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双相情感障碍中的组织学习策略与言语记忆缺陷

Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder.

作者信息

Nitzburg George C, Cuesta-Diaz Armando, Ospina Luz H, Russo Manuela, Shanahan Megan, Perez-Rodriguez Mercedes, Larsen Emmett, Mulaimovic Sandra, Burdick Katherine E

机构信息

1Icahn School of Medicine at Mount Sinai,Departments of Psychiatry and Neuroscience,New York,New York.

出版信息

J Int Neuropsychol Soc. 2017 Apr;23(4):358-366. doi: 10.1017/S1355617717000133.

Abstract

BACKGROUND

Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies.

METHODS

The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies.

RESULTS

Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship.

CONCLUSIONS

VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or "chunking" techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358-366).

摘要

背景

言语记忆(VM)损害在双相情感障碍(BD)中较为突出,且与功能预后相关。然而,尚未在大量双相情感障碍患者样本中研究VM损害的复杂性。此外,一些人提出VM缺陷可能由组织策略介导,如语义或序列聚类。因此,双相情感障碍患者VM衰退的确切性质尚不清楚,这限制了补救措施。我们研究了双相情感障碍患者与健康对照者(HCs)中VM缺陷的复杂性,并探讨了言语学习差异是否由聚类策略的使用介导。

方法

对113名情感稳定的双相情感障碍患者和106名健康对照者进行了加利福尼亚言语学习测试(CVLT)。我们比较了所有CVLT指标的诊断组,并研究了言语学习中的组间差异是否由聚类策略介导。

结果

尽管双相情感障碍患者在注意力、学习和记忆方面表现明显较差,但这些指标仅轻度受损。然而,双相情感障碍患者有效学习策略的使用较差,回忆一致性较低,这些指标处于中度受损范围。此外,对语义聚类的相对依赖完全介导了诊断类别与言语学习之间的关系,而对序列聚类的依赖部分介导了这种关系。

结论

情感稳定的双相情感障碍患者的VM缺陷普遍存在,但一般为轻度受损。然而,患者在组织策略的使用上不足,在语义和序列聚类方面与健康对照者有明显区别。补救措施可能受益于关于记忆术或“组块”技术的教育,以减轻双相情感障碍中的VM缺陷。(《神经心理学报》,2017年,23卷,358 - 366页)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45e/5856464/e1d5cf5551a4/nihms949118f1.jpg

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