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Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder

Published online by Cambridge University Press:  06 April 2017

George C. Nitzburg
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Armando Cuesta-Diaz
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Luz H. Ospina
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Manuela Russo
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Megan Shanahan
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Mercedes Perez-Rodriguez
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Emmett Larsen
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Sandra Mulaimovic
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Katherine E. Burdick
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York The James J. Peters VA Hospital, Bronx, New York
Corresponding
E-mail address:

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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. (JINS, 2017, 23, 358–366)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2017 

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