) subscale was significantly higher for the ADHD-C sub-group than in the ADHD-I sub-group, whose score was similar to that of the control group (control: 1.6±2.1; ADHD-I: 1.55±1.0; ADHD-C: 4.5±2.6, P<0.0001). Receiver Operating Characteristics (ROC) analysis showed similar results. The area under the curve (AUC) of IA subscale score was 0.90 (95% confidence: 0.83–0.96) and for HI subscale score was 0.75, (95% confidence: 0.63–0.86). Classification into groups used a cut-off point of 3+ items out of nine, in the SQ and 6+ items out of nine in the clinical assessment. These two classifications showed 68% agreement (46% sensitivity and 95% specificity). In both ADHD sub-groups, the self-reported average number of positive symptoms per student was relatively low for both clusters; this phenomenon was pronounced in the specific subtypes. The self-rated HI cluster score was considerably low in the ADHD-C sub-group (4.5±2.6), and the IA one was particularly low in the ADHD-IADHD-I sub-group (5.9±1.9).
This study's results indicate that ADHD symptoms are under-reported for both inattentive and hyperactive-impulsive clusters, indicating that adults with ADHD tend to under-estimate their own ADHD-related impairments. We suggest that this questionnaire may be used both in research and academic settings to help counsellors and students to obtain early indication of ADHD and to refer students suspected of having ADHD to full clinical assessment.
Most older adults perceive themselves as good drivers; however, their perception may not be accurate, and could negatively affect their driving safety. This study examined the accuracy of older drivers’ self-awareness of driving ability in their everyday driving environment by determining the concordance between the perceived (assessed by the Perceived Driving Ability [PDA] questionnaire) and actual (assessed by electronic Driving Observation Schedule [eDOS]) driving performance. One hundred and eight older drivers (male: 67.6%; age: mean = 80.6 years, standard deviation [SD] = 4.9 years) who participated in the study were classified into three groups: underestimation (19%), accurate estimation (29%), and overestimation (53%). Using the demographic and clinical functioning information collected in the Candrive annual assessments, an ordinal regression showed that two factors were related to the accuracy of self-awareness: older drivers with better visuo-motor processing speed measured by the Trail Making Test (TMT)-A and fewer self-reported comorbid conditions tended to overestimate their driving ability, and vice versa.
Organisations and associated management practices are generally considered responsible for promoting employees' enjoyment of work. Our study, on the other hand, seeks to examine the capacity of individual workers to regulate their own experience of fun. We interviewed eight ‘remarkable’ workers who claimed to always (or nearly always) have fun at work. We utilised a critical realist approach in the analysis that enabled the consideration of both structure and agency in the experience of workplace fun. A key research finding was that participants possessed a strong sense of control over their own happiness at work, demonstrated in four ways: (1) a priority placed on fun, (2) a sense of responsibility for fun, (3) a positive orientation to the world and (4) a sense of mastery and challenge in work tasks. Research findings may inspire both individual workers and organisations to adopt an agentic outlook in the workplace, implementing strategies that enhance employee control.
Cognitive changes that accompany the gradual degradation of neural systems are countervailed by a set of attention-related processes that serve to reorganize and maintain function with advancing age. This chapter focuses on the potential role of the right hemisphere fronto-parietal network in maintenance of adequate sustained attention to the environment by older adults, as well as self-monitoring of changes in their cognition and behavior over time. Modulation of norepinephrine activity in the locus coeruleus, via its impact on this right lateralized network, may be of particular importance in increasing the capacity of older people to preserve cognitive functioning as a multitude of biological changes take place in their brains. We review studies demonstrating that noninvasive electrical brain stimulation to the right prefrontal cortex improves both sustained attention and error awareness, suggesting that this key interconnected hub region in the right hemisphere holds the potential to be exploited and upregulated in older adults to ameliorate deficits.
This chapter focuses on mindfulness as a tool to build creativity in research. Researchers tend to be busy, rarely stopping to take the time to notice how they go about their research and why. This chapter argues that you can be more productive if you pay explicit attention to the behaviors, thoughts, and attitudes that comprise your research practice. By developing the ability to notice and accept what is happening, you can develop the ability to act more intentionally.