Cognitive psychologyCognitive psychology

Rosie IVÁDYRosie IVÁDY

Course scheduleCourse schedule

9-10.30 lecture 9-10.30 lecture 10.30-10.45 break10.30-10.45 break

10.45- 12.15 lecture 10.45- 12.15 lecture 12.15-12.45 lunch break 12.15-12.45 lunch break 12.45-13.30 talking seminar12.45-13.30 talking seminar

Course requirementsCourse requirements

Test on Friday at 9.00Test on Friday at 9.00– Multiple choice questionsMultiple choice questions– True/false questionsTrue/false questions

Slides can be found on my homepage the day Slides can be found on my homepage the day following class atfollowing class at

www.cogsci.bme.hu/~ivadywww.cogsci.bme.hu/~ivady

Day 1 – Unconscious knowledge, memory and Day 1 – Unconscious knowledge, memory and learning. Evolutionary psychology inborn?learning. Evolutionary psychology inborn?

Day 2 – Psycholinguistics, language and thoughtDay 2 – Psycholinguistics, language and thought

Day 3 – Theory of mind and the teleological stance. Day 3 – Theory of mind and the teleological stance. Evolution of language and theory of mindEvolution of language and theory of mind

Day 4 – Social and pathological. Religion and mental Day 4 – Social and pathological. Religion and mental health. Morals, taboos, and the Penal Codehealth. Morals, taboos, and the Penal Code

The realm of unknown: implicit The realm of unknown: implicit knowledge and learningknowledge and learning

Budapest Semester in Cognitive Budapest Semester in Cognitive ScienceScience

Cognitive PsychologyCognitive PsychologyDay 1.Day 1.

Memory and learningMemory and learning

Today’s features:Today’s features:– Memory – conscious and unconsciousMemory – conscious and unconscious– Learning – is there implicit learning?Learning – is there implicit learning?– Implicit cognition – its social and practical Implicit cognition – its social and practical

perspectivesperspectives

MemoryMemory

Long-term memory

Working orShort-term

Memory

Sensory

Input

Sensory Memory

Attention Encoding

Retrieval

Maintenance Rehearsal

Sensory Memory StoreSensory Memory StoreDivided into two Divided into two subtypes:subtypes:– iconic memory - visual iconic memory - visual

informationinformation– echoic memory - echoic memory -

auditory informationauditory informationSensory

InputSensory Memory

Sensory Memory StoreSensory Memory Store

Visual or iconic Visual or iconic memory was memory was discovered by Sperling discovered by Sperling in 1960in 1960

It is only conscious in part It is only conscious in part – not all of it– not all of it

Sensitive to eye movementSensitive to eye movement

Bright background Bright background following it (mask)following it (mask)

Eidetic memoryEidetic memory

Around 15% of children Around 15% of children

Lasts around 40 secondsLasts around 40 seconds

More susceptible to More susceptible to interferenceinterference

More likely to create false More likely to create false memories!memories!

Leads to the question – how Leads to the question – how much trace do non-much trace do non-conscious events leave in conscious events leave in normal population?normal population?

Subliminal adsSubliminal ads

Subliminal is defined in two waysSubliminal is defined in two ways– Embedded figures of text, not obvious to Embedded figures of text, not obvious to

superficial examination (picture ads)superficial examination (picture ads)– Short exposure times (television or movies)Short exposure times (television or movies)

The question of subliminal The question of subliminal advertisementsadvertisements

Wilson Bryan Key: Subliminal Seduction and Media Sexploitation

James Vicary - primingJames Vicary - priming

1957 – subliminal advertising1957 – subliminal advertising– Eat popcornEat popcorn– Drink Coca-ColaDrink Coca-Cola

Embedded in a film (0,03s cuts) increased Embedded in a film (0,03s cuts) increased sales by 20-60%sales by 20-60%However he never published this findingHowever he never published this finding– Later in an interview he claimed that this was a Later in an interview he claimed that this was a

fabricationfabrication– No one could reproduce it in its originalNo one could reproduce it in its original

CritiqueCritique

Moore: weak effects and strong effectsMoore: weak effects and strong effects– Weak effects – over emotions – improbable Weak effects – over emotions – improbable

because of the competition with various because of the competition with various supraliminal stimulisupraliminal stimuli

– Strong effects – over buyer behaviour – Strong effects – over buyer behaviour – improbable because of the control over one’s improbable because of the control over one’s behaviourbehaviour

Subliminal advertising is banned in most English-Subliminal advertising is banned in most English-speaking countriesspeaking countries

Yet many self-help audiotapes containing subliminal Yet many self-help audiotapes containing subliminal messages are soldmessages are sold– Self-esteem, weight loss, memory enhancementSelf-esteem, weight loss, memory enhancement

even though many studies failed to find evidence that even though many studies failed to find evidence that they work they work – mind you: these are double blind studies!mind you: these are double blind studies!

– Also they contain far too long sentences to be processed Also they contain far too long sentences to be processed linguistically – see priming studies (Greenwald, 1992) – linguistically – see priming studies (Greenwald, 1992) – Brand names?Brand names?

PlaceboPlacebo

Most companies deny that they use subliminal Most companies deny that they use subliminal adsads– Yet 74% of people believe in itYet 74% of people believe in it– 71% of those who believed in it thought it works 71% of those who believed in it thought it works

as wellas well

Rosenthal effect? (Cassandra-type or self-Rosenthal effect? (Cassandra-type or self-fulfilling prophecy)fulfilling prophecy)

New evidenceNew evidence

Revival after 2000 – new studiesRevival after 2000 – new studiesCooper and Cooper (2002)Cooper and Cooper (2002)– Subliminally primed people with pictures of Coca Subliminally primed people with pictures of Coca

Cola cans and the word thirstyCola cans and the word thirsty– Their self-rated thirst roseTheir self-rated thirst rose

Dijksterhuis et al (2005)Dijksterhuis et al (2005)– Subliminally primed drink&cola and neutral wordsSubliminally primed drink&cola and neutral words– Exp group drank more, but no difference is whatExp group drank more, but no difference is what

Karremans et al (2006)Karremans et al (2006)– Self-rated thirstSelf-rated thirst– Primed with Lipton Ice or neutral words (Npeic Tol Primed with Lipton Ice or neutral words (Npeic Tol

– same letters) for 23 ms– same letters) for 23 msIn pilots they found that usually the prime can not be In pilots they found that usually the prime can not be guessed – not consciousguessed – not conscious

– Allegedly, they were supposed to partake in a Allegedly, they were supposed to partake in a detection task detection task

BBBBbBBBBB – how many small bs?BBBBbBBBBB – how many small bs?

– Choice between Lipton Ice tea (Coke being too Choice between Lipton Ice tea (Coke being too sweet or too popular – brand loyalty) and Spa Roodsweet or too popular – brand loyalty) and Spa Rood

Direct emotional primingDirect emotional priming

Strahan et al. (2005)Strahan et al. (2005)– Subliminal priming will only affect people’s Subliminal priming will only affect people’s

choices if they are goal-relevantchoices if they are goal-relevant– It affects attitude to bevarages, BUT only if the It affects attitude to bevarages, BUT only if the

person is thirsty! Higher evaluationperson is thirsty! Higher evaluation

Bargh (1996)Bargh (1996)– Trait priming – the person is only going to be rude Trait priming – the person is only going to be rude

after the priming, IF (and only if) given the after the priming, IF (and only if) given the possibilitypossibility

Priming studiesPriming studies

Facial expressions Facial expressions (emotional priming)(emotional priming)

– Unconscious effectUnconscious effect

– 18-30 ms presentation18-30 ms presentation

– Judged neutral faces Judged neutral faces more unpleasantmore unpleasant

– Höschel et al. 2001Höschel et al. 2001

MemoryMemory

Long-term memory

Working orShort-term

Memory

Sensory

Input

Sensory Memory

Attention Encoding

Retrieval

Maintenance Rehearsal

How do we know STM and LTM How do we know STM and LTM are separate stores?are separate stores?

AmnesiaAmnesia

SourcesSources

Blow to head, Concussion Blow to head, Concussion

Korsakoff syndrome (severe vit. B1 Korsakoff syndrome (severe vit. B1 deficiency)deficiency)

Alzheimer’sAlzheimer’s

Damage to hippocampus, thalamic structuresDamage to hippocampus, thalamic structures

ECT (electroconvulsive shock therapy)ECT (electroconvulsive shock therapy)

Midazolam: artifically induced amnesiaMidazolam: artifically induced amnesia

AmnesiaAmnesia

Types of amnesiaTypes of amnesia– AnterogradeAnterograde

– RetrogradeRetrograde

Retrograde amnesiaRetrograde amnesiaTemporal gradientTemporal gradient: : – early memories are better remembered than memories before early memories are better remembered than memories before

trauma (trauma (Ribot’s law)Ribot’s law)

– Recently formed memories continue to undergo neurological Recently formed memories continue to undergo neurological change: change: memory consolidationmemory consolidation

Retrograde amnesia often becomes less severe over Retrograde amnesia often becomes less severe over timetime– Most remote memories are likely to return firstMost remote memories are likely to return first

Does not affect overlearned information (e.g. skills)Does not affect overlearned information (e.g. skills)

Anterograde AmnesiaAnterograde AmnesiaInability to acquire Inability to acquire new informationnew information

– Think of movie “memento”Think of movie “memento”

– Does not affect short-term memoryDoes not affect short-term memory

– Does not affect general knowledge from the pastDoes not affect general knowledge from the past

– But, it is difficult to learn But, it is difficult to learn newnew facts facts

– Affects memory regardless of modality (visual, auditory, Affects memory regardless of modality (visual, auditory, tactile, etc). Spares skilled performancetactile, etc). Spares skilled performance

– Hyper-specific memory for those skills that are learned Hyper-specific memory for those skills that are learned after onset – learning is expressed only in context in after onset – learning is expressed only in context in which it was encodedwhich it was encoded

Famous Anterograde Amnesiac: Famous Anterograde Amnesiac: HMHM

Severe epilepsy, treated with surgery to bilaterally Severe epilepsy, treated with surgery to bilaterally remove medial temporal lobes, including remove medial temporal lobes, including hippocampushippocampus

Operation 9/1953, 27 years oldOperation 9/1953, 27 years old

Two systems? Dissocition studies:Two systems? Dissocition studies:

– STM & LTM tests differ:STM & LTM tests differ:Non-word repetition testNon-word repetition testWord list learningWord list learning

Presentation ratePresentation ratemeaningfulnessmeaningfulness

Hebb : dual trace mechanismHebb : dual trace mechanism– Cell assembly and Cell assembly and – reverbarating activity – STMreverbarating activity – STM

Atkinson & Schiffrin:Atkinson & Schiffrin:– One might consider the short-term store simply as

being a temporary activation of some portion of the long-term store.

Long-Term Memory Long-Term Memory Capacity unlimitedCapacity unlimited

Thought by some to be permanentThought by some to be permanent

Encoding transfers info from STM to LTMEncoding transfers info from STM to LTM –semantically organized –semantically organized basisbasis

Anterograde amnesia eliminates this – or does it?Anterograde amnesia eliminates this – or does it?

Long-term memory

Working orShort-term

Memory

Sensory

Input

Sensory Memory

Attention Encoding

Retrieval

Maintenance Rehearsal

Spared (implicit) learning in Spared (implicit) learning in anterograde amnesiaanterograde amnesia

Claparede study (1911). Claparede study (1911). – Patient never remembered having met Claparede (doctor) Patient never remembered having met Claparede (doctor)

beforebefore– Claparade offers handshakes with pinprickClaparade offers handshakes with pinprick– Next time, no explicit memory of event (or doctor)Next time, no explicit memory of event (or doctor)– Still, patient refuses to shake hands and offers explanation: Still, patient refuses to shake hands and offers explanation:

“sometimes pins are hidden in people’s hands”“sometimes pins are hidden in people’s hands”

Korsakoff patients & Trivia questions Korsakoff patients & Trivia questions – Given feedback, then retested. No conscious memory for Given feedback, then retested. No conscious memory for

items but better performance. “I read about it somewhere”. items but better performance. “I read about it somewhere”. (Schacter, Tulving & Wang, 1981). (Schacter, Tulving & Wang, 1981).

Famous Anterograde Amnesiac: Famous Anterograde Amnesiac: HMHM

Severe epilepsy, treated with surgery to bilaterally Severe epilepsy, treated with surgery to bilaterally remove medial temporal lobes, including remove medial temporal lobes, including hippocampushippocampus

Operation 9/1953, 27 years oldOperation 9/1953, 27 years old

H.MH.M

General knowledge intact but “stuck in time”. General knowledge intact but “stuck in time”. – Did not learn words introduced after 1953: Did not learn words introduced after 1953:

“jacuzzi”, “granola”, “flower-child”“jacuzzi”, “granola”, “flower-child”

Was able to form some memoriesWas able to form some memories– Initially couldn’t learn how to get to his new home. Initially couldn’t learn how to get to his new home.

Took many years to learn his own houseTook many years to learn his own house

– Could learn to mirror reverse read and mirror traceCould learn to mirror reverse read and mirror trace

HMHM – Milner’s study – Milner’s study (1962)(1962)

Milner, 1965

improvement in H.M. for mirror tracing task (without conscious recollection of previous training episodes) the medial temporal lobes are not necessary for all types of long-term memory.

Learning a new skill: mirror-Learning a new skill: mirror-reverse readingreverse reading

Amnesics can learn to mirror-reverse read Amnesics can learn to mirror-reverse read and are sensitive to repetitionsand are sensitive to repetitions

Implicit and explicit memoryImplicit and explicit memory

IImplicit memorymplicit memory: : past experiences influence perceptions, thoughts & actions past experiences influence perceptions, thoughts & actions without awareness that any information from past is accessedwithout awareness that any information from past is accessed

EExplicit memoryxplicit memory::conscious access to info from the past conscious access to info from the past (“I remember that..” )(“I remember that..” )

-> -> involves involves conscious recollectionconscious recollection

A long storyA long story

Declarative Non-Declarative

William James (1880) Principles of Psychology

Memory Habits

Henri Bergson (1910)

Independent Recollection

Bodily Habits. Recall through action only.

William Mc Dougal (1924)

Explicit Implicit

Gilbert Ryle (1949)

Knowing that Knowing how

Jerome Bruner (1950)

Memory with record

Memory without record

Larry Squire (1988)

Declarative Procedural

Squire’s modelSquire’s model

Expressed through performance rather than recollection

Representational

Are true or false - verbalizable

Temporal specification

ConversionConversionSquire argues that Squire argues that these two are not these two are not clear-cut distinct clear-cut distinct systemssystems– Remember Tulving’s Remember Tulving’s

semantic memorysemantic memory

– Remember source Remember source amnesia!amnesia!

ChildrenChildren

ConfabulationConfabulation

DreamsDreams

HypnosisHypnosis

Amnesia and animalsAmnesia and animals

declarative memory can gradually turn into non-declarative memory can gradually turn into non-declarative with repeated exposure declarative with repeated exposure

Animal models of the conversionAnimal models of the conversion– Plus shaped maze - rats learn to find food, which was Plus shaped maze - rats learn to find food, which was

always westalways west

– Started from the south – then were put into the northStarted from the south – then were put into the northFirst few trials – turned to west – impaired when lidocaine injected First few trials – turned to west – impaired when lidocaine injected in hippocampusin hippocampus

Subsequent trials – turned to left (habit, not individual memory) – Subsequent trials – turned to left (habit, not individual memory) – impaired when injected with lidocaine in the caudate nucleusimpaired when injected with lidocaine in the caudate nucleus

Human learningHuman learning

Healthy and amnesiacs learn differentlyHealthy and amnesiacs learn differently– Exposed to sentences such as „medicine caused Exposed to sentences such as „medicine caused

hiccups”hiccups”– Had to complement fragments (___ ____ hiccups)Had to complement fragments (___ ____ hiccups)

Healthy Healthy – rapid learningrapid learning– Semantic mistakesSemantic mistakes

AmnesiacAmnesiac– Slow learningSlow learning– Faithful to original stimulusFaithful to original stimulus

– In non-verbal tasks however (movements) trying In non-verbal tasks however (movements) trying to remember declaratively often impairs to remember declaratively often impairs performance!performance!

Competition of strategiesCompetition of strategies

Squire – the two systems often compete to be Squire – the two systems often compete to be the strategy of remembrance – as in healthy the strategy of remembrance – as in healthy human habit learning tasks in fMRIhuman habit learning tasks in fMRI– First medial temporal lobe activationFirst medial temporal lobe activation

Many mistakesMany mistakes

– Gradually the caudate nucleus takes overGradually the caudate nucleus takes overMore punctualMore punctual

– Movements/habits seem to be different from Movements/habits seem to be different from languagelanguage

Species dependent strategiesSpecies dependent strategies

Visual pattern discrimination learning Visual pattern discrimination learning – (+ vs ->)(+ vs ->)– Monkeys with medial temporal lesions learn the task – Monkeys with medial temporal lesions learn the task –

slowlyslowly– Amnesiacs seem to learn it very fast, then forget which Amnesiacs seem to learn it very fast, then forget which

answer is correctanswer is correct

– For humans the task is too easy and likely to be taken over For humans the task is too easy and likely to be taken over by the declarative systemby the declarative system

More accurate would be trying to discriminate More accurate would be trying to discriminate between paintings (original vs forgery)between paintings (original vs forgery)– This is the same argument as Dijk. Makes!This is the same argument as Dijk. Makes!

Modern interpretationsModern interpretations

Two most popular areTwo most popular are

– Larry Squire – procedural – declarativeLarry Squire – procedural – declarativeLater rephrased non-declaratie and declarativeLater rephrased non-declaratie and declarative

– Peter Graf, Daniel Schachter – implicit – explicitPeter Graf, Daniel Schachter – implicit – explicitThey worked with healthy individuals and experimental They worked with healthy individuals and experimental settingssettings

Explicit & Implicit Memory Tests

Look at the following words. I will test your memory for these words in various ways.

SPONGE CANDY DOLPHIN

PACKAGE POSTER LICORICE

ZEBRA SECTION CAMOFLAGE

MISTAKE PORTAL KNAPSACK

COFFEE QUAIL ALPINE

HANDLE PANTRY CARPET

EAGER CELLO PRESSURE

LLAMA ORIOLE ACRID

Memory TestMemory Test

Explicit test of memory: recallExplicit test of memory: recall

– Write down the words you remember from the list in the Write down the words you remember from the list in the earlier slideearlier slide

Memory TestMemory Test

Explicit test of memory: recallExplicit test of memory: recall

– Write down the words you remember from the list in the Write down the words you remember from the list in the earlier slideearlier slide

Implicit test of memory: word fragmentsImplicit test of memory: word fragments

– On the next slide, you will see some words missing letters, On the next slide, you will see some words missing letters, some “word fragments” and some anagrams. Guess what some “word fragments” and some anagrams. Guess what each word might be.each word might be.

EGNOPS *AN*Y *OL*H**

PACKAGE P*S*E* LICORICE

*E*RA SE*T*O* C**O*LA*E

*I*TA*E PORTAL KNAPSACK

COFFEE *U*IL AEILNP

*AN*LE *A*T*Y ACEPRT

*A*E* C*L** *RE*S**E

AALLM EILOOR *C*ID

EGNOPS *AN*Y *OL*H**

PACKAGE P*S*E* LICORICE

*E*RA SE*T*O* C**O*LA*E

*I*TA*E PORTAL KNAPSACK

COFFEE *U*IL AEILNP

*AN*LE *A*T*Y ACEPRT

*A*E* C*L** *RE*S**E

AALLM EILOOR *C*ID

Not all implicit memory tests are verbal: Closure Pictures

Priming paradigms:

Subjects presented with target words. Subsequent recognition phase: Targets and distractors.

•Off-line tasksFragment Completion A--a--inWord Stem Completion Bri---

Implicit memory is evidenced when Ss complete or identify more studied than non-studied words.

•On-line tasksPerceptual IdentificationLexical DecisionDegraded Word Naming

Implicit memory evidenced by faster RTs for studied words

Implicit memory testsImplicit memory tests

ArdeniskAssassinAssassingrsfersd

Forgetting: Tulving et al (1982):

S’s learn list of uncommon words (e.g. Toboggan).Test = standard recognition, fragment completion (_O_O_GA_)

0

10

20

30

40

50

60

70

One hour One week

Recognition

FragmentCompletion

Repetition priming effect equal for recognised and non recognised words

Fragment completion performance unchanged after 1w

Gradedness in timeGradedness in time

•Jacoby & Dallas (1981) Targets presented visually at learning, but spoken at testNo effects on recognition memorySignificantly reduced priming effects in implicit test.

•Roediger & Blaxton (1987)Changed typescript between learning and test:No effects on recognition memorySignificantly reduced priming effects in implicit test.

Modality shiftsModality shifts

Explicit Memory: Sensitive to retention interval / Dividing attention

Implicit Memory: sensitive to manipulations of surface features (e.g. modality shifts).

What about amnesiacs in IM tests?What about amnesiacs in IM tests?

Graf, Squire, & Mandler (1984):Graf, Squire, & Mandler (1984):

– Study words: Study words: cheese, house, …cheese, house, …

– Explicit memory test: Explicit memory test: cued recall.cued recall. Complete fragment to a word from study list:Complete fragment to a word from study list:

ch _ _ _ _ch _ _ _ _

– Implicit memory test: Implicit memory test: word stem completion.word stem completion. Complete Complete fragment to form fragment to form anyany word: word: ch _ _ _ _ ch _ _ _ _

Word-stem completion spared in Word-stem completion spared in amnesiacsamnesiacs

Graf et al. (1984).

Graf, Squire & Mandler, (1984)

Presented amnesic patients and controls with word lists - S’s made pleasantness ratings – no explicit instruction to learn

Incidental learningIncidental learning

0

10

20

30

40

50

60

70

80

90

Free Recall Cued Recall Recog Stem Completion

Amnesics

Controls

Test stimuli for Cued Recall and Stem Completion identical -

E.g. BRI--

only instructions differed.

1. Stochastic Independence (Sherry & Schacter, 1987)• If Implicit and Explicit memory effects represent the function of separable

memory systems, there should be no correlations between measures of Implicit and Explicit memory.

• Tulving et al: (1982) There is no correlation between recognition and fragment completion.

1. Validity condition• If implicit memory is one system then there ought to be

correlations between different measures of that systems performance.

• BUT: No correlations - so lots of different implicit memory systems?

• Partly this is the reason of the multiple subsets of Squire’s non-declarative model (and the reason he renamed it from procedural)

Are they different?Are they different?

•System accounts - favoured by neuropsychologists observing preserved abilities in amnesics•Tulving & Schacter (1994) - Differences in implicit / explicit memory reflect the operation of separate memory systems.

•Process accounts - favoured by experimental psychologists working healthy subjects (often using priming paradigms)

Roediger (1990)

Distinction between Implicit / Explicit memory is confounded by distinction between the processes required to perform these tests. •Explicit tests - conceptual information•Implicit tests - require “data-driven” processes that operate on more perceptual level.

Critique of healthy subjectsCritique of healthy subjects

Two criteriaTwo criteria– Unintentional retrieval strategyUnintentional retrieval strategy

The instruction must be : complete it with the first word that comes The instruction must be : complete it with the first word that comes to your mindto your mind

– Not accompanied by conscious recollectionNot accompanied by conscious recollectionThey do not find out in the middle of the experiment that the They do not find out in the middle of the experiment that the studied lists and „independent tasks are related”studied lists and „independent tasks are related”

– The first one is always true, but the second is dubiousThe first one is always true, but the second is dubious– Butler: as few studies meet both, the two systems – at least Butler: as few studies meet both, the two systems – at least

basen on healthy individuals – might not be separatebasen on healthy individuals – might not be separate– Squire – this is ignoring accumulated neuropsychological Squire – this is ignoring accumulated neuropsychological

knowledgeknowledge

Strategies to deal with thisStrategies to deal with this

Retrieval intentionality criterionRetrieval intentionality criterion– InstructionsInstructions

Chance recognitionChance recognition– Implicit task performance is better than the explicit one – Implicit task performance is better than the explicit one –

therefore there is some unconscious informationtherefore there is some unconscious information

Awareness questionnairesAwareness questionnaires– Inability to recall the true nature of the mental state at test Inability to recall the true nature of the mental state at test

laterlater

On-line awareness analysisOn-line awareness analysis– First word that comes to your mind BUT NOT the one on First word that comes to your mind BUT NOT the one on

the listthe list– False negatives – if completed with a different word – is it False negatives – if completed with a different word – is it

conscious recollection or simply lack of even implicit conscious recollection or simply lack of even implicit memory?memory?

DissociationDissociation

Major symptoms (Steinberg, 1997)1. Amnesia – holes of memory

1. Few days to several years

2. Depersonalization – detached from oneself- alien3. Derealization – surroundings are unreal4. Identity Confusion – unnoticeable to environment5. Indentity Alteration – can be noticed

Linked to early childhood trauma – usually sexual abuse– Explanation – because of the harassment the body is no longer

percieved as a safe home – escaping is only possible in the mind– Sexual abuse – causes DID in 80% of cases

??? In Hungary there are hardly any – supposedly 1% should bePost-traumatic stress disorder is very rarely detected

DID: Dissociative Identity Disorder (DSM-IV)

•Key symptom is “inter-identity amnesia” - One identity claims amnesia for events experienced by other identities.

Dissociative Identity DosirderDissociative Identity Dosirder

Rafaele et al (2002): Tested 31 DID patients on 3 implicit memory tests. Also tested 25 controls and 25 DID “simulators”

Material learned as one personality and tested as another

Equal implicit memory effects in all three groups for both data driven and conceptually driven implicit memory tasks.

“What we did find in both our implicit and explicit memory studies was a dissociation between objective memory performance and patients’ subjective reports: that is, although patients indicated no subjective recollection of the encoding phase performed by a different identity states at all, their test scores indicated normal memory functioning”Thus (according to Rafaele et al) - DID patients suffer from a lack of “memory meta-awareness”.

Transitory amnesiaTransitory amnesia

Psychogenic amnesiaPsychogenic amnesia– Following a traumatic event, complete loss of Following a traumatic event, complete loss of

memory for a few daysmemory for a few days– The case of M.F. The case of M.F. – he was at the Gare de l’Est for 5 days – was going to go on he was at the Gare de l’Est for 5 days – was going to go on

Tuesday, but suddenly discovered that on the train ticket he Tuesday, but suddenly discovered that on the train ticket he bougt Saturday was printed.bougt Saturday was printed.

– After his divorce and suicidal thoughts he lived in his car – After his divorce and suicidal thoughts he lived in his car – which provided him with protection and bodywhich provided him with protection and body

– Too embarassed to confess he’s unemployed, he lies Too embarassed to confess he’s unemployed, he lies constantly to his new partnerconstantly to his new partner

Lack of consciousnessLack of consciousness

Coma, vegetative state and Coma, vegetative state and locked-in syndromelocked-in syndrome

Disorders of consciousnessDisorders of consciousness

Vegetative StateVegetative StateMinimally conscious stateMinimally conscious stateLocked-in syndromeLocked-in syndrome

Often no motor responsesOften no motor responses

Arousal – opening of eyes, reaction to immediate Arousal – opening of eyes, reaction to immediate stimulistimuliAwareness of environment and selfAwareness of environment and self– Awareness of the self versus the otherAwareness of the self versus the other

Vegetative stateVegetative state

Patients seem to be awake – but there is no indication of Patients seem to be awake – but there is no indication of will, voluntary action.will, voluntary action.

Wakefulness is present, but awareness is notWakefulness is present, but awareness is not

Terri Schiavo – judicial murder?Terri Schiavo – judicial murder?

What is death?What is death?– Brain deathBrain death

– Devastation of neocortex Devastation of neocortex Permanent cessation of ‘‘those higher functions of the nervous system that demarcate man from the lower primates

Permanent (after 3-12 months)

Some Alzheimer’s diseases, anencephalic neonates

Minimally Conscious StateMinimally Conscious State

The border between VS and MCS is blurredThe border between VS and MCS is blurredinconsistent, erratic responsivenessinconsistent, erratic responsivenessNon-reflex bahaviourNon-reflex bahaviour– To qualify, they have to show clearly discernible To qualify, they have to show clearly discernible

evidence of consciousnessevidence of consciousnessFollowing simple commands consistently (3/4!!)Following simple commands consistently (3/4!!)Yes/no answers – regardless of accuracyYes/no answers – regardless of accuracyIntelligible verbalizationIntelligible verbalizationPurposeful behaviour (reaction to own name)Purposeful behaviour (reaction to own name)

Locked-in syndromeLocked-in syndrome

(maladie de l'emmuré vivant, Eingeschlossensein)(maladie de l'emmuré vivant, Eingeschlossensein)Damage to the ventral part of the midbrain (pons) – a Damage to the ventral part of the midbrain (pons) – a trajectory to muscle movementstrajectory to muscle movementsPatients are fully aware of their environment, but are Patients are fully aware of their environment, but are unable to moveunable to move– They can move their extraorbital muscles – basically the They can move their extraorbital muscles – basically the

eyes – and sometimes face muscleseyes – and sometimes face muscles

Can communicate using dasher and eye trackingCan communicate using dasher and eye tracking– Jean-Dominique BaubyJean-Dominique Bauby

Comatose patientsComatose patients

Anoxic coma – very little chance to wake upAnoxic coma – very little chance to wake upTraumatic coma- better prognosticsTraumatic coma- better prognosticsStroke - Stroke -

How do you know if you should switch the How do you know if you should switch the machine off?machine off?Those who do not start to wake up after 2-4 Those who do not start to wake up after 2-4 weeks have very bad prognosisweeks have very bad prognosis

Glasgow Coma Scale Glasgow Coma Scale

Best eye response (E)Best eye response (E)There are 4 grades starting with the most severe:There are 4 grades starting with the most severe:

1.1. No eye opening No eye opening 2.2. Eye opening in response to Eye opening in response to painpain. (Patient responds to pressure . (Patient responds to pressure

on the patient’s on the patient’s fingernailfingernail bedbed; if this does not elicit a ; if this does not elicit a response, response, supraorbitalsupraorbital and and sternalsternal pressure or rub may be pressure or rub may be used.) used.)

3.3. Eye opening to speech. (Not to be confused with an awaking Eye opening to speech. (Not to be confused with an awaking of a sleeping person; such patients receive a score of 4, not of a sleeping person; such patients receive a score of 4, not 3.) 3.)

4.4. Eyes opening spontaneously Eyes opening spontaneously

Glasgow Coma Scale Glasgow Coma Scale

Best verbal response (V)Best verbal response (V)There are 5 grades starting with the most severe:There are 5 grades starting with the most severe:

1.1. No verbal response No verbal response 2.2. Incomprehensible sounds. (Moaning but no words.) Incomprehensible sounds. (Moaning but no words.) 3.3. Inappropriate words. (Random or exclamatory articulated Inappropriate words. (Random or exclamatory articulated

speech, but no conversational exchange) speech, but no conversational exchange) 4.4. Confused. (The patient responds to questions coherently but Confused. (The patient responds to questions coherently but

there is some disorientation and confusion.) there is some disorientation and confusion.) 5.5. Oriented. (Patient responds coherently and appropriately to Oriented. (Patient responds coherently and appropriately to

questions such as the patient’s name and age, where they are questions such as the patient’s name and age, where they are and why, the year, month, etc.) and why, the year, month, etc.)

Glasgow Coma Scale Glasgow Coma Scale

Best motor response (M)Best motor response (M)There are 6 grades starting with the most severe:There are 6 grades starting with the most severe:

1.1. No motor response No motor response 2.2. Extension to pain (Extension to pain (adductionadduction of arm, internal rotation of shoulder, of arm, internal rotation of shoulder,

pronationpronation of forearm, of forearm, extensionextension of wrist, of wrist, decerebratedecerebrate responseresponse) ) 3.3. Abnormal flexion to pain (Abnormal flexion to pain (adductionadduction of arm, internal rotation of of arm, internal rotation of

shoulder, shoulder, pronationpronation of forearm, of forearm, flexionflexion of wrist, of wrist, decorticatedecorticate responseresponse) ) 4.4. Flexion/Withdrawal to pain (Flexion/Withdrawal to pain (flexionflexion of elbow, of elbow, supinationsupination of forearm, of forearm,

flexionflexion of wrist when supra-orbital pressure applied ; pulls part of body of wrist when supra-orbital pressure applied ; pulls part of body away when nailbed pinched) away when nailbed pinched)

5.5. Localizes to pain. (Purposeful movements towards painful stimuli; e.g., Localizes to pain. (Purposeful movements towards painful stimuli; e.g., hand crosses mid-line and gets above hand crosses mid-line and gets above clavicleclavicle when supra-orbital when supra-orbital pressure applied.) pressure applied.)

6.6. Obeys commands. (The patient does simple things as asked.) Obeys commands. (The patient does simple things as asked.)

Clinical diagnosisClinical diagnosis

How to decide on comaHow to decide on coma

Brain responsesBrain responses– active and passive odball paradigm active and passive odball paradigm

– Mismatch negativity (MMN) – novelty of stimulus Mismatch negativity (MMN) – novelty of stimulus -150-250 ms onset-150-250 ms onset

– P300 ellicited by infrequent stimuliP300 ellicited by infrequent stimuliCalled P3a if it is task irrelevant stimuliCalled P3a if it is task irrelevant stimuli

– Tone-evoked usuallyTone-evoked usually

Self-referential stimuliSelf-referential stimuli

Own-name effect – coctail party effect in Own-name effect – coctail party effect in – dichotic listening tasksdichotic listening tasks– RSVP - No attentional blink for own name, but a RSVP - No attentional blink for own name, but a

significant attentional blink for the stimulus aftersignificant attentional blink for the stimulus after– Slows judgements – such as two digits having the Slows judgements – such as two digits having the

same parity - considerablysame parity - considerably

Comatose patientsComatose patients

Subjects own name (SON) – ellicits Subjects own name (SON) – ellicits involuntary orientation, attention and P300involuntary orientation, attention and P300

Deviant tones – probability of 0,14 (other Deviant tones – probability of 0,14 (other tones)tones)

Novel tones – probability of 0,03 (own name)Novel tones – probability of 0,03 (own name)

P300 to own nameP300 to own name

The combination of P300 and MMN is the best The combination of P300 and MMN is the best predictor of awakening from comapredictor of awakening from coma

The predictions are somewhat more reliable in The predictions are somewhat more reliable in anoxic coma casesanoxic coma cases

P300 – an interesting storyP300 – an interesting story

Difficult: diurnal and age-related changesDifficult: diurnal and age-related changesSchizophrenia – reduced P300 componentSchizophrenia – reduced P300 component– Impaired controlled information processingImpaired controlled information processing

Hypnosis : altered consciousnessHypnosis : altered consciousnessAlcoholics also show decreased P300 – not clear if it Alcoholics also show decreased P300 – not clear if it is addiction or alcohol itselfis addiction or alcohol itselfLIE DETECTION – Brain fingerprinting in LIE DETECTION – Brain fingerprinting in MERMER by Lawrence FarwellMERMER by Lawrence Farwell– "Memory and Encoding Related Multifaceted "Memory and Encoding Related Multifaceted

Electroencephalographic Response" Electroencephalographic Response"

Brain FingerprintingBrain FingerprintingKnown and relevant events produce a different P300 Known and relevant events produce a different P300 than unknown and irrelevant ones (remember the than unknown and irrelevant ones (remember the odball) odball) information present/absent judgementinformation present/absent judgement– Details of a crime unknown but to the culprit presented – if Details of a crime unknown but to the culprit presented – if

there are none, not applicable…there are none, not applicable…– Can be applied to alibi defense as well (time!)Can be applied to alibi defense as well (time!)– Pictures, words, phrasesPictures, words, phrases

6-10 crime-related, 6-10 life-related (related basline) 6-10 crime-related, 6-10 life-related (related basline) and 12-20 irrelevant stimuli (unrelated baseline)and 12-20 irrelevant stimuli (unrelated baseline)Accuracy is reported to be over 99%Accuracy is reported to be over 99%Admissible in US courtAdmissible in US courtHarrington v. State, Case No. PCCV 073247.Harrington v. State, Case No. PCCV 073247.