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Memory assessment

This document provides an overview of neuropsychological assessment of memory. It discusses various aspects of memory including length of storage, type of information remembered, and stages of memory. It describes different memory tests used in clinical assessment including logical memory, verbal paired associates, visual reproduction, design, digit symbol coding, and the auditory verbal learning test. Interpretive considerations are provided for each test. The document aims to enhance understanding of memory and its clinical assessment through neuropsychological tests.

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Neuropsychological Assessment of Memory DR ZAHIRUDDIN OTHMAN PSYCHIATRY DEPT, USM 23-09-2018 1
What is Memory? 2
Understanding Memory 1. Length of storage 2. Type of information to be remembered 3. The stages involved in remembering 4. Recall and recognition 5. Explicit and implicit memory 6. Retrospective and prospective memory 3
Understanding Memory Length of storage ◦ Sensory Memory ◦ Iconic Memory ◦ Echoic Memory ◦ Working Memory ◦ Short-term or Immediate Memory ◦ Phonological & visuo-spatial ◦ Long-term Memory ◦ Delayed Memory ◦ Recent Memory ◦ Remote Memory Sensory Memory Iconic Memory (vision) •Capacity: Essentially that of the visual system •Duration: About 0.5 to 1.0 seconds •Processing: None beyond raw perceptual processing Echoic Memory (hearing} •Capacity: ? •Duration: About 4 to 5 seconds •Processing: None beyond raw perceptual processing Short-term memory (STM) a.k.a. working memory •Capacity: About 7 ± 2 "chunks" of information •Duration: About 18 to 20 seconds •Processing: information is often encoded verbally Long-term memory (LTM) •Capacity: Virtually unlimited •Duration: Up to a lifetime •Processing: Information is organized according to meaning and is associatively linked InputAttention Storage Retrieval Rehearsal decay interference retrieval failure Forgetting 4
Understanding Memory Type of information to be remembered ◦ Declarative / Explicit Memory ◦ Semantic Memory (facts) ◦ Autobiographical Memory ◦ Episodic Memory (events) ◦ Non-declarative / Implicit Memory ◦ Procedural Memory ◦ Classical Conditioning ◦ Non-associative learning 5
Memory Disturbances Psychological description ◦ Length of storage ◦ Immediate / Delayed / Recent / Remote ◦ Type of information lost ◦ Events / Facts / Skills ◦ Stages ◦ Encoding / Storage / Retrieval 6
Memory Disturbances Clinical description ◦ Amnesia / Paramnesia ◦ Transient / Persistent ◦ Acute / Chronic ◦ Retrograde / Anterograde ◦ Symptom / Syndrome / Disorder ◦ Psychological / Organic ◦ Selective / Global 7
Recall Test Recognition ◦ Identifying that the information has been seen/heard before Recall ◦ Reproducing the information from memory 1. Free recall 2. Cued recall ◦ the retrieval of memory with the help of cues, which can be category, first letter, semantic etc. Factors Affecting Recall Attention Motivation Interference Context State- dependent memory 8
Digit/symbol coding Now look down here where the squares have numbers in the top but the squares at the bottom are empty In each of the empty squares, put the mark that should go like this… (examiner puts in the first 4 symbols) 9
Logical memory I Verbal paired associates I Design I Visual reproduction I Logical memory II Verbal paired associates II Design II Visual reproduction II Visual Working Memory Spatial addition Symbol span 10
Logical memory Two short stories are presented orally The examinee is asked to retell each story from memory immediately after hearing it The examinee is asked to retell both stories Then the examinee is asked yes/no questions about both stories Logical Memory I Logical Memory II narrative 11
Verbal Paired Associates The examiner read 10 or 14 pairs of words Examiner read the first word of each pair, and examinee provide the corresponding word The examinee is orally presented with the first word. Tasks: free, cued and delayed recall. VPA-I VPA-II associated word pairs 12
Interpretive Considerations: LM and VPA Both (LM & VPA) measure aspects of semantic and auditory memory Presentation of information is organized/ meaningful for LM and unorganized for VPA. VPA requires single word responses; LM requires longer, more cohesive responses. VPA is multi-trial learning measure. For Adult Battery, LM represents single-trial learning ability 13
Visual Reproduction A series of 5 designs is shown, one at a time, for 10 seconds each The examinee is asked to draw the design from memory The examinee is asked to draw the designs from memory in any order The examinee is asked to choose which of 6 designs on a page matches the original design The examinee is asked to draw the designs while looking at them (optional task) VR-I VR-II nonverbal visual stimuli 14
Design The examiner shows a grid with 4–8 designs for 10 seconds The examinee selects the designs from a set of cards and places them in a grid in the same place as previously shown The examinee is asked to recreate the pages shown with the cards and grid The examinee is shown a series of grids and asked to select the two designs that are correct Design-II unfamiliar visual stimuli Design-I 15
Interpretive Considerations: VR and DE Both measure aspects of visual details and spatial memory. Response process for VR includes more visual- construction and fine motor abilities than DE. 16
Spatial Addition Assesses visual-spatial working memory using a visual addition task. Examiner shows the examinee, sequentially, two grids with blue and red circles. [5 sec.] Then, examiner asks examinee to add or subtract the location of the circles based on a set of rules. 17
Symbol Span This subtest assesses visual working memory using novel visual stimuli. The examinee is briefly shown a series of abstract symbols on a page and then asked to select the symbols from an array of symbols, in the same order they were presented on the previous page 18
Interpretive Considerations: SA and SP SA taps spatial location memory and the ability to compare spatial images. SP is highly focused on recall of visual details and the sequence of the images must also be maintained in memory. SA uses a free recall format. SP uses a recognition memory format 19
Auditory-Verbal Learning Test •Examiner reads a list of 15 words (List A) •Free recall •Trial I, II, III, IV, and V Learning •Examiner reads a list of 15 words (List A) •Free recall Interference •Immediate free recall (trial VI) •Delayed recall (trial VII) Post-interference recall •identify the original words among 50 words from A and B lists plus words that are related (semantic/ phonetic) Recognition 20
Auditory-Verbal Learning Test Uses 15-word lists (A, B and C) Measures learning and retention 1. Immediate word span under overload (trial I) 2. Final acquisition level (trial V) 3. Total acquisition (total trial I to V) 4. Immediate recall (trial VI) 5. Delayed recall (trial VII) 6. Recognition 21
AVLT Normative Data Vakil,E.,Greenstein, Y.J.,& Blachstein,H.(2010).Normativedataforcompositescoresforchildrenandadultsderived fromtheReyAuditoryVerbal LearningTest. TheClinicalneuropsychologist,244,662-77.22
AVLT Measures Vakil,E.,Greenstein, Y.J.,& Blachstein,H.(2010).Normativedataforcompositescoresforchildrenandadultsderived fromtheReyAuditoryVerbal LearningTest. TheClinicalneuropsychologist,244,662-77.23