Cognitive, social and emotional processes in unawareness of illness following stroke

 

Show simple item record

dc.contributor.advisor Solms, Mark en_ZA
dc.contributor.advisor Fotopoulou, Aikaterini en_ZA
dc.contributor.author Besharati, Sahba en_ZA
dc.date.accessioned 2015-12-01T09:24:07Z
dc.date.available 2015-12-01T09:24:07Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Besharati, S. 2015. Cognitive, social and emotional processes in unawareness of illness following stroke. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15491
dc.description Includes bibliographical references en_ZA
dc.description.abstract Disturbances in unawareness can offer an important avenue to investigate the neurocognitive processes involved in the construction of the bodily self. The general aim of the present thesis was to advance the current state of knowledge on a prototypical disorder of self-awareness, anosognosia for hemiplegia (AHP): unawareness of motor deficits contralateral to a brain lesion. Based on insights gained from both clinical and experimental research on anosognosia, it is argued that purely sensorimotor accounts do not explain several features of the syndrome, such as the delusional and emotional aspects. Therefore a revision of prevailing, modular theories of anosognosia is proposed that take into account the involvement of affective and so cial processes. Accordingly, the thesis aimed to: (1) investig ate the emotional and social factors that underlie motor unawareness; (2) identify the neurocognitive factors and neuroanatomical correlate that underlie such factors; and (3) develop potential, bedside rehabilitation interventions for AHP that are informed by the above investigations. These aims were achieved using an integrative methodological approach, which combined neuropsychological testing, psychophysiological experiments and neuroimaging methods. A series of experiment al group investigations and clinical case studies were conducted in 53 adult patients with right-hemisphere strokes. The main results of these studies showed that: (i) motor awareness is modulated by negative, but not positive emotion in a social context; (ii) anosognosia is associated with specific deficits in 3rd person perspective taking in visual-spatial and mentalising tasks; (iii) anosognosia is modulated by 'other' referent and 3rd person verbal and visual perspective taking. These experimental findings on the role of emotion and social processes in AHP were in turn used to develop a rehabilitation intervention applied in two case studies that showed promising results. Additionally, converging neuroimaging evidence provided support for the unique involvement of the inferior frontal gyrus, insula ribbon, supramarginal and superior temporal gyrus, and dorsal frontal white matter in anosognosia, which have well-established links to motor monitoring, subjecting feelings and self-awareness, and the proposed 'mentalising network'. These finding are in support of a proposed new account of AHP, which move s away from traditional modular theories of anosognosia, towards a dynamic model of the construction of the bodily self. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Psychology en_ZA
dc.title Cognitive, social and emotional processes in unawareness of illness following stroke en_ZA
dc.type Doctoral Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Humanities en_ZA
dc.publisher.department Department of Psychology en_ZA
dc.type.qualificationlevel Doctoral
dc.type.qualificationname PhD en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Besharati, S. (2015). <i>Cognitive, social and emotional processes in unawareness of illness following stroke</i>. (Thesis). University of Cape Town ,Faculty of Humanities ,Department of Psychology. Retrieved from http://hdl.handle.net/11427/15491 en_ZA
dc.identifier.chicagocitation Besharati, Sahba. <i>"Cognitive, social and emotional processes in unawareness of illness following stroke."</i> Thesis., University of Cape Town ,Faculty of Humanities ,Department of Psychology, 2015. http://hdl.handle.net/11427/15491 en_ZA
dc.identifier.vancouvercitation Besharati S. Cognitive, social and emotional processes in unawareness of illness following stroke. [Thesis]. University of Cape Town ,Faculty of Humanities ,Department of Psychology, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/15491 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Besharati, Sahba AB - Disturbances in unawareness can offer an important avenue to investigate the neurocognitive processes involved in the construction of the bodily self. The general aim of the present thesis was to advance the current state of knowledge on a prototypical disorder of self-awareness, anosognosia for hemiplegia (AHP): unawareness of motor deficits contralateral to a brain lesion. Based on insights gained from both clinical and experimental research on anosognosia, it is argued that purely sensorimotor accounts do not explain several features of the syndrome, such as the delusional and emotional aspects. Therefore a revision of prevailing, modular theories of anosognosia is proposed that take into account the involvement of affective and so cial processes. Accordingly, the thesis aimed to: (1) investig ate the emotional and social factors that underlie motor unawareness; (2) identify the neurocognitive factors and neuroanatomical correlate that underlie such factors; and (3) develop potential, bedside rehabilitation interventions for AHP that are informed by the above investigations. These aims were achieved using an integrative methodological approach, which combined neuropsychological testing, psychophysiological experiments and neuroimaging methods. A series of experiment al group investigations and clinical case studies were conducted in 53 adult patients with right-hemisphere strokes. The main results of these studies showed that: (i) motor awareness is modulated by negative, but not positive emotion in a social context; (ii) anosognosia is associated with specific deficits in 3rd person perspective taking in visual-spatial and mentalising tasks; (iii) anosognosia is modulated by 'other' referent and 3rd person verbal and visual perspective taking. These experimental findings on the role of emotion and social processes in AHP were in turn used to develop a rehabilitation intervention applied in two case studies that showed promising results. Additionally, converging neuroimaging evidence provided support for the unique involvement of the inferior frontal gyrus, insula ribbon, supramarginal and superior temporal gyrus, and dorsal frontal white matter in anosognosia, which have well-established links to motor monitoring, subjecting feelings and self-awareness, and the proposed 'mentalising network'. These finding are in support of a proposed new account of AHP, which move s away from traditional modular theories of anosognosia, towards a dynamic model of the construction of the bodily self. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Cognitive, social and emotional processes in unawareness of illness following stroke TI - Cognitive, social and emotional processes in unawareness of illness following stroke UR - http://hdl.handle.net/11427/15491 ER - en_ZA


Files in this item

This item appears in the following Collection(s)

Show simple item record