Visual and auditory spatial and nonspatial delayed-response performance by Korsakoff and non-Korsakoff alcoholic and aging individuals.

36 male alcoholics (13 with Korsakoff's syndrome) and 24 controls performed visual and auditory delayed-response tasks sensitive to prefrontal cortical damage in nonhuman primates. Korsakoff patients were consistently impaired compared with other Ss. Impairments by Korsakoff patients were evident when demands were placed on visual processing time (brief stimulus durations), and the deficits became exaggerated with increased demands on short-term memory. Under the most difficult experimental conditions, controls and non-Korsakoff alcoholics who were over 50 yrs old performed somewhat worse compared with younger groups 27–49 yrs old. Age-linked deficits were mild compared with Korsakoff's deficits, and age-group differences disappeared with easier task demands. The results implicate cortical pathology in alcoholism and normal chronological aging and suggest that prefrontal damage accompanies Korsakoff's syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The nature of the memory deficit in Korsakoff's psychosis.

Compared the performance of 10 alcoholics with Korsakoff's psychosis (mean age, 51.5 yrs) with that of 10 alcoholics without Korsakoff's psychosis (mean age, 47.9 yrs) on a probe-recognition task. Results are consistent with the view that Korsakoff patients have a greater susceptibility to proactive inhibition than do non-Korsakoff patients. A signal detection analysis of the results suggests that this might be reflected in lower initial registration strength for recent items. Ss' scores on the Wechsler Memory Scale also indicate that Korsakoff Ss did most poorly on tasks demanding the greatest use of information processing involving long-term memory (e.g., paired-associate learning). Results are discussed in terms of current theories of amnesia. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Paired-associate learning and priming effects in amnesia: A neuropsychological study.

Conducted 4 experiments investigating the role of priming effects in paired-associate learning. Ss for all 4 experiments were 5 male and 3 female alcoholics (mean age 53.8 yrs; WAIS—R IQs 85–203) with Korsakoff syndrome. Control Ss were 26 male alcoholics (mean age 47.6 yrs). Exp I illustrated the distinction between the memory impairment of amnesic (Korsakoff) Ss and their intact priming ability. In Exp II, amnesic Ss showed good paired-associate learning for related word pairs but controls performed significantly better. Exp II also showed that the forgetting of related word pairs by amnesic Ss followed the same time course as the decay of word priming. Exp III showed that amnesic Ss were as good as controls at learning related word pairs when word-association tests were used. Exp IV showed that amnesic Ss exhibited normal priming when they were asked to free associate to words that were semantically related to previously presented words. Results indicate that both priming effects and paired-associate learning of related words depended on activation, a process that is preserved in amnesia. Activation is a transient phenomenon presumed to operate on and facilitate access to preexisting representations. (67 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognition and recall in amnesics.

Examined whether recall is disproportionately disrupted by amnesia compared with recognition, using 7 amnesics (mean age 51 yrs) without a history of alcoholism, 9 amnesic alcoholic Korsakoff syndrome patients (mean age 66 yrs), and 9 controls (mean age 53.2 yrs). It was postulated that if amnesia affects memory uniformly across different direct memory measures, recall of normal controls should not differ from the recall of amnesics when recognition scores of these 2 groups are equated. On the other hand, if recall is disproportionately disrupted, normal recall should be superior to amnesic recall even when recognition is equated. In the present study, amnesic recognition was equated with that of controls by providing amnesics with 8 sec of study time and normal Ss with 0.5 sec. Normal recall was superior to amnesic recall even when no differences were found in recognition. The results further specify the selective nature of amnesia. It is suggested that amnesia reflects a selective disruption of an aspect of memory critical to successful recall. (47 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The experimental investigation of a case of alcohol-induced frontal lobe atrophy.

Examined the performance of a nonamnesic male chronic alcoholic (aged 70 yrs) with significant frontal cortical atrophy on 3 memory tests (decay from immediate memory, release from proactive interference, and word completion). Results were compared with those from a male (aged 58 yrs) with alcoholic dementia and manifestations of Wernicke-Korsakoff syndrome and 2 nonalcoholic controls (aged 68 and 74 yrs). All Ss were evaluated using computerized tomography (CT) scans. Frontal atrophy alone was not related to impairment of verbal retention. Findings are important for the proposed neuropathology of some memory deficits of alcoholic Korsakoff patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When true recognition suppresses false recognition: evidence from amnesic patients

False recognition occurs when people mistakenly claim that a novel item is familiar. After studying lists of semantically related words, healthy controls show extraordinarily high levels of false recognition to nonstudied lures that are semantic associates of study list words. In previous experiments, we found that both Korsakoff and non-Korsakoff amnesic patients show reduced levels of false recognition to semantic associates, implying that the medial temporal/diencephalic structures that are damaged in amnesic patients are involved in the encoding and/or retrieval of information that underlies false recognition. These data contrast with earlier results indicating greater false recognition in Korsakoff amnesics than in control subjects. The present experiment tests the hypothesis that greater or lesser false recognition of semantic associates in amnesic patients, relative to normal controls, can be demonstrated by creating conditions that are more or less conducive to allowing true recognition to suppress false recognition. With repeated presentation and testing of lists of semantic associates, control subjects and both Korsakoff and non-Korsakoff amnesics showed increasing levels of true recognition across trials. However, control subjects exhibited decreasing levels of false recognition across trials, whereas Korsakoff amnesic patients showed increases across trials and non-Korsakoff amnesics showed a fluctuating pattern. Consideration of signal detection analyses and differences between the two types of amnesic patients provides insight into how mechanisms of veridical episodic memory can be used to suppress false recognition.     

Implicit memory for pictures in amnesia: Role of etiology and priming task.

This study examined the performance of patients with Korsakoff and non-Korsakoff amnesia on tests of picture priming. Both groups showed intact priming on a picture-naming task but impaired priming on a fragment-completion task when fragmented pictures were presented at study. When whole pictures were presented at study, patients with non-Korsakoff amnesia showed intact priming, but Korsakoff patients' priming remained impaired. Both groups performed equally poorly on a picture-recognition task. It is concluded that non-Korsakoff patients show intact picture priming when explicit memory does not contaminate fragment-completion performance. Korsakoff patients, in contrast, show a selective impairment in the perceptual processes that mediate picture-fragment completion priming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bilateral frontal lobe disease and selective delayed response deficits in humans.

Compared the performance of 6 male patients (aged 24–65 yrs) with frontal lobe disease; 17 amnesic male patients (12 with etiology of alcoholic Korsakoff's disease [mean age 53.6 yrs] and 5 with surgically treated ruptured anterior communicating artery aneurysm [mean age 45.6 yrs]), and 12 male alcoholic controls (mean age 39.7 yrs) with no memory impairment on delayed alternation (DA) and delayed response (DR) tasks, known to be sensitive to frontal lobe damage in nonhuman primates. Ss (except the Korsakoff and alcoholic Ss) completed the Wechsler Memory Scale, and all Ss completed the Wechsler Adult Intelligence Scale (WAIS) and the Wisconsin Card Sorting Test. Results show that bilateral frontal lobe damage was associated with impairment on both tasks. There was no relation between performances on DA and DR and performance on the Wechsler Memory Scale, strengthening the suggestion that the former tasks are not sensitive to anterograde amnesia in humans. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory and metamemory: A study of the feeling-of-knowing phenomenon in amnesic patients.

Tested accuracy of the feeling of knowing in 2 experiments, using 8 patients with Korsakoff's syndrome (mean age 54 yrs), 8 electroconvulsive shock therapy (ECT) patients (mean age 46.5 yrs), 4 Ss (mean age 47 yrs) with other causes of amnesia, 2 alcoholic control groups (7 Ss with a mean age of 47.6 yrs and 19 Ss with a mean age of 48.5 yrs), and 18 healthy controls (mean age 49 yrs). In Exp I, feeling-of-knowing accuracy for the answers to general information questions that could not be recalled was tested. Ss were asked to rank nonrecalled questions in terms of how likely they thought they would be to recognize the answers and were then given a recognition test for these items. Only Korsakoff's syndrome Ss were impaired in making feeling-of-knowing predictions. The other amnesic Ss were as accurate as control Ss in their feeling-of-knowing predictions. In Exp II, these findings were replicated in a sentence memory paradigm that tested newly learned information. Results show that impaired metamemory is not an obligatory feature of amnesia, because amnesia can occur without detectable metamemory deficits. The impaired metamemory exhibited by patients with Korsakoff's syndrome reflects a cognitive impairment that is not typically observed in other forms of amnesia. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do alcohol expectancies mediate drinking patterns of adults?

Compared the reinforcement expectancies of adult alcoholics with beliefs of 2 other adult populations. 171 participants (mean age 42.8 yrs) in alcohol treatment programs, 65 hospitalized medical patients (mean age 42.6 yrs), and 344 college students (mean age 24 yrs) identified their beliefs about the consequences of alcohol consumption through an alcohol expectancy questionnaire (AEQ). Results indicate that the previously defined AEQ beliefs among nonalcoholic populations identified by S. A. Brown et al (1980) and B. A. Christiansen et al (see record 1982-25609-001) are applicable to alcoholic populations. In the present study, nonalcoholics and alcoholics differed significantly in terms of their alcohol expectancies. In general, alcoholics were found to maintain strong alcohol expectancies, and expectancies increased across and within populations as a function of drinking patterns. Theoretical, research, and clinical implications of these findings and the AEQ are discussed. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recoverability of psychological functioning following alcohol abuse: acquisition of meaningful synonyms

Assessed the recovery of alcoholics' ability to learn meaningful verbal items after the cessation of drinking via 3 spaced administrations of the Synonym Learning Test (SLT) during a 1-mo inpatient alcohol treatment program. The SLT procedure also assessed Ss' vocabulary level. Three matched groups of 11 male alcoholics (mean ages 41.55, 45.45, and 43.36 yrs) were tested. The study design separated practice effects from actual recovery via the administration of the 1st testing to each group at a different time delay after drinking ceased—5, 15, and 25 days, respectively. To ascertain baseline SLT performance, a control group of 11 nonalcoholic hospitalized patients (mean age 37.55 yrs) were tested once. Results show that vocabulary knowledge was unimpaired by chronic alcohol abuse, whereas the ability to learn new vocabulary words was impaired immediately after cessation of drinking but recovered to normal levels by 2 wks postdrinking. Length of drinking history did not influence either vocabulary knowledge or new vocabulary learning. The correlation between new vocabulary learning and initial vocabulary suggested that SLT scores must be adjusted for vocabulary in future clinical use of the procedure. Implications for alcohol treatment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dietary and nutritional abnormalities in alcoholic liver disease: a comparison with chronic alcoholics without liver disease

OBJECTIVE: To document the profile and role of malnutrition in alcoholic hepatitis, compared with chronic alcoholics and nonalcoholic chronic liver disease. METHODS: To this end, we studied 67 patients with alcoholic liver disease (ALD) (group I), 52 chronic alcoholics without histological evidence of liver disease (group II), 44 nonalcoholic cirrhotics (group III), and 52 healthy controls (group IV). Alcoholic and nonalcoholic calories were calculated and percentage dietary and nutritional deficiencies computed. Anthropometric indices, nitrogen balance, and immune status of the patients were assessed. RESULTS: Alcohol constituted about 48% of daily caloric intake in patients with ALD. The percentage mean intake of carbohydrate, protein, and energy was decreased in all three study groups compared with controls. The deficiencies were more pronounced in patients with severe than with moderate ALD. These deficiencies were more severe in the group III patients. Whereas body fat stores were maintained in groups I and II, reduction in lean body mass and serum transferrin was significant in patients in groups I and III. In group II patients compared to group I patients, the body mass index (19.9 +/- 4.0 vs. 22.3 +/- 3.4) and triceps skinfold thickness (6.1 +/- 4.8 vs. 10.2 +/- 5.6 mm) were significantly lower. CONCLUSIONS: 1) protein energy malnutrition is common in both alcoholic and nonalcoholic cirrhotics, but is more pronounced in the latter; 2) the degree and profile of malnutrition in chronic alcoholics and in alcoholic cirrhotics are comparable; 3) based on our results, we hypothesize that malnutrition may not play a primary role in the pathogenesis of ALD.     

Reliability and validity of a scale for rating memory impairment in hospitalized amnesiacs.

Investigated the reliability and concurrent validity of an inpatient memory impairment scale (IMIS), a 10-item behavior rating scale for use with hospitalized amnesiac patients, using 13 male and 7 female memory-impaired chronic alcoholic and Korsakoff patients (average age 58.12 yrs). A generalizability analysis revealed that the IMIS had a high degree of internal consistency. When 2 or more raters were used, interrater reliability was also high. Scores on the IMIS correlated .77 with the mean score of 7 practical and experimental cognitive memory tasks, and .86 with the mean score of 3 questionnaires evaluating orientation and memory for recent events. It is concluded that the IMIS has encouraging psychometric characteristics and that behavior ratings can be used to assess degree of amnesiac deficit accurately. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive functioning in alcoholics: The role of subject attrition.

Studied the role of 4 S factors in research on cognitive ability in alcoholics. These factors were S attrition by failure to meet test performance criteria, duration of alcoholism, education, and age. To assess cognitive ability, 2 versions of the Wisconsin Card Sorting Test were used. A total of 60 alcoholic and 37 control male Ss participated. Findings are as follows: (a) Alcoholics had a higher attrition rate than controls (30 vs 3%). (b) The attrition rate was particularly high among alcoholics who were over the age of 45 and had less than 13 yrs of education. (c) Older or less educated alcoholics performed more poorly on the 1st part of the test than did younger or more educated alcoholics. (d) Among controls and alcoholics who completed the entire test, less educated Ss performed more poorly than did more educated Ss. (e) Alcoholics who completed the entire test performed more poorly than did controls. Duration of alcoholism was not related to performance. The importance of S factors, (i.e., S attrition and S selection) in the study of cognitive deficits in alcoholics is emphasized. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal and visuospatial performance in male alcoholics: A test of the premature-aging hypothesis.

Tested the premature-aging hypothesis of generalized dysfunction, using a paired-associate learning test that has separate verbal and visuospatial subtests of the same structure and method. Ss were 36 hospitalized White male chronic alcoholics (mean age 42.4 yrs), 36 control Ss (mean age 42.5 yrs), and 24 elderly Ss (mean age 71.4 yrs). Ss were also administered the Shipley Institute of Living Scale for Measuring Intellectual Impairment and Memory-for-Designs test. Results show that elderly control Ss performed significantly worse than middle-aged control Ss on both learning subtests. For Ss between 30 and 80 yrs of age, increasing age resulted in increasing errors. According to the generalized dysfunction hypothesis, the performance of alcoholics should be similar to that of the elderly, showing impairment compared to control Ss on both learning tests. However, alcoholics performed at the same level as the middle-aged control Ss on verbal learning and were significantly poorer on visuospatial learning. The generalized dysfunction version of the premature-aging hypothesis for performance of alcoholics on neuropsychological tests was not supported. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential improvement of cognitive functions in recovering alcoholic women.

In Study 1, 40 long-term sober alcoholics (mean age 42.15 yrs) performed at or near the level of 40 age-matched short-term sober alcoholics on several perceptuomotor speed tasks, at the level of 70 age-matched nonalcoholic controls on several complex problem-solving measures, and intermediate to the 2 groups on most measures, suggesting a differential improvement in cognitive abilities. In Study 2, the same neuropsychological battery (including the Beck Depression Inventory, Raven Advanced Progressive Matrices Test, and WAIS) was first administered to 25 short-term sober alcoholics and 25 controls and readministered to both groups 1.8 yrs later. Relative to the controls, alcoholics demonstrated deficits over both testings on all abstracting, visual–spatial, and perceptuomotor measures, although they did show a trend toward greater improvement on these tests in the follow-up. Results suggest that posttreatment drinking may be a variable of considerable importance in studies of recovery of cognitive functions in alcoholics. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experience-dependent recovery of visuospatial functioning in older alcoholic persons.

Exposed 2 groups of alcoholic males to verbal and visuospatial paired-associate learning tasks known to be sensitive to alcohol dysfunction. Group 1, with 16 Ss (mean age 52.19 yrs), received 4 task administrations 3–4 days apart, beginning 4 days after drinking stopped. Group 2, with 14 Ss (mean age 49.79 yrs), received identical administration beginning 16 days after drinking stopped. An alternate form of the tasks was administered at the final session to assess transfer of training. Two matched nonalcoholic control groups of 12 Ss each (mean age 50.79 yrs) established normative performance on both forms of the tasks. Although the alcoholic Ss' verbal learning was unimpaired, visuospatial functioning was equally impaired initially in both alcoholic groups despite differing periods of abstinence, indicating the lack of time-dependent recovery. However, practice with the visuospatial task resulted in improved visuospatial performance and positive transfer of training not significantly different from normal Ss. It is suggested that since alcoholism treatment outcome is related to neuropsychological status, rehabilitation of cognitive functioning may improve treatment success. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assertive behavior and perceived discomfort of alcoholics in assertion-required situations.

20 male alcoholics and a matched group of 20 nonalcoholic drinkers (mean ages 50.0 and 49.6 yrs, respectively) were assessed on self-report and behavioral tests of assertive behavior and discomfort. Although there were no group differences in assertive behavior, alcoholics reported more assertive discomfort on both tests. The difference on the behavioral test was due to responses in negative situations. Both groups were less assertive in negative situations and more assertive with familiar males than with familiar females. With unfamiliar persons, however, all Ss were more assertive with females. Findings suggest assertive training with alcoholics should focus on reducing psychological discomfort in assertion-required situations. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frontal lobe dysfunctions in Korsakoff's syndrome and chronic alcoholism: Continuity or discontinuity?

The effect of long-term heavy alcohol consumption on brain functions is still under debate. The authors investigated a sample of 17 Korsakoff amnesics, 23 alcoholics without Korsakoff's syndrome, and 21 controls with peripheral nerve diseases, matched for intelligence and education. Executive functions were examined for word fluency, the modified Wisconsin Card Sorting Test, an alternate response task, and an "n-back" working memory task. Korsakoff amnesics, but not alcoholics, showed a marked memory impairment. They also scored lower in each of the executive tasks--the alcoholics only in the alternate response task. This task also correlated with the years of the alcohol dependency. First, the authors conclude that Korsakoff's syndrome is associated not only with a memory impairment but also with a global executive deficit. Second, the decline in the ability to alternate between different responses argues for a restricted neurotoxic effect of alcohol on some frontal lobe areas (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The premature aging hypothesis: Old before its time?

This study tested the hypothesis that alcoholism results in premature aging of memory functioning. It was proposed that support for the premature aging hypothesis must come from qualitative as well as quantitative similarities between younger alcoholics and older controls. The California Verbal Learning Test (CVLT) was administered to young and old alcoholics and to young and old controls. The CVLT provides measures of recall, recognition, learning strategies, and error types. Alcoholism and aging produced similar levels of immediate and delayed free recall. However, poor recognition memory and more frequent intrusion and false positive errors were associated with alcoholism but not with aging. Qualitative differences in error types between alcoholism and aging were also found. Results indicated that alcoholism and aging produce independent verbal learning decrements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)