Functional Cognitive Disorders (FCD): How Is Metacognition Involved?

Area of Science:

• Neuroscience
• Cognitive Psychology
• Neurology

Background:

• Functional cognitive disorders (FCD) are increasingly recognized, particularly in memory clinics.
• Existing research suggests links between FCD and functional neurological disorders (FND).
• A theoretical gap exists in understanding the underlying mechanisms of FCD.

Purpose of the Study:

• To explore the theoretical underpinnings of FCD.
• To propose that FCD are disorders of metacognition, particularly metamemory.
• To review existing evidence and adapt theoretical models for FCD.

Main Methods:

• Review of existing literature on FCD, FND, metacognition, and metamemory.
• Adaptation of Nelson and Narens' monitoring and control model of metamemory.
• Consideration of FCD within a metacognitive model of anosognosia.

Main Results:

• Evidence suggests impairments in metacognition, specifically metamemory, in FCD.
• A novel application of the monitoring and control model posits improper setting of the monitoring function in FCD.
• A metacognitive framework offers potential for hypothesis-driven research and management.

Conclusions:

• FCD may be understood as disorders of metacognition.
• A metacognitive approach, particularly focusing on metamemory monitoring, provides a new theoretical basis for FCD.
• This formulation offers practical implications for future research and clinical management strategies.