{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:15:14Z","timestamp":1785248114235,"version":"3.55.0"},"reference-count":68,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Impairment in self-awareness (ISA) is one of the common consequences of an acquired brain injury (ABI) and is associated with anosodiaphoria. Collectively, these co-occurring neuropsychological disorders pose significant obstacles in the neurorehabilitation of moderate-to-severe ABI patients. Individuals who recover from ISA may present with anxiety and\/or depression as adaptive reactions to the ABI, along with related functional disabilities. The present study investigated whether the level of metacognitive self-awareness (SA) is associated with the presence of anxiety and depression, apathy, or anosodiaphoria in patients with moderate-to-severe ABI. It aimed also at investigating the possible relationship between the severity of disability and both psycho-emotional diseases and the presence of PTSD symptoms in patients with high metacognitive SA. Methods: Sixty patients with moderate-to-severe ABI and different levels of metacognitive SA completed a series of questionnaires, which assessed their self-reported metacognitive SA, anosodiaphoria, anxiety and depression, apathy, and PTSD symptoms. Results: Low-metacognitive-SA patients showed lower levels of anxiety and depression and higher anosodiaphoria than high-metacognitive-SA patients. Patients with high metacognitive SA and high levels of disability showed significant higher states of anxiety and PTSD symptoms than patients with high metacognitive SA and low levels of disability. Conclusions: The neurorehabilitation of individuals with moderate to severe ABI should address, in particular, the complex interaction between ISA and anxiety and depression in patients during the rehabilitation process.<\/jats:p>","DOI":"10.3390\/brainsci15080841","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:25:52Z","timestamp":1754558752000},"page":"841","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Emotional Status in Relation to Metacognitive Self-Awareness and Level of Functional Disability Following Acquired Brain Injury"],"prefix":"10.3390","volume":"15","author":[{"given":"Valentina","family":"Bandiera","sequence":"first","affiliation":[{"name":"Department of Human Science, LUMSA University, 00193 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2434-6260","authenticated-orcid":false,"given":"Dolores","family":"Villalobos","sequence":"additional","affiliation":[{"name":"Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, 28223 Madrid, Spain"},{"name":"Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28015 Madrid, Spain"},{"name":"Institute of Knowledge Technology, Complutense University of Madrid, 28223 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Economic, Psychological, Communication, Educational and Motor Sciences, Niccol\u00f2 Cusano University, 00166 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3043-743X","authenticated-orcid":false,"given":"Gaia","family":"Galluzzi","sequence":"additional","affiliation":[{"name":"Department of Psychology, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8566-1936","authenticated-orcid":false,"given":"Alessia","family":"Quinzi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5704-095X","authenticated-orcid":false,"given":"Arianna","family":"D\u2019Aprile","sequence":"additional","affiliation":[{"name":"Independent Researcher, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-8017","authenticated-orcid":false,"given":"Umberto","family":"Bivona","sequence":"additional","affiliation":[{"name":"Department of Human Science, LUMSA University, 00193 Rome, Italy"},{"name":"IRCCS Fondazione Santa Lucia, 00179 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","unstructured":"Prigatano, G.P. 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