Toglia Joan, Goverover Yael
School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, United States.
Department of Occupational Therapy, New York University, New York, NY, United States.
Neuropsychol Rehabil. 2022 Sep;32(8):1676-1725. doi: 10.1080/09602011.2022.2075017. Epub 2022 May 18.
This study aimed to (1) describe the scope of research related to the Dynamic Comprehensive Model of Awareness (DCMA) (Toglia & Kirk, 2000); (2) identify themes and support for key model postulates; and (3) suggest future research directions related to this model. Using PRISMA scoping guidelines, 366 articles were reviewed, and 54 articles met our inclusion criteria. Selected studies were clustered into three themes: (1) the relationship between general and online self-awareness (50%); (2) interventions based on the model (41%); and (3) factors contributing to self-awareness (9%). Most studies were conducted with participants with acquired brain injury (BI) and traumatic BI (68%), most used a cross-sectional design (50%), and most intervention studies utilized a single-subject design (18%), followed by an experimental design (9%). This review provides evidence for the wide application of the across varying ages and populations. The need for a multidimensional assessment approach is recognized; however, stronger evidence that supports a uniform assessment of online self-awareness is needed. The intervention studies frequently described the importance of direct experience in developing self-awareness; however, few studies compared how intervention methods to influence general versus online self-awareness, or how cognitive capacity, self-efficacy, psychological factors, and context, influence the development of self-awareness.
(1)描述与意识动态综合模型(DCMA)(托利亚 & 柯克,2000年)相关的研究范围;(2)确定关键模型假设的主题及支持依据;(3)提出与该模型相关的未来研究方向。采用PRISMA范围界定指南,共审查了366篇文章,其中54篇符合我们的纳入标准。所选研究分为三个主题:(1)一般自我意识与网络自我意识之间的关系(50%);(2)基于该模型的干预措施(41%);(3)影响自我意识的因素(9%)。大多数研究的参与者为获得性脑损伤(BI)和创伤性脑损伤患者(68%),大多数采用横断面设计(50%),大多数干预研究采用单病例设计(18%),其次是实验设计(9%)。本综述为该模型在不同年龄和人群中的广泛应用提供了证据。人们认识到需要采用多维评估方法;然而,需要更有力的证据来支持对网络自我意识进行统一评估。干预研究经常描述直接体验在培养自我意识中的重要性;然而,很少有研究比较干预方法对一般自我意识和网络自我意识的影响,或者认知能力、自我效能感、心理因素和环境如何影响自我意识的发展。