A comprehensive profile of awareness in mild cognitive impairment

Electronic versions

Documents

  • Judith Roberts

    Research areas

  • School of Psychology

Abstract

This thesis explores awareness in mild cognitive impairment(MCI). The limited research on this particular topic has yielded inconclusive results yet it suggeststhatawareness does vary in people with MCI. The heterogeneity across findingsis asa result of conceptual and methodological differenceswhich are discussedin chapter 2(literature review). Much of the literature has focussed on the role and accuracy of subjective memory complaint (SMC) in predicting future dementia, whereas focussing on SMC alone excludes people who would meet the criteria for MCI but who do not present with SMC. The literature review highlights the importance of focussing on awareness rather than SMC alone. Forthe purpose of this thesis, awareness is conceptualised as „a reasonable or realistic perception or appraisal of a given aspect of one‟s situation, functioning or performance, or of the resulting implications, which may be expressed explicitly or implicitly‟. Awareness is also placed within a framework of different levels, specifically, meta-representation, evaluative judgment and performance monitoring.Study 1(chapter 3)explores the meta-representation level of awareness in MCI by adopting a qualitativeapproach through interpretative phenomenological analysis (IPA). This study provides an exploratory model of the experience of MCI with a focus on the participants‟ appraisal of their memory or cognitive difficulty. This study identified four themes, „fear and uncertainty‟, „interdependence‟, „life goes on as normal‟ and „disavowal of difficulty‟. Studies 2(chapter 4)and 3(chapter 5)present quantitative data from a cross-sectional and longitudinal perspective respectively, and explore awareness in MCI at the level of evaluative judgment and performance monitoring. Overall findings support the biopsychosocial model which implicates the role of psychological and social factors as well as cognition in how people with MCI appraise their symptoms, which can result in a variety of context-dependent coping styles. Findings from these three studies are discussed with consideration of theoretical and practical challenges as well as future directions.

Details

Original languageEnglish
Awarding Institution
Supervisors/Advisors
  • Linda Clare (Supervisor)
Award dateJan 2011