Bahrain FFP1 Memory Lecture 2024-2025 PDF

RCSI Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn Building Blocks of Behaviour II - Memory Class Medicine Year 1 Course FFP1 Enter subtitle here...

RCSI Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn Building Blocks of Behaviour II - Memory Class Medicine Year 1 Course FFP1 Enter subtitle here (24pt, Arial Regular) Lecturer. Ms. Lumadate: Enter Bashmi [email protected] 25.06.13 Date September 2024/2025  Learning Outcomes 1. Identify the 3 key components of memory 2. Outline models of memory 3. Describe the characteristics of each memory type 4. Discuss reasons for forgetting 5. Describe common memory disorders Think of an example Describe a time when you couldn’t remember something. Write it down on a piece of paper. – e.g. “I forgot my neighbour’s name” – I forgot to tell my friend about a book to get for college – I forgot to pick up my brother after school – I forgot to pay my friend for the loan she What does this case teach us about memory? Clive Wearing: www.youtube.com/watch?v=Vwigmktix2Y  LEARNING OUTCOME 1: Identify the 3 key components of memory Word Association When you think of memory what is the first word that comes to mind? Key components of memory ? ? ? Encodi Storag Retriev ng e al Clinical case: Clive Wearing What key component of Clive’s memory was compromised?  “Using phones Component 1: Encoding and computers How information gets INTO during memory lectures can cost students ATTENTION is critical half a grade in Focusing awareness on exams” characteristics  Everyday “memory” failures e.g. names Divided attention impedes memory Component 1: Encoding Question: What does this exercise illustrate? Levels of Processing Theory (Craik & Lockhart, 1972) Types of encoding: 1. Shallow: Structural (physical appearance) 2. Intermediate: Phonemic (sound) 3. Deep: Semantic (meaning) Deeper levels result in longer lasting memory codes i.e. better recall Question: How can you apply this theory to: 1. Improve your study techniques? 2. Help your patients/clients remember information? Encodi Storag Retriev ng e al How information is MAINTAINED in memory LEARNING OUTCOME 2: Outline models of memory  Component 2: Storage Invention of computers influenced theories of memory storage  information processing models Atkinson & Shiffrin (1970’s) MULTI-STORE MODEL – Most influential theory – 3 separate stores Sensory Memory Short-Term Memory (STM) Long-Term Memory (LTM) – Not anatomical structures! – Computer used as a metaphor Component 2: Storage Limited Unlimited Information lasts for capacity; capacity; milliseconds or seconds information information depending on stimulus lasts lasts type about 20 indefinitely seconds  LEARNING OUTCOME 3: Describe the characteristics of each memory type  1. Sensory memory Auditory, tactile or visual information preserved momentarily – Just enough time to recognise and direct your attention – Likened to an “echo” rather than a store e.g. visual “after-image” Clinical case: Clive Wearing Was Clive able to form sensory memories? 2. Short-term memory (STM) Limited capacity: – 7±2 units of information (Miller’s Law) – New information/interference can displace current information i.e. 8th, 9th, 10th bits of info bump out earlier info Limited duration: – 20-30 seconds – REHEARSAL extends duration e.g. verbal repetition STM as "Working Memory" (Baddeley & Hitch, 1974) Not just a rehearsal buffer and not just sensory information https://www.simplypsychology.org/working %20memory.html Clinical case: Clive Wearing Was Clive’s working memory intact? 3. Long-term memory (LTM) – Unlimited capacity – Indefinite duration Permanent? “Flashbulb” memory debate Evidence of decay, interference and/or retrieval failure – Multiple memory systems organised in logical framework: Declarative – Semantic (general ‘that’ knowledge) (facts, explicit e.g., capital of Long- knowledge) e.g., events in the France? term Procedural heptathlon? – Episodic (dated recollections memory ‘how’ of personal (actions, perceptual- experiences) motor skills, conditioned e.g., first responses) boy/girlfriend e.g. riding a bicycle Clinical case: Clive Wearing What memory stores were affected? Encodi Storag Retriev ng e al LEARNING OUTCOME 4: Discuss reasons for forgetting  Component 3: Retrieval How information is RECOVERED OR from memory ??? Issues with retrieval: – Not an exact replicas – Can be distorted by unrelated events – "Misinformation effect" – Misleading post-event information – e.g. question wording – Implications for eye-witness testimony Loftus & Palmer (1974). https://doi.org/10.1016/S0022-5371(74)80011-3 Irish study on creating false memories: False Memories for Fake News https://www.ncbi.nlm.nih.gov/pubmed/31432746  Factors that affect retrieval: The order of encoding – Serial-Position effect:  U-shaped retrieval Better recall for info at the start (LTM) Better recall for info at the end (WM)  Factors that affect retrieval: Time – Most forgetting occurs immediately after memorisation – Ebbinghaus (1885): ‘nonsense’ syllables e.g., XOS Meaningfulness ↑ recall Connectedness ↑ recall – Relate new info to existing knowledge Retrieval cues – Hints, reinstating context cues Retrieval methods used – Recall: no cues; most difficult – Recognition: select from an array of options – Re-learning: effort saved 2nd time indicates extent of learning the 1st time – Reconstruction: combines stored information with other available information Why do we forget? Information lost Information due to retrieval Information lost if not lost if not failure, encoded encoded interference, decay  Why do we forget? 1. Ineffective encoding Information not encoded properly due to lack of attention – pseudo-forgetting 2. Decay Memory fades with time due to decay in physiological mechanisms Not much empirical support 3. Interference: Competition from other information e.g.: New information impairing retention of old (retroactive interference) Old information interfering with retention of new (proactive interference) 4. Retrieval failure “Tip-of-the-tongue” phenomenon Retrieval often best when context is similar to encoding context 5. Motivated forgetting Freud - people bury unpleasant, painful, or embarrassing memories deep in unconscious mind - REPRESSION  LEARNING OUTCOME 5: Describe common memory disorders Clinical Disorders of Memory AMNESIA: Partial or total memory loss Retrograde amnesia: – Inability to remember events that happened prior to onset  retrieval failure Anterograde amnesia: – Inability to take in new factual information or remember day-to-day events  consolidation failure Post-traumatic amnesia: – Combines both – Period of retrograde shrinks – Period of anterograde determines classification of head injury [mild, moderate, or severe] Clinical case: Clive Wearing What kind of amnesia did Clive have?  Causes of Amnesia Brain injury Drugs (e.g. BZDs; anaesthetics) Encephalitis Electroconvulsive therapy (ECT) Alcoholism (Korsakoff’s Syndrome) Lack of stimulation Severe emotional trauma Alzheimer’s disease – ~50% of people by age 85 – Not normal ageing  Memory loss in Alzheimer’s Disease Working memory: – Intact at first BUT increased sensitivity to distraction Long-term memory – Procedural relatively intact – Declarative (Semantic): Difficulty with language & recall of conceptual information e.g. clock Can occur several years before diagnosis – Declarative (Episodic): Among 1st signs & symptoms (“forgetfulness” - missed appointments) Ribot’s law - recent memories are more likely to be lost Deficits in consolidation from ST to LT Implications: – Vivid memories can be confused with psychotic symptoms – Therapeutic application: Reminiscence therapy Practical implications  Practical implications: Professional – Patients’ memory and recall Know the factors that affect recall Insight into why patients do not remember information/present with memory problems Not always age-related! Referral and/or screening for cognitive impairment Situational factors may play a role (e.g. stress, distraction) Recall is critical for good adherence! You can facilitate your patients’ recall 1. Factors that affect encoding e.g. divided attention 2. WM capacity – Don’t present too much information at once – CHUNK information into explicit categories (e.g. treatment steps, side-effects) 3. The order information is presented – Give most important information early and summarise at the end (PRIMACY & RECENCY EFFECT) 4. Facilitate encoding from WM to LTM – Repeat key information to promote REHEARSAL and transfer to LTM – Make information MEANINGFUL to promote DEEP ENCODING and ELABORATION e.g. explain rationales, give specific concrete examples, use visual aids – Create CONNECTIONS - Relate information to patients’ existing knowledge and prior learning 5. Facilitate recall – Provide recall cues e.g. diagrams/visuals of exercises, information leaflets, written instructions Practical implications: Personal – Study Skills Maximise your encoding capacity – Minimise interference; maximise attention Be mindful of WM capacity Space learning; avoid mass practice – Relearning consolidates Avoid shallow processing – e.g. Reading and rereading Use strategies for DEEP processing – Elaborate on information, draw diagrams, think of examples, paraphrase information, explain concept to a friend – Build connections with existing knowledge Use techniques to help your recall – e.g. reconstruction, reinstating context, chunk information, think of cues  Apply your learning Think about your “memory loss” incident from the start of the class (Describe a time when you couldn’t remember something). Based on your learning in this lecture… 1. What type of memory was it? – i.e. pseudo-memory (encoding failure), sensory, WM, LT (semantic, episodic or procedural) 2. What are the most likely reasons for why you forgot the information? 3. What might have helped your recall? Relevant reading Required reading: – an Teijlingen E, Humphris GM. (2019) Psychology and Sociology Applied to Medicine: An Illustrated Colour Text. 4 th edition. Elsevier Health Sciences, p 26 – 27. Older editon: Alder, Beth; Teijlingen, Edwin van; Porter, Michael (2011) Psychology and Sociology Applied to Medicine, 3rd edition pages 28-29; Recommended, if you want to read more: – Kessels RPC. Patients’ memory for medical information. Journal of the Royal Society of Medicine 2003; 96: 219-222. http://jrsm.rsmjournals.com/cgi/reprint/96/5/219 – SEE FOLDER FOR SEVERAL PAPERS – https://www.simplypsychology.org/working%20m emory.html