Disorder of Memory and Attention

What is a Memory and Attention Disorder?

Memory is the process of accumulation, retention and reproduction of information. Dysmnesias are distinguished: hypermnesia, hypomnesia, amnesia, displacement and paramnesia phenomena: confabulation, pseudo-reminiscence, echomnesia, palimpsest. Attention – focus and degree of focus on the object and activity. Attention pathology includes instability, delayed switching, insufficient concentration, attention deficit.

Background, norm and evolution

The memory process interests everyone in connection with the interest in the ability to learn and retrain. It consists of the phenomena of accumulation, retention and perception of new information. These properties of memory are characteristic of all living and inanimate nature. Memory is accumulated in culture in the objective world, on information carriers, in particular, books and computers. The unit of memory is one bit (8 bits = 1 byte), which can contain information of 2 types: “yes” (1) and “no” (0). Personal computers of the beginning of the 21st century contain information equal to 20 GB (1 GB = 2 ^ 30 bytes). In a biological sense, memory is divided into short-term and long-term. Long-term memory is fixed in the structure of DNA, and short-term memory in the structure of RNA. The brain organization of memory is connected with the circle of Papets. The Papets circle includes the activating effect of the reticular formation, tonsils and septum on the feedback between the cortex, hippocampus, hypothalamus and thalamus. Accordingly, attention disorders are mainly associated with the reticular formation, memory disorders – with the cortex, hippocampus. The neuronal “trace” as a morphological substrate is represented by axon-axon connections, as well as connections between the bodies of neurons, the number of which increases as a result of training. The neuromorphological and neurofunctional imprint of the image is called an engram; it can be formed extremely as a result of instant imprinting. This phenomenon was first discovered by K. Lorenz, who noted that the newly born goslings capture the first image seen as a parent. In mammals, oxytocin, which is produced as a result of compression of the cervix in the last stage of childbirth, helps to quickly capture the image of the child as a native. Sensory memory is allocated associated with the capture of visual, tactile, olfactory and audio images. Short-term memory translates into long-term, this is facilitated by the processes of repetition, the emotional significance of the memorized, as well as the position of the memorized among other phenomena. Reproduction is facilitated by a psychological phenomenon such as transfer, the essence of which is expressed in the fact that what is reproduced is associated with a similar phenomenon or event in the past. This means that a variety of forms of education in childhood contributes to a freer reproduction of information in adulthood and late adulthood. In biology, species memory is also distinguished, which exists due to the transfer of individual genocomplexes during evolution, as well as genocultural memory expressed by memes – units of communication between genetic structures and the results of their cultural embodiment. There is a special eidetic memory that allows you to reproduce previously imaginatively holistic images. Unconscious memory contains hidden information that is reproduced after overcoming resistance and other forms of psychological defense. It is believed that attention depends on interest, attention skills, and temperament. It has stability, focus, switchability and volume.

Symptoms of Memory and Attention Disorders

Among memory disorders, dysmnesia stands out:

  • hypermnesia is characterized by an involuntary influx of memories of the past, increased ability to capture, long-term retention of information and ease of reproduction. Hypermnesia is characteristic of some paroxysmal disorders, intoxication with psychoactive substances, hypomania. As a monosymptom, they can be in mentally healthy individuals, in particular, S. Richter, who remembered many years later what the car looked like in which he was taken to a performance many years ago, and what the hands of the boy who were falling for him looked like at the performance.
  • hypomnesia – a weakening of memory with difficulties in memorization, retention and reproduction. It is characteristic of asthenic conditions, depression, organic disorders.
  • amnesia – loss of fragments of memory. The dissociative amnesia, characterized by forgetting emotionally significant traumatic events, is a special case of extreme crowding out as a natural property of memory to transfer the memory of a traumatic event into the unconscious. Reproduction of the memory in this case is possible during the psychoanalytic process or in hypnosis. Retrograde amnesia is a loss of memory for events preceding an injury, more often a traumatic brain injury. Anterograde amnesia – loss of events that occur after stress or traumatic brain injury. Fixative amnesia – forgetting current events, including those coinciding with an injury, most often with current day events. Progressive amnesia is characterized by a consistent destruction of memory from the present to the past, while the events of the distant past are better remembered than the events of the present or the near past. The law of memory loss from the present to the past is denoted by the law of Ribot. Thus, memory impairment occurs in most organic atrophic disorders of the brain, in particular Alzheimer’s disease and vascular dementia. The reproduction of traces of memory may be impaired as a result of speech disorders, in these cases the patient cannot name the item because he does not remember what it is called, but remembers why it is needed (amnestic aphasia).

In addition, the reproduction of memory may be impaired as a result of a violation of the recognition of an object (sensory aphasia) or a violation of the recognition of the purpose (meaning) of objects or phenomena (semantic aphasia). Sensory and amnestic aphasia are characteristic of local focal organic lesions of the brain, and semantic – for schizophrenia. However, there are analogues of these psychopathological phenomena in everyday life, for example, we can use objects intended by their creators for other purposes than those with which we use them.

Paramnesia is a process of distortion of memories, they include:

  • confabulations – replacing parts of the memory with fantasies or fantastic delusions (confabulatory delirium). In these cases, the patient talks about the feats, achievements, wealth or crimes allegedly committed by him in the past;
  • pseudo-reminiscence – replacing sections of impaired memory with a fragment from another section of the past that really happened to the patient. The recalled memory resembles a confusion of dates. The combination of fixative amnesia, retro-, anterograde amnesia with confabulations and pseudo-reminiscences is typical for Korsakov’s syndrome;
  • cryptomnesia – patients attribute to themselves the memories and information received from other persons from literary sources. Sometimes these phenomena are called involuntary plagiarism. It is characteristic of organic disorders and delirium;
  • echomnesia – a feeling that what is happening previously happened in the past, or seen in dreams and then repeated. Typically, such events are given overvalued value. It is characteristic of delirium and organic disorders, in particular, for a delusional interpretation of the past;
  • palimpsest – there is a twofold description of this symptom. As a short-term memory loss with alcohol toxic intoxication with a narrowing of consciousness and with pathological affect. Another definition of a palimpsest is associated with the simultaneous reproduction of two equivalent memories that fall on the same period of time, while the patient hesitates, which of them is significant and real. It is noted in disorders of multiple personality, but is also observed during the psychoanalytic process.

Attention – focus and degree of focus on the object and activity. Attention pathology includes:

  • instability of attention, which is characterized by a quick switching of fixation of attention, distraction, inability to concentrate on any business for a long time. Typical of disinhibition syndromes in children, with hypomania and hebephrenia;
  • delayed switching (rigidity), most often observed in organics and patients with epilepsy. The patient cannot be distracted from the chosen topic, gets stuck, returns to it again and again;
  • insufficient concentration is characteristic of asthenic conditions and fatigue, minimal disorders of consciousness. Attention is “floating” in nature, there is no long-term fixation, which is reflected in the behavior (distraction).

Diagnosis of Memory and Attention Disorders

The methods of studying memory and attention include the method of remembering 10 words, attention assessment according to Schulte tables, proof-reading and counting according to E. Kraepelin, Newnsberger’s technique, as well as pictographic methods (see the corresponding section of the textbook).

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