Self reflection in healthy participants and patients with an acquired brain injury

The dissertation contains two published studies on self-reflection. The aim of the first study was to investigate whether already known effects in self-appraisals also occur after a change of perspective. Examined were the Self Serving Bias Effect (SSBE), which manifests in a predominantly positive self-appraisal and the Mnemic Neglect Effect (MNE), which is reflected in a memory advantage for information that serves the positive self-concept. In a computer experiment 60 healthy females were asked to judge positive and negative personality traits as self-describing or non-self-describing, once from their own and once while taking the perspective of a close other. Afterwards, they were asked to reproduce all personality traits that they remembered from the computer experiment. In addition, the participants’ self-esteem was assessed and its association with the self-appraisals was investigated. The known effects SSBE and MNE were found in the self-appraisals with and without a change in perspective. Interestingly, the SSBE was more pronounced when taking the perspective of a close other. In contrast, self-esteem was significantly positively associated with the SSBE only in self-appraisals from their own perspective. The second study aimed to investigate whether Ecological Momentary Assessment (EMA) as a research method can be used in patients with an acquired brain injury. EMA seemed to offer an opportunity to investigate the complex and multifaceted impairments of these patients and dynamics in their self-appraisals. This was particularly interesting, as these patients often differ in their assessment of their impairment from those of professionals and relatives. Therefore, it was also examined whether the patients’ self-appraisal is relatively stable or varies in the course of the investigation. In the study, 15 patients with different brain injuries were asked about their current activity, social context and mood eight times a day for seven days via app on a study smartphone. In addition, each time they were asked to assess their own functional status and the frequency of their self-reflection. The study results show that, with some limitations discussed in the article, EMA can be used in patients with an acquired brain injury. Furthermore, the results reveal that the self-appraisal of the individual patients varied in the course of the investigation. Interestingly, neither the patients' compliance nor the extent of fluctuation in their responses were related to their age and degree of impairment, which is critically discussed. In summary, the results of this dissertation show, in addition to already known effects, that the self-appraisal of healthy females is influenced by a change of perspective, that EMA as a method to investigate self-appraisals can also be used in patients with an acquired brain injury and that the self-appraisal of individual patients varies

How females think about themselves and how they assume that significant others think about them: The influence of perspective taking on self-referential processing

People maintain a positive self-concept through positive self-appraisals (Self-Serving Bias Effect, SSBE) and a diminished memory for self-threatening information (Mnemic-Neglect Effect, MNE). Other people also influence a person's self-concept. This study investigated SSBE and MNE in 60 females by using a trait-judgment paradigm applying two perspectives (self- and third-person appraisals) and a recall task. Additionally, self-esteem was assessed as an associated factor. SSBE and MNE were found in both kinds of appraisal perspectives. Interestingly, participants saw themselves as even more positive in reflected appraisals. SSBE and self-esteem were associated only in self-appraisals, indicating a larger SSBE on self-appraisals with raising self-esteem. In conclusion, both what females think about themselves and how they assume that others think about them preserve their overall positive self-concept

Self-Referential Processing and Resting-State Functional MRI Connectivity of Cortical Midline Structures in Glioma Patients

Metacognition has only scarcely been investigated in brain tumor patients. It is unclear if and how the tumor-lesioned brain might be able to maintain an adequate sense-of-self. As cortical midline structures (CMS) are regarded as essential for self-referential mental activity, we investigated resting-state fMRI connectivity (FC) of CMS to the default-mode network (DMN) and to the whole brain, comparing glioma patients and matched controls. Subjects furthermore performed a trait judgement (TJ), a trait recall task (TR), and neuropsychological testing. In the TJ, adjectives had to be ascribed as self- or non-self-describing, assessing the self-serving effect (SSE), a normally observed bias for positive traits. In the TR, the mnemic neglect effect (MNE), a memory advantage for positive traits, was tested. The groups were compared and partial correlations between FC and test metrics were analyzed. Although patients were significantly impaired in terms of verbal memory, groups did not differ in the SSE or the MNE results, showing preserved metacognitive abilities in patients. FC of CMS to the DMN was maintained, but was significantly decreased to whole brain in the patients. FC of the dorsomedial prefrontal cortex (DMPFC) to whole brain was correlated with the MNE in patients. Preserving the DMPFC in therapeutic interventions might be relevant for maintaining self-related verbal information processing in the memory domain in glioma patients

Self-referential processing and perspective taking in patients with a borderline personality disorder

Forster SD, Beblo T, Pohl S, Steuwe C, Gauggel S, Mainz V. Self-referential processing and perspective taking in patients with a borderline personality disorder. Journal of psychiatric research. 2021;140:87-94.Divergent self- and other-referential processes play a particular role in the development and maintenance of borderline personality disorder (BPD). This study investigated self-referential processes in patients with BPD and age-matched controls. Participants performed a trait-judgment task, taking their own and the perspective of a close other person. Memory was assessed during recall of the previous choices. Results revealed over all more negative self-appraisals in patients than controls, which seemed due to making less positive self-referential choices rather than an increased choice of negative traits. Interestingly, taking another perspective, patients had a healthier, predominantly positive self-assessment, albeit still attenuated compared to controls. The characteristics of the appraisals were mirrored in memory performances. Moreover, self-esteem seems to be a potential protective factor, as self-appraisals were more positive with higher self-esteem. Altogether, this study shows significantly deviant self-referential processes in patients with BPD, suggesting that patients do not integrate what they believe others think about them into their self-concept. Copyright © 2021 Elsevier Ltd. All rights reserved