Memory self-awareness and memory self-monitoring following severe closed-head injury

Department of Psychology, Washington State University, Pullman, WA 99164-4820, USA.
Brain Injury (Impact Factor: 1.81). 10/2004; 18(10):997-1016. DOI: 10.1080/02699050410001719934
Source: PubMed


To examine the accuracy of memory self-awareness and memory self-monitoring abilities in participants with severe closed-head injury (CHI).
A performance-prediction paradigm was used to evaluate meta-memory abilities in 31 participants with severe CHI (>1 year post-injury) and 31 controls. To assess memory self-awareness, before completing story recall, visual reproduction and list learning memory tasks, participants predicted the amount of information they would remember for each task. Memory self-monitoring was evaluated by examining participants' ability to increase the accuracy of their predictions following experience with each memory task.
Although participants with CHI exhibited poorer recall than controls, they were equally aware of how differing task demands influence recall. They also successfully modified their predictions following task exposure.
Meta-memory was better preserved than actual memory performance. It may be possible to build on meta-memory skills to help patients with CHI more consistently use strategies that aid memory performance.

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    ABSTRACT: This article provides a clinical review of current treatment approaches to short-term and working memory impairments in individuals who have sustained traumatic closed-head injuries. Preliminarily, general information on closed-head injuries is presented. Specific short-term and working memory impairments, as well as assessments and interventions used in the practice of speech-language pathology, are then discussed. Finally, a literature review regarding outcomes and treatment efficacy is presented, revealing potentially limited generalization, though subjective benefits are described. The goal of this article is to prompt clinicians to evaluate their current interventions, thereby maximizing the effectiveness of the therapeutic process and ulti- mately enhancing the lives of the individuals served.
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    ABSTRACT: Background: The hippocampus and corpus callosum have been shown to be vulnerable in head injury. Various neuroimaging modalities and quantitative measurement techniques have been employed to investigate pathological changes in these structures. Cognitive and behavioural deficiencies have also been well documented in head injury. Aims: The aim of this research project was to investigate structural changes in the hippocampus and corpus callosum. Two different quantitative methods were used to measure physical changes and neuropsychological assessment was performed to determine cognitive and behavioural deficit. It was also intended to investigate the relationship between structural change and neuropsychology at 1 and 6 months post injury. Method: Forty-seven patients with head injury (ranging from mild to severe) had undergone a battery of neuropsychological tests and an MRI scan at 1 and 6 months post injury. T1-weighted MRI scans were obtained and analysis of hippocampus and corpus callosum was performed using region-of-interest techniques and voxel-based morphometry which also included comparison to 18 healthy volunteers. The patients completed neuropsychological assessment at 1 and 6 months post injury and data obtained was analysed with respect to each assessment and with structural data to determine cognitive decline and correlation with neuroanatomy. Results: Voxel-based morphometry illustrated reduced whole scan signal differences between patients and controls and changes in patients between 1 and 6 months post injury. Reduced grey matter concentration was also found using voxel-based morphometry and segmented images between patients and controls. A number of neuropsychological aspects were related to injury severity and correlations with neuroanatomy were present. Voxel-based morphometry provided a greater number of associations than region-of-interest analysis. No longitudinal changes were found in the hippocampus or corpus callosum using region-of-interest methodology or voxel-based morphometry. Conclusions: Decreased grey matter concentration identified with voxel-based morphometry illustrated that structural deficit was present in the head injured patients and does not change between 1 and 6 months. Voxel-based morphometry appears more sensitive for detecting structural changes after head injury than region- of-interest methods. Although the majority of patients had suffered mild head injury, cognitive and neurobehavioural deficits were evidenced by a substantial number of patients reporting increased anxiety and depression levels. Also, the findings of relationships between reduced grey matter concentration and cognitive test scores are indicative of the effects of diffuse brain damage in the patient group.
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