Self-Knowledge and Self-Referential Processing in Memory Disorders: Implications for Neuropsychological Rehabilitation

Abstract

Damage to the brain can affect the core of the individual, i.e. the self. Results from a small number of studies with amnesic individuals indicate that patients' ability to show preserved knowledge of self may vary. The present study explored self-knowledge in patients with memory impairment as a result of confabulation, mild cognitive impairment, Alzheimer's disease and acquired brain damage. We found that different memory disorders differentially affected patients' self-knowledge. At least some patients showed a preserved sense of self, and were able to acquire information about another person that they had met postmorbidly. Frontal function and stability of cognitive impairments over time appear to be two variables important in determining whether patients can have a consistent and updated sense of self. We also explored the extent to which self-referential and other-referential processing might enhance memory in individuals with memory-impairment. The self-reference effect (SRE) and other-reference effect (ORE) have been consistently found in normal adults. Results indicated that patients showed a normal SRE and ORE. The SRE and ORE appeared to be at least partly dependent on degree of knowledge of the person being referenced, and were also related to general memory and frontal function. Only the SRE, however, was also related to patients' ability to improve memory as a result of emotional processing. These findings may have important implications for caregivers and healthcare professionals working with memory-impaired patients, and may pave the way to novel memory rehabilitation methods.