Exp Brain Res (2008) 186:509–515 DOI 10.1007/s00221-008-1341-9 123 RESEARCH NOTE Neuropsychology of self-awareness in young adults Doreen Hoerold · Paul M. Dockree · Fiadhnait M. O’KeeVe · Helen Bates · Maria Pertl · Ian H. Robertson Received: 30 October 2007 / Accepted: 2 March 2008 / Published online: 14 March 2008  Springer-Verlag 2008 Abstract Disorders of self-awareness are common following cortical damage, particularly to the frontal lobes, but there have been few studies of individual diVerences in self-awareness in the normal population. In the current study, we explored patterns of metacognitive awareness among healthy young adults, based on discrepancies of self- and other-ratings on the Frontal Systems Behavior Scale (FrSBe; Grace and Malloy, 2002). Those who showed poor metacognitive awareness showed more fre- quent lapses of attention, and higher levels of everyday absentmindedness, than those who accurately appraised their own behavior or those who overestimated their own FrSBe scores. Furthermore, among those with poor meta- cognitive awareness, online emergent awareness correlated positively with prospective memory performance, and neg- atively with anxiety scores. Our results suggest that accu- rate self-awareness in non-neurological participants relies on eYcient sustained attention functioning, supporting the role of frontal control systems in neuroanatomical models of self-awareness. Keywords Insight · Self-awareness · Sustained attention · Frontal lobes · Executive functions Introduction Self-awareness can be deWned as the accuracy of individu- als’ assesments of their past, current or future behavior, measured either in relation to objective performance, or in relation to the ratings of signiWcant others or caregivers. Self-awareness/insight is of considerable importance in brain rehabilitation since a lack of acknowldgement of problems mitigates against taking the necessary steps to overcome them, as many studies have documented (Fleming et al. 1998; Sherer et al. 1998). Disorders of self-awareness are common following cor- tical damage (O’KeeVe et al. 2007a, c; Prigatano and Sch- acter 1991), particularly to the frontal lobes (McDaniel et al. 1995; Stuss et al. 2001), but also to other regions, including right parietal circuits (e.g., Pia et al. 2004). Dam- age to right parietal areas has frequently been associated with unawareness of motor deWcits, which is thought to reXect a failure to update and integrate bodily and spatial information. Recent investigations have related anosogno- sia for motor deWcits to right insular (Karnath et al. 2005) and right pre-motor areas, such as Brodmann’s areas 6 and 44 (Berti et al. 2005). While right-lateralized structures cer- tainly appear to play an important role (Reed et al. 1993; Starkstein et al. 1992), it has been noted that compelling evidence also exists for left hemispheric involvement in self-awareness, through the link of inner speech capacity and self-awareness (e.g., Morin and Michaud, 2007). Attempts to use CT-based lesion analyses of traumatic brain injury (TBI) patients to predict impaired self-aware- ness have failed to demonstrate consistent relationships between lesion location or volume and degree of unaware- ness (Sherer et al. 2005). However, TBI is known to disrupt connectivity between many areas through diVuse axonal injury, making it diYcult to link discrete lesions to impair- ment levels. The neuropsychology of self-awareness is in itself an unresolved theoretical challenge (Prigatano 2005). Attempts to understand which cognitive functions are most D. Hoerold (&) · P. M. Dockree · F. M. O’KeeVe · H. Bates · M. Pertl · I. H. Robertson Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland e-mail: hoeroldd@tcd.ie