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Chapter 8

PSYC32 Chapter 8.docx

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Michael Inzlicht

Chapter 8: Tests of Memory Functioning Case • Joseph: depression, PTSD (abuse at the hands of his father) • Anxiety, taking lots of medication, went to therapy, had a very dark life • Felt like there was a period of time (a significant relationship and its demise) he really just can’t rmr and mem is his primary concern • The shame and guilt he felt, and the fact that these E’s were strong enough caused him to try to actively forget the sit’n. Active forgetting caused him to not form good connections to the info as it was being consolidated o However, cues from other ppl involved in his life at the time helped him rmr more details even though these caused him to feel more E’s all over again Introduction: Types of Mem • Memory is a volatile topic which has led to many diff ideas by theorists that conflict • Lezak (2004), Howieson + Loring: feel there are only 3 types of memory, for clinical purposes: o 1-sensory memory (registration) o 2- short-term mem (working mem, intermediate mem) o 3- long-term mem  Within long-term mem, some reasearchers say there are two subtypes:  1)Declarative (Explicit) = facts and events avail to consciousness • Some further divide declarative mem, particularly for clinical issues: • 1-semantic (fact memory) • 2-episodic (personal information)  2)Nondeclarative (Implicit) = unconscious • Again for clinical issues, this is sometimes divided futher into: • 1-item-specific implicit memory • 2-procedural memory • However, some researches make a distinction btwn short-term and working mem o Baddeley: Working mem involves more control processes (active involvement) o i.e. short-term = passive, working mem = active • 3 stages of mem: encoding, storage, retrieval • The transfer from short-term/working mem  long-term mem = putting it into “storage” phase • Retrieval as well is from things in long-term mem Sensory Mem = Registration • First stage of mem. Though some say it’s not a stage bc it is just info brought in by the senses and held their until perceptions are formed • Holds a large amount of sensory info for a brief period (just some seconds) • Iconic memory: first impression of a visual stimulus (up to 200ms) • Echoic memory: first impression of an auditory stimulus (up to 2000ms) • Iconic/echoic may move into working memory Immediate, Short-term, or Working Mem • Short-term (here used interchangeably w/ working mem): holds info received from sense for a limited amount of time • Lezak suggests that ~ can be equated w/ simple, immediate span of attn • Immediate mem: has been described by Miller as having a capacity of 7 (+/- 2) U o is of sufficient duration to allow a person to respond to ongoing events when more enduring forms of mem have been lost (i.e. even someone w/ long-term mem difficulties can be capable of remembering a phone number) o often thought to be just one system but some research says there is more • Vallar + Papagno said two subsystems of immediate mem: o Phonological loop: for processing lang o Visuospatial sketch pad: for visuospatial data • This follows the research of Baddeley+Hitch who suggested a multicomponent model of working mem which contained 2 slave systems which where responsible for short-term maintenance of info and a central executive which supervises + coord’s info of slaves • Baddeley has more recently added a 4th component to the schema: episodic buffer = a temp, limited capacity storage sys which holds and integrates info from different modalities (visual, auditory) through connection w/ long-term mem • Hebb, 1949, stated that immediate mem is maintained in reverberating neural circuits (= self-contained networks that sustain a nerve impulse by channelling it repeatedly through the same network). Research has supported this: seems like info will completely disappear if not converted into a stronger biochem organization that allows it to be moved to long-term mem  Long-Term Mem • ~ = the actual acquiring of new info. i.e. synonymous w/ learning • Consolidation = process in which info is stored in ~ o May happen quickly or may take time o May even happen w/o active involvement • Before the cognitive revolution in the 1980s, it was assumed that most mem consolidation occurred within 30 mins • However, now, w/ greater understanding of biochem pathways, an exact time cannot be stated • Some researchers even think there are two critical periods • Learning is also considered more of an active process than consolidation • However, incidental learning may happen passively, w/o conscious thought Processes of Mem Fxn’ing Sensory Mem • Either the sensory impressions are paid attn to and processed into working mem, or it quickly decays • Attn, concn, and rehearsal appear to be the primary means for transfer from sensory to working Working Mem • To transfer from working to long-term: • Rehearsal = mental repetition which causes info to remain in working mem for sufficient time until it may be processed and sent to long-term mem o Animal lesion studies + human imagery studies have found that rehearsal involves prefrontal, posterior parietal cortex, thalamus, caudate, + globus pallidus • The actual process by which the transfer from working  long occurs is physical changes in the structure of neurons, in the aforementioned areas Long-Term Mem • ~ involves consolidation + learning • Briefly presented info must be given enough meaning and connections • Additional synapses need to be formed between neurons • The brain has approx 10^15 synapses (=100 terabytes, as hypothesized by Landauer) o But, the avg 70-year life span only stores about 125MB of data in the brain • 3 main interconnected brain structures that operate ~: o Medial temporal lobes around the hippocampus o Diencephalon o Basal forebran • Areas of the limbic sys and related structures associated w/ mem: o Fornix, septum, mammilary bodies, thalamus, frontal lobe, hippocampus • H.M. : had epilepsy. Penfield bilaterally removed a good portion of his medial temporal o This is closely connected w/ hippo o His reasoning ability and digit span remained intact o But Milner said H.M. never remembered her, even though they spent a lot of time o i.e. if his attn was not directly on something, he would not rmr o retrograde + anterograde amnesia bc of surgery o originally a controversial finding, but Mishkin showed same thing in macaque monkeys Retrieval of Info from Long-term Mem • 2 major processes to retrieve info: • 1- recall: (free recall) = process of trying to grasp the info in long-term mem w/o any cues (i.e. an essay test) • 2- recog: “easier” way to obtain info from long-term mem, bc cues are presented (i.e. M/C) Difficulties w/ Mem Amnesia • ~ = inability to rmr certain events/ circumstances o Causes: TBI, chronic alcoholism, psychological trauma, etc. • Dissociative ~: ~ w/o any other cog deficits (i.e. a lapse in memory bc of a, traumatic event) • Retrograde ~: mem loss of material learned before the trauma o Depending on severity, they may lose all or some of their declarative mem o Most common pattern is loss of months-years before trauma, but some intact mem for older info (i.e. remember their early childhood) • Anterograde ~: opposite, difficulty learning new things, retain new memories o Most severe = unable to learn any new info at all o Less serious = learning may just be a lot slower and require much more repetition • Most ppl who suffer brain impairment sustain a combo of retro + antero • Transient Global ~: retro + antero to some degree. Lasts for a much shorter period (i.e. transient), so minutes-days o Causes: concussion, brief cerebral ischemia, physical/emotional stress, drugs, cold showers, sexual activity (bc all of these can affect cerebral blood flow) Tests of Mem Impairment • Mem assessment is usually part of a larger battery, but sometimes it is the primary concern • If this is the case, the cnpsy’ist has a choice to use: o Standard mem test battery o Individual test of mem ability • Goal of assessment is always to get the best picture of the client’s strengths + weaknesses • 2 most commonly used mem batteries: o WMS-IV: Wechsler Mem Scal -IV o MAS: Memory Assessment Scale • Record review, eval of referral q, clinical interview, observation, and interviews w/ ppl who know client well can all also be handy though • Attn, concn, and motivation are all factors in all forms of memory assessment Tests of Attn and Concn Orientation • ~ = ability to be aware of oneself in R to the surrounding in which one is located • Requires attn, adequate perceptual abilities, adequate mem skills • Difficulties w/ ~ may be one of the first indicators of brain imp • ~ difficulties w/ time and place are the most common and occur w/ both widespread cortical imp (i.e. Alzheimer’s) or more circumscribed lesions, such as to the limbic sys in Korsakoff’s • However, if only mild cog difficulties, then ~ may remain intact • thus, ~ is a good indicator of moderate  severe brain imp, but not of cog/attn competence • after time and date, you can check their self-~ • a test of ~ is a component of all types of mental status exams, many individual tests of memories, and many memory test batteries o though there usually isn’t an entire section dedicated to it, just a few questions o but, more in depth tests exist and can be used if there are concerns about client’s ~ • very little info on the reliability and validity of ~ tests Awareness Interview • Anderson + Tranel, 1989 • Dev’d to determine an individual’s orientation in various spheres • A structured interview about place, time, person’s self-orientation, insight to any of their own issues w/ motor, thinking, speech, mem, etc. • Graded scoring schedule for eval of overall severity of awareness problems • Provides useful wording for q’s that the nspy’ist can use in eval’ing orientation + awareness • Lezak said the 3-point ratings for each item could be subjective o but there is actually a high interrater reliability • high scores on this interview (high awareness scores)  good fxn in ADLs Temporal Orientation Test • Benton, Sivan, Hamsher, Varney, + Spreen, 1994 • To detect errors in temporal perception (for day, month, year, day of week, present clock time) • Scoring sys that differentially weights each of the 5 time categories and subtracts the total error score from 100 • Any loss of greater than 5 score points = sig temporal disorientation • Does a fairly good job of differentiating impaired vs control (in one study, only 4% of elderly controls received an error score over 2) Personal Orientation Test • Semmes, Weinstein, Teuber, Ghent, 1963 • Eval’s a person’s ability to deal w/ personal body parts within space • Part A: touch parts of own body, as directed by examiner • Part B: name parts of body touched by the examiner • Part C: touch parts of the examiner’s body, as directed by examiner • Part D: Touch own body in imitation of examiner • Part E: Touch own body according to numbered schematic diagrams • Part F (sixth test, that is more optional): subject is asked to move objects, seen and felt • Pt’s w/ left hemi damage  greater difficulty following verbal instructions • Right hemi damage  tend to ignore left side of body or objects presented to their left side Finger Localization Test • Benton, 1994 • Detects finger agnosia (can’t recognize own finger) • Many possible causes for this agnosia • If only one hand, there is probably a sensory deficit • If both hands, finger agnosia, bc lesions to either side of the brain • ~ has 3 parts: • A: identify fingers when touched by examiner • B: shields the hand, but then the same as A • C: Two fingers touched simultaneously • Ten trials for each condition • 7-9 errors = borderline, 10-12 = moderately defective, 13+ = defective Standardized Road Map Test of Direction Sense • Money, 1976 • Test of right-left orientation • There is a practice example first • Then the examiner traces a dotted pathway w/ a pencil and asks the pt to state the direction (right or left) taken at each turn • Lezak states no norms for people who are 18+ o But, a cutoff of 10 errors/32 points is recommended regardless of age o Both control and impaired tend to <10 errors o So, if >10, clear sign of impaired right-left orientation • Men do better on this task than women until elderly Mental Reorientation Test • Ratcliff, 1979 • to identify difficulties in spatial transformations • small figures of men are presented in 4 positions and each are shown 8 times • pt’s task is to name which of the stimulus’ hands holds a black disc • in all subjects, fewer errors when upright (vs. inverted) o regardless of whether the figure was placed facing forward/backward Fargo Map Test • Beatty, 1988 • Identifies difficulty in toographical orientation o Can measure recent + remote spatial mem, visuospatial orientation • This test involves knowledge of the United States map (so obviously there is a bias) and other specific areas that pt may have learned in the past and also gained from living in various areas • Begin by asking pt where they have lived • Then they need to locate from 12-16 designated target items on a map of US and 17 regional outline maps • Near correct location = score of 1, less precise 0.5, complete failure = 0 Attn, Concn, and Tracking • ~ (of information) are very diff to separate in a clinical sense • Attn problems may surface as distractibility or inability to focus on a topic even when trying • Good attn is a prereq for concn and tracking • Concn problems may be due to attn problems, inability to maintain focus, or both • Tracking problems may be bc of attn or concn difficulties • Behv of pt must be observed, as well as their performance on npsy tests to determine whether a difficulty is due to a simple attn problem or a more complex concn or tracking problem Reaction Time • Slow processing speed is often at the root of attn difficulties • ~ can measure processing speed and help to understand nature of attn deficits • ~ may be slowed by any of degenerative or acquired disorders • ~ can be measured by any task that has timed components Vigilance • ~ tests measure ability to sustain and focus attn • Most ~ tests involve stimuli being presented sequentially • Subject is told to respond when a given #, letter, pattern, item, etc. is presented • ~ tests tend to also measure attn, concn • Similar to the tests of awareness, little psychometric data is available for ~ tests as well Continuous Performance Tests (CPTs_ • Several forms. Rosvold, Misky, Sarason, Bransome + Beck, 1956 dev’d the CPT-I o Random letters of alphabet appear on computer screen and subject is asked to respond when X occurs, or when XA (X followed by A) o Errors may occur for reasons other than attn, therefore this test may not be very good at sorting out the cause of the difficulty • Connors, 1992 dev’d the CPT-II, has 5 versions for various computer formats o Respond every time any letter other than X appears o Thus, this tests allows for errors of omission and commission (reversing the targets) o CPT-II also = good measure of ability to sustain attn, bc monotonous task takes 14 mins o Also measures response speed, response accuracy o Connors also provided normative data for ppl w/ ADHD, neural imp, and controls o But, criticized for:  allowing examiner to interrupt test to answer pt’s q’s (may invalidate test).  And also bc split-half reliability procedure is very dif
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