Cognitive Intervention Targeting Autobiographical Memory Impairment in Patients With Schizophrenia Using a Wearable Camera: A Proof-of-Concept Study

Digital Neuropsychology beyond Computerized Cognitive Assessment: Applications of Novel Digital Technologies

Compared with other health disciplines, there is a stagnation in technological innovation in the field of clinical neuropsychology. Traditional paper-and-pencil tests have a number of shortcomings, such as low-frequency data collection and limitations in ecological validity. While computerized cognitive assessment may help overcome some of these issues, current computerized paradigms do not address the majority of these limitations. In this paper, we review recent literature on the applications of novel digital health approaches, including ecological momentary assessment, smartphone-based assessment and sensors, wearable devices, passive driving sensors, smart homes, voice biomarkers, and electronic health record mining, in neurological populations. We describe how each digital tool may be applied to neurologic care and overcome limitations of traditional neuropsychological assessment. Ethical considerations, limitations of current research, as well as our proposed future of neuropsychological practice are also discussed.

The positive dimension of schizotypy is associated with self-report measures of autobiographical memory and future thinking but not experimenter-scored indices

ABSTRACTThe ability to remember our past and to imagine the future are critical to our sense of self. Previous research has indicated that they are disrupted in schizophrenia. However, it is unclear (i) whether this is found when examining experimenter-scored indices of content and/or participants' self-report of phenomenological characteristics, and (ii) how these abilities might be related to symptoms. This study sought to address these questions by taking a dimensional approach and measuring positive and negative schizotypal experiences in healthy people (n = 90). Participants were given cue words. For some, they remembered an event from the past and for others they generated an event in the future. No significant relationships were found with any aspect of schizotypy when participants' descriptions were scored by the experimenter according to a standardised episodic content measure. In contrast, several significant positive correlations were observed for past memory and future thinking when examining the positive dimension of schizotypy and participants' ratings, particularly to sensory characteristics of the experience and mental pre- or reliving. These results indicate enhanced subjective experiences of autobiographical memory and future thinking in those who report delusional and hallucinatory-like occurrences, which might be linked to mental imagery or metacognitive alterations.

Improving autobiographical memory in schizophrenia using wearable cameras: A single-case experimental study

Autobiographical memory (AM) impairments influence both sense of identity and social functioning of patients with schizophrenia. However, cognitive remediation methods addressing these difficulties do not sufficiently consider the heterogeneity of this disorder and frequently face methodological limitations. The aim of the present study was to evaluate the efficacy of a method using a wearable camera (NarrativeClip®), through an alternating treatments design across two types of AM training. In parallel, repeated measures were used to appreciate the efficacy, specificity, and generalizability of the programme's benefits. Three patients were invited to wear the camera during 24 personal events. Ten of these events memories were trained by visual cueing (wearable camera condition), 10 others by verbal cueing (written diary condition) and 4 were not trained (control condition). Using pictures collected by the wearable camera seemed particularly relevant, since it promoted more detailed recalls than the diary method, from the first training session and until the end of a one-year follow-up. In addition, the repeated measures performed revealed (1) the efficacy (improvement in AM capacities after participating in the programme), (2) specificity (persistence of working memory deficits), and (3) generalizability (improvement in measures of episodic memory) of our cognitive remediation programme's effects.

Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates

Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.

“I remember the attack”: a pilot study investigating flashbulb memory in individuals with schizophrenia

Flashbulb memories are autobiographical memories for important and emotional events, which have the particularity of being at the intersection of personal and public events. Autobiographical memory impairments are highly prevalent in schizophrenia, a psychiatric condition intrinsically linked to self-disorders. Thus, we aimed to evaluate flashbulb and event memory functioning in individuals with schizophrenia. Twenty-four individuals diagnosed with schizophrenia and 25 control participants were tested on a flashbulb memory questionnaire about the July 14th, 2016, Nice (France) terrorist attack, including questions on flashbulb and event memory, certainty, vividness, rehearsal, emotion, novelty, consequentiality, implication, and importance. Participants also underwent cognitive assessments. Analysis showed lower scores for both flashbulb and event memories in patients compared to control participants. Subjective ratings of the phenomenological characteristics of flashbulb memory were similar between the two groups overall. However, individuals with schizophrenia reported having higher levels of emotion when they first learned about the attack compared to the control group. Our results replicate findings of impaired autobiographical memory functioning in schizophrenia and extend these findings to public events. Our findings also indicate that flashbulb memories may lead to substantial contextual recall in schizophrenia patients and that collective memories, such as a terrorist attack, can have a profound emotional impact on patients.

Lifelogging as a rehabilitation tool in patients with amnesia: A narrative literature review on the effect of lifelogging on memory loss

Visual lifelogging is the procedure that enables individuals to visually record daily life activities by means of small wearable cameras, which can be worn around the neck or on the clothing. Lifelogging devices automatically take pictures or videos after pre-set time intervals or after dynamic input changes. Although some studies have shown effectivity of reviewing lifelogging images in brain-damaged individuals with forms of amnesia as a rehabilitation tool, systematic endeavours to overview this literature is yet missing. The aim of this narrative literature review was to review all the available case-studies, experimental studies and group studies in brain-damaged individuals applying lifelogging devices in a clinical context. The included studies showed efficacy for both subjective and objective measures of memory. In mild to severe amnesia, reviewing images recorded by the lifelogging device was beneficial to subjective and objective measures of memory. Lifelogging is demonstrated to have a great potential in helping people who are suffering from memory loss. It can offer an excellent alternative to currently more frequently used memory rehabilitation techniques and can be applied more in clinical settings.

Unraveling the role of retrieval deficits in autobiographical memory impairment in schizophrenia: A comparison of involuntary and voluntary autobiographical memories

Patients with schizophrenia show severe autobiographical memory impairment, thought to reflect retrieval deficits caused by executive dysfunction. However, prior research has focused exclusively on strategic (voluntary) retrieval, and ignored involuntary retrieval resulting from automatic and associative processes, involving minimal cognitive control. We report two studies with patients diagnosed with schizophrenia (Ns = 40 and 50 respectively) comparing their impairment in involuntary versus voluntary autobiographical memory. We use two different methodologies, not previously used in schizophrenia research: a naturalistic study involving real-life data and an experimental setup. Both studies consistently showed that involuntary and voluntary autobiographical memories were similarly impaired in schizophrenia. The absence of interaction effects between group and retrieval suggests that schizophrenic patients did not benefit from memory tasks involving little retrieval effort. These findings suggest that autobiographical memory impairment in schizophrenia are not caused by problems with self-initiated voluntary retrieval, but instead likely reflect encoding or binding deficits.