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Memory 記憶力 授課老師:劉倩秀老師 課程名稱:腦功能職能治療與評估 10/18/2007 1. 記憶歷程之三階段: Registration, Retention and Retrieval 2. 記憶儲存模型 (Atkinson & Shiffrin, 1971) Sensory memory, STM, LTM 3. Working memory model (Baddeley & Hitch 1974) 4. Long-term memory declarative, procedural, prospective memory 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 2 記憶歷程之三階段: Registration, Retention and Retrieval The studies of memory that are based on the processes that operate in the long-term memory system have identified three stages: Registration, or coding at the time of learning; Retention, or storage over time; Retrieval of information when it is required. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 3 Registration: Information that is elaborated and processed with meaning at the time of registration increases the likelihood of later retrieval. We are more likely to remember someone’s name if we also learn other personal details about family and where he or she lives than if we only register physical appearance. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 4 Retention: Retention is a dynamic process. Stored knowledge is modified and updated by new information entering from working memory over time. Once an item has been registered in memory, subsequent forgetting Could be the result of decay over time Could be due to interference by later learning The loss of neurotransmitters has been linked to poor registration and storage in memory, for example in Alzheimer’s diseases (Kopelman, 1986) 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 5 Retrieval: Retrieval is affected by the context, and items are more likely to be retrieved in the same environment as they were learnt. External cueing is an important aid to retrieval of items or events from memory. Recall of the name of a person Be cued by the first letter Other information about the person Recognition of the person from a group of names or photographs 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 6 We are familiar this item in memory but we cannot retrieve it. One explanation is that the current processing does not match the stored information and fails to cue the memory. Mood also affects retrieval. Learning in the altered state can be recalled better in the same state. Depressed patients easily recall memories of sad events and this can add to their depression (Teasdale, 1983) 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 7 Memory can be broadly divided into three systems: 1. Sensory memory Sensory memory is the brief processing of information received by the sense organs that lasts only a few milliseconds before passing on to shortterm memory. Sensory memory is modality specific: visual (iconic), auditory (echoic), tactile, olfactory, proprioceptive 2. Short-term memory Short-term memory holds information from the sensory memory for several seconds before it is either transferred to long-term memory, or lost due to interference from new items coming in. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 8 3. Long-term memory Long-term memory retains information for periods of time from a few minutes to many years. Forgetting in long-term memory may be due to decay over time, or perhaps the memory remains stored but cannot be retrieved. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 9 記憶儲存模型 (Atkinson & Shiffrin, 1971) STM 感覺記憶 LTM 感覺登錄器 視覺 環境輸入 暫時的工作記憶 永久記憶儲存 庫 聽覺 . .. 控制歷程 本體覺 (複誦, 提取策略..) 反應輸出 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 10 Short-term memory / working memory The original description of a short-term store has been developed into a working memory system where there is rehearsal of items and some active processing for meaning. Working memory has several components which select and manipulate verbal, visual and spatial information over several seconds before passing on to long-term memory and also to other cognitive systems. (Baddeley and Hitch, 1970s) 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 11 其他心理學家,由不同角度探討LTM&STM 著重於工作記憶扮演的角色 工作記憶 (WM) 為LTM的一部份,且包含STM WM是LTM中,近期被活化的部份 包含短暫,稍縱即逝的STM及其內容 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 12 Working memory model (Baddeley & Hitch 1974) There are three main components of working memory: 1. Visuospatial sketchpad ; 2. Central executive; 3. Phonological loop. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 13 1. Visuospatial sketchpad The visuospatial sketchpad stores visual and spatial information entering from the eye over a few seconds in time. This “inner eye” component of working memory holds both spatial information and visual images that cannot be rehearsed verbally, such as size, shape, colour and distance. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 14 It can also be used to inspect and manipulate visual images entering from the eyes or from long-term memory. In finding our way around, “snapshots” of visual and spatial information are held for a short time to allow us to recognize landmarks. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 15 2. Central executive The central executive controls the processing in the other components of working memory by the allocation of attention to each one. The central executive is particularly important when the cognitive demands of a task are high, for example listening to a conversation while reading the newspaper. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 16 3. Phonological loop The phonological loop stores speech-based information in a phonological store (inner ear), and verbally rehearses it in the same order (inner voice). The verbal rehearsal, know as the articulatory system, is repeated in the same order, like an audiotape that is replayed for about two seconds before it decays or passes on into long-term memory. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 17 In speaking and reading, several words are held long enough make sense of the words that follow. Words can enter the phonological store directly from the ear, from rehearsal of written or spoken words, and from longterm memory for names of objects or people. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 18 Long-term memory The long-term memory system has unlimited capacity and processes a large variety of information. Items from working memory enter longterm memory where they are processed for meaning and context. Stored memories in long-term memory are retrieved into working memory before the relevant response is activated, for example speech or action. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 19 The three memory systems 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 20 Summary of the structure of long-term memory (explicit) 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 (implicit) 21 Procedural memory –how? Procedural memory is the subsystem related to the performance of learned skilled activity. All the motor and language skills what we have learnt the part of procedural memory. We remember how to swim; to ride a bicycle; to speak our first language without knowing the complicated rules of grammar. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 22 The knowledge of learned motor skills stored in procedural memory is linked to the specific conditions for the actions involved. Activation of the correct procedure depends on matching of the input conditions from working memory, and from decision-making. Skilled actions become more automatic with practice. Repetition of the particular condition / action pair in procedural memory leads to easier and faster activation. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 23 Procedural memory is spared in most patients with memory loss, so that motor skills well learned before cerebral damage are retained. This has important implications for the return to work in memory-impaired individuals. It may be called “knowing how”. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 24 Declarative memory – what? Declarative memory is the recollection of knowledge of people, objects, places and events, and that certain facts are true or false. It can be called “knowing what”. Declarative memory has been divided into: semantic memory episodic memory 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 25 Semantic memory: is general knowledge of facts is knowing that Rome is the capital of Italy is knowing bananas are yellow Episodic memory constitutes memories linked to a time and place is record of particular events knowing where you spent a holiday last year knowing the first trip you made by plane 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 26 The distinction between semantic and episodic is blurred and the two types interact in everyday memory. Knowledge that began as episodic becomes generalized into semantic memory over time. Learning to use a microcomputer May at first be associated with a particular model in a college laboratory (episodic) After a time, the operation of computer becomes part of our general knowledge of the world (semantic) 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 27 Autobiographical memory Autobiographical memory is another component of declarative memory. Episodic and autobiographical both have a context in time and space, but autobiographical memory is linked to specific life events which have significance for the individuals. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 28 Prospective memory – when? Prospective memory is remembering what to do and when to do it. It is explicit memory which requires attention processing. Everyday routine tasks are mostly automatic and they are performed with minimal demands on prospective memory. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 29 In non-routine actions, prospective memory is needed to activate the plan at the right time. An external cue to activate the plan, for example a letter-box on the way home promotes you to post a letter. In the absence of a cue, the attention demands in working memory may affect the success or failure of prospective memory. We forget to make an important phone call when there are many demands on our attention. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 30 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 31 Memory problems 記憶問題 授課老師:劉倩秀老師 課程名稱:腦功能職能治療與評估 10/18/2007 Working memory deficits Working memory is the stage of memory processing, which lasts a few seconds, between the input of sensory information from the environment and the registration processing in long-term memory. It should be noted that working memory is not the same as the term “short-term memory” which is often clinically to mean recent memory of the previous few minutes or hours. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 33 Working memory deficits - communication, finding route, shopping In speaking and reading, a few words at a time are rehearsed subvocally in the phonological loop, before output in speech or passing on to long-term verbal memory. In following a route, visual images of landmarks are held for a brief time in the visuospatial sketchpad and compared with long-term visual memory for recognition. The mental arithmetic which is part of checking the change in shopping involves working memory to manipulate and rehearsal small groups of numbers. 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 34 Deficits in working memory Patients cannot recall numbers or words that are heard Patients can recall the same information when it is presented visually 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 35 Assessment for working memory Digit span Functional assessment for working memory Observation of functional activities handling money, using the telephone, reading a newspaper, holding a conversation Discussion with the family for more informaiton 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 36 Deficit in long-term memory Retrograde amnesia (premorbid amnesia) Loss of some memories acquired before onset Anterograde amnesia (postmorbid amnesia) difficulty in learning and remembering new information due to the loss of the contextual processing at the time of registration 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 37 Korsakoff-type amnesia have a severely impaired long-term memory they can hold a conversation and recall numbers if there is no delay after seeing them a kind of severe Retrograde amnesia 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 38 Loss of procedural memory retain the ability to perform skilled actions learnt in the past, although memory aids are needed for the parts of the activity that rely on semantic memory. some patients may be able to learn new motor works, although they are often unaware of the changes 陳述記憶(外顯): 程序記憶(內隱):文字完成作業,以技能為主的作業,騎腳 踏車,完成拼圖 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 39 Loss of declarative memory Episodic memory loss cannot remember what he had for breakfast, or that a relative visited yesterday, because daily events cannot be coded in time and place inability to follow a TV program which demands remembering what happened a few minutes before, inability to to recall a conversation with a friend, lead to social isolation from the family and friends 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 40 Prospective memory loss inability to activate plans for action at the correct time omissions occur in the daily routine the person may fail to get dressed, or eat lunch or phone a member of the family 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 41 Functional assessment for prospective memory asking the patient to execute a previously agreed action, for example make a telephone call, at a specified time in the future the interval between the request and the action can be gradually increased from minutes to hours or to the next day 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 42 Compensatory strategies The outcome of memory assessment leads to the choice of compensation strategies which enable the memory-impaired person to function in their own environment Internal strategies: mnemonics, paired associates and visual imagery => limited application in daily living External strategies: diaries, wall planners => for prospective memory Alarm watches => promote for the initiation of tasks Audiotapes => promote for the sequencing of tasks 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 43 Autobiographical memory a history which gives us our personal identity “we are what we remember” Component parts: people, places, objects, events (we have experienced) involve recall of declarative memory for a unique event flashbulb memory: specific memories of dramatic and emotional events episodic memory frequent rehearsal and retelling of the event may account for the accuracy of recall rather than a special mechanism 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 44 Autobiographical Memory Interview (AMI) semi-structured interview divided into two parts: Personal semantic schedule recall specified facts from the past Childhood (names of teachers and school) Early adult life (name of first employer, date and place of wedding) Recent life (holiday, journeys, hospitalizations) Score for accuracy Autobiographical incidents schedule recall of specific incidents from each of the same life-periods Assess retrograde episodic memory 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 45 Confabulation Confabulation is a feature of memory impairment when the recall of autobiographical memory is apparently sensible, but untrue. Both the details and the context of a memory are confused, and the relationship of events in time is disrupted. Many dense amnesics do not confabulate, and those who do may show normal recall and recognition of semantic memory 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 46 Memory function related to brain areas 10/18/2007 輔仁職治系 腦功能職能治療與評估 劉倩秀老師 47