Psychology Essays Amnesic Syndrome Amnesia

Psychology Essays Amnesic Syndrome dim issueAmnesic Syndrome Amnesia hypothetical amnesic syndrome single fictional character handling Clive habilimentAmensia Amnesic SyndromeAmnesia is a general, classically used term essentially to describe the per centumial(p) or total loss of w arho victimisation. Due to the complexity of human storage functioning, several different types of amnesia exist, in particular, Amnesic Syndrome (A.S.) which, in its to the highest degree coherent, is a cluster of amnesic symptoms. Amnesic syndrome is characterised by the permanent repositing impairment which can occur in anterograde form the syndromes defining feature and retrograde form.Unlike general amnesic condition, the symptomatic origin of A.S. excludes degenerative disorders, for example Parkisons transient amnesias and psychogenic disorders. The etiology of A.S. include those brought on by (direct or indirect) injury to the thought and defame to whatever number of neuroanatomi cal locations responsible for holding functioning, namely subcortical areas the diencephalon, a major region of the brain that includes the third ventricle, thalamus, hypothalamus, and pituitary secretor and as well as cortical areas covering the mesial surfaces of the temporal lobe, especially the hippocampus. grounds the effects of this damage is feasible in no small part to using the modular remembering system approach and observing the invention of preservation and loss in other words, what the patient is and is non fit of. It is understood that long term reposition (LTM) is structured as to assort declarative memory of what we know to be as fact from slight explicitly accessible memory functioning such as those unvoicedly stored and that which is not pertaining to factual information, referred to as non-declarative memory.Aggleton Brown (1999) account that both the subcortical and cortical locations, as menti onenessd above, are components of the same memory system bear on with the explicit, declarative memory. This declarative memory is made up of the subcategories episodic face-to-face pillowcases one experiences and semantic relating to vocabulary, language ability and mark recognition.It is therefore fall that the damage suffered to part or all of these areas of the brain would largely impress the declarative memory of a patient, whilst leaving the implicit, non-declarative memory congenerly unimpaired. This is rightful(a) in cases of both anterograde and retrograde amnesic syndrome. on that suggest are as well as several non memory related characteristics of amnesia which appear in A.S., degrees of which depend on the origin of the syndrome, for instance the location of injury and which part of the brain are affected. Characteristics include orientation, intellectual deficit and confabulation. Confabulation, some quantifys referred to as islands of confabulation, describes the attempts made to rationalise memories (or neutralises in memory) in order to shoot down up sense to the self and others, which may involve the production of false information. sensation Case Clive WearingClive Wearing is considered by many to be the just about sever case of amnesia. Once a renowned and eminent thespian and medicamentologist, Clive was struck by an inflammatory brain infection herpes encephalitis, in March of 1985. An sign CT and subsequent MRI scan fielded major and significant damage to the left over(p) wing temporal lobe, also extending into the low-level and posterior head-on lobe as rise as damage to the medial side of the right temporal lobe. This was accompanied by indications of involvement of the left lateral ventricle and third ventricle part of the diencephalon, along with the virtually complete destruction of the hippocampus.It is believed that these areas of damage are the cause of several behaviours Clive Wearing exhibited and continues to do so today. It is well fielded that Clive (CW) has severe episodic memory dysfunction, resulting in retrograde amnesia for virtually the whole of his adult look and much of his childhood along with anterograde amnesia demo by his incapacity for explicit acquire.CW has become synonymous for his moment to moment knowingness whereby the period of guerrillas is lost in a perceptual time void and where perceived information is lost as soon as his eye c drop off quite literally in a blink alone to be confronted with the experience of a completely new awakening retell many times. CWs semantic memory, though generally preserved in A.S., showed evidence of impairment as he is unable to produce object names, define words and comprehend written material, instead lending himself towards confabulation.CWs pattern of deficits in declarative memory can be explained by the neurological damage that he suffered. The major damage to the hippocampus (relatively destroying it) is the close likely cause of the severity of his amn esia, whereas the retrograde amnesia is attrisolelyed to the diencephalic damage, and semantic memory impairment adheres to the more widespread temporal lobe damage.Functioning and Indications for interposition turnabout to CWs deficit in declarative memory, his non declarative memory is left relatively unimpaired. There are many reports of CWs implicit memory functioning, well-nigh notably his procedural memory for reading, playing, conducting and singing music which are practically preserved. Clive has, on more than one occasion, denied seeing a division of music or up to now playing the voiced, only to (when directed), sit wipe out and play the piece and add I remember this one. redundant evidence for CWs implicit memory comes from the world-class few days of his condition where he began to abbreviate his questions, he would only need to eat up his wife How long? to be understood as to what was meant, How long occupy I been ill? suggesting an awareness, on some level, that the question has been subscribeed before, as well as the knowledge of the fact that she knows what it means.Evidence for implicit eruditeness comes from the report after eighteen months of his new home, where he has been interpreted for daily walks to menstruate the ducks, now asks do the ducks want their tea? when prompted to put on his coat, ceasing to ask how long he has been ill a seven-year obsessive habit.Though his unmixed disorientation, he has also gained other (purely) implicit memories like the layout of his residence where he is able to go to the bathroom, kitchen and dining room unsupervised. However, if he stops, gets distracted, or rings en route he becomes lost. And though not able to describe his residence, his wife Deborah has reported how he leave behind undo his seat belt and offer up to get out and open the gate as they draw near. He is unable to explicitly identify the locations hardly is capable of action.The role of music in CWs implicit lear ning is certainly an interesting one, as not only is his procedural memory relatively unimpaired but he is also capable, providing someone puts the music before him to get him into action, of learning and practicing new pieces.It is also reported that he also hummed something which he had not played for half an hour. This discovery is of great relevance to the following discussion section on intercession as it suggests that this is could be down to rehearsal of it subvocally, possibly reflecting use of the phonological loop process in memory encoding.Brocas area is a relatively contained section in the inferior frontal gyrus of the frontal lobe and is namely responsible for the production of speech and sounds. There is little evidence to suggest of a deficit in CWs ability to produce speech and sound and therefore any relative damage to this area, which in turn enables the seeming subvocal rehearsal that has been reported. Seeing as CW appears to have some phonological functionin g and fairly preserved implicit memory, this seems a rational starting point for rehabilitative interference.Proposed InterventionWhereas in previous clinical approaches where rehabilitation was usually based on a broad station of therapies (CBT, psychotherapy, etc), neuropsychological therapy tackles small areas either to test theories or to increase the understanding of a particular subject area. In the case CW, it is the impairment experienced involving disorientation that ordain be the focal point of this intervention.The intervention leave alone operate at the level of impairment the precise problem being disorientation. In terms of the intervention mechanism restoring or reinstating the original function this seems very unlikely to be possible. The alternative therefore, is to in area an intervention mechanism that entrust utilise and develop existing capacities with the use of international aids and strategies to overcome the problem.Implicit learning of routes throu gh basic repeat would not be recommended in this case. Instead, it would be preferable to use the operable existing/surviving capacities (i.e. subvocal rehearsal and procedural memory) as this approach, if fittedly effective, could be transferred for other possible activitys in different lieus.CWs procedural memory of music lends itself extremely neatly to the notion of journeys and routes due to its formulative and progressive nature. CWs wife Deborah speaks of the momentum of music where it is said that music, much like any route has steps, phrases, beginnings and ends (Wearing and Wilson, 1995).In an article, author and neurologist Oliver Sacks (2007) provides a compelling tale of this momentum indicating the link of memory and ancestryThere is not a process of recalling, assembling, recategorizing, as when one attempts to reconstruct or remember an event or a scene from the past. We recall one tone at a time, and each tone entirely fills our consciousness yet concurren tly relates to the whole. It is similar when we walk or run or swimwe do so one step, one stroke at a time, yet each step or stroke is an integral part of the whole. Indeed, if we think of each nock or step too consciously, we may lose the thread, the motor bank line. (Sacks, 2007)In normal automatisation of procedural information which can range from making a cup of tea to driving a vehicle, the memory trace of each encounter is encoded and strengthened with each practise so that in future cases relevant information is retrieved quickly. In the case of CW this report suggests that a method of auditory mnemonic reduction encoding be used, set up with vanishing retrieval cues, little by little outside so as to encourage the strengthening of the mnemonic information in an perfect learning environment.Encoding with visual and auditory mnemonics has been shown to be very effective in the development of creating links and encoding memorable retrieval cues (e.g. Burrows Solomon, 19 75 Sharps Price, 1991 Haan et al., 2000) and provides a back up approach to the proposal intervention. The use of vanishing cues enables a duration of information to be divided into a number of relevant cues that are subsequently and gradually upstage, thus resulting in a scope of learnt information which may exact very few or even no recall cues. perfect learning has been effective in a number memory-impairment cases (e.g. Tailby Haslam, 2003 Page et al., 2006), where errorless learning employs a 100% correct response technique in strengthening memory traces.Single Case Design Proposalneuropsychological intervention of any sort would usually naturally happen at a time the patient starts to demonstrate gaining a sense of normal functioning, that is after the initial period of spontaneous recovering has occurred, as initiating intervention during this time of inbred recovery is not suggestible results may show absent or false improvement. In the case of CW however, this is n ot an area of concern.The intervention impart operate with auditory mnemonics and vanishing cues. It will be a tri-level multiple service line design as to assess its effectualness crosswise and between situations. ternion routes / journeys will be decided upon in relation to CWs most important or habitual preferences. For the purpose of this proposal the three routes will be that from his room (a) to the dining room (b) to the hall the location of his piano and (c) outside via fire escape route.The initial phase of the intervention will be reporting the baseline measure for each route. This will be the amount of time it takes CW to get from his room to the each of the destinations, observations will also be made as of any experiences of disorientation and if so note down where along the route and how often they occur, using several measures maximize the stability of the assessment as they will be equated with the results of the intervention phase. The measurement phase will co ntinue for 1 month before the early-level intervention is employed.The second phase will start with the implementation of the startle-level intervention for the first situation (a). The route that CW takes will be marked off using posters showing a coloured symbol (e.g. a green triangle) at significant points. CW will also have accompanied with him a thingumabob that allows him to play a single relatively short melody, one that he is familiar with.This will then be set to repeat, although it is assumed that one piece played from start to finish should last for more than sufficient time than it takes him to reach his destination in this case the dinning room. During this time CW is promote to hum or sing the melody out loud. This first-level intervention for the first situation will continue for 2 months and measurements will be taken following the same concept as those in the baseline phase. avocation this will be the second-level intervention where the visual cues (green trian gles) are gradually removed in suitable order so that there are no significantly unequal gaps in cues along the route. CW will at this time thus far be encouraged to play and hum to the chosen melody along the route. This phase will be carried out over a total of 2 months, again, whilst measurements are taken.The third-level intervention will entail CW not having access to the melody playing device, however he will still be encouraged to hum or sing what could be referred to at this point as the dinning room melody. Measurements will be carried out as previously done. This stage will continue for 1 month and then conclude the second phase of the intervention. After which the additional 2 routes will be initiated in sequence following the example of the first situation. A summarised list of the programme will look as follows. arrange 1 Multiple baseline recordingMeasurements are taken across all situations (length 1 month)Phase 2 Intervention of first situation (a) to dinning ro om train 1 melody played with cues (length 2 months)Level 2 cues gradually removed (length 2 months)Level 3 melody device removed (length 1 month)Phase 3 Intervention of second situation (b) to hallLevel 1 melody played with cues (length 2 months)Level 2 cues gradually removed (length 2 months)Level 3 melody device removed (length 1 month)Phase 4 Intervention of third situation (c) fire escape routeLevel 1 melody played with cues (length 2 months)Level 2 cues gradually removed (length 2 months)Level 3 melody device removed (length 1 month)Phase 5 Assessment of resultsThe appendix includes graphs that represent three possible outcomes of the intervention. The first in Appendix 1 demonstrates a successful intervention, rating of which will be discussed below. The second in Appendix 2 illustrates a clearly unsuccessful intervention whereas the third in Appendix 3 illustrates the possible results of a temporary positive effect of intervention followed by a decline in impr oved performance.Signs that the intervention is successful will be a significant improvement in performance compare with baseline measurements. That is not necessarily to say that route-taking will be quicker, but that incidence of disorientation would have been significantly reduced.The proposed evaluation of the intervention will consist of checking whether it has been successful in its aim and the reasons behind this outcome. If an improvement has been demonstrated it must be examined as to the source of change. Sources of change vary in terms of the circumstances of the case, for instance spontaneous recovery and innate brain recovery at this stage of the condition is highly unlikely and would have been captured in baseline measurements.General treatment effects i.e. what happens in CWs home such as care and interactions are also some other source of change which, in other cases may be an affect. The length of the intervention may allow changes in circumstance to affect perfor mance. major(ip) changes of this sort are unlikely however it would still be best(predicate) to report any relevant changes. If an improvement has not been affirmed the intervention will be seen as not effective.This doesnt necessarily that the supposititious basis was at fault, the judgement of available case information may not have been sufficient. Problematic methodology could also be a cause. If the phases (and containing levels of aid) of the intervention were not carried out for long enough, or correctly the effectiveness of the proposed intervention would be compromised.Providing the intervention was successful and improvement was made, it would be decisive to examine the genuine extent to which the persons life had changed for the better. This could take the form of improved functioning, increased independence and improved sense of well-being. It would also be relevant to examine the capacity to generalise the principle for application in other situations. The nature of t he proposed multiple baseline design allows, on demonstration of positive results, that the intervention could be applied to similar situations and even for use in other cases of similar patients with A.S.ReferencesAggleton, J. P., and Brown, M. W. (1999) Episodic memory, amnesia, and the hippocampal-anterior thalamic axis. Behavioral and judgement Sciences. 22 (4). pp. 425-440Burrows, D. and Solomon, B. A. (1975). Parallel scanning of auditory and visual information. Memory and Cognition. 3 (4). pp. 416-420.Haan, E. H. F., Appels, B., Aleman, A. and Postma, A. (2000). Inter-and intra-modal encoding of auditory and visual presentation of material Effects on memory performance. The Psychological Record. 50 (3). pp. 577-86.Page, M., Wilson, B. A, Shiel, A., Carter, G. and Norris, D. (2006) What is the locus of the errorless-learning advantage? Neuropsychologia. 44 (1). pp. 90-100Sacks, O. (2007) The abysm A Neurologists Notebook. The New Yorker. New York. 83 (28). pp.100.Sharps, M. J . and Price, J. L. (1991). Auditory imagery and necessitous recall. The Journal of General Psychology. 119 (1). pp. 81-87.Tailby. R. and Haslam C. (2003) An investigation of errorless learning in memory-impaired patients improve the technique and clarifying theory. Neuropsychologia. 41 (9). pp. 1230-40.Wilson, B.A. and Wearing, D. (1995) Prisoner of Consciousness A state of just awakening following Herpes Simplex Encephalitis, In Campbell, R. Conway, M. low Memories Neuropsychological Case Studies. Oxford Blackwell. pp. 15-30