Research: Self-assessment of cognition is not what it seems

Epub ahead of printAkbar et al. Self-assessment of Cognition in Multiple Sclerosis: The Role of Personality and Anxiety. Cogn Behav Neurol. 2011 Sep 6. 

Objective: To investigate the role of personality and anxiety to self-report measures of cognition in MS’ers.

Background: Self-report measures of cognition have consistently been shown to correlate better with depressed mood than neuropsychological test performance in MS’ers, with few studies focusing on the role of anxiety and personality.

Method: 108 MS’ers completed the following: (a) patient and informant report Multiple Sclerosis Neuropsychological Questionnaire (MSNQ); (b) Hospital Anxiety and Depression Scale; (c) cognitive assessment with the Brief Repeatable Battery of Neuropsychological Tests; and (d) personality assessment using the self-report NEO Five-Factor Inventory.

Results: Higher patient MSNQ (P-MSNQ) scores (greater reported cognitive dysfunction) were significantly correlated with lower scores on the Paced Auditory Serial Addition Test (PASAT; r=-0.20, P<0.05), increased depression (r=0.45, P<0.01) and anxiety (r=0.54, P<0.01), higher neuroticism (r=0.51, P<0.01), and lower conscientiousness (r=-0.35, P<0.01). After controlling for demographic variables, significant predictors of P-MSNQ scores were anxiety (ΔR=0.272, P<0.001), conscientiousness (ΔR=0.067, P=0.002) and performance on the PASAT (ΔR=0.050, P=0.005). Depression and neuroticism did not contribute significant variance in comparison to anxiety.
“The Paced Auditory Serial Addition Test is a cognitive test that is used frequently in MS; please see additional post below.”

Conclusions: Overall, MS’er self-reports of cognition do not correspond well to neuropsychological performance. Anxiety and conscientiousness contributed significantly to MS’ers perceptions of their cognitive failings and thus should be taken into account when addressing these complaints.
“This study suggest there is no short-cut when assessing and documenting complaints about cognition in MS’ers. We can’t rely on self-reporting and need to order a neuropsychological battery.”

19 Jul 2011
The Paced auditory serial addition test (PASAT): a cognitive test in MS trials. For those of you who participate in MS clinical trials you will know how difficult it is to perform the paced auditory serial addition test (PASAT). 

One thought on “Research: Self-assessment of cognition is not what it seems”

  1. I can't access the full paper so I don't know the full methodology – was the study longitudinal? One factor that has to be taken into account when assessing cognitive dysfunction is the original start point. I've experienced healthcare professionals telling me I couldn't possibly have cognitive dysfunction, as I was (at that time) working for a PhD. It was extremely hard to convince them that truly, yes I could notice a difference.

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