Impaired awareness of social and emotional competencies following orbital frontal lobe damage

The frontal lobes have been hypothesized to be involved in mediating certai n forms of awareness, including social self-awareness. However, there has b een little investigation of the relative contribution of different frontal lobe regions in the process of social self-awareness. Our earlier studies s uggested that the orbital frontal lobe may provide the neural substrate for this special form of awareness. To test this hypothesis, we compared five patients with focal, orbital frontal lobe damage to six patients with restr icted posterior ventromedial (PVM) frontal lobe damage on a self-awareness measure. Results indicated that the orbital frontal group has difficulty es timating their social and emotional competencies compared to cognitive or i nstrumental abilities. In contrast, the PVM group demonstrated no alteratio ns in any form of awareness. Findings support a crucial role for orbital fr ontal regions in monitoring social self-awareness. (C) 1999 Academic Press.