drseanmullen
I’m increasingly interested in metacognitive calibration because cognition is not only about how well your brain performs. It is also about how accurately your brain knows how well it is performing. Metacognition is essentially “thinking about thinking.” It includes our ability to monitor our own memory, judgment, attention, decision-making and errors. Calibration is the correspondence between that internal assessment and reality. Imagine I answer a set of questions and say I am 90% confident in my answers. If I am correct about 90% of the time, I am pretty well calibrated. But suppose I am 90% confident and only correct 60% of the time. My performance has declined, but my confidence has not declined with it. I am overconfident and miscalibrated. The reverse can happen too. Someone can perform extremely well while believing they are performing poorly. That distinction matters enormously to me. We keep asking whether SARS-CoV-2 can affect memory, attention, executive function, processing speed, mood, etc. But I think there is another important question: What if infection also affects our ability to accurately evaluate our own cognition? The striatum is involved in reward prediction, motivation, learning from outcomes, deciding what information is worth obtaining, recognizing when reality differed from expectation, and using those discrepancies to change future behavior. When you think, “I chose A, but what would have happened if I chose B?”, you are engaging in counterfactual thinking. Research has implicated the caudate and nucleus accumbens in seeking and processing exactly this kind of information. So imagine that an infection does not have to “destroy” the brain or directly infect every neuron. It could produce inflammation, vascular dysfunction, altered neurotransmission or other collateral damage within neural systems that help us assign value, recognize errors and update our behavior. Then the consequence might not simply look like: “I can’t remember things anymore.” It could potentially look more subtly like: “I don’t realize how much my memory has changed.” “I am just as confident in my judgment as I was before, even though my accuracy has declined.” “I keep making the same kind of mistake because the error does not register as strongly.” “I know something didn’t work, but I don’t update my behavior appropriately.” “I underestimate how cognitively fatigued I am.” “I overestimate what I can safely or effectively do.” Or potentially the opposite: “My performance is fine, but I no longer trust my own decisions.” Those specific effects have not been demonstrated as consequences of COVID. That is precisely why I think they are worth studying. There is an analogy from infectious disease biology that helps explain why I find the broader idea plausible. Toxoplasma gondii. We’ve all heard of this but honestly, I just haven’t given it much airtime because it sounds 🤪 But biology can change the neural machinery underlying behavior without the organism having any awareness that its decision-making machinery has changed. Most important is that rats who lose their innate sense to steer clear of cats ( in the classic case of the protozoan parasite) they don’t sit there thinking, “My threat-assessment circuitry appears to be behaving differently today.” The world simply feels different to the rat. That is the part that fascinates me. What if biological insults in humans alter not only cognition, but the subjective signal we use to decide whether our cognition is trustworthy? Then measuring cognitive performance alone would miss something incredibly important. Because perhaps the most consequential form of cognitive impairment isn’t merely getting something wrong. It is getting something wrong while becoming less capable of knowing that you’re wrong. That is why I’m interested in metacognitive calibration. And how many people just seem to be off? If only there was a mental-tuneup shop 😝