Intergenerational and sex differences in metacognitive effectiveness during the Covid-19 pandemic

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Studies have often reported a severe increase in mental illnesses and behavioural disorders, especially in pathologies related to metacognitive performance, attributed to organic and functional deterioration. This repeated cross-sectional study investigated generational and sex differences in basic cognition, metacognitive effectiveness and self-assessment by comparing samples before the outbreak, immediately after the first lockdown and at the end of the COVID-19 crisis. We recruited a sample of adult, mentally healthy working-age subjects (n = 1385; age = 18–65) to perform computerized short-term memory tests designed to investigate the associations among basic cognition, metacognitive effectiveness (metamemory and decisional awareness), and self-assessment. Cognitive and metacognitive abilities—metamemory and decisional awareness—and self-assessment are associated with each other and, after the initial turbulent deviations of the first lockdown, returned close to default, but metamemory constantly decreased regardless of age and sex during the examined period. The decline in metacognitive effectiveness that impacted males and females of most generations similarly, but to different extents, provides an explanation for the rise of mental disorders and consequent psychopathologies during the crisis. metacognitive effectiveness self-assessment generational differences sex differences COVID-19 Figures Figure 1 Figure 2 Background Reducing the impact of the COVID-19 pandemic on mental health has taken a back seat in response to an immediate health emergency. The expected consequences of the social, economic and health crisis created uncertainty – a constant threat for almost the entire population globally – and led to an increase in mental health disorders and behavioural changes regardless of age [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. Among the adverse immediate effects of the crisis on mental health, post-traumatic stress disorder (PTSD) ranked first, followed closely by depression, anxiety and other behavioural and psychological disorders [ 8 , 9 ]. Metacognitive abilities include higher-order self-reflective processes from memory monitoring (metamemory) [ 10 , 11 , 12 ] through decisional judgements (metadecision) [ 13 ], theory of mind [ 14 ], reasoning [ 15 ], self-assessment [ 16 ] and even affective abilities [ 17 , 18 ], which are capacity-dependent [ 19 , 20 ] and essential components of psychosocial functioning [ 21 ]. Metacognitive effectiveness plays an inevitable role in mental health [ 22 ], and organic or functional impairments in neural correlates, such as the anterior and posterior cingulate cortex, insula, precuneus, superior temporal gyrus, inferior parietal lobe, ventromedial prefrontal cortex, and dorsolateral and frontopolar cortex [ 23 , 24 ], characterize frequent psychiatric conditions from major depression through anxiety disorders to substance abuse [ 25 ]. Insecurity and negative emotional attitudes are known to affect cognitive performance [ 26 , 27 , 28 ], particularly in the areas of attention and executive functions [ 29 , 30 ], whereas psychological symptoms associated with existential threats disrupt circadian rhythms and disturb natural regeneration [ 31 ]. Traditional and social media generated panic [ 32 , 33 ], and the constant monitoring of news to tell fake and factual epidemiological information apart [ 34 , 35 ], the rise in media consumption [ 36 ], the lockdowns and other restrictions [ 37 ] have contributed to the exacerbation of psychosocial discomfort to different degrees [ 38 , 39 ]. Recent findings suggest that isolation and physical distancing itself [ 40 ] – mistakenly echoed as social distancing, inducing fear of each other [ 41 , 42 ] – may also be responsible for functional uncertainty [ 43 ] and are associated with neuropsychological and neurobiological changes in early childhood and with age [ 44 ]. Crossing the blood‒brain barrier enables the virus to inflict direct damage to the central nervous system [ 45 , 46 , 47 , 48 , 49 , 50 , 51 ] and even cause psychiatric and neuropsychiatric complications [ 52 ], whereas comparative analysis of exposed and virus-naïve samples revealed differences in executive functions but not in working memory performance [ 53 ]. Symptoms commonly associated with the infection and its long-term effects – e.g., cardiovascular and respiratory issues [ 54 , 55 , 56 , 57 , 58 ], fatigue [ 59 ], pain [ 60 ], brain fog [ 61 ], and sleep disorders [ 62 , 63 ] – are present in individuals with postvaccination syndrome (PVS) [ 64 ] affect brain functions and result in impaired cognitive capacity and learning abilities [ 65 , 66 ], while also altered behaviours and mood [ 67 , 68 , 69 ]. AIMS The complex impact of the pandemic on human behaviour is reflected in the increased prevalence of clinical pathologies that are directly or indirectly associated with—or at least can be explained by—impaired metacognitive effectiveness; however, metamemory performance, decisional awareness and self-assessment have neither been studied in detail yet nor in the context of intergenerational and sex differences in association with COVID-19. Our study aimed to investigate a relatively large sample of mentally healthy working-age adults so that we could find novel associations of basic cognition, self-assessment and metacognitive abilities— metamemory and decisional awareness—when the first reports of the outbreak arrived. The collection of the third dataset was already scheduled when we started to suspect that either the virus, the control measures or both had affected metacognitive ability. Adverse experiences influence generations and sexes to different degrees [ 70 ], and as resilience [ 71 ], coping strategies [ 72 ], self-regulation [ 73 ], self-talk [ 74 ], and self-assessment [ 16 ] are closely linked to metacognitive abilities, given the opportunity, we have decided to examine the periodical deviations in cognitive performance, metacognitive effectiveness and self-assessment in terms of generational and sex differences. Methods Sample characteristics The study investigates a sample of self reportedly mentally healthy (sine morbo), working-age subjects (N = 1385, age = 18–65) of four generations – Generation Z (GZ; born between 1997–2012), Millennials (GM; born between 1981–96), Generation X (GX; born between 1965–80), Boomers (GB; born between 1946–64) [ 75 ] – on the basis of availability and willingness, who were tested online at their best convenience on their own devices before the outbreak (BL), after the first lockdown (W1) and at the end of the crisis (PC). Apparatus The three online short-term memory tests (Fig. 2 ) —2 learning levels (ranging from 3 to 4 stimuli) and 5 test levels (ranging from 5 to 9 stimuli)—each consisted of the digitalized version of the Corsi block-tapping test [ 76 ] as a baseline task (CBTT) for its clinical and developmental relevance [ 77 , 78 ], the Inoue-Matsuzawa masked memory task [ 79 ] in its original limited hold (IMMMT LH ) and self-paced (IMMMT SP ) settings redesigned to measure metacognitive ability. We performed statistical analyses—Spearman correlations and Kruskal‒Wallis tests—with jamovi version 2.5 [ 80 , 81 ]. The threshold for statistical significance was set at p < .05. Variables The subjects reported their age and sex as biological variables. We measured cognitive performance at the learning and test levels separately task by task and accumulated scores in all learning (P LA ) and all test phases (P TA ). We logged the reaction times of hits (RT) and false alarms (FA) with millisecond accuracy levels by level and task by task and averaged them into new variables (RT LA =learning level average reaction time; RT TA =test level average reaction time; FA LA = learning level average false alarm reaction time; FA TA = test level average false alarm reaction time). After each task, we asked the participants to rank their performance compared with that of their peers on a Likert scale of 6 (SA), which we translated into percentage values, then transformed the scores task by task into percentages and averaged their difference (SA-P S ) into the self-asessment bias index (SAB PA ). Metamemory (MM) shows the total score improvement between the self-paced (IMMMT SP ) and limited hold (IMMMT LH ) settings of the Inoue-Matsuzawa masked memory tasks. The ratio of false alarms and average reaction times level by level and then task by task resulted in the decisional awareness (DA; DA = FA/RT) index. Results Baseline associations Older subjects before COVID-19 scored lower (Table 1 ) in both the learning (P LA ) and test phases (P TA ), were overconfident (SAB PA ) and tended to be more hesitant before mistakes (FA TA and DA TA ). The better learners (P LA ) were better performers (P TA ), scored slower (RT TA ) but failed quicker (FA TA ), improved less in the metamemory task (MM), depreciated their performance (SAB PA ) and were less aware of their wrong decisions (DA TA ). Those with better metacognitive skills (MM; SAB PA ; DA TA ) were also slower in scoring (RTTA) and failing (FATA). Decisional awareness (DA TA ) is positively correlated with metamemory performance (MM) and overconfidence (SAB PA ). Table 1 Spearman correlations of the baseline sample (N = 392) before COVID-19 revealed associations with age, learning and test performance (P LA ; P LT ), reaction time (RT TA ; FA TA ) and metacognitive ability (MM; SAB PA ; DA TA ). BASELINE AGE P LA P TA RT TA FA TA MM SAB PA P LA Spearman's rho − .169 *** — p value < .001 — P TA Spearman's rho − .202 *** .431 *** — p value < .001 < .001 — RT TA Spearman's rho − .065 .185 *** .575 *** — p value .201 < .001 < .001 — FA TA Spearman's rho .113 * − .154 ** − .482 *** − .036 — p value .025 .002 < .001 .473 — MM Spearman's rho − .013 − .162 ** − .133 ** − .273 *** .198 *** — p value .792 .001 .008 < .001 < .001 — SAB PA Spearman's rho .153 ** − .195 *** − .281 *** − .142 ** .140 ** .028 — p value .002 < .001 < .001 .005 .005 .578 — DA TA Spearman's rho .109 * − .194 *** − .714 *** − .545 *** .704 *** .198 *** .156 ** p value .031 < .001 < .001 < .001 < .001 < .001 .002 Note. N = 392; * p < .05, ** p < .01, *** p < .001 Before, during and after COVID-19 In general, COVID-19 negatively affected short-term memory during the learning phase (P LA ) more strongly during the first lockdown (W1), whereas scores in the self-paced setting (IMMMT SPT ) of the tests and metamemory performance (MM) constantly decreased over time. Male subjects learned (RT LA ) and failed (FA TA ) more slowly but scored quicker (RT TA ) and more quickly in CBTT T and less so in IMMMT SPT and MM than did women, who were initially (BL) more confident, suddenly (W1) became more uncertain and then quicker again (PC) in their bad decisions (DA TA ). The pandemic has further deepened the gender gap with respect to self-assessment (SAB PA ), as both sexes were negatively biased at the beginning of the sampling period, but while men improved their original accuracy, women remained almost as self-depreciating as they were. We were able to reveal generational differences regarding almost every observed aspect except for the self-paced setting (IMMMT LA ), the false alarm reaction time (FA LA ) in the learning phase, and the reaction time during the test phase (RT TA ). Millennials (GM), despite being the slowest (RT LA ; RT TA ), outperformed everyone else in the test phase (P TA ) before the outbreak (BL) and at the end of the crisis (PC). Generation Z (GZ) could take the lead for a short while during the first wave (W1), whereas Boomers (BM) were the quickest (RT) and least successful (P). Metamemory performance (MM) decreased over time, with a spike in each generation at W1, similar to decisional awareness (DA TA ); however, the latter increased by the end of restrictions (PCs) for GX and GB. The original order of self-assessment bias (SAB PA ) changed the most during the observed period for GB, whose overconfidence at the beginning further increased by W1 but became the least optimistic at the end. The baseline bottom Generation Z improved self-confidence (SAB PA ) almost to accuracy, whereas Millennials became the most pessimistic at W1, but all returned to the original ranks of bias with a slight overall increase in optimism. In contrast to other generations, GX improved in their self-assessment constantly and became the most accurate group at the end of the sampling period. The within- and between-generational sex differences varied the most at the end of the first lockdown (W1), rearranging the rankings of performance (P TA ), decisional awareness (DA TA ) and self-assessment bias (SAB PA ) indices by the end of the pandemic, as expected, on the basis of our previous findings; however, there were no significant disparities in metamemory (MM) performance between the groups (Table 2 , Fig. 1 , Table 3 ). Table 2 Kruskall‒Wallis tests revealed differences between subjects in pandemic periods (C-19), periodical sex (C-19×SEX) and generational (C-19×GEN) differences and the interaction of sex and generations over time (C-19×SEX×GEN). C-19 C-19×SEX C-19×GEN C-19×SEX×GEN χ² df p ε² χ² df p ε² χ² df p ε² χ² df p ε² CBTT L 5.7518 2 .056 .00416 9.32 5 .097 .00673 74.33 11 < .001 *** .05370 88.2 22 < .001 *** .06370 IMMMT LHL 4.7164 2 .095 .00341 8.77 5 .119 .00634 45.68 11 < .001 *** .03301 56.2 22 < .001 *** .04060 IMMMT SPL .0463 2 .977 3.34E-05 4.54 5 .475 .00328 3.46 11 .983 .00250 27.6 22 .190 .01990 P LA 6.1253 2 .047 * .00443 6.47 5 .263 .00468 72.15 11 < .001 *** .05213 8.2 22 < .001 *** .05790 RT LA 1.4314 2 .489 .00104 24.95 5 < .001 *** .01805 43.97 11 < .001 *** .03182 83.0 22 < .001 *** .06000 FA LA 1.4337 2 .488 .00245 2.48 5 .779 .00423 17.32 11 .099 .02955 28.0 22 .176 .04780 CBTT T 3.0446 2 .218 .0022 26.25 5 < .001 *** .01896 78.52 11 < .001 *** .05673 11.3 22 < .001 *** .07970 IMMMT LHT 2.1131 2 .348 .00153 6.21 5 .286 .00449 52.37 11 < .001 *** .03784 66.1 22 < .001 *** .04780 I MMMT SPT 13.5205 2 .001 ** .00977 14.33 5 .014 * .01035 53.15 11 < .001 *** .03840 64.8 22 < .001 *** .04680 P TA 4.8571 2 .088 .00351 9.34 5 .096 .00675 79.98 11 < .001 *** .05779 95.9 22 < .001 *** .06930 RT TA .0965 2 .953 7.01E-05 15.21 5 .009 ** .01106 17.36 11 .098 .01262 64.8 22 < .001 *** .04710 FA TA 3.5638 2 .168 .00258 17.86 5 .003 ** .01291 91.5 11 < .001 *** .06616 107.8 22 < .001 *** .07790 MM 9.465 2 .009 ** .00684 11.92 5 .036 * .00861 24.02 11 .013 * .01736 3.1 22 .116 .02180 SAB PA 5.4122 2 .067 .00391 43.67 5 < .001 *** .03156 31.65 11 < .001 *** .02287 78.6 22 < .001 *** .05680 DA A 2.6501 2 .266 .00193 12.69 5 .026 * .00923 54.24 11 < .001 *** .03945 72.6 22 < .001 *** .05280 Note. N = 1385; * p < .05, ** p < .01, *** p < .001 Table 3. Heatmap of percentage fluctuations (Δ; red=increase, blue=decrease) of means relative to the prepandemic baseline (BL) average over time (W1=end of first lockdown, PC=end of restrictions) across generations (GZ=Generation Z; GM=Millennials; GX= Generation X; GB= Baby Boomers) and sex (male and female) in test performance (P TA ), metamemory (MM), decisional awareness (DA TA ) and self-assessment bias (SAB PA ). Conclusions We have found strong links between baseline cognitive performance, metacognitive effectiveness—measured in metamemory performance and decisional awareness—and self-assessment, which deviated the most from default after the initial shock in men and women of four generations during the COVID-19 crisis. In general, we revealed continuous decay in metamemory performance regardless of age and sex—an alarming discovery from the therapeutic aspect [ 82 , 83 ]—during the investigated period, the probable result of—unlike the expected performance-related explanations [ 84 ] based on the scores of our subjects—changes in mood and attitude that manifested in demotivation [ 85 , 86 ], isolation and social deprivation led to the underutilization of metacognitive abilities [ 87 ], or a direct effect of SARS-CoV-2 exposure in addition to previous results [ 53 , 88 , 89 ]. The exploration of self-assessment revealed that subjects initially underrated their performance in general; however, men displayed more confidence by default and further improved their accuracy over time until they were almost realistic. The lower self-assessment scores of female subjects might reflect their low self-confidence [ 90 ] because they judge themselves too harshly [ 91 ]. The most surprising of all generational differences was that although Boomers endured the most throughout their lifespan and we were expecting them to be the least vulnerable to adverse experiences [ 92 ], Boomers have suffered the most damage—likely because isolation had a greater impact on them [ 93 ] or their offspring were at such risk for the first time—during the investigated period, whereas other generations deviated from default during the first lockdown and almost returned to their original scores by the end of the crisis. Another observation comparing Gen B to other generations concerns decisional awareness, the metacognitive index measuring the ratio between the reaction times of false alarms and hits, where they displayed significant hesitation before mistakes, almost as if they had lost track of what they were doing [ 94 ]. Boomers also deviated the most from default in self-assessment, ranked themselves the highest by the end of the first lockdown, and became the least confident at the end of the crisis among the observed generations, possibly because self-assessment requires metacognitive and intuitive processes, since there was no performance-related feedback during the tasks. Given the time-sensitive nature of short-term memory tests [ 95 ], including the implicit registry of results during the tasks and considering the mental health correlates of metacognitive effectiveness, measuring such uncertainties might contribute to the development of novel preventive diagnostic methods of all related psychopathologies in the future, especially if subjects are profoundly assessed and even the slightest subclinical deviances are explored beforehand and not just reporting a sine morbo mental status. Additionally, we cannot completely rule out the effect of the – morally obliged, peer pressured, heavily incentivized or often even employer-mandated, but definitely discriminating and socially polarizing [ 96 ] – vaccination on metacognition in light of recent studies that examined how vaccine-related local and systemic side effects [ 97 , 98 ], especially in the case of mRNA-based immunization [ 99 , 100 ], including organic [ 101 ] and functional neurological disorders [ 102 , 103 , 104 ], and further increased the severity of the mental burden for affected individuals [ 105 ]. Separating causes from effects and understanding what, when, how and why certain changes affected individuals during the pandemic are extremely difficult. Although we were able to confirm the decrease in metacognitive effectiveness that we expected on the basis of the increased prevalence of related mental disorders, the exploration of whether and how and to what extent the neural correlates of metamemory are affected by direct exposure to the virus, immunization, or psychosocial discomfort as a result of the control measures requires further investigation. Sample characteristics allow us to generalize our results to mentally healthy working-age populations with the usual limitations of academic research [ 106 ]; hence, the prevention of an increase in psychosocial discomfort and a decline in mental health arising from such synergy of multiple negative events requires more thoughtful communication and improved action preparedness from future crisis managers, both globally and locally. Declarations Acknowledgements: The authors would like to thank first of all our subjects, their colleagues— Adam Ritter, Dénes Tibor Dudás, Dr. Marianna Török, Judit Páli, Mónika Albu and Anikó Kónya—for their valuable insights and the students who contributed to our research. Funding Statement: We have received nonfinancial support from the Doctoral School’s Workgroup for Science Management at Semmelweis University. Conflicts of Interest: The authors have not reported any conflicting interests. Ethical Approval: All procedures complied with the Helsinki Declaration and institutional guidelines and were approved by the Institutional Research Ethics Committee at the Institute of Psychology at Károli University of the Reformed Church (52/2019/P/ET & 36/2020/P/ET). Informed Consent: Informed consent was obtained from all the participants. Consent for Publication : not applicable. Data Availability Statement: The data presented in this study are available only upon properly substantiated request from the corresponding author due to legal agreements and ethical reasons. Authors Contributions: Conceptualization, R.K. and I.L.; methodology, R.K., R.B., B.G and I.L.; software, R.K. and I.L.; validation, Sz.T. and I.L.; formal analysis, R.K. and B.G.; investigation, R.K., RB and EF; resources, I.L.; data curation, I.L. and R.K.; writing—original draft preparation, R.K.; writing—review and editing, R.K., R.B., E.F, and I.L.; visualization, R.K.; supervision, Sz.T. and I.L.; project administration, I.L.; funding acquisition, R.K and I.L. All authors have read and agreed to the published version of the manuscript. References Pieh C, Budimir S, Delgadillo J, Barkham M, Fontaine JR, Probst T. Mental health during COVID-19 lockdown in the United Kingdom. Psychosom Med. 2021;83(4):328–37. https://doi.org/10.1097/PSY.0000000000000871 PMid:33009276 . 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7570318","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":533415956,"identity":"e45db568-d3ce-4bde-933b-102e8bccbf82","order_by":0,"name":"Roland 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University","correspondingAuthor":false,"prefix":"","firstName":"Réka","middleName":"","lastName":"Bogdányi","suffix":""},{"id":533415959,"identity":"a3b66f78-66f6-453b-8e5c-7acee30806df","order_by":3,"name":"Bence Gergely","email":"","orcid":"","institution":"Károli University of the Reformed Church in Hungary","correspondingAuthor":false,"prefix":"","firstName":"Bence","middleName":"","lastName":"Gergely","suffix":""},{"id":533415960,"identity":"d98c16ad-2db2-4ff7-b187-8cce7690a646","order_by":4,"name":"Szabolcs Takács","email":"","orcid":"","institution":"Károli University of the Reformed Church in Hungary","correspondingAuthor":false,"prefix":"","firstName":"Szabolcs","middleName":"","lastName":"Takács","suffix":""},{"id":533415961,"identity":"ac4971a1-0f4b-4863-bee3-1627b96d7cb4","order_by":5,"name":"Imre Lázár","email":"","orcid":"","institution":"Semmelweis University","correspondingAuthor":false,"prefix":"","firstName":"Imre","middleName":"","lastName":"Lázár","suffix":""}],"badges":[],"createdAt":"2025-09-09 06:53:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7570318/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7570318/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":94208062,"identity":"e3318917-0be4-4d7b-b8e5-c63279e94bc2","added_by":"auto","created_at":"2025-10-23 15:03:22","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":2297380,"visible":true,"origin":"","legend":"","description":"","filename":"BMC090925MS.docx","url":"https://assets-eu.researchsquare.com/files/rs-7570318/v1/2063ef215351224d00cb1e3e.docx"},{"id":94208060,"identity":"1aced3b3-ac48-49f1-b424-5ba5606bd4fe","added_by":"auto","created_at":"2025-10-23 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14:55:22","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":282390,"visible":true,"origin":"","legend":"","description":"","filename":"6991c24a90d148b49678c41db0e2f8391structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7570318/v1/f86ab71953026d275416a950.xml"},{"id":94207360,"identity":"7a893a5c-df83-4f10-b13f-084ada37af66","added_by":"auto","created_at":"2025-10-23 14:55:22","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":299530,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7570318/v1/d0ad5e35d6275a0066c15274.html"},{"id":94207356,"identity":"4a2baf74-1691-4d04-b469-59cc357cd4f6","added_by":"auto","created_at":"2025-10-23 14:55:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":282840,"visible":true,"origin":"","legend":"\u003cp\u003eKruskall‒Wallis tests revealed differences between subjects by pandemic period in general (C-19), periodical sex (C-19×SEX; Male: blue line; Female: red line) and generational (C-19×GEN) differences and the interaction effects of sex and generations over time (C-19×SEX×GEN) on test performance (P\u003csub\u003eTA\u003c/sub\u003e), metamemory (MM), decisional awareness (DA\u003csub\u003eTA\u003c/sub\u003e) and self-assessment bias (SAB\u003csub\u003ePA\u003c/sub\u003e).\u003c/p\u003e","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7570318/v1/eba4966cb964027391b4567f.png"},{"id":94207354,"identity":"29648f1e-35f2-48ea-9341-9996ef570a9e","added_by":"auto","created_at":"2025-10-23 14:55:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":48597,"visible":true,"origin":"","legend":"\u003cp\u003eTest screens of the three computerized short-term memory tasks. The baseline task requires the recall of the spatiotemporal sequence of homogenous stimuli (CBTT). Tasks 2 and 3 simultaneously presented single-digit numerals in numeric order in limited (IMMMT\u003csub\u003eLH\u003c/sub\u003e) and self-paced (IMMMT\u003csub\u003eSP\u003c/sub\u003e) hold settings.\u003c/p\u003e","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7570318/v1/b7330c33954e5619e465c930.png"},{"id":94209102,"identity":"e49ac4f0-fbd3-4a0e-9d7d-3fe39cfa41ff","added_by":"auto","created_at":"2025-10-23 15:11:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1463736,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7570318/v1/5327bcd3-d5ad-4bab-b827-86114d0a4111.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Intergenerational and sex differences in metacognitive effectiveness during the Covid-19 pandemic","fulltext":[{"header":"Background","content":"\u003cp\u003eReducing the impact of the COVID-19 pandemic on mental health has taken a back seat in response to an immediate health emergency. The expected consequences of the social, economic and health crisis created uncertainty – a constant threat for almost the entire population globally – and led to an increase in mental health disorders and behavioural changes regardless of age [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Among the adverse immediate effects of the crisis on mental health, post-traumatic stress disorder (PTSD) ranked first, followed closely by depression, anxiety and other behavioural and psychological disorders [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMetacognitive abilities include higher-order self-reflective processes from memory monitoring (metamemory) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] through decisional judgements (metadecision) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], theory of mind [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], reasoning [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], self-assessment [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] and even affective abilities [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], which are capacity-dependent [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and essential components of psychosocial functioning [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Metacognitive effectiveness plays an inevitable role in mental health [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], and organic or functional impairments in neural correlates, such as the anterior and posterior cingulate cortex, insula, precuneus, superior temporal gyrus, inferior parietal lobe, ventromedial prefrontal cortex, and dorsolateral and frontopolar cortex [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], characterize frequent psychiatric conditions from major depression through anxiety disorders to substance abuse [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Insecurity and negative emotional attitudes are known to affect cognitive performance [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], particularly in the areas of attention and executive functions [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], whereas psychological symptoms associated with existential threats disrupt circadian rhythms and disturb natural regeneration [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Traditional and social media generated panic [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], and the constant monitoring of news to tell fake and factual epidemiological information apart [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], the rise in media consumption [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], the lockdowns and other restrictions [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] have contributed to the exacerbation of psychosocial discomfort to different degrees [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Recent findings suggest that isolation and physical distancing itself [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] – mistakenly echoed as social distancing, inducing fear of each other [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e] – may also be responsible for functional uncertainty [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] and are associated with neuropsychological and neurobiological changes in early childhood and with age [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eCrossing the blood‒brain barrier enables the virus to inflict direct damage to the central nervous system [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] and even cause psychiatric and neuropsychiatric complications [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e], whereas comparative analysis of exposed and virus-naïve samples revealed differences in executive functions but not in working memory performance [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. Symptoms commonly associated with the infection and its long-term effects – e.g., cardiovascular and respiratory issues [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e], fatigue [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e], pain [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e], brain fog [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e], and sleep disorders [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e] – are present in individuals with postvaccination syndrome (PVS) [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e] affect brain functions and result in impaired cognitive capacity and learning abilities [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e], while also altered behaviours and mood [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eAIMS\u003c/h3\u003e\n\u003cp\u003eThe complex impact of the pandemic on human behaviour is reflected in the increased prevalence of clinical pathologies that are directly or indirectly associated with—or at least can be explained by—impaired metacognitive effectiveness; however, metamemory performance, decisional awareness and self-assessment have neither been studied in detail yet nor in the context of intergenerational and sex differences in association with COVID-19.\u003c/p\u003e\u003cp\u003eOur study aimed to investigate a relatively large sample of mentally healthy working-age adults so that we could find novel associations of basic cognition, self-assessment and metacognitive abilities— metamemory and decisional awareness—when the first reports of the outbreak arrived. The collection of the third dataset was already scheduled when we started to suspect that either the virus, the control measures or both had affected metacognitive ability. Adverse experiences influence generations and sexes to different degrees [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e], and as resilience [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e], coping strategies [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e], self-regulation [\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e], self-talk [\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e], and self-assessment [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] are closely linked to metacognitive abilities, given the opportunity, we have decided to examine the periodical deviations in cognitive performance, metacognitive effectiveness and self-assessment in terms of generational and sex differences.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch2\u003eSample characteristics\u003c/h2\u003e\u003cp\u003eThe study investigates a sample of self reportedly mentally healthy (sine morbo), working-age subjects (N = 1385, age = 18–65) of four generations – Generation Z (GZ; born between 1997–2012), Millennials (GM; born between 1981–96), Generation X (GX; born between 1965–80), Boomers (GB; born between 1946–64) [\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e] – on the basis of availability and willingness, who were tested online at their best convenience on their own devices before the outbreak (BL), after the first lockdown (W1) and at the end of the crisis (PC).\u003c/p\u003e\u003ch3\u003eApparatus\u003c/h3\u003e\u003cp\u003eThe three online short-term memory tests (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e) —2 learning levels (ranging from 3 to 4 stimuli) and 5 test levels (ranging from 5 to 9 stimuli)—each consisted of the digitalized version of the Corsi block-tapping test [\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e] as a baseline task (CBTT) for its clinical and developmental relevance [\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e], the Inoue-Matsuzawa masked memory task [\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e] in its original limited hold (IMMMT\u003csub\u003eLH\u003c/sub\u003e) and self-paced (IMMMT\u003csub\u003eSP\u003c/sub\u003e) settings redesigned to measure metacognitive ability.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eWe performed statistical analyses—Spearman correlations and Kruskal‒Wallis tests—with \u003cem\u003ejamovi\u003c/em\u003e version 2.5 [\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e]. The threshold for statistical significance was set at p \u0026lt; .05.\u003c/p\u003e\u003ch3\u003eVariables\u003c/h3\u003e\u003cp\u003eThe subjects reported their age and sex as biological variables. We measured cognitive performance at the learning and test levels separately task by task and accumulated scores in all learning (P\u003csub\u003eLA\u003c/sub\u003e) and all test phases (P\u003csub\u003eTA\u003c/sub\u003e). We logged the reaction times of hits (RT) and false alarms (FA) with millisecond accuracy levels by level and task by task and averaged them into new variables (RT\u003csub\u003eLA\u003c/sub\u003e=learning level average reaction time; RT\u003csub\u003eTA\u003c/sub\u003e=test level average reaction time; FA\u003csub\u003eLA\u003c/sub\u003e= learning level average false alarm reaction time; FA\u003csub\u003eTA\u003c/sub\u003e= test level average false alarm reaction time). After each task, we asked the participants to rank their performance compared with that of their peers on a Likert scale of 6 (SA), which we translated into percentage values, then transformed the scores task by task into percentages and averaged their difference (SA-P\u003csub\u003eS\u003c/sub\u003e) into the self-asessment bias index (SAB\u003csub\u003ePA\u003c/sub\u003e). Metamemory (MM) shows the total score improvement between the self-paced (IMMMT\u003csub\u003eSP\u003c/sub\u003e) and limited hold (IMMMT\u003csub\u003eLH\u003c/sub\u003e) settings of the Inoue-Matsuzawa masked memory tasks. The ratio of false alarms and average reaction times level by level and then task by task resulted in the decisional awareness (DA; DA = FA/RT) index.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eBaseline associations\u003c/h2\u003e\u003cp\u003eOlder subjects before COVID-19 scored lower (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) in both the learning (P\u003csub\u003eLA\u003c/sub\u003e) and test phases (P\u003csub\u003eTA\u003c/sub\u003e), were overconfident (SAB\u003csub\u003ePA\u003c/sub\u003e) and tended to be more hesitant before mistakes (FA\u003csub\u003eTA\u003c/sub\u003e and DA\u003csub\u003eTA\u003c/sub\u003e). The better learners (P\u003csub\u003eLA\u003c/sub\u003e) were better performers (P\u003csub\u003eTA\u003c/sub\u003e), scored slower (RT\u003csub\u003eTA\u003c/sub\u003e) but failed quicker (FA\u003csub\u003eTA\u003c/sub\u003e), improved less in the metamemory task (MM), depreciated their performance (SAB\u003csub\u003ePA\u003c/sub\u003e) and were less aware of their wrong decisions (DA\u003csub\u003eTA\u003c/sub\u003e). Those with better metacognitive skills (MM; SAB\u003csub\u003ePA\u003c/sub\u003e; DA\u003csub\u003eTA\u003c/sub\u003e) were also slower in scoring (RTTA) and failing (FATA). Decisional awareness (DA\u003csub\u003eTA\u003c/sub\u003e) is positively correlated with metamemory performance (MM) and overconfidence (SAB\u003csub\u003ePA\u003c/sub\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSpearman correlations of the baseline sample (N\u0026thinsp;=\u0026thinsp;392) before COVID-19 revealed associations with age, learning and test performance (P\u003csub\u003eLA\u003c/sub\u003e; P\u003csub\u003eLT\u003c/sub\u003e), reaction time (RT\u003csub\u003eTA\u003c/sub\u003e; FA\u003csub\u003eTA\u003c/sub\u003e) and metacognitive ability (MM; SAB\u003csub\u003ePA\u003c/sub\u003e; DA\u003csub\u003eTA\u003c/sub\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"16\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBASELINE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAGE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP\u003csub\u003eLA\u003c/sub\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eP\u003csub\u003eTA\u003c/sub\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRT\u003csub\u003eTA\u003c/sub\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eFA\u003csub\u003eTA\u003c/sub\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eMM\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eSAB\u003csub\u003ePA\u003c/sub\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003csub\u003e\u003cb\u003eLA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.169\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003csub\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.202\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e.431\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRT\u003c/b\u003e\u003csub\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e.185\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e.575\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.201\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFA\u003c/b\u003e\u003csub\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e.113\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.154\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.482\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.036\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e.025\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.473\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMM\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.162\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.133\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.273\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e.198\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.792\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e.008\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSAB\u003c/b\u003e\u003csub\u003e\u003cb\u003ePA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e.153\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.195\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.281\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.142\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e.140\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.028\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e.005\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e.005\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.578\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDA\u003c/b\u003e\u003csub\u003e\u003cb\u003eTA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpearman's rho\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e.109\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.194\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.714\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;.545\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e.704\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e.198\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e.156\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e.031\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"16\" nameend=\"c16\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNote. N\u0026thinsp;=\u0026thinsp;392; * p\u0026thinsp;\u0026lt;\u0026thinsp;.05, ** p\u0026thinsp;\u0026lt;\u0026thinsp;.01, *** p\u0026thinsp;\u0026lt;\u0026thinsp;.001\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eBefore, during and after COVID-19\u003c/h2\u003e\u003cp\u003eIn general, COVID-19 negatively affected short-term memory during the learning phase (P\u003csub\u003eLA\u003c/sub\u003e) more strongly during the first lockdown (W1), whereas scores in the self-paced setting (IMMMT\u003csub\u003eSPT\u003c/sub\u003e) of the tests and metamemory performance (MM) constantly decreased over time. Male subjects learned (RT\u003csub\u003eLA\u003c/sub\u003e) and failed (FA\u003csub\u003eTA\u003c/sub\u003e) more slowly but scored quicker (RT\u003csub\u003eTA\u003c/sub\u003e) and more quickly in CBTT\u003csub\u003eT\u003c/sub\u003e and less so in IMMMT\u003csub\u003eSPT\u003c/sub\u003e and MM than did women, who were initially (BL) more confident, suddenly (W1) became more uncertain and then quicker again (PC) in their bad decisions (DA\u003csub\u003eTA\u003c/sub\u003e). The pandemic has further deepened the gender gap with respect to self-assessment (SAB\u003csub\u003ePA\u003c/sub\u003e), as both sexes were negatively biased at the beginning of the sampling period, but while men improved their original accuracy, women remained almost as self-depreciating as they were. We were able to reveal generational differences regarding almost every observed aspect except for the self-paced setting (IMMMT\u003csub\u003eLA\u003c/sub\u003e), the false alarm reaction time (FA\u003csub\u003eLA\u003c/sub\u003e) in the learning phase, and the reaction time during the test phase (RT\u003csub\u003eTA\u003c/sub\u003e). Millennials (GM), despite being the slowest (RT\u003csub\u003eLA\u003c/sub\u003e; RT\u003csub\u003eTA\u003c/sub\u003e), outperformed everyone else in the test phase (P\u003csub\u003eTA\u003c/sub\u003e) before the outbreak (BL) and at the end of the crisis (PC). Generation Z (GZ) could take the lead for a short while during the first wave (W1), whereas Boomers (BM) were the quickest (RT) and least successful (P). Metamemory performance (MM) decreased over time, with a spike in each generation at W1, similar to decisional awareness (DA\u003csub\u003eTA\u003c/sub\u003e); however, the latter increased by the end of restrictions (PCs) for GX and GB. The original order of self-assessment bias (SAB\u003csub\u003ePA\u003c/sub\u003e) changed the most during the observed period for GB, whose overconfidence at the beginning further increased by W1 but became the least optimistic at the end. The baseline bottom Generation Z improved self-confidence (SAB\u003csub\u003ePA\u003c/sub\u003e) almost to accuracy, whereas Millennials became the most pessimistic at W1, but all returned to the original ranks of bias with a slight overall increase in optimism. In contrast to other generations, GX improved in their self-assessment constantly and became the most accurate group at the end of the sampling period. The within- and between-generational sex differences varied the most at the end of the first lockdown (W1), rearranging the rankings of performance (P\u003csub\u003eTA\u003c/sub\u003e), decisional awareness (DA\u003csub\u003eTA\u003c/sub\u003e) and self-assessment bias (SAB\u003csub\u003ePA\u003c/sub\u003e) indices by the end of the pandemic, as expected, on the basis of our previous findings; however, there were no significant disparities in metamemory (MM) performance between the groups (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e, Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eKruskall‒Wallis tests revealed differences between subjects in pandemic periods (C-19), periodical sex (C-19\u0026times;SEX) and generational (C-19\u0026times;GEN) differences and the interaction of sex and generations over time (C-19\u0026times;SEX\u0026times;GEN).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"21\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c18\" colnum=\"18\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c19\" colnum=\"19\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c20\" colnum=\"20\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c21\" colnum=\"21\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eC-19\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e\u003cp\u003eC-19\u0026times;SEX\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c16\" namest=\"c12\"\u003e\u003cp\u003eC-19\u0026times;GEN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c21\" 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colname=\"c13\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.983\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e.00250\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e27.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e.190\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e.01990\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003csub\u003e\u003cb\u003eLA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" 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colname=\"c16\"\u003e\u003cp\u003e\u003cb\u003e.02287\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u003cb\u003e78.6\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e\u003cb\u003e22\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e\u003cb\u003e.05680\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDA\u003c/b\u003e\u003csub\u003e\u003cb\u003eA\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.6501\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.266\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e.00193\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e12.69\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e.026\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e.00923\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e54.24\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e11\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e\u003cb\u003e.03945\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u003cb\u003e72.6\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e\u003cb\u003e22\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e\u003cb\u003e***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e\u003cb\u003e.05280\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"21\" nameend=\"c21\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNote. N\u0026thinsp;=\u0026thinsp;1385; * p\u0026thinsp;\u0026lt;\u0026thinsp;.05, ** p\u0026thinsp;\u0026lt;\u0026thinsp;.01, *** p\u0026thinsp;\u0026lt;\u0026thinsp;.001\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable 3. Heatmap of percentage fluctuations (\u0026Delta;; red=increase, blue=decrease) of means relative to the prepandemic baseline (BL) average over time (W1=end of first lockdown, PC=end of restrictions) across generations (GZ=Generation Z; GM=Millennials; GX= Generation X; GB= Baby Boomers) and sex (male and female) in test performance (P\u003csub\u003eTA\u003c/sub\u003e), metamemory (MM), decisional awareness (DA\u003csub\u003eTA\u003c/sub\u003e) and self-assessment bias (SAB\u003csub\u003ePA\u003c/sub\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/127393_c7e80a1c9bb65875/127393_custom_files/img1761231084.png\"\u003e\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWe have found strong links between baseline cognitive performance, metacognitive effectiveness\u0026mdash;measured in metamemory performance and decisional awareness\u0026mdash;and self-assessment, which deviated the most from default after the initial shock in men and women of four generations during the COVID-19 crisis.\u003c/p\u003e\u003cp\u003eIn general, we revealed continuous decay in metamemory performance regardless of age and sex\u0026mdash;an alarming discovery from the therapeutic aspect [\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]\u0026mdash;during the investigated period, the probable result of\u0026mdash;unlike the expected performance-related explanations [\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e] based on the scores of our subjects\u0026mdash;changes in mood and attitude that manifested in demotivation [\u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e, \u003cspan citationid=\"CR86\" class=\"CitationRef\"\u003e86\u003c/span\u003e], isolation and social deprivation led to the underutilization of metacognitive abilities [\u003cspan citationid=\"CR87\" class=\"CitationRef\"\u003e87\u003c/span\u003e], or a direct effect of SARS-CoV-2 exposure in addition to previous results [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e88\u003c/span\u003e, \u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe exploration of self-assessment revealed that subjects initially underrated their performance in general; however, men displayed more confidence by default and further improved their accuracy over time until they were almost realistic. The lower self-assessment scores of female subjects might reflect their low self-confidence [\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e] because they judge themselves too harshly [\u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe most surprising of all generational differences was that although Boomers endured the most throughout their lifespan and we were expecting them to be the least vulnerable to adverse experiences [\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e], Boomers have suffered the most damage\u0026mdash;likely because isolation had a greater impact on them [\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e] or their offspring were at such risk for the first time\u0026mdash;during the investigated period, whereas other generations deviated from default during the first lockdown and almost returned to their original scores by the end of the crisis. Another observation comparing Gen B to other generations concerns decisional awareness, the metacognitive index measuring the ratio between the reaction times of false alarms and hits, where they displayed significant hesitation before mistakes, almost as if they had lost track of what they were doing [\u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e]. Boomers also deviated the most from default in self-assessment, ranked themselves the highest by the end of the first lockdown, and became the least confident at the end of the crisis among the observed generations, possibly because self-assessment requires metacognitive and intuitive processes, since there was no performance-related feedback during the tasks. Given the time-sensitive nature of short-term memory tests [\u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e95\u003c/span\u003e], including the implicit registry of results during the tasks and considering the mental health correlates of metacognitive effectiveness, measuring such uncertainties might contribute to the development of novel preventive diagnostic methods of all related psychopathologies in the future, especially if subjects are profoundly assessed and even the slightest subclinical deviances are explored beforehand and not just reporting a \u003cem\u003esine morbo\u003c/em\u003e mental status.\u003c/p\u003e\u003cp\u003eAdditionally, we cannot completely rule out the effect of the \u0026ndash; morally obliged, peer pressured, heavily incentivized or often even employer-mandated, but definitely discriminating and socially polarizing [\u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e96\u003c/span\u003e] \u0026ndash; vaccination on metacognition in light of recent studies that examined how vaccine-related local and systemic side effects [\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e, \u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e98\u003c/span\u003e], especially in the case of mRNA-based immunization [\u003cspan citationid=\"CR99\" class=\"CitationRef\"\u003e99\u003c/span\u003e, \u003cspan citationid=\"CR100\" class=\"CitationRef\"\u003e100\u003c/span\u003e], including organic [\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e] and functional neurological disorders [\u003cspan citationid=\"CR102\" class=\"CitationRef\"\u003e102\u003c/span\u003e, \u003cspan citationid=\"CR103\" class=\"CitationRef\"\u003e103\u003c/span\u003e, \u003cspan citationid=\"CR104\" class=\"CitationRef\"\u003e104\u003c/span\u003e], and further increased the severity of the mental burden for affected individuals [\u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSeparating causes from effects and understanding what, when, how and why certain changes affected individuals during the pandemic are extremely difficult. Although we were able to confirm the decrease in metacognitive effectiveness that we expected on the basis of the increased prevalence of related mental disorders, the exploration of whether and how and to what extent the neural correlates of metamemory are affected by direct exposure to the virus, immunization, or psychosocial discomfort as a result of the control measures requires further investigation.\u003c/p\u003e\u003cp\u003eSample characteristics allow us to generalize our results to mentally healthy working-age populations with the usual limitations of academic research [\u003cspan citationid=\"CR106\" class=\"CitationRef\"\u003e106\u003c/span\u003e]; hence, the prevention of an increase in psychosocial discomfort and a decline in mental health arising from such synergy of multiple negative events requires more thoughtful communication and improved action preparedness from future crisis managers, both globally and locally.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e The authors would like to thank first of all our subjects, their colleagues\u0026mdash; Adam Ritter, D\u0026eacute;nes Tibor Dud\u0026aacute;s, Dr. Marianna T\u0026ouml;r\u0026ouml;k, Judit P\u0026aacute;li, M\u0026oacute;nika Albu and Anik\u0026oacute; K\u0026oacute;nya\u0026mdash;for their valuable insights and the students who contributed to our research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement:\u003c/strong\u003e We have received nonfinancial support from the Doctoral School\u0026rsquo;s Workgroup for Science Management at Semmelweis University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e The authors have not reported any conflicting interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e All procedures complied with the Helsinki Declaration and institutional guidelines and were approved by the Institutional Research Ethics Committee at the Institute of Psychology at K\u0026aacute;roli University of the Reformed Church (52/2019/P/ET \u0026amp; 36/2020/P/ET).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent:\u003c/strong\u003e Informed consent was obtained from all the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e: not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e\u0026nbsp; The data presented in this study are available only upon properly substantiated request from the corresponding author due to legal agreements and ethical reasons.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions:\u003c/strong\u003e Conceptualization, R.K. and I.L.; methodology, R.K., R.B., B.G and I.L.; software, R.K. and I.L.; validation, Sz.T. and I.L.; formal analysis, R.K. and B.G.; investigation, R.K., RB and EF; resources, I.L.; data curation, I.L. and R.K.; writing\u0026mdash;original draft preparation, R.K.; writing\u0026mdash;review and editing, R.K., R.B., E.F, and I.L.; visualization, R.K.; supervision, Sz.T. and I.L.; project administration, I.L.; funding acquisition, R.K and I.L. 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The weirdest people in the world? Behav Brain Sci. 2010;33(2\u0026ndash;3):61\u0026ndash;83. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1017/S0140525X0999152X\u003c/span\u003e\u003cspan address=\"10.1017/S0140525X0999152X\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMid:20550733.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"metacognitive effectiveness, self-assessment, generational differences, sex differences, COVID-19","lastPublishedDoi":"10.21203/rs.3.rs-7570318/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7570318/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe pandemic and its control measures affected the mental health of the general population regardless of confirmed viral exposure at an unprecedented scale. Studies have often reported a severe increase in mental illnesses and behavioural disorders, especially in pathologies related to metacognitive performance, attributed to organic and functional deterioration.\u003c/p\u003e\u003cp\u003eThis repeated cross-sectional study investigated generational and sex differences in basic cognition, metacognitive effectiveness and self-assessment by comparing samples before the outbreak, immediately after the first lockdown and at the end of the COVID-19 crisis.\u003c/p\u003e\u003cp\u003eWe recruited a sample of adult, mentally healthy working-age subjects (n\u0026thinsp;=\u0026thinsp;1385; age\u0026thinsp;=\u0026thinsp;18\u0026ndash;65) to perform computerized short-term memory tests designed to investigate the associations among basic cognition, metacognitive effectiveness (metamemory and decisional awareness), and self-assessment.\u003c/p\u003e\u003cp\u003eCognitive and metacognitive abilities\u0026mdash;metamemory and decisional awareness\u0026mdash;and self-assessment are associated with each other and, after the initial turbulent deviations of the first lockdown, returned close to default, but metamemory constantly decreased regardless of age and sex during the examined period.\u003c/p\u003e\u003cp\u003eThe decline in metacognitive effectiveness that impacted males and females of most generations similarly, but to different extents, provides an explanation for the rise of mental disorders and consequent psychopathologies during the crisis.\u003c/p\u003e","manuscriptTitle":"Intergenerational and sex differences in metacognitive effectiveness during the Covid-19 pandemic","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-23 14:55:17","doi":"10.21203/rs.3.rs-7570318/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-10-10T06:31:40+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-08T08:05:10+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-16T10:14:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-13T11:53:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-09-13T11:50:05+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8efbfdad-18bd-4773-a0a8-24caf0630c00","owner":[],"postedDate":"October 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-23T14:55:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-23 14:55:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7570318","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7570318","identity":"rs-7570318","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}