Negative Emotions and Anosognosia

Patients with anosognosia fail to acknowledge, or feel distressed by, their disability. Given the recent suggestion that right (frontal) systems are selectively involved in negative emotions, it might be claimed that anosognosia results from a disruption in negative emotions. This is not consistent with the finding that some anosognosic patients exhibit substantial fluctuations in emotion, including the experience of negative emotions such as sadness. The present study investigates a patient (IW) with a right convexity lesion and anosognosia. He reported being frequently overcome by powerful emotions, especially sadness. IW was assessed on a self-report emotion questionnaire, where his reports were typically of higher levels of emotion than the control group. He was also assessed on the more indirect measure of Affective Story Recall. Here his pattern of emotional experience was similar to that of two control groups, one of which consisted of non-anosognosic patients with hemiparesis. His performance on Story Recall was notable in that he directed his emotions to a different 'object' to that of controls (other vs. self, respectively). These findings are not consistent with any claim that anosognosia results from an absence of negative emotions.