Norm-based subjective evaluation of cognitive processes in epileptic patients: a microgenetic approach

The aim of this study was to determine whether patients suffering from a chronic illness and taking medication which can affect their cognitive functioning are able to assess their own cognitive performance, as compared to healthy controls. Can we observe improvements in the accuracy of these self-evaluations as treatment progresses? 58 epilepsy patients participated in the first part of the study. We used diagnostic tests to measure immediate verbal memory, concentration and psychomotor speed. The subjects were asked to predict their performance on these tests. In the second stage of the study, we conducted an analogous assessment in a group of 346 healthy second-year medical students. In the first stage of the study (before optimization of the patients’ treatment) we obtained non-significant correlations between the subjects’ predictions and actual objective results on the psychological tests. To optimize treatment, we decreased the number of anti-seizure drugs, corrected the drug concentration in the patients’ blood and achieved an improved clinical status. This way we achieved a statistically confirmed improvement within all examined cognitive functions. However, we noted no improvement in the agreement between the patients’ predictions and their empirical results. Among the healthy subjects the correlation between their predictions and actual results was likewise very low. There was no agreement between the assumptions the patients made regarding their cognitive performance and the results they obtained in objective tests. The results are interpreted according to microgenetic theory, especially as regards symptom formation.