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PubMed1993

Deficits in short-term memory in posttraumatic stress disorder.

OBJECTIVE: The purpose of this study was to compare the memory function of patients with posttraumatic stress disorder (PTSD) to that of matched comparison subjects. METHOD: Vietnam veterans with combat-related PTSD (N = 26) were compared to physically healthy comparison subjects (N = 15) matched for age, race, sex, years of education, handedness, socioeconomic status, and alcohol abuse. Memory and intelligence were assessed with a battery of neuropsychological tests, including the Russell revision of the Wechsler Memory Scale, the Selective Reminding Test, and subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R). RESULTS: The PTSD patients scored significantly lower than the comparison subjects on the Wechsler Memory Scale logical memory measures for immediate recall (mean = 11.6, SD = 3.3 versus mean = 20.9, SD = 6.6) and delayed recall (mean = 8.0, SD = 3.3 versus mean = 17.8, SD = 6.4). The PTSD patients also scored significantly lower on the total recall, long-term storage, long-term retrieval, and delayed recall measures for the verbal component of the Selective Reminding Test and on the recall, long-term storage, long-term retrieval, and continuous long-term retrieval measures for the visual component of the Selective Reminding Test. There was no significant difference between the PTSD patients and comparison subjects in prorated full-scale IQ as measured by the WAIS-R. CONCLUSIONS: Patients with PTSD may have deficits in short-term memory. Counseling and rehabilitation that address these deficits may be of value for PTSD patients.

Humans↗
PubMed2004

Thought disorder in schizophrenia: working memory and impaired context.

This research was designed to provide data on whether thought disorder in schizophrenia patients is due to difficulty in holding external stimuli or the external context online in working memory. We assessed 231 early phase acute inpatients, including 68 schizophrenic patients and 38 bipolar manic patients. Patients were administered a thought disorder test that requires holding stimuli online in working memory as they respond and another in which the stimuli is in direct view of the patients throughout the test procedure. The results indicated that patients who were thought disordered on the test requiring holding the external stimuli online in memory also were more thought disordered on the test that provides full vision of the stimuli throughout the testing (p < 0.001). Thus, schizophrenia patients vulnerable to thought disorder show thought disorder regardless of whether or not they are required to hold the stimuli online in memory. Overall, the data did not support the formulation that thought disorder is primarily a consequence of failure to hold external stimuli or contextual material online in working memory. An alternate view of thought disorder is presented.

Adult↗
PubMed2005

Executive function and memory in posttraumatic stress disorder: a study of Bosnian war veterans.

The present study assessed neuropsychological functions related to attention, executive function and everyday memory in a group of men with a diagnosis of combat-related posttraumatic stress disorder (PTSD). Twenty Bosnian male combat veterans with a diagnosis of PTSD were tested using the Sustained Attention to Response Task, the Hayling Sentence Completion Test, the Trail Making Test, Rivermead Behavioral Memory Test and Wechsler Adult Intelligence Scale (verbal scales). Their performance was compared with age- and IQ-matched male war veterans with no PTSD. The study disclosed pervasive cognitive impairments with large effect sizes pertaining to attention, working memory, executive function, and memory. The effects did not appear to be attributable to alcohol abuse, loss of consciousness, or educational level. We speculate that, in the present group of combat veterans, PTSD was associated with dysfunction of a higher-level attentional resource which in turn affected the activity in other systems concerned with memory and thought.

Adult↗
PubMed1986

Memory as assessed by recognition and reading time in normal and memory-impaired people with Alzheimer's disease and other neurological disorders.

Three experiments are reported that examine the dissociations in performance on two tests of retention, speeded reading and recognition in young people, home-dwelling and institutionalized elderly people, and people with severe memory disorders. In Experiment 1, subjects read sentences in normal and in geometrically transformed script at initial presentation, 1-2 hr later, and again 4-14 days later. On the latter two occasions, they were required to distinguish old sentences that they had read previously from new ones. In general, the young and elderly subjects could distinguish old from new sentences at the short delay, and all but the institutionalized elderly people could do so at the long delay. Retention as measured by reading speed typically paralleled recognition performance in that those items that were recognized best were read most quickly. The dissociation between these two tests of retention is seen only in people with memory disorders. Although these people could not distinguish old from new items even at short delays (most could not even remember having seen any sentences), their retention as assessed by reading time was similar to that of the other groups. Old sentences were read most quickly, indicating retention of item-specific information, and reading time of new sentences improved, indicating the acquisition and retention of a general skill. Experiment 2 examined what type of item-specific information was retained. Young, elderly, and memory-disordered subjects studied weakly associated word pairs and sentences. A few minutes later they were tested on both recognition and speeded reading of old, new, and recombined pairs and sentences, the last being those in which words from a studied pair or sentence were recombined with words from other such pairs or sentences. The results of both retention tests indicated that young and elderly people could distinguish old from new and recombined items. People with memory disorders, however, again failed on recognition but performed normally on speeded reading. Like the other two groups, they read old items faster than either recombined or new items. In Experiment 3, similar results were obtained even when the word pairs were constructed using randomly associated items. The results of all three experiments suggest that on implicit tests of memory, such as speeded reading, people with memory disorders can be shown to have formed and retained new associations despite failing utterly on explicit tests, such as recognition, that require conscious recollection of a previous episode.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed2001

Treating memory problems in adults with neurogenic communication disorders.

Historical approaches to memory therapy have focused on rehearsal or "relearning" of memory skills and on compensation for impairments. Whereas the use of rehearsal-based approaches has received little empirical support, the use of external compensatory devices has proved helpful to patients with a variety of neurogenic communication disorders. More recent approaches have capitalized on advances in cognitive psychology, permitting the identification of strengths and weaknesses in specific memory functions, and increasing our understanding of the role of response errors in the therapy process. These advances, together with applied behavioral analysis, allow therapy to be tailored to the cognitive profile of an individual patient, and help explain the successes and failures of earlier techniques. In this article, both historical and current approaches are discussed, and memory therapy guidelines are suggested.

Brain↗
PubMed2003

Selective processing of threatening information: effects of attachment representation and anxiety disorder on attention and memory.

To investigate the effect of the mental representation of attachment on information processing, 28 anxiety disorder outpatients, as diagnosed by the Anxiety Disorders Interview Schedule-Revised, were administered the Adult Attachment Interview and the State-Trait Anxiety Inventory. They also completed an emotional Stroop task with subliminal and supraliminal exposure conditions, a free recall memory task, and a recognition test. All tasks contained threatening, neutral, and positively valenced stimuli. A nonclinical comparison group of 56 participants completed the same measures. Results on the Stroop task showed color-naming interference for threatening words in the supraliminal condition only. Nonclinical participants with insecure attachment representations showed a global response inhibition to the Stroop task. Clinical participants with secure attachment representations showed the largest Stroop interference of the threatening words compared to the other groups. Results on the free recall task showed superior recall of all types of stimuli by participants with secure attachment representations. In the outpatient group, participants with secure attachment representations showed superior recall of threatening words on the free recall task, compared to insecure participants. Results on the recognition task showed no differences between attachment groups. We conclude that secure attachment representations are characterized by open communication about and processing of threatening information, leading to less defensive exclusion of negative material during the attentional stage of information processing and to better recall of threatening information in a later stage. Attachment insecurity, but not the type of insecurity, seems a decisive factor in attention and memory processes.

Adult↗
PubMed1998

Neuroendocrine activity and memory-related impairments in posttraumatic stress disorder.

This article reviews memory-related impairments in trauma survivors with posttraumatic stress disorder and their possible association to neuroendocrine alterations seen in this disorder. The neuroendocrine profile in PTSD first described in chronically ill combat veterans is characterized by lower basal cortisol levels, higher glucocorticoid receptor number, enhanced sensitivity to exogenous steroids, and increased variation in basal cortisol levels over the diurnal cycle. The generalizability and time course of these neuroendocrine alterations are explored in longitudinal studies and studies in other traumatized populations. These studies suggest that at least some aspects of this neuroendocrine profile can also be seen in other populations, including women, children, and victims of childhood trauma. Additionally, the alterations may be present early in the course of illness, perhaps even in the immediate aftermath of trauma, and may continue to be manifest in elderly trauma survivors. The mechanisms by which these neuroendocrine alterations may influence the formation and processing of traumatic memories are discussed.

Adult↗
PubMed2006

Patterns of memory impairment in bipolar disorder and unipolar major depression.

Unipolar and bipolar depression are known to exert detrimental effects on learning and memory processes. However, few comparisons have been undertaken between bipolar and unipolar patients with comparable illness histories, and predictors of impairment are not well understood. Adult outpatients with unipolar major depressive illness (UP, n = 30) and bipolar disorder (BP, n = 30), group-matched for illness duration and severity of depressive symptomatology (16% clinically remitted, 42% partially remitted, 42% depressed), and 30 demographically matched controls completed measures of general cognitive functioning and declarative memory. Despite comparable general intellectual abilities, BP and UP patients exhibited significant memory deficits relative to healthy controls. A similar deficit profile was observed in both patient groups, involving poorer verbal recall and recognition. Impairments were not secondary to strategic processing deficits or rapid forgetting. Although depression severity was not associated with neurocognitive performance, number of hospitalizations and family history of mood disorder significantly affected memory function in BP, but not UP, patients. Results suggest qualitatively similar patterns of memory impairment in BP and UP patients, consistent with a primary encoding deficit. These impairments do not appear to be secondary to clinical state, but rather suggest a similar underlying pathophysiology involving medial temporal dysfunction.

Adult↗
PubMed2004

Procedural memory in dissociative identity disorder: when can inter-identity amnesia be truly established?

In a serial reaction time task, procedural memory was examined in Dissociative Identity Disorder (DID). Thirty-one DID patients were tested for inter-identity transfer of procedural learning and their memory performance was compared with 25 normal controls and 25 controls instructed to simulate DID. Results of patients seemed to indicate a pattern of inter-identity amnesia. Simulators, however, were able to mimic a pattern of inter-identity amnesia, rendering the results of patients impossible to interpret as either a pattern of amnesia or a pattern of simulation. It is argued that studies not including DID-simulators or simulation-free memory tasks, should not be taken as evidence for (or against) amnesia in DID.

Amnesia↗
PubMed2002

Memory biases in the anxiety disorders: current status.

Information-processing models of emotional disorders suggest that anxious individuals may be characterized by a memory bias for threat-relevant information. This paper reviews and synthesizes evidence for explicit (conscious) and implicit (unconscious) memory biases in the anxiety disorders. Our review suggests variations among the anxiety disorders for explicit memory biases. Specifically, there is support for explicit memory biases for threat-relevant information in panic disorder (PD), particularly when information has been deeply encoded, but not in social phobia (SP) or generalized anxiety disorder (GAD). The few available studies suggest the presence of explicit memory biases in posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD), but further research is needed. In contrast, some degree of support for implicit memory biases has been demonstrated for each of the anxiety disorders. Inconsistencies in the existing literature, topics worthy of future research attention, and directions for revising existing information-processing models of anxiety are discussed.

Anxiety Disorders↗
PubMed2003

Anxiety disorder and accompanying subjective memory loss in the elderly as a predictor of future cognitive decline.

OBJECTIVE: The aim of the study was to empirically investigate the hypothesis that anxiety in the elderly, secondary to loss of memory, predicts future cognitive decline. METHOD: The participants were 137 elderly subjects with no depression or cognitive impairment from a community geriatric assessment unit, 45% with anxiety. In addition to demographic characteristics, cognitive status was assessed using the Mini Mental State Examination; depression was assessed by Tucker's short Interviewer-Assisted Depression Rating Scale; anxiety by Sinoff's Short Anxiety Screening Test and Activities of Daily Living function by Shah's modified Barthel's Index. RESULTS: At follow-up 37 persons had dropped out, leaving 100 participants for final analysis. Mean re-examination time was 3.2 years with no group differences. The mean MMSE and modified Barthel scores decreased significantly more in those with anxiety. A relative risk of 3.96 for developing future cognitive impairment was found. Regression analysis showed that only anxiety was a significant predictor of cognitive decline. By path analysis, a more parsimonious model showed anxiety to have both a direct and an indirect effect on predicting future cognitive decline, and that the effect of loss of memory on cognitive decline was via anxiety. CONCLUSIONS: Anxiety is inter-related and inseparable with loss of memory and its presence is a strong predictor for future cognitive decline, directly or indirectly via depression. It appears that loss of memory is the initial problem with consequent development of anxiety. Therefore, anxiety, like depression, is probably an early predictor of future cognitive decline and even possible future cognitive impairment.

Activities of Daily Living↗
PubMed2005

Neuropsychological performance in schizotypal personality disorder: importance of working memory.

BACKGROUND: Cognitive deficits consistently have been reported in schizophrenia patients and in patients with schizotypal personality disorder. For this study, the authors wanted to identify which of the domains of cognitive impairment represent "core" deficits of schizophrenia, comparing subjects with schizotypal personality disorder to two comparison groups: healthy volunteers and patients with personality disorders unrelated to schizophrenia. METHOD: Three groups completed a neuropsychological battery: patients with DSM-III-R schizotypal personality disorder (N=82); patients with DSM-III-R personality disorders unrelated to schizophrenia (i.e., a personality disorder other than schizotypal, schizoid, or paranoid [N=44]); and healthy volunteers (N=63). The battery included the California Verbal Learning Test, Trailmaking Test parts A and B, the Dot test of working memory, the Stroop Color and Word Test, the Paced Auditory Serial Addition Test, the WMS visual reproduction test, and the WAIS-R vocabulary and block design. RESULTS: Normative standards for performance that controlled for age, gender, and education were created from the scores of the healthy volunteers. Overall, schizotypal personality disorder patients performed significantly worse than the healthy volunteers and those with personality disorders unrelated to schizophrenia. Specifically, patients with schizotypal personality disorder demonstrated impaired performance on the Paced Auditory Serial Addition Test, WMS visual reproduction test, Dot test, and California Verbal Learning Test. In addition, in a regression analysis, performance on the Paced Auditory Serial Addition Test demonstrated the largest effect size. Indeed, it accounted for unique variance above and beyond all other cognitive measures, since controlling for Paced Auditory Serial Addition Test performance abolished group differences across all other measures. CONCLUSIONS: Patients with schizotypal personality disorder demonstrated moderate cognitive impairment compared with healthy volunteers (significant for seven out of 11 measures). These differences reached statistical significance for tasks of working memory, episodic memory, and delayed recall. Working memory performance accounted for the group differences. This study supports the view that working memory represents a core deficit of schizophrenia spectrum disorders.

Adult↗
PubMed2004

Perspectives on attention deficit hyperactivity disorder: executive functions, working memory, and language disabilities.

The conceptualization of the nature of attention deficit hyperactivity disorder (ADHD) has changed in the last decade. ADHD is now viewed as a neurologically based condition with primary deficits in executive functions and working memory (WM). Students with ADHD have deficits in discourse organization, inferring, and monitoring that are related to their executive function and WM deficits. A large number of students with ADHD also have comorbid reading and language disabilities that exist in addition to the deficits directly associated with the ADHD. Comprehensive evaluation of students with ADHD is essential to address their specific learning needs.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Behavioral toxicology: evaluating cognitive functions.

Behavioral toxicology is concerned with the identification of adverse effects on neural and behavioral functions resulting from exposure to a neurotoxicant. Many substances are known to have effects on cognitive functions such as memory, attention and perception. This paper reviews some of the issues that must be addressed when trying to assess these neurotoxic effects on cognition, and identifies a variety of paradigms that have been explored for use in behavioral toxicology.

Arousal↗
PubMed2002

Categoric overgeneral autobiographical memory in adolescents with major depressive disorder.

BACKGROUND: Categoric, overgeneral autobiographical memory is more common in depressed adults than controls and predicts persistence of depression. This cross-sectional study investigated whether, compared with non-depressed psychiatric cases and community controls, first episode major depressive disorder (MDD) in adolescents is associated with categoric overgeneral memory retrieval. METHODS: Ninety-six clinically referred adolescents (aged 12-17 years) with MDD, 26 non-depressed psychiatric cases and a sample of 33 community controls were recruited. All subjects were assessed using the Kiddie-Schedule for Schizophrenia and Affective Disorders, and completed Williams' cued Autobiographical Memory Test and the Mood and Feelings Questionnaire. Hamilton Depression Rating Scales were completed with MDD subjects, as an index of depression severity. RESULTS: Adolescents with current first episode MDD retrieved more categoric overgeneral memories than controls, but not than non-depressed psychiatric cases. Adolescents in full remission from a recent episode of MDD retrieved more categoric memories to positive cues than controls. Categoric memory in MDD was related to observer-rated and self-reported severity, but not to the pattern of co-morbid diagnoses. There were negative correlations between IQ and categoric memories in both clinical cases and controls. A positive correlation between categoric memory to negative cues and self-reported depressive symptoms was found in clinical cases (but not controls). CONCLUSIONS: In adolescents, increased categoric overgeneral memory is associated with, but not specific to first episode MDD. Positive categoric memories are also increased in fully remitted MDD as compared to controls.

Adolescent↗
PubMed1985

Verbal rehearsal and memory in language-disordered children.

Twelve language-disordered (mean age 10:7) and 12 normal children (mean age 10:10) received a series of free-recall lists composed of pictorial items. They were instructed to rehearse aloud after each item. From the rehearsal periods and recalls 12 variables were calculated. They represented retention of item and order information, semantic organization, effects of primacy and recency in input order, repetition, and intrusion errors. These variables were submitted to factor and discriminant analyses and linear regression; the intrusion errors were also classified. The analyses suggest that rehearsal and recall reflect three components: capacity for item and order information, semantic organization, and susceptibility to non-list intrusion. The predominant differences between groups were in capacity and intrusions. The memory deficits of the language-disordered subjects are described as diminished verbal capacity, a description that has implications for the relationship between language and memory and the specific nature of the disorder.

Adolescent↗
PubMed2004

Learning and memory in Holocaust survivors with posttraumatic stress disorder.

BACKGROUND: Impairments in explicit memory have been observed in Holocaust survivors with posttraumatic stress disorder. METHODS: To evaluate which memory components are preferentially affected, the California Verbal Learning Test was administered to Holocaust survivors with (n = 36) and without (n = 26) posttraumatic stress disorder, and subjects not exposed to the Holocaust (n = 40). RESULTS: Posttraumatic stress disorder subjects showed impairments in learning and short-term and delayed retention compared to nonexposed subjects; survivors without posttraumatic stress disorder did not. Impairments in learning, but not retention, were retained after controlling for intelligence quotient. Older age was associated with poorer learning and memory performance in the posttraumatic stress disorder group only. CONCLUSIONS: The most robust impairment observed in posttraumatic stress disorder was in verbal learning, which may be a risk factor for or consequence of chronic posttraumatic stress disorder. The negative association between performance and age may reflect accelerated cognitive decline in posttraumatic stress disorder.

Aged↗