Anosognosia and self-correction of naming errors in aphasia

Dean, Michael P; Della Sala, Sergio; Beschin, Nicoletta and Cocchini, Gianna. 2017. Anosognosia and self-correction of naming errors in aphasia. Aphasiology, 31(7), pp. 725-740. ISSN 1464-5041 [Article]

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Abstract or Description

Background: There has been comparatively little research into anosognosia for aphasia (a lack of awareness of acquired language deficits). Direct assessments of metacognitive awareness tend to rely on high levels of verbal competence and are difficult for people with aphasia to complete. Therefore indirect measures of awareness have been considered, notably the person’s self-correction of his or her naming errors. Different mechanisms for self-correction based in comprehension or production skills have been proposed. In addition, in other areas of cognition, the relationships between direct and indirect measures and underlying forms of awareness have not been clearly established.
Aims: The aims of this study were: a) to investigate the relationship between a direct and an indirect measure of awareness of aphasia, b) to examine the role of executive functioning in performance on both assessment types, and c) to examine the relationship between these measures and underlying language comprehension and production skills.
Methods & Procedures: Forty-eight people with aphasia participated, drawn from rehabilitation hospital caseloads. Participants were assessed on a language battery, a non-verbal test of executive function, a direct measure of awareness (ratings of difficulties), and had self-correction behaviour examined in a 40-item naming test.
Outcomes & Results: There was a trend relationship between performance on the direct and indirect measures. Both related to overall severity of language impairment, with more severely impaired people being less aware of their difficulties. The two measures, however, dissociated with respect to single-word production and comprehension scores: the direct measure related to production and not comprehension, while the indirect measure related to comprehension and not production. Executive functioning related only to the direct measure of metacognitive awareness. Within production scores, the rate of correction success rather than pre-correction naming rate was associated with metacognitive awareness.
Conclusions: This study revealed different underlying bases, in language processes and executive function, for two measures of anosognosia for aphasia. When used to assess awareness of deficits, direct and indirect methods should not be regarded as equivalent.

Item Type:


Identification Number (DOI):


Anosognosia, awareness, metacognition, executive function, self-monitoring, error detection

Departments, Centres and Research Units:

Psychology > Centre for Cognition, Computation and Culture (CCCC)
Psychology > Cognitive Neuroscience Unit


12 September 2016Accepted
4 October 2016Published Online

Item ID:


Date Deposited:

14 Sep 2016 15:43

Last Modified:

29 Apr 2020 16:20

Peer Reviewed:

Yes, this version has been peer-reviewed.


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