How to test anosognosia in stroke patients? Improving the reliability and validity of VATA-M and VATA-L psychometric measures

Anosognosia is a pervasive disturb which includes a specific impairment in the meta-cognition about patient’s own morbid state, and which can totally compromise the efficacy of neuropsychological rehabilitation and treatment. From the neuropsychological point of view a reduced number of psychometric measures was used to explore this relevant construct. The present contribution explores the validity and reliability of some existing measures (VATA-L; VATA-M) which respectively test the patient’s selfawareness of language and motor deficits. The total score of these tests included the subctractive rating (caregivers/patient score) as a significant cut-off to discriminate between high vs. low anosognosia profile. VATA-L and VATA-M measures were administered to 45 patients (M 20/F 25, age 70.20±14.1) and their caregivers (M 15/F 30, age 51.8±14.4). Secondly, these psychometric indexes were correlated with caregiving strain (FSQ-SF), caregiver’s perceived difficulties in assisting the patient and level of awareness attributed to the patient (both rating on a visual analogue scale), and level of functional dependence (FIM). Results indicate possible directions to improve the validity and reliability of both tests, taking into account some specific features of patients’ profile (i.e. left/right hemisphere lesions distinction), the comprehensibility of some items (in relationship with the cognitive effort they induce), the direct link and comparability between patients’ and caregivers’ evaluations, and the ecological validity of the selected measures. These include a proposal of an integrative measure (pre-VATA-M) to discriminate between high vs. low reliable items.