Cognitive and Motivational Factors in Anosognosia

Anosognosia is a patient’s denial of his or her impairment or illness. The starting point for this chapter is that anosognosia can be considered as a delusion. We sketch the two-factor framework for understanding delusions and how anosognosia would fit into this framework. We set out competing views on the role of motivation in anosognosia and evaluate the prospects for an account of anosognosia at least partly in terms of motivation. We describe a study of cognitive impairments in patients with anosognosia and propose that the role of impairments of working memory and executive processes should be investigated further; and we consider how the results of a study in which motivation is not explicitly investigated might, in principle, suggest that motivation is also playing a role in some cases. * The authors’ names are listed in alphabetical order.