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

The frontal lobes have been hypothesized to be involved in mediating certain forms of awareness, including social self-awareness. However, there has been little investigation of the relative contribution of different frontal lobe regions in the process of social self-awareness. Our earlier studies suggested 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 restricted posterior ventromedial (PVM) frontal lobe damage on a self-awareness measure. Results indicated that the orbital frontal group has difficulty estimating their social and emotional competencies compared to cognitive or instrumental abilities. In contrast, the PVM group demonstrated no alterations in any form of awareness. Findings support a crucial role for orbital frontal regions in monitoring social self-awareness.