Metacognitive judgment and denial of deficit: Evidence from frontotemporal dementia

Patients suffering from the behavioral variant of Frontotemporal Dementia (FTD-b) often exaggerate their abilities. Are those errors in judgment limited to domains in which patients under-perform, or do FTD-b patients overestimate their abilities in other domains? Is overconfidence in FTD-b patients domain-specific or domain-general? To address this question, we asked patients at early stages of FTD-b to judge their performance in two domains (attention, perception) in which they exhibit relatively spared abilities. In both domains, FTD-b patients overestimated their performance relative to patients with Dementia of Alzheimer Type (DAT) and healthy elderly subjects. Results are consistent with a domain-general deficit in metacognitive judgment. We discuss these findings in relation to ``regression to the mean'' accounts of overconfidence and the role of emotions in metacognitive judgments.