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Clinical Reasoning and Diagnostic Errors
Published in Paul Cerrato, John Halamka, Reinventing Clinical Decision Support, 2020
These experiments do not imply that common cognitive errors don’t have a negative impact on diagnosis. There is ample evidence to demonstrate that premature closure, confirmation bias, and availability bias do reduce diagnostic accuracy. But some of these errors may in fact be related to both Type 1 and Type 2 thinking. And as Norman et al. explain: “[T]he resolution of errors is not simply a case of exerting additional analytical effort; without sufficient knowledge, additional processing is not likely to be helpful in resolving errors.”23 The operative term is “sufficient knowledge.” The research suggests that knowledge deficits are just as important as unrealistic leaps of associative memory in causing diagnostic errors. In other words: “general admonitions to slow down, reflect, or be careful and systematic likely have minimal effect beyond slowing the diagnostic process. By contrast, knowledge deficits are a significant contributor to diagnostic error, and strategies to induce some reorganization of knowledge appear to have small but consistent benefits.”23 The emphasis on a deeper knowledge of specific disease entities is consistent with Schleifer’s definition of true expertise, as discussed above, namely: One of the hallmarks of a genuine expert diagnostician is their more completely developed disease scripts, and their ability to spot inconsistencies that don’t fit into these scripts.
Memory
Published in Allan Hobson, Psychodynamic Neurology, 2014
Obviously, it is a tough job to integrate disparate elements such as these into a seamless waking consciousness but that is what I must do if I am to remain whole, intact, and singular. The integration of far-flung parts of my life is a task of which I am quite aware when I am awake. But when I dream, I may make these very remote associations available for synthetic fusion more easily than I do when I am awake. In this light, my very bizarre Vermont farm dream makes sense as an ego reconstruction exercise. My associative memory is enriched and strengthened by these associative links, and dreams are notably hyperassociative.
Offenders with intellectual disabilities
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Pamela J Taylor, William R Lindsay, Gregory O’Brien, John L Taylor
The issue of suggestibility of accused persons with intellectual disability during police interviews has been well researched. Gudjonsson (1992) argued that people with intellectual disability were more susceptible to yielding to leading questions and shifting their answers under interrogation by the police and, as such, more liable to give false confessions. He developed the Gudjonsson Suggestibility Scales (GSS; Gudjonsson, 1997), which are used widely. Clare and Gudjonsson (1993) found that participants with intellectual disability confabulated more and were more acquiescent during interrogative interview while Everington and Fulero (1999) found that people with intellectual disability were more likely to alter their answers in response to negative feedback. Beail (2002), however, in a review of a number of studies involving the GSS, questioned whether artificial test situations were similar enough to real-life interrogation situations:…because the results are based on an examination of semantic memory whereas police interviews are more concerned with episodic or autobiographical event memory. Also, experienced events usually involve multi-modal sensory input, resulting in a more elaborate trace in associative memory (p.135).
The QuadMax Task: Parametrically Manipulating Associative Memory Load across the Adult Lifespan
Published in Experimental Aging Research, 2023
Corinna Y. Franco, Alexander Alcaraz-Torres, Ilana J. Bennett
Adults of all ages had worse associative memory (hits minus recombined FA) at higher associative loads, driven by significantly fewer correct “old” responses to repeated sets (hits) and more incorrect “old” responses to recombined sets (recombined FA) as a function of set size. These findings extend the well-documented paired-associative (Naveh-Benjamin, 2000; Old & Naveh-Benjamin, 2008) and emerging triplet-associative memory (Clark & Shiffrin, 1987; Torres-Trejo & Cansino, 2016) literatures by demonstrating associative memory deficits at higher associative loads than previously studied. Specifically, whereas the paired-associative literature has demonstrated significant differences between non-associative and associative memory for pairs of items, our findings show that associative load effects follow a monotonic trajectory in which associative memory get worse with each increase in set size. Because our paradigm manipulated the number of items to be associated across three set sizes, we interpret these results as support for the notion that associative memory is modulated by demands on binding processes that link words within a set at study into a cohesive memory trace and support retrieval of this bound set at test (Naveh-Benhamin, 2000; Zimmer et al., 2006).
The Impact of Semantic Relatedness on Associative Memory in Aging Depending on the Semantic Relationships between the Memoranda
Published in Experimental Aging Research, 2019
Emma Delhaye, Adrien Folville, Christine Bastin
When considering the results at the group level, we found evidence of an associative memory deficit in all conditions. As observed previously, this was mainly due to enhanced false recognition of recombined pairs. Moreover, across both young and older adults groups, thematically-related pairs were better recognized than were taxonomically-related pairs, which were in turn better recognized than unrelated pairs. This suggests that the presence of a semantic relationship and the nature of this relationship (thematic more than taxonomic) have a beneficial effect on associative discrimination. However, with the exception of a smaller effect size of the age effect in the false recognition of recombined thematic pairs, whole-group analyses failed to support the hypothesis that the nature of the semantic relationship may modulate the amplitude of age-related differences. This may be explained by a difficulty of older adults to distinguish experimentally-familiar studied pairs from preexperimentally-familiar semantically-related recombined pairs. Previous studies indeed showed that preexperimental familiarity, not only of the studied pairs but also of the recombined pairs, could modulate the presence or absence of benefit from prior knowledge in associative memory in older adults (Delhaye et al., 2019).
hif-1 plays a role in hypoxia-induced gustatory plasticity of Caenorhabditis elegans
Published in International Journal of Neuroscience, 2019
Nabila Sorathia, Neha Chawda, Konstantina Saraki, Medha S. Rajadhyaksha, Momna Hejmadi
We next set out to explore whether the HIF-dependent pathway also mediates formation of associative memory. Our associative memory paradigm paired the presence of NaCl with absence of food. As expected, following conditioning, worms negatively associated the presence of NaCl with starvation (Figure 3a) resulting in less attraction towards NaCl (CI < 50%); and the reduction in CI of worms on the conditioned plate (+NaCl, −E. coli) as compared to the naïve plate (+NaCl, +E. coli) was >50% (Figure 3b). Figure 3a, b thereby established the induction of associative memory in WT worms with a 73% reduction in CI on starvation. Exposure to hypoxia induced a strong aversive response compared to normoxia in WT worms. Interestingly, although hif-1 mutants also showed associative memory under normoxic conditions, exposure to hypoxia did not induce the strong aversive response seen in the WT worms, further confirming a role of hif-1 in mediating/formation of associative memory.