Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia.

OBJECTIVES: Among the psychosocial interventions intended to reduce the behavioral and psychological symptoms of dementia (BPSD), doll therapy (DT) is increasingly used in clinical practice. Few studies on DT have been based on empirical data obtained with an adequate procedure; however, none have assessed its efficacy using an active control group, and the scales used to assess changes in BPSD are usually unreliable. The aim of the present study was to measure the impact of DT on people with severe dementia with a reliable, commonly used scale for assessing their BPSD, and the related distress in formal caregivers. Effects of DT on the former's everyday abilities (ie, eating behavior) were also examined. METHOD: Twenty-nine nursing home residents aged from 76 to 96 years old, with severe dementia (Alzheimer's or vascular dementia), took part in the experiment. They were randomly assigned to an experimental group that used dolls or an active control group that used hand warmers with sensory characteristics equivalent to the dolls. Benefits of DT on BPSD and related formal caregiver distress were examined with the Neuropsychiatric Inventory. The effects of DT on eating behavior were examined with the Eating Behavior Scale. RESULTS: Only the DT group showed a reduction in BPSD scores and related caregiver distress. DT did not benefit eating behavior, however. CONCLUSIONS: This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies.

Working memory and updating processes in reading comprehension.

In this study, we examine the relation between reading comprehension ability and success in working memory updating tasks. Groups of poor and good comprehenders, matched for logical reasoning ability, but different in reading comprehension ability, were administered various updating tasks in a series of experiments. In the first experiment, the participants were presented with lists of words, the length of which (4-10 words) was unknown beforehand, and were required to remember the last 4 words in each series. In this task, we found a decrease in performance that was related to longer series and poor reading ability. In the second experiment, we presented lists of nouns referring to items of different sizes, in a task that simulated the selection and updating of relevant information that occurs in the on-line comprehension process. The participants were required to remember a limited, predefined number of the smallest items presented. We found that poor comprehenders not only had a poorer memory, but also made a greater number of intrusion errors. In the third and fourth experiments, memory load (number of items to be selected) and suppression request (number of potentially relevant items) were manipulated within subjects. Increases in both memory load and suppression requests impaired performance. Furthermore, we found that poor comprehenders produced a greater number of intrusion errors, particularly when the suppression request was increased. Finally, in a fifth experiment, a request to specify the size of presented items was introduced. Poor comprehenders were able to select the appropriate items, although their recall was poorer. Altogether, the data show that working memory abilities, based on selecting and updating relevant information and avoiding intrusion errors, are related to reading comprehension.

Working memory in aging: maintenance and suppression.

The present research is focused on a fine-grained analysis of memory decline with aging, and the role of suppression mechanisms in age-related memory decline. Three groups of participants (continuous age ranges; young-old: 55-65 years, old: 66-75 years, and old-old: more than 75 years) were administered Forward and Backward span test, and a Working Memory task with Categorization (WMC). This new task requires lists of five words to be processed in order to individuate animal nouns, and that the last word of each list be contemporarily maintained. The words incorrectly recalled as target items, but presented during the task (intrusion errors), were computed in order to analyze the efficiency of suppression mechanisms. The findings indicated a continuous decline in working memory measures, and an early decline in short-term memory (passive storage) measures (between 60's and 70's). An age-related increase in intrusion errors was observed; the intrusion index was inversely related to working memory performance but, according to the hypotheses, was not related to short-term memory measures. These results suggest that the stronger working memory effect observed through age might be due to the combined influence of a decline in the capacity of short-term memory, and a loss of efficiency in suppression mechanisms.

Increases in intrusion errors and working memory deficit of poor comprehenders.

This study tests the hypothesis that the ability to inhibit already processed and actually irrelevant information could influence performance in the listening span test (Daneman & Carpenter, 1980) and have a crucial role in reading comprehension. In two experiments, the listening span test and a new working memory test were given to two groups of young adults, poor and good comprehenders, matched for logical reasoning ability. In Experiment 1, the poor comprehenders had a significantly lower performance in the listening span test associated to a higher number of intrusions--that is, recalled words that, in spite of being in sentence form, were not placed in the last position. In Experiment 2, a new working memory test was devised in order to analyse more effectively the occurrence of intrusions. Subjects were required to listen to a growing series of strings of animal and non-animal words. While listening, they had to detect when an animal word occurred, and at the end of each series they had to recall the last word of each string. The poor comprehenders obtained a significantly lower performance in the memory task and made a higher number of intrusions, particularly of animal words.

Memory for different kinds of mental images: role of contextual and autobiographic variables.

A set of three experiments analyzed the possibility of distinguishing between different kinds of mental images and their effects in improving memory performance. Single vs contextualized images, impersonal vs autobiographic, autobiographic vs episodic-autobiographic images were compared on recall, generation times, vividness and goodness rates. Results showed that the relational processes offered by contextualized images give better performance than single images, also when they are well-detailed ones (specific images). The longest evocation times and the highest goodness and vividness judgements of episodic-autobiographic images showed the peculiarity of these kind of images that were also better recalled than contextual ones.

Deaf and hard of hearing adolescents' memory for concrete and abstract prose. Effects of relational and distinctive information.

In two experiments, we examined deaf and hard of hearing adolescents' memory for prose as compared to that of hearing students. The study focused on the possibility that deaf and hard of hearing readers might make relatively less use of relational information in textual materials. Text structure and material concreteness were manipulated, and memory for relational and distinctive information was assessed. Results indicated that deaf and hard of hearing students remembered the abstract materials as well as they did the concrete materials. They were less likely than hearing students to remember idea units (concrete or abstract) holistically within passages, but they showed relatively better memory for individual words. This difference disappeared when the same sentences were presented without global paragraph coherence. The findings suggest that deaf and hard of hearing readers may be less likely than hearing readers to integrate text information across idea units, although they may retain as much information from within units.

Bizarreness effect in dream recall.

This study aimed to ascertain a) whether morning reports of dream experience more frequently reproduce bizarre contents of night reports than nonbizarre ones and b) whether this effect depends on the rarity of bizarre contents in the dream or on their richer encoding in memory. Ten subjects were awakened in rapid eye movement (REM) sleep three times per night for 4 nonconsecutive nights and asked to report their previous dream experiences. In the morning they were asked to re-report those dreams. Two separate pairs of judges scored the reports: the former identified the parts in each report with bizarre events, characters or feelings and the latter parsed each report into content units using transformational grammar criteria. By combining the data of the two analyses, content units were classified as bizarre or nonbizarre and, according to whether present in both the night and corresponding morning reports, as semantically equivalent or nonequivalent. The proportion of bizarre contents common to night and morning reports was about twice that of nonbizarre contents and was positively correlated to the quantity of bizarre contents present in the night report. These findings support the view that bizarreness enhances recall of dream contents and that this memory advantage is determined by a richer encoding at the moment of dream generation. Such a view would seem to explain why dreams in everyday life, which are typically remembered after a rather long interval, appear more markedly bizarre than those recalled in the sleep laboratory.

Differences in vividness ratings of perceived and imagined patterns.

The present research focuses on the different subjective experiences evoked by perceived and imagined matrices of letters of the alphabet. In three experiments adult subjects were asked to rate the vividness of a letter included in a matrix of letters which varied due to manipulations in colour, rotation and movement. Subjects were asked to observe (perceptual modality), draw and observe (drawing modality), retrieve (memory modality) or imagine (imagery modality) the matrices. For some manipulations of the critical letter (in particular, 45 degrees inclination and high contrast colour), the perceptual modality produced comparatively higher vividness ratings than the other two modalities. The perceptual effect of inclination was also duplicated with the memory modality group. It is argued that different visual processes, either immediate and pre-attentive, or sequential and attentive, may be operating under voluntary control. Although visual imagery varies in some ways from immediate visual perception, the similarities found, between the drawing and imagery modalities, on the one hand, and the perceptual and memory modalities, on the other hand, suggest that they share some common underlying processes.