Postcards from the Id

New Research Into Effective Study Habits

This NY Times article does a nice job summarizing recent research findings, which run counter to the prevailing wisdom when it comes to study habits.  I particularly like the section that addresses a multi-modal study style, in which various distinct, but related, areas are studied during an individual study session, as opposed to lengthy periods of study focused on one topic.  As the article notes, athletes and musicians have figured this out long ago, so why haven't students?  Worth a read, especially if you have kids, are a teacher of some sort, or are in school yourself.

Brief Take On The WAIS-IV

I've been using the WAIS-IV exclusively for about nine months, which I think has been long enough to offer a few brief comments on it, as compared to prior versions of the WAIS, as well as tests in general.

Generally speaking, I really like using the WAIS-IV, compared to previous versions.  Administration consists of 10 primary subtests, which have been streamlined in terms of discontinuation rules.  For example, Block Design is discontinued after two consecutive scores of zero, Matrix Reasoning after three consecutive zeroes, etc.  In addition, with each new version of the WAIS, the subtests have gravitated towards ones with easier-to-score items; this version, for example, has relegated Comprehension to "Alternate" staus, and there was much rejoicing.  The subtests themselves have been improved in terms of their introduction, as more sample items are provided to give direction to individuals who are unfamiliar with this type of task, or who may have difficulty grasping what they are supposed to do - I believe this has addressed a prior concern of mine; that individuals who already have relatively low intellectual functioning may have needed longer to simply grasp what the tasks entialed, possibly hurting their score.

Conceptually, the test has adopted the four-factor model, rather than the old two-factor model.  Now, Processing Speed and Working memory are affored their own spot at the table, and all subtests load separately on the various factors, rather than having overlap.  Given that many clinicians reported the four factors anyway, this formalized shift is nice.

Overall, I've been really happy with the latest version of the WAIS-IV.  It addressed a few minor concerns I had with the WAIS-III, is streamlined, and relatively quick in terms of administration time.   

Book Quote - Episodic Memory And The Seven 'Sins' of Memory

"Schacter (1999, 2001) recently classified the misdeeds of memory into seven basic 'sins:' transience, absent-mindedness, blocking, misattribution, suggestibility, bias, and persistence.  The first three sins involve types of forgetting.  transience involves decreasing accessibility of information over time; absent-mindedness entails inattentive or shallow processing that contributes to weak memories of ongoing events or forgetting to do things in the future; and blocking refers to the temporary inaccessibility of information that is stored in memory.  The next three sins all involve distortion or inaccuracy.  Misattribution involves attributing a recollection or idea to the wrong source; suggestibility refers to memories that are implanted at the time of retrieval; and bias involves retrospective distortions and unconscious influences that are related to current knowledge and beliefs.  The seventh and final sin, persistence, refers to intrusive memories that we cannot forget, even though we wish that we could."

- From Episodic Memory, Chapter 5 ("Misattribution, false recognition, and the sins of memory"), pages 71-72 

Experimental "Error" May Not Be An Error At All

There is a fantastic article in the latest issue of Wired entitled, "Accept Defeat: The Neuroscience of Screwing Up."  The article discusses, in a very readable way, the real-world problems of scientific research, and provides a neurological explanation for why researchers often make very-human mistakes when considering data and results that do not conform to their pre-existing expectations.  Several historical examples are offered, ans research by psychologist Kevin Dunbar into the process of research illuminates how preconceived notions about what "should" happen often negatively impact the interpretation of unexpected results - often leading to a conclusion that there must have been a mistake, rather than considering alternatives.  From the article:

Dunbar came away from his in vivo studies with an unsettling insight: Science is a deeply frustrating pursuit. Although the researchers were mostly using established techniques, more than 50 percent of their data was unexpected. (In some labs, the figure exceeded 75 percent.) “The scientists had these elaborate theories about what was supposed to happen,” Dunbar says. “But the results kept contradicting their theories. It wasn’t uncommon for someone to spend a month on a project and then just discard all their data because the data didn’t make sense.” Perhaps they hoped to see a specific protein but it wasn’t there. Or maybe their DNA sample showed the presence of an aberrant gene. The details always changed, but the story remained the same: The scientists were looking for X, but they found Y.

One suggestion for avoiding non-inquisitive thinking: diversity, primarily of attitude and scientific background.  That is, individuals who don't already "know" the material at hand may well bring a fresh perspective.  In addition, outsiders are often less constrained by what is "settled" in the field in question, and might be more willing to challenge orthodoxy.  I recall in When Life Nearly Died, it took several non-paleontologists (I believe their background was physics, though I can't recall for sure) to break down the century-old taboo against suggesting a meteor might have caused a mass extinction of the dinosaurs. 

I highly recommend you read the whole thing, both for the discussion of the research into the scientific processes of research, as well as the neurological discussion into how the brain handles disparate data.  Great stuff, and one of the best articles I've read in Wired in some time.

Book Quote - The Amnestic Syndrome

" Global amnesia refers to a dense and circumscribed deficit in memory in the context of otherwise preserved intelligence.  It encompasses the acquisition of events and facts encountered postmorbidly (anterograde amnesia), as well as the retreival of information acquired premorbidly (retrograde amnesia).  Patients with amnesia are capable of holding a limited amount of information in mind for a very brief period of time, but with increased retention interval or increased interference, their recall and recognition of the information inevitably fails.  Anterograde amnesia is usually global, in that memory for all new information is affected - regardless of the nature of the information (i.e. verbal or nonverbal) or the modality in which it is presented (i.e. auditory or visual).  In most patients, anrerograde amnesia is associated with some degree of retrograde loss, although its extent is more variable.  The reverse, however, is not necessarily the case, as some patients have been described who demonstrate relatively focal retrograde amnesia in the absence of anterograde memory loss (Kapur, 1993; Kopelman, 2000)."

- From The Handbook of Memory Disorders, Chapter 7 (by Margaret O'Connor and Mieke Verfaellie)

I've had several cases recently in which some degree of memory impairment has been reported.  As a result, I've contined to focus on various aspects of memory impairment, which explains the recent posts on memory-related topics.  I thought this paragraph effectively described the issues associated with the two general types of amnesia: 1) Anterograde - from the point of onset, a person cannot form new memories, and; 2) Reterograde - a person cannot recall memories from a particular time period in the past, but is able to form new memories. 

With respect to anterograde amnesia, two movies that have portrayed this issue are: 1) 50 First Dates, in a lighthearted, comedic manner, and; 2) Memento, in a darker, film noir manner.  In each case, a head injury impairs the individual to the point where they can no longer form long-term memories; once time passes, or new information is presented (interference), the preceeeding stimuli is lost.  Memento is particularly effective in demonstrating the impact this sort of problem can have, utilizing a clever time-sequencing device to impart the memory problem onto the audience.  If one is interested in reading a fascinating portrayal of this type of problem, I highly recommend the chapter "The Last Hippie" from Oliver Sacks' An Anthropologist on Mars .

Retrograde amnesia has been shown in film as well.  In the case of a brain injury, Overboard with Goldie Hawn presents a woman who loses memory of her past after a fall and subsequent hit on the head.  More common in the movies (liely due to theatrical potential) is psychogenic retrograde amnesia (amnesia for past events for psychological, not medical, reasons).  In The prince of Tides, Nick Nolte works through a childhood trauma for which he cannot recall the event; many movies will portray memory loss of this type as a result of a traumatic event (including the comission of a crime), often using this set up as a plot device.

As time and interest permits, I'll keep posting stuff I think might be interesting!

Book Quote - On The Issue Of Short-Term Memory

"These tests of attention require intact short-term memory.  Most patients with brain disorders have intact short-term memory when recall follows repetition immediately, with neither delay nor interference.  When their attention is directed away from tasks by an interpolated activity, retention, even for relatively brief intervals, becomes tenuous.  Patients with actual short-term memory impairment do exist but it is relatively rare (e.g. Vallar & Shallice, 1990; Warrington & Shallice, 1984), so this possibility should be evaluated.  Poor performance on a simple digit span task is more likely to be representative of an attentional impairment rather than a true memory impairment.

Attentional capacity is resistant to the effects of many brain disorders.  It may be restricted in the first months following head trauma but it is likely to return to normal during latter states (Bazarian et al., 1999; Lezak, 1979; Ponsford & Kinsells, 1992).  Most mildly demented Alzheimer's patients have normal capacity for reciting a string of digits (Pachana et al., 1996; Rubin et al., 1992).  However, when the information becomes more complex, as in sentence span tests, or more information is presented than can normally be grasped at once, as in supraspan tests (Benton et al., 1983; Milner, 1970; see also Lezak, 1995), the reduced attentional capacity of many brain-injured persons becomes evident."

- From The Handbook of Memory Disorders, page 639

 - See also this link for some information regarding the concept of attention, as it relates to the issues noted above.

Basically, what this passage indicates is that organic brain issues typically do not impact short-term memory; to the extent an individual is displaying problems with short-term memory, the actual issue is most likely related to attention.

Quote - Testing Of The Frontal Lobes

"Every clinical assessment of behavior requires a careful review of frontal lobe functions.  Nonetheless, several challenges face behavioral neurologists and neuropsychologists in their clinical attempts to assess the frontal lobes.  Whereas an assessment of sensorimotor systems is guided by a relatively well understood pattern of brain-behavior relationships, the frontal lobes are incredibly complex, and because of their extensive interconnections with other neural structures, they control or influence a broad range of behaviors.  Injury to the frontal lobes can affect initiation of complex motor behavior, attention, executive functioning, working memory, episodic memory, language, emotions, and behavior."

- From the chapter "Bedside Frontal Lobe Testing," pg. 279, of The Human Frontal Lobes

Understanding The Functioning Of Frontal Lobes

The frontal lobes have received an increasing amount of attention of late, with terms like “Executive Functioning” becoming quite popular.  Simply put, the frontal lobe is a section of mammalian brains that occupies the front portion of our head (right behind our foreheads).  Some of the functions of the frontal lobe include: attention, working memory, generating and inhibiting behaviors (think of this as a “gate-keeper” between thinking of doing something, and doing it), forming concepts, temporal sequencing and planning, considering context and perspective (including in social settings), and general managerial/executive performance.  While the left side (your left!) focuses more on language, the right side addresses social considerations. 

One other item to note: when faced with a novel situation (rather than something routine, or instinctual), it is the frontal lobe that will activate, using the functions listed above to consider the issue.  For example, when asked to solve “2+2=?”, one’s frontal lobe is not activated; this is a problem so simple, and solved so frequently, that it is a reflexive response - no planning is involved.  If, on the other hand, one is asked, “Which is larger: 3a + 4b x 4c or 5a x 6b - 8c where a is equal to half the product of b x c?” then the puzzle might require a bit more frontal lobe activity, including to determine whether the problem even makes sense (since I just made that up out of thin air).  Assuming it is legitimate, one might consider a number of strategies designed to determine the answer; it is the planning and organization associated with truly solving a puzzle that the frontal lobe provides.  The frontal lobe would help decide whether to solve the problem as well, or whether to say "Forget this!" and go watch TV.  In a different context, figuring out when the “time is right” to broach a subject in a social setting, such as asking for a raise, or a date, or whether a joke is appropriate to tell in a particular setting, is also the domain of the frontal lobe. 

I completed an evaluation not too long ago where my primary concern about the individual’s overall functioning at the present time was his possible frontal lobe dysfunction.  Specifically, he appeared to grasp all of the concepts relevant to competency to stand trial, and when asked directly for an answer to a question, or prompted to respond, he would.  But there appeared to be little in the way of motivation; that is, he would respond when asked, but he did not necessarily appear to initiate any effort into demonstrating his competency.  Tests measuring his degree of effort matched this theory as well; he did not make anything up, or intentionally provide wrong answers (that would require a plan, and implementation of it!), but rather he would provide answers with the first thing that popped into his head.  There would be no consideration of the problem; no recognition (or an inability to act on any recognition) that as the problems and issues became more difficult, sustained focus for a lengthier period of time might be required to answer the question (for example, in multi-step questions, similar to “Say a train leaves New York at 7 am at 65 miles per hour, and...”); and no consideration of the larger context in which the evaluation was taking place.  Simply put, he was basically a reactive, amotivated individual (thanks in large part to tons of drug use, including inhalant abuse) who required prompting to initiate most behaviors.  When asked about his behavior on the unit, staff would state, “Most of the time, he just sits there.”  An interesting case, to say the least, and one that prompted me to learn more about the functioning of the frontal lobes (thus demonstrating that mine is still working at least to some degree).

In the spirit of this effort at self-education, I purchased The Human Frontal Lobes, by Bruce Miller and Jeffrey Cummings.  I have just started to look through it a bit, but it looks to contain just about anything anyone could ever want to know about the front part of the brain.  Here is a snippet from the introduction:

“The frontal lobes are no longer considered a single functional entity.  Rather, there are a variety of ways to anatomically subdivide this brain region, all based upon distinctive constructs.  Most researchers accept that the frontal lobes have three major divisions: motor, premotor, and prefrontal regions.  Motor and premotor areas are considered distinctive functional units, whereas prefrontal cortex is more complex, requiring further subdivision.  One system to subdivide the frontal cortex relies on the distinctive functions of different prefrontal regions.  Another approach considers regional connections to and from specific subcortical regions.  (Pg. 7)”

That’s page seven, from the introduction.  Man, do I have my work cut out for me; that passage alone gave my frontal lobe a headache.  Obviously, this is a tome that would be best tackled in small doses over time, rather than late night reading where I hope the ending surprises me.  In any event, as I go through the book, even on an as-needed basis, I’ll keep an eye out for little bits here and there that might be of interest, and pass it along.  If you’re “in the biz,” and need a thorough book on this area of neurological and neuropsychological functioning, consider this one.

Attention Problems In Kindergarten Predict Poor High School Achievement

This has happened a few times recently.  I write a post about a topic, in this case attention, and then in the next day or two an article or study comes out relevant to that very topic.  Maybe I should write a post about me winning the lottery...

Anyway, back to the subject at hand.  According to the article, kids assessed with poor attention in kindergarten were found to score significantly lower on high school tests later on, even when many other factors are considered.  Regardless of other behavioral problems, mental health issues, or IQ, attention problems at an early age negatively impacted a child’s academic performance later on.  From the article:

The study, "The Impact of Childhood Behavior Problems on Academic Achievement in High School," analyzes data on approximately 700 children who were followed from kindergarten (ages 5 through 6) through the end of high school (ages 17 through 18). It examines the relationship between aggressive, inattentive and depressive behaviors and children's later performance on standardized high school achievement tests.

The researchers found that inattentiveness in kindergarten was the only behavior that consistently predicted lower scores on reading and math achievement tests administered more than a decade later.

What’s interesting about this research is how attention came out so strongly, in terms of a consistent factor.  Other issues, such as anxiety, depression, and aggression, do not appear to have consistently impaired children’s later academic achievement.  As the article later notes, this provides further guidance on prioritizing issues impacting students, with attention problems being a key concern.  In addition, the article notes that attention problems do not necessary mean Attention Deficit Hyperactivity Disorder - there are multiple reasons a child is having difficulty with attention.  The important thing is that if a child is displaying significant problems with attention in academic settings, the results of this study suggest we shouldn’t wait to see if he or she “grows out of it;” the association between the early attention problems and later difficulties is too strong.

The Concept of Attention - Selected Quotes and Observations

Here are some quotes and observations regarding the concept of attention, on of many cognitive functions often assessed by clinicians, in a wide variety of contexts.  It seems like a simple thing to understand, but there's much more to attention than meets the eye.  All of the quotes below are from the book Neuropsychological Assessment, by Muriel Lezak.

“Attention refers to several different capacities or processes that are related aspects of how the organism becomes receptive to stimuli and how it may begin processing incoming or attended-to excitation.”

Attention has been placed in several different functional sub-categories, depending on how it is conceptualized.  Features of attention that have been observed or discussed have included reflexive versus voluntary attention, stimulus-driven versus memory-driven, and the varying amounts of attention that can be focused on different stimuli.

“A salient characteristic of the attentional system is its limited capacity.  Only so much processing activity can take place at a time, such that engagement of the system in processing one attentional task calling on controlled attention can interfere with a second task having similar processing requirements.”

“Attentional capacity varies not only between individuals but also within each person at different times and under different conditions.”

As an example, an individual who is fatigued, weak from malnourishment, etc. will demonstrate less attentional capacity than they would under improved conditions.

“Simple immediate span of attention - how much information can be grasped at once - is a relatively effortless process that tends to be resistant to the effects of aging and of many brain disorders.”

This is akin to working memory - how much information an individual can hold at one time, in the moment (for example, when someone is attempting to remember a telephone number they just heard).

“Four other aspects of attention are more fragile and thus often of greater clinical interest.”

“(1) Focused or selective attention - is probably the most studied aspect and the one people usually have in mind when talking about attention.  It is the capacity to highlight the one or two most important stimuli or ideas being dealt with while suppressing awareness of competing distractions.  It is commonly referred to as concentration.”  

“(2) Sustained attention or vigilance - refers to the capacity to ward off distractions to selective attention.”

“(3) Divided attention - involves the ability to respond to more than one task at a time or to multiple elements or operations within a task, as in a complex mental task.  It is thus very sensitive to any condition that reduces attentional capacity.”

“(4) Alternating attention - allows for shifts in focus and tasks.”

“Impaired attention and concentration are among the most common mental problems associated with brain damage.  When attentional deficits occur, all the cognitive functions may be intact and the person may even be capable of some high level performances, yet overall cognitive productivity suffers from inattentiveness, faulty concentration, and consequent fatigue.”

The issue that generally comes to mind first when discussing attentional deficits is Attention Deficit Hyperactivity Disorder (ADHD).  However, as noted above, an individual’s attentional capacity will suffer due to a wide variety of impairments, including head injuries, medical issues, and other trauma that impacts the brain.  Attention is generally screened as part of any sort of mental status examination (an assessment of an individual’s current cognitive state).  However, if an issue with attention is observed, more detailed assessment can be conducted.  As these quotes demonstrate, attention is a much more complex concept than many realize, and it requires a thorough assessment if there is concern it is impacting an individual’s overall cognitive functioning.