Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder.
Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder.
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DOI：
10.1017/s1355617717000133
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Burdick KE
中科院分区：
文献类型：
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作者：
Nitzburg GC;Cuesta-Diaz A;Ospina LH;Russo M;Shanahan M;Perez-Rodriguez M;Larsen E;Mulaimovic S;Burdick KE
言语记忆（VM）损伤在双相情感障碍（BD）中很突出，并且与功能预后有关。然而，尚未在大样本BD患者中研究VM损伤的复杂性。此外，一些人提出VM缺陷可能由组织策略介导，如语义或序列聚类。因此，BD患者VM破坏的确切性质尚不清楚，这限制了修复工作。我们研究了双相障碍患者与健康对照（hc）的VM缺陷的复杂性，并检验了语言学习差异是否通过使用聚类策略介导。加州语言学习测试（CVLT）对113名有效稳定的BD患者和106名hc患者进行了测试。我们比较了诊断组的所有CVLT指标，并研究了语言学习的组间差异是否由聚类策略介导。虽然双相障碍患者表现出明显较差的注意力、学习和记忆，但这些指标仅轻度受损。然而，双相障碍患者表现出较差的有效学习策略使用和较低的回忆一致性，这些指标在中度受损范围内。此外，语义聚类的相对依赖完全介导了诊断类别与言语学习之间的关系，而序列聚类的依赖部分介导了诊断类别与言语学习之间的关系。情感稳定型双相患者VM缺陷普遍存在，但一般为轻度损害。然而，患者在语义和序列聚类上表现出与hc明确分离的组织策略的使用不足。补救措施可能受益于关于助记装置或“分块”技术的教育，以减轻双相障碍的VM缺陷。
Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or “chunking” techniques to attenuate VM deficits in BD.