Memory Dysfunction in Learning Disorder, Psychopathology, and Social Behavior

Frank Wood
Wake Forest University Baptist Medical Center
Winston-Salem, North Carolina

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 Prerequisites: None

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Course Description:  
Part 1.  Organic memory disorder is the most common false positive diagnosis in neuropsychology, behavioral neurology, and neuropsychiatry.  Accordingly, we review details of clinical memory testing—using verbal and visual tests of structured (narrative or geometric) and rote (list) memory.  In the context of relevant literature including methodological issues, we use the large (N=10,000+) Wake Forest School of Medicine adult and child longitudinal data base to illustrate the severity of the problem: many instances of memory failure—in brain injured as well as in “normal” patients—are secondary to chronic learning disorders or psychopathology. We will adduce “markers,” both within the tests themselves and in the larger context of the patient’s history, that give promise of distinguishing among various etiologies for memory dysfunction.  The goal is to define better methods of child and adult clinical assessment.

Part 2.   Given the empirical findings above, we then switch to theoretical considerations, both cognitive and neuroanatomical.  The episodic-semantic memory distinction will be reviewed for its heuristic value, and compared to other distinctions.  On the one hand, the episodic-semantic distinction appears at present to fit well, whereas the procedural-declarative distinction appears less useful or valid.  Similarly, certain functionally distinct (but overlapping) neuroanatomical systems may also map better to the episodic-semantic distinction,  for example in its resonance to the context-bound (episodic) properties of hippocampal, parahippocampal, and frontal cortical activity, or in its capacity to accommodate the distinct varieties of attentional processes (focal vs. diffuse, distal vs. proximal, etc.) that accompany all types of memory.  On the other hand, our goal is a better theory of memory.     

Part 3.   We then systematically review the types of memory disorder and functional neuroanatomical variation that characterize learning disabilities and psychopathology.   Dyslexia, attention deficit hyperactivity disorder, autism, unipolar and bipolar affective disorder, and the schizophrenia spectrum will be among the specific conditions addressed.  Our perspective is equally clinical (how self-reported and clinician-tested memory deficits can help confirm or disconfirm a diagnosis) and theoretical (what the memory dysfunctions in these syndromes teach us about their underlying functional neuroanatomy).

Part 4.  Memory is a social as well as personal phenomenon.  Given the above studies, we should let their larger view of memory inform our understanding of larger social issues.  We thus will conclude the course by noticing the instances in anthropology, art, literature, law, politics, and history where memory or its failure (equally) can be seen as a central ingredient in human experience, motivating an astonishing range and power of social behaviors.
   Reading List