3. memory
Seven stages in memory
1. Adequate perception , comprehension, and response to
the material to be learned.
2. Short term storage
3. Formation of durable trace
4. Consolidation
5. Recognition that certain materials need to be recalled
6. Isolation of the relevant memory
7. Using the recalled material
4. Types
Memory is of 3 types
i. Sensory
ii. Short term
iii. Long term
5. Sensory type
Registered for each of the sense and its purpose is to
facilitate the rapid processing of incoming stimuli so
that the comparison can be made with material
already stored in short and long term memory.
Fades within few seconds.
Closely related to attention.
6. Short term memory
Working memory/ primary memory
For the storage of memory much longer than the few
seconds available to sensory memory.
Aids the constant updating of one’s surroundings.
7. Long term memory
When memories are rehearsed in the short term they
are encoded in the long term memory.
Encoding is a process of placing information into what
is believed to be a limitless memory reservoir.
Storage of material in long term memory allows for
recall of events from the past and for utilization of
information learned through educational system.
8. Autobiographical memories- memories of events
that relate to oneself
Flashbulb memories- specific type of
autobiographical memory in which the person
becomes aware of an emotionally arousing event.
9. Explicit memory
Declarative/rational memory
Patient is conscious that they are remembering.
Hippocampus - stored
2 types
i. Episodic memory- memory of specific events
ii. Semantic memory- memory of abstract facts
10. Implicit Memory
Procedural/skills
Limbic system (amygdala + cerebellum)
Performance of tasks such as typing, swimming and
cutting a loaf of bread are also expressions of prior
learning but there is no active awareness of memory is
being reached in undertaking the particular skill.
11. Process of remembering has 4 parts
i. Registration
ii. Retention
iii. Retrieval
iv. Recall
12. AMNESIA
Partial or total inability to recall part experience and
events.
1. Organic
2. Psychogenic
13. Normal Memory failure
If an item is not rehearsed the memory fades and
therefore cannot be retrieved.
Normal memory decay
Proactive interference – old memories interfere with new
learning and hence recall.
Retroactive interference – new memories interfere with
learning of new material.
15. (ii) Katathymic amnesia
Motivated forgetting
A set of ideas which are disturbing when conscious are
repressed in an attempt to avoid the affect which they
would otherwise produce.
More persistent and circumscribed
Conscious motivation to forget – suppression or
unconscious motivation – primary repression.
No loss of personal identity
Hysteria
Normal persons with painful memories
16. (iii) Hysterical Amnesia
Dissociative amnesia
There is a complete loss of memory and personal
identity but the patient can carry out complicated
patterns of behavior and is unable to look after
himself.
Often associated with fugue or wandering state.
More common in those with prior history of head
injury.
17. 2) ORGANIC AMNESIA
(i)Acute coarse brain disease
Poor memory is due to disorders of perception and
attention and the failure to make a permanent trace.
Retrograde amnesia
Acute head injury
Amnesia which embraces the events just before the
injury
Disturbance of short term memory loss
18. Post traumatic amnesia:
the period between loss of consciousness and
appearance of full awareness and memory
duration is directly related to severity of the head
injury.
19. Anterograde amnesia
Events occurring after the injury.
The patient is fully conscious ,but has no memory for
the events which occur.
Result of failure to make permanent traces.
Seen in
Alcoholic blackout
Delirium
Twilight state due to epilepsy
Pathological drunkenness
20. Transient global amnesia
A sudden onset of retrograde amnesia covering a period of
few days upto several years.
Perception and personal identity remain normal.
An anterograde amnesia continues until recovery (up to
several hours)
The amnesia subsequently shrinks to a period of half to 5
hours.
Some pts there is evidence of ischemia in the territory of
the posterior cerebral circulation
The immediate cause is probably b/l temporal or thalamic
lesions.
21. Sub acute coarse brain disease
The pt is unable to register new memories.
The memory disorder is characterized by inability to earn
new information (anterograde amnesia) and old
information (retrograde amnesia)
Memories from remote past remains intact.
Seen in
Korsakoff’s syndrome
CVA
Multiple sclerosis
Head injury
ECT
22. Chronic Coarse Brain disease
The amnesia extends over many years.
Ribot’s law of memory regression: In dementing
illness the memory of recent events is lost before the
memory for remote events.
23. Distortion of memories
Paramnesia
Falsification of memory by distortion.
I. Distortion of recall
II. Distortion of recognition.
25. Retrospective falsification
The subject modifies his memories in terms of his general
attitudes.
Unintentional and dependent on person’s current
emotional experiential and cognitive state.
Seen in
Normal people - degree of retrospective falsification is
inversely related to the degree of insight and self criticism of
the individual
Hysterical personality
Depressive illness
Agitated depression
Mania
26. Retrospective delusions
The pt dates back his delusions.
Could be regarded as delusional retrospective
falsification.
schizophrenia
27. Confabulations
Pictorial thinking (Leonard) , Memory Hallucinations
(Bleuler)
A false description of an event , which is alleged to have
occurred in the past.
Filling in of gaps in memory by imagined or untrue
experiences.
Diminishes as the impairment worsens.
2 broad patterns emerge – embarrassed type in which the
patient tries to fill in gaps as memory as a result of an
awareness of a deficit , fantastic type in which the lacunae
is filled by details exceeding the need of memory
impairment.
28. Embarrased is more common.
Seen in
Organic states
Hysterical psychopaths
Amnestic syndrome
Chronic schizophrenia
29. False memory- recollection of an event which did not
occur which the individual believes did take place.
Screen memory- recollection that is partially true and
partially false.
Pseudologia fantastica- fluent plausible lying that
occurs in those without organic brain pathology such
as personality disorder of anti social and hysterical
type.
30. Munchausen’s syndrome- variant of pathological
lying in which the individual presents to the hospital
with bogus medical illness , complex medical histories
and often multiple surgical scars.
31. Ganser’s Syndrome
Voibereden/ approximate answers - Pt understands the
question but deliberately avoids the correct answer
Clouding of consciousness with disorientation
Auditory and visual hallucination
Amnesia during the period for which symptoms were
manifest.
Seen in
hysterical pseudo dementia
Conversion symptoms
Recent head injury
Infection
Severe emotional stress
32. Cryptamnesia- experience of not remembering that
one is remembering.
Hyperamnesia – Exaggerated registration, retention
and recall.
33. Disorders of recognition.
Déjà vu
The subject has the experience that he has seen or
experienced the current situation before, although it
has no basis in fact.
The sense of recognition is never absolute.
Normal people
Temporal lobe lesions
34. Jamais vu – event that has been associated before is
not experienced with appropriate feelings of
familiarity.
Déjà entendu : feeling of auditory hallucination
Deja pense – new thought as having been previously
occurred.
36. Positive misidentification
Pt recognizes strangers as his friends and relatives
Some pts assert that all of the people whom they meet
are doubles of real people.
Confusional state
Acute schizophrenia
Chronic schizophrenia
37. Negative misidentification
Pt denies that his friends and relatives are people
whom they say they are and insists they are strangers
in disguise
Excessive concretization of memory images.
38.
39. consciousness
A state of awareness of the self and the environment.
Active consciousness – when the subject focuses his
attention on some internal or external event.
Passive consciousness: when the same events attract
the subject’s attention without any conscious effort on
his part.
40. Distractability
Disturbance of active attention
the pt is diverted by almost all new stimuli and habituation
to new stimuli takes longer than usual.
Seen in
Fatigue
Anxiety
Severe depression
Mania
Schizophrenia
Organic states
41. Orientation
Capacity of a person to gauge accurately the time space
and person in his current setting.
Time –
Is labile
Quite readily disturbed by
rapt concentration.
Strong emotion
Organic brain factors.
42. Space
Disturbed later than time
Unable to find his way or place
Person
Patient fails to remember his own name and identity.
Lost with greatest difficulty,
43. Ways which consciousness can be changed
Dream like changes of consciousness
Lowering of consciousness
Restriction of consciousness
44. Dream like changes of
consciousness
There is a lowering of the level of consciousness which
is a subjective experience of a rise in the threshold for
all incoming stimuli
Pt is disoriented for time place , but not for person.
Clinical features
Visual hallucination
Unable to distinguish between mental image and
perceptions.
45. Disordered thinking as in dream showing excessive
displacement, condensation and misuse of symbols.
Auditory hallucinations – common elementary rarely
continuous voices, organized hallucinations take form
off odd disconnected words or phrases.
Other hallucinations of touch , pain, electric feelings,
muscle sense and vestibular sensations often occur.
When underlying physical illness is severe, insomnia is
marked.
46. Occupational delirium : when the pt is restless and
carries out the actions of his trade.
Subacute delirious state : mild degree of delirium ,
where pt may have a general lowering of consciousness
during the day and be incoherent and confused, while
at night delirium often occurs with visual
hallucinations.
47. Lowering of consciousness
Pt is apathetic, generally slowed down , unable to
express himself clearly and may perseverate.
After some weeks there is remarkable partial recovery
and the pt is left with mild organic defect.
Seen in
Severe infections, like typhoid and typhus
Arteriosclerotic disease following CVA
48. Restriction of consciousness
There is some lowering down of level of consciousness
and the awareness is narrowed down to few ideas and
attitudes which dominate the pts mind.
Twilight state : there is a
• A restriction of the morbidity changed consciousness
• A break in the continuity of consciousness
• Relatively well ordered behaviour.
• Commonest- epilepsy
49. Hysterical twilight state: the restriction of
consciousness resulting from unconscious motives