Revisiting the dynamic comprehensive model of self-awareness: a scoping review and thematic analysis of its impact 20 years later

Neuropsychol Rehabil. 2022 Sep;32(8):1676-1725. doi: 10.1080/09602011.2022.2075017. Epub 2022 May 18.

Abstract

This study aimed to (1) describe the scope of research related to the Dynamic Comprehensive Model of Awareness (DCMA) (Toglia & Kirk, 2000); (2) identify themes and support for key model postulates; and (3) suggest future research directions related to this model. Using PRISMA scoping guidelines, 366 articles were reviewed, and 54 articles met our inclusion criteria. Selected studies were clustered into three themes: (1) the relationship between general and online self-awareness (50%); (2) interventions based on the model (41%); and (3) factors contributing to self-awareness (9%). Most studies were conducted with participants with acquired brain injury (BI) and traumatic BI (68%), most used a cross-sectional design (50%), and most intervention studies utilized a single-subject design (18%), followed by an experimental design (9%). This review provides evidence for the wide application of the DCMA across varying ages and populations. The need for a multidimensional assessment approach is recognized; however, stronger evidence that supports a uniform assessment of online self-awareness is needed. The intervention studies frequently described the importance of direct experience in developing self-awareness; however, few studies compared how intervention methods to influence general versus online self-awareness, or how cognitive capacity, self-efficacy, psychological factors, and context, influence the development of self-awareness.

Keywords: Metacognition; anosognosia; brain injury; cognitive impairment; feedback; rehabilitation.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Brain Injuries*
  • Brain Injuries, Traumatic*
  • Cross-Sectional Studies
  • Humans
  • Maleates
  • Perception

Substances

  • Maleates
  • dichloromaleic acid