Hostname: page-component-848d4c4894-wzw2p Total loading time: 0 Render date: 2024-05-14T06:45:10.928Z Has data issue: false hasContentIssue false

Processing efficiency and directed forgetting in bipolar disorder

Published online by Cambridge University Press:  16 December 2005

DAVID E. FLECK
Affiliation:
Division of Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio
PAULA K. SHEAR
Affiliation:
Division of Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio Department of Psychology, University of Cincinnati, Cincinnati, Ohio
STEPHEN M. STRAKOWSKI
Affiliation:
Division of Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio Department of Psychology, University of Cincinnati, Cincinnati, Ohio

Abstract

We hypothesized that patients with bipolar disorder would demonstrate verbal recognition performance deficits consistent with processing efficiency theory, a theory about how emotional states modulate performance by interfering with working memory resources or increasing cognitive arousal/effort. We predicted that (1) a manic group (n = 26) would demonstrate slow reaction time (RT) and low accuracy, (2) a euthymic group (n = 23) would demonstrate slow RT to maintain high accuracy; and (3) a healthy comparison group (n = 25) would demonstrate fast RT and high accuracy. The groups were administered symptom-rating scales and compared on a computerized, trial-by-trial, directed forgetting in recognition task. This task requires participants to comply with an overt instruction to forget irrelevant studied words, and it places a relatively high demand on working memory. The manic group was impaired on directed-forgetting sensitivity; however, when RT was statistically controlled, the groups demonstrated similar directed-forgetting effects. These findings are consistent with processing efficiency theory. They suggest that bipolar patients perform directed forgetting in recognition by increasing effortful control at encoding at the expense of processing efficiency, although acute mania reduces the capacity for control, thereby impairing recognition performance. Problems with processing efficiency are viewed as trait characteristics of bipolar disorder that may be overlooked by traditional error-based assessments. (JINS, 2005, 11, 871–880.)

Type
Research Article
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Altshuler, L.L., Ventura, J., van Gorp, W.G., Green, M.F., Theberge, D.C., & Mintz, J. (2004). Neurocognitive function in clinically stable men with bipolar I disorder or schizophrenia and normal control subjects. Biological Psychiatry, 56, 560569.Google Scholar
Andreasen, N.C. (1984). Scale for the assessment of positive symptoms (SAPS). Iowa City: The University of Iowa.
Baddeley, A.D. & Hitch, G. (1974). Working memory. In G.H. Bower (Ed.), The Psychology of Learning and Motivation (Vol. 8, pp. 4789). New York: Academic Press.
Basden, B.H., Basden, D.R., & Gargano, G.J. (1993). Directed forgetting in implicit and explicit memory tests: A comparison of methods. Journal of Experimental Psychology: Learning, Memory, and Cognition, 19, 603616.Google Scholar
Basso, M.R., Lowry, N., Neel, J., Purdie, R., & Bornstein, R.A. (2002). Neuropsychological impairment among manic, depressed, and mixed-episode inpatients with bipolar disorder. Neuropsychology, 16, 8491.Google Scholar
Bearden, C.E., Hoffman, K.M., & Cannon, T.D. (2001). The neuropsychology and neuroanatomy of bipolar affective disorder: A critical review. Bipolar Disorders, 3, 106150.Google Scholar
Clark, L., Iversen, S.D., & Goodwin, G.M. (2001). A neuropsychological investigation of prefrontal cortex involvement in acute mania. American Journal of Psychiatry, 158, 16051611.Google Scholar
Cohen, R., Lohr, I., Paul, R., & Boland, R. (2001). Impairments of attention and effort among patients with major affective disorders. Journal of Neuropsychiatry and Clinical Neurosciences, 13, 385395.Google Scholar
Deckersbach, T., Savage, C.R., Reilly-Harrington, N., Clark, L., Sachs, G., & Rauch, S.L. (2004). Episodic memory impairment in bipolar disorder and obsessive-compulsive disorder: the role of memory strategies. Bipolar Disorders, 6, 233244.Google Scholar
Eysenck, M.W. & Calvo, M.G. (1992). Anxiety and performance: The processing efficiency theory. Cognition and Emotion, 6, 409434.Google Scholar
First, M.G., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1997). Structured clinical interview for DSM-IV Axis I disorders—patient edition (SCID–I/P). New York: Biometrics Research Department, New York State Psychiatric Institute.
Fleck, D.E., Berch, D.B., Shear, P.K., & Strakowski, S.M. (2001). Directed forgetting in explicit and implicit memory: The role of encoding and retrieval mechanisms. Psychological Record, 51, 207221.Google Scholar
Fleck, D.E., Shear, P.K., & Strakowski, S.M. (2005). Processing efficiency and sustained attention in bipolar disorder. Journal of the International Neuropsychological Society, 11, 4957.Google Scholar
Fleck, D.E., Shear, P.K., Zimmerman, M.E., Getz, G.E., Corey, K.B., Jak, A., Lebowitz, B.K., & Strakowski, S.M. (2003). Verbal memory in mania: Effects of clinical state and task requirements. Bipolar Disorders, 5, 375380.Google Scholar
Goodwin, F.K. & Jamison, K.R. (1990). Manic-depressive illness. New York: Oxford University Press.
Grier, J.B. (1971). Nonparametric indexes for sensitivity and bias. Psychological Bulletin, 75, 424429.Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 5661.Google Scholar
Harnishfeger, K.K. (1995). The development of cognitive inhibition: Theories, definitions, and research evidence. In F.N. Dempster & C.J. Brainerd (Eds.), Interference and Inhibition in Cognition (pp. 175204). San Diego: Academic Press.
Hasher, L. & Zacks, R.T. (1988). Working memory, comprehension, and aging: A review and a new view. In G.H. Bower (Ed.), The Psychology of Learning and Motivation (Vol. 22, pp. 193225). San Diego: Academic Press.
Kieseppä, T., Tuulio-Henriksson, A., Haukka, J., van Erp, T., Glahn, D., Cannon, T.D., Partonen, T., Kaprio, J., & Lönnqvist, J. (2005). Memory and verbal learning functions in twins with bipolar-I disorder, and the role of information-processing speed. Psychological Medicine, 35, 205215.Google Scholar
Krabbendam, L., Honig, A., Wiersma, J., Vuurman, E.F.P.M., Hofman, P.A.M., Derix, M.M.A., Nolen, W.A., & Jolles, J. (2000). Cognitive dysfunction and white matter lesions in patients with bipolar disorder in remission. Acta Psychiatrica Scandinavica, 101, 274280.Google Scholar
MacLeod, C.M. (1989). Directed forgetting affects both direct and indirect tests of memory. Journal of Experimental Psychology: Learning, Memory, and Cognition, 15, 1321.Google Scholar
MacLeod, C.M. (1998). Directed forgetting. In J.M. Golding & C.M. MacLeod (Eds.), Intentional Forgetting: Interdisciplinary Approaches (pp. 157). Mahwah, NJ: Lawrence Erlbaum.
MacLeod, C.M. (1999). The item and list methods of directed forgetting: Test differences and the role of demand characteristics. Psychonomic Bulletin and Review, 6, 123129.Google Scholar
Martinez-Aran, A., Vieta, E., Reinares, M., Colom, F., Torrent, C., Sanchez-Moreno, J., Benabarre, A., Goikolea, J.M., Comes, M., & Salamero, M. (2004). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry, 161, 262270.Google Scholar
Murphy, F., Sahakian, B., Rubinsztein, J., Michael, A., Rogers, R., Robbins, T., & Paykel, E. (1999). Emotional bias and inhibitory control processes in mania and depression. Psychological Medicine, 29, 13071321.Google Scholar
Norman, D.A. & Shallice, T. (1986). Attention to action: Willed and automatic control of behavior. In R.J. Davidson, G.E. Schwartz, & D. Shapiro (Eds.), Consciousness and Self-Regulation (Vol. 4, pp. 118). New York: Plenum Press.
Nuyen, J., Sitskoorn, M.M., Cahn, W., & Kahn, R. (2005). Verbal memory in first-episode schizophrenia: Heterogeneity in performance? Journal of the International Neuropsychological Society, 11, 152162.Google Scholar
Pies, R.W. (1998). Handbook of essential psychopharmacology. Washington, DC: American Psychiatric Press.
Quraishi, S. & Frangou, S. (2002). Neuropsychology of bipolar disorder: A review. Journal of Affective Disorders, 72, 209226.Google Scholar
Strakowski, S.M., Adler, C.M., Holland, S.K., Mills, N.P., & DelBello, M.P. (2004). A Preliminary FMRI study of sustained attention in euthymic, unmedicated bipolar disorder. Neuropsychopharmacology, 29, 17341740.Google Scholar
Strakowski, S.M., DelBello, M.P., Sax, K.W., Zimmerman, M.E., Shear, P.K., Hawkins, J.M., & Larson, E.R. (1999). Brain magnetic resonance imaging of structural abnormalities in bipolar disorder. Archives of General Psychiatry, 56, 254260.Google Scholar
van Gorp, W.G., Altshuler, L., Theberge, D.C., & Mintz, J. (1999). Declarative and procedural memory in bipolar disorder. Biological Psychiatry, 46, 525531.Google Scholar
van Gorp, W.G., Altshuler, L., Theberge, D.C., Wilkins, J., & Dixin, W. (1998). Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence. Archives of General Psychiatry, 55, 4146.Google Scholar
Woodward, A.E. & Bjork, R.A. (1971). Forgetting and remembering in free recall: Intentional and unintentional. Journal of Experimental Psychology, 89, 109116.Google Scholar
Young, R.C., Biggs, J.T., Ziegler, V.E., & Meyer, D.A. (1978). A rating scale for mania: Reliability, validity, and sensitivity. British Journal of Psychiatry, 133, 429435.Google Scholar
Zacks, R.T. & Hasher, L. (1994). Directed ignoring: Inhibitory regulation of working memory. In D. Dagenbach & T.H. Carr (Eds.), Inhibitory processes in attention, memory, and language (pp. 241264). San Diego: Academic Press.