Disorders of Memory
Neha Kangralkar
Contents/Structure
1. Introduction to Memory
( 2 hours)
- Definition
- History of Memory (Early works eg Ebbinghaus)
- Influential Views of Memory(Attkinson and Shiffrin Model)
- Information storage ways( Declarative/ Explicit Memory and
Implicit/Procedural Memory)
- Other aspects of Memory: Forgetting, memory alterations(memory distortions
and construction), Repression, Autobiographical Memory
Contents/Structure
2. Disorders of Memory( Types, Clinical Features Overview and Etiology)
(4 - 5 Hours)
General ways of classification
a. Amnesias:
● Meaningful Disturbance of Memory & Disturbance Secondary to
Psychiatric Disorders
- Dissociative disorders
- Memory Impairment in Schizophrenia
- Affective disorder of Memory
- Ganser State
Contents/Structure
● Organic Amnesia(Types, Clinical Features and Etiology)
Amnesia due Acute brain disease(Retrograde)
Amnesia due to Subacute brain disease(Anterograde)
Amnesia due to Dementia (incl Alzheimer)
Amnesia due to Korsakoff Syndrome
Amnesia due to Traumatic Brain Injury
Contents/Structure
B. Distortions of Memory/paramnesia
● Distortions of Recall
- Retrospective falsification
- False memory
- Screen Memory
- Confabulations
- Pseudologia Fantastica
Contents/Structure
- Munchausen Syndrome
- Vorbeireden
- Cryptamnesia
- Retrospective delusion
● Distortions of Recognition
- Deja Vu
- Deja entendu etc
C. Hyperamnesia
Introduction
Introduction and Definition
● Memory is the means by which we retain and draw on our past experiences to
use that information in the present. – Tulving
● As a process, memory refers to the dynamic mechanisms associated with
storing, retaining, and retrieving information about past experience
● Memory is defined as the faculty of encoding, storing and retrieving
Introduction
1. Hermann Ebbinghaus(1885):
- Memory: A contribution to Experimental Psychology
- “Nonsense Syllables” Experiment
- Forgetting Curve
- Distributed Practice and massed Practice
2. The Atkinson and Shiffrin Model:
- Highly influential model proposed by Atkinson and Shiffrin(1968)
- Talked about Senory Memory, Short term memory and Long term memory
3. Explicit and Implicit Memory( Mulligan
Introduction(Attkinson Shiffrin’s Memory Model
Introduction ( Framework of Memory)
● Memory has 3 main divisions
1) Sensory memory
2) Short Term
3) Long term
Other Aspects of Memory
● Forgetting
- Some causal factors for forgetting (fading , result of interference)
- Memory Distortion( response to false/ leading probes, influence of schemas,
source monitoring)
- Memory construction(suggestibility, monitoring, false memories)
- Repression
Introduction :
Biological Aspects of Memory
Brain Areas that play a part in Memories
● Temporal Lobe( Middle/medial)
- Hippocampus
● Frontal Cortex
- Prefrontal Cortex Region
● Brain stem
- Thalamus( Dorsomedial nucleus part)
● Cerebellum
Brain and Memory(Declarative memory)
•The hippocampus appears to have a special role in
memory tasks that require the relating or combining of
information from different cortical sources, such as the
relation of specific objects or events in time and space
•The dorsomedial nucleus( situated in thalamus) is
involved in memory consolidation
Brain and Memory
● Damage to the dorsal medial nucleus(Thalamus region) is
often implicated in Korsakoff’s syndrome and in some cases
of specific amnesia
● The prefrontal area of the right hemisphere is prominently
activated for retrieval of episodic information
● The cerebellum aids in sequential motor learning such as the
steps required in learning the piano.( Non declarative
memory)
Popular Case of HM & Different
Memory Parts
( Multimodal Teaching too: Video)
Audiovisual learning aid: Video
Memory and Amnesia
1. Retrograde Amnesia : Retrograde amnesia (RA) refers
to the loss of information that was acquired before the
onset of amnesia.
2. Anterograde Amnesia: Anterograde amnesia (AA)
refers to an impaired capacity for new learning.
A. Amnesias(Psychogenic)
Meaningful Disturbance of Memory & Disturbance
Secondary to Psychiatric Disorders
1. Dissociative Amnesia
- Fugue , Katathymic Amnesia, Dissociative Focal Retrograde
Amnesia
2. Memory Impairment in Schizophrenia
3. Affective disorder of Memory
4. Ganser State
A. Amnesias(Psychogenic)
Meaningful Disturbance of Memory & Disturbance
Secondary to Psychiatric Disorders
1. Dissociative Amnesia
- Fugue
- Katathymic Amnesia
- Dissociative Focal Retrograde Amnesia
Dissociative Amnesia (Characteristics as per ICD-10)
The common theme shared by dissociative (or conversion)
disorders is a partial or complete loss of the normal integration
between memories of the past, awareness of identity and
immediate sensations, and control of bodily movements.
There is normally a considerable degree of conscious control over
the memories and sensations that can be selected for immediate
attention, and the movements that are to be carried out
A. Amnesias(Psychogenic)
Meaningful Disturbance of Memory & Disturbance
Secondary to Psychiatric Disorders
2. Memory Impairment in Schizophrenia
- Memory deficit is not limited to Chronic Schizophrenia
- Deficits in LTM including evidence of impaired retrieval in
both recall and recognition.
- There is also evidence of impaired short term memory,
demonstrated by deficit of forward digit span.
A. Amnesias(Psychogenic)
Meaningful Disturbance of Memory & Disturbance
Secondary to Psychiatric Disorders
3. Affective disorders of Memory
- Depression is linked to self-reported memory problems
- Mood disorder, such as depression, reduces the amount of
cognitive processing resources available for a given task
-
A. Amnesias(Psychogenic)
Meaningful Disturbance of Memory & Disturbance
Secondary to Psychiatric Disorders
4. Ganser Syndrome four main features of Ganser syndrome
as:
a) approximate answers,
b) clouding of consciousness,
c) somatic conversion features, and
d) pseudohallucinations (not always present).
Etiological Factors
1. The role of Severe Trauma
2. Iatrogenic factors. widespread publicity given to some
people with multiple personality
3. Past medical history
4. Stressful life events
Organic Amnesia
Organic Amnesia
● Organic Amnesia(Types, Clinical Features and Etiology)
Amnesia due to Dementia (incl Alzheimer)
Amnesia due to Korsakoff Syndrome
Amnesia due Acute brain disease
Amnesia due to Subacute brain disease
Amnesia due to Traumatic Brain Injury
Qualitative Experience of Living with Dementia
“More and more, she was experiencing a growing distance
from her self-awareness. Her sense of Alice—what she
knew and understood, what she liked and disliked, how she
felt and perceived—was also like a soap bubble, ever higher
in the sky and more difficult to identify, with nothing but
the thinnest lipid membrane protecting it from popping into
thinner air”
Qualitative Experience
I can’t stand the thought of looking at you someday, this
face I love, and not knowing who you are.”
― lisa genova, Still Alice
Amnesia due to Dementia( Organic Amnesia)
Dementia is a chronic organic mental disorder, characterized by the
following main clinical features:
1. Impairment of intellectual functions
2. Impairment of memory (predominantly of recent memory,
especially in early stages),
3. Deterioration of personality with lack of personal care
4. Impairment occurs globally
5. There is also impairment in judgement , impulse control,
abstract thinking.
Amnesia due to dementia
6. Usually no impairment of consciousness.
7. Course of illness is progressive
8.Onset is usually gradual
9. Additionally there is often impairment in language,
recognition, object naming, motor skills etc.
10. Emotional Lability
Amnesia due to dementia
11. Catastrophic reaction
12. Thought abnormalities like delusion
13. Urinal and faecal incontinence may develop in later
stage
14. Disorientation of time, place and person.
Aetiology
1. The exact etiology of Alzheimers is unknown.
2. Common risk factors:
3. Familial disposition( mutation of genes like amyloid
precursor protein( amyloid beta hypotheses) chromosome
21 etc.
4. Head injury, cardiovascular diseases, viruses etc.
Amnesia due to dementia
- Organic Amnesia is loss of memory due to organicity
- There is an evidence of a general medical condition which
can be aetiologically related to the memory impairment
- episodic memory is specifically and persistently affected,
and with a decline from previous level of functioning.
- They manifest as an inability to learn new information(
anterograde amnesia) and to recall past events ( retrograde
amnesia)
Organic Amnesia
● Amnesia due to Korsakoff
- Korsakoff’s syndrome is the amnestic syndrome
caused by thiamine deficiency, but other causes
include cerebrovascular disease, multiple sclerosis,
transient global amnesia, head injury and
electroconvulsive treatment (ECT).
Organic Amnesia
This can be further divided into:
1. Amnesia due Acute brain disease
2. Amnesia due to Subacute brain disease
3. Amnesia due to chronic coarse brain disease
Organic Amnesia
1. Amnesia due Acute brain disease
- Memory is poor owing to disorders of perception and
attention.Leading to failure of encoding in LTM( Eg
Acute Head Injury, Loss of memory due to Alc)
- These are usually reversible
- Can last for upto a few hours
Organic Amnesia
2. Amnesia due to Subacute brain disease
- There is an inability to register new memories
- The memory disorder is characterised by the inability to
learn new information and the inability to recall
previously learned material
- Aka Amnestic Syndrome Eg: Korsakoff
Organic Amnesia
3. Amnesia due to chronic coarse brain disease
- Patients with a progressive chronic brain disease have
an amnesia extending over many years
- the memory for recent events is lost before that for
remote events
Distortions of Memory/Paramnes
Distortions of Memory/paramnesia
● Distortions of Recall
- Retrospective falsification
- False memory
- Screen Memory
- Confabulations
- Pseudologia Fantastica(pathological lying)
Distortions of Memory/Paramnesia
- Munchausen Syndrome
- Vorbeireden( Approximate answers)
- Retrospective delusion
● Distortions of Recognition
- Deja Vu
- Deja entendu etc
References
Baron, R. A. (1997). Psychology (4th ed.). Pearson Education.
Casey, P., & Kelly, B. (2024). Fish’s clinical psychopathology: Signs and symptoms in
psychiatry (5th ed.). Cambridge University Press.
Gelder, M., Cowen, P., & Harrison, P. (2006). Shorter oxford textbook of psychiatry (5th
ed.). Oxford University Press.
Oyebode, F. (2014). Sims’ symptoms in the mind E-book: Textbook of descriptive
psychopathology (5th ed.). W.B. Saunders Company.
Sternberg, R. J. (2011). Cognitive Psychology (6th ed.). CENGAGE Learning Custom
Publishing.
Stirling, J. D. (2002). Introducing Neuropsychology. Psychology Press.
References
1. Barrons Psychology
2. Sim’s Symptoms of Mind
3. Fish’s Psychopathology
4. Shorter Oxford Textbook of Psychiatry
5. Stirling ( neuropsych)
6. Cognitive Psychology by Robert Sternberg
