Honors Program


Document Type


Date of this Version

Spring 5-2021


Amadon, G. 2021. Metacognitive function in moderate to severe traumatic brain injury. Undergraduate Honors Thesis. University of Nebraska - Lincoln.


Copyright Grace Amadon 2021.


Traumatic brain injury (TBI) is an injury to the brain caused by a bump, blow, jolt to the head. Individuals with TBI demonstrate decreased awareness of their own potential deficits and functional abilities. These deficits have critical implications for recovery as self-awareness is important for those recovering from TBI in the implementation and engagement of rehabilitative processes after TBI. The following study analyzed 18 individuals with TBI approximately 11 years post injury to document metacognitive functioning after injury. Participants completed a metacognitive working-memory paradigm where they made judgements of their future and past performance on identifying a target shape and location. Task accuracy, subjective confidence, and metacognitive ratings were recorded through this paradigm. Task accuracy and metacognitive ratings were used in calculating the area under the receiver operating characteristic curve, as well as over- and under- confidence errors, both of which were used to measure metacognitive accuracy. Results indicate that individuals with TBI select the correct target stimulus less than half of the time. In the same manner, these individuals were somewhat unconfident in their responses based on a response considering a Likert scale of 1-4; however, participants were overconfident in their responses. Finally, there was a high degree of discrepancy between an individual's confidence and accuracy, exhibiting a low level of metacognitive sensitivity. These findings suggest the need to implement rehabilitative strategies that target self-awareness in order to promote successful return to work, life, and subjective normalcy following TBI.