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Medical Psychology and Sociology: Learning and Memory

Why do you decide in favor of certain actions and behavior over others? Several learning models have been developed in psychology to better understand and explain this behavior. Classical and operant conditioning, learning by self-control, and observational learning are important foundations that form the bases of psychotherapy. In addition to presenting facts about learning, this article discusses topics on memory and language that are relevant to your exam.

Last updated: Aug 13, 2022

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Classical Conditioning: Stimulus Control

The founder of the principle of classical conditioning, Ivan Pavlov (1849–1936), discovered the reaction-stimulus chain, which is the so-called respondent model. He combined the action of feeding dogs with the sound of a bell and discovered that eventually, the dogs salivated merely by hearing the bell, even without the sight of food.

The originally unconditioned stimulus (food) that led to an unconditioned reaction (salivation) was combined with a neutral impulse (sound of the bell). Over time, this neutral impulse triggered an unconditioned reaction and gradually became the conditioned stimulus.

A conditioned reaction can also be deleted (become extinct) by leaving out the conditioned impulse. The deleted reaction can reappear if the impulse is reintroduced; however, the reaction would be in a milder form (spontaneous recovery).

If similar impulses have the same reaction, they can be referred to as stimulus generalization. However, the term stimulus discrimination is reserved for when similar impulses can be distinguished.

Table: Classical conditioning
Factors affecting classical conditioning
Neutral stimulus Unconditioned stimulus Unconditioned response Conditioned stimulus Conditioned response
Initially, does not elicit an intrinsic response Will elicit an unconditioned response Not learned, more biological Originally neutral stimulus that is paired with an unconditioned stimulus Learned response to the conditioned stimulus
Conditioning

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Classical conditioning includes the following steps:

  • Discrimination: when the conditioned stimulus is differentiated from other stimuli
  • Generalization: when a stimulus other than the original conditioned stimulus elicits a conditioned response
  • Acquisition: the process of learning the conditioned response
  • Extinction Extinction The procedure of presenting the conditioned stimulus without reinforcement to an organism previously conditioned. It refers also to the diminution of a conditioned response resulting from this procedure. Psychotherapy: occurs when the conditioned and unconditioned stimuli are no longer paired
  • Spontaneous recovery: occurs when an extinct conditioned response reappears when the conditioned stimulus is reintroduced
Classical conditioning

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CR: conditioned response
CS: conditioned stimulus
US: unconditioned stimulus

Operant Conditioning: Trial and Error

The American psychologist B.F. Skinner (1904–1990) is inevitably associated with the term operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy. In operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy, organisms associate their own actions with consequences. An action followed by a positive reinforcer (reward) increases that action, whereas an action followed by punishment tends to decrease the frequency of that action. Behavior that operates on the environment to produce rewarding or punishing stimuli is called operant behavior. During the acquisition of stimulus-reaction patterns, the question is: How do we adjust our originally spontaneous behavior through reward and punishment?

The following terms are important in operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy:

  • Positive reinforcement Positive reinforcement Psychotherapy: The probability Probability Probability is a mathematical tool used to study randomness and provide predictions about the likelihood of something happening. There are several basic rules of probability that can be used to help determine the probability of multiple events happening together, separately, or sequentially. Basics of Probability of a certain behavior occurring increases through positive reinforcement Positive reinforcement Psychotherapy.
  • Negative reinforcement Negative reinforcement Psychotherapy: Discontinuation of negative impulses also leads to an increase in incidents.
  • Reinforcement: consequences of positive or negative behavior

Warning:

  • Reinforcement: increase in behavior regardless of positive or negative reinforcement Negative reinforcement Psychotherapy
  • Positive and negative are not judgmental.
  • Positive: adding consequences
  • Negative: removing consequences

Skinner box: an experimental setup with a fixed lever used for animal studies. If the lever is pushed, the rat is rewarded with a food pill for its behavior. The behavior of the rat (pushing down the lever) is reinforced; thus, the action is executed more often. If the rat receives a painful stimulus after pushing the lever, it will soon stop the behavior.

Differentiation of positive and negative reinforcement Negative reinforcement Psychotherapy versus punishment

Table: The behavioral consequence will be …
… added … removed
Positive reinforcement Positive reinforcement Psychotherapy Positive strengthening (behavior increases) Punishment (behavior decreases)
Negative reinforcement Negative reinforcement Psychotherapy Punishment (behavior decreases) Negative strengthening (behavior increases)
Reinforcement

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Table: Escape Escape With constant immune mechanisms holding unstable tumor cells in equilibrium, tumor-cell variants may emerge. These cancer cells may express fewer antigens on their surfaces or lose their MHC class I expression.Variants may also protect themselves from T-cell attack via expression of IC molecules on their surfaces, like normal cells.Creation of an immunosuppressive state in the microenvironment is another way to grow without immunologic interference. Cancer Immunotherapy and avoidance learning
Escape Escape With constant immune mechanisms holding unstable tumor cells in equilibrium, tumor-cell variants may emerge. These cancer cells may express fewer antigens on their surfaces or lose their MHC class I expression.Variants may also protect themselves from T-cell attack via expression of IC molecules on their surfaces, like normal cells.Creation of an immunosuppressive state in the microenvironment is another way to grow without immunologic interference. Cancer Immunotherapy Avoidance
Learning how to avoid an aversive stimulus by engaging in a particular behavior Performing a behavior to ensure that the aversive stimulus is not encountered

More important terms and examples of operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy

Table: More important terms and examples of operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy
Term Definition Example
Primary reinforcement Satisfaction of primary needs Food, sleep Sleep A readily reversible suspension of sensorimotor interaction with the environment, usually associated with recumbency and immobility. Physiology of Sleep, rest
Secondary reinforcement Linking to primary reinforcement (social, material) Praise, admiration, money
Emitted behavior Spontaneously occurring behavior that can be reinforced Dog lifts its paw, gets rewarded, and repeats the behavior.
Prompting Cue through initiating behavior externally Learning a language
Fading Gradual fading out of prompts throughout the conditioning process A teacher gives tips to get the right answer and gradually reduces the number of tips during the process.
Shaping Stepwise acquisition of complex behaviors by rewarding the consequences A toddler learning to tie his shoelaces
Chaining Learning complex chains of behavior; usually, the last element is reinforced 1st Brushing teeth Teeth Normally, an adult has 32 teeth: 16 maxillary and 16 mandibular. These teeth are divided into 4 quadrants with 8 teeth each. Each quadrant consists of 2 incisors (dentes incisivi), 1 canine (dens caninus), 2 premolars (dentes premolares), and 3 molars (dentes molares). Teeth are composed of enamel, dentin, and dental cement. Teeth: Anatomy: toothpaste on the brush, clean various areas, gargle, use dental floss
Premack principle Linking a less favorable activity with a popular one “First, you have to eat the salad; then, you’ll get dessert!”

Reinforcement plans

Reinforcement plans are consistent relations between behavior and consequence that result in contingency.

High contingency is a given when almost every behavior results in a consequence. However, low contingency is expected when consequences follow only occasionally. Continuous reinforcement means that every single desired behavior is strengthened. Intermittent reinforcement means that only a certain number of all desired behavior is strengthened. A distinction is drawn between ratio plans and interval plans as tabulated below.

Table: Reinforcement plans
Fixed ratio plans Consequence after a fixed rate, e.g., every 3rd time
Variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables ratio plans Consequence after a variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables rate, e.g., after the 2nd, then the 5th, then the 10th time
Fixed interval plans Consequence after a fixed time interval, e.g., every 5 minutes
Variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables interval plans Consequence after a variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables time interval, e.g., after 5 minutes, then after 10 minutes, and then after 15 minutes

Important: While continuous reinforcement leads to the rapid learning of a behavior, behaviors are more resistant to erasure if reinforcement occurs intermittently and with a variable-ratio schedule (this may help explain the addictive-type behavior of gamblers).

Learning by Understanding: Cognitive Learning

While learning by understanding, we come to a solution by understanding the circumstances. Hence, an individual arrives at a solution through pure reflection and not through an outward visible and observable experience. The “lightbulb moment” falls in this category of learning by understanding: A sudden flash of inspiration Inspiration Ventilation: Mechanics of Breathing leads to understanding and solution-oriented behavior. This approach can be extrapolated to other situations (e.g., a mathematics problem).

Model-based Learning: Observational Learning

Note: Observational learning is a type of cognitive learning and is also known as social learning or vicarious learning.

Behavior is learned with potentially positive or negative consequences using a model. Other people are observed and their behavior is imitated and learned accordingly. Consequently, there is neither reinforcement nor consequence for the observer.

Many pro- and antisocial behaviors become conceivable through observational learning.

Examples:

  • Fear of spiders or mice conveyed through media or social environment (parents, siblings)
  • Xenophobia
  • Cooperativeness

Biological processes that affect observational learning

Mirror neurons Neurons The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. Nervous System: Histology are found in several regions of the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification, including:

  • The premotor cortex
  • The primary somatosensory cortex Somatosensory cortex Area of the parietal lobe concerned with receiving sensations such as movement, pain, pressure, position, temperature, touch, and vibration. It lies posterior to the central sulcus. Cerebral Cortex: Anatomy
  • The inferior parietal Parietal One of a pair of irregularly shaped quadrilateral bones situated between the frontal bone and occipital bone, which together form the sides of the cranium. Skull: Anatomy cortex

These neurons Neurons The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. Nervous System: Histology fire when a task is performed and/or when that same task is observed. They help us understand the actions of others and assist in learning through imitation. They are also potentially responsible for the learning of vicarious emotions such as empathy Empathy An individual’s objective and insightful awareness of the feelings and behavior of another person. It should be distinguished from sympathy, which is usually nonobjective and noncritical. It includes caring, which is the demonstration of an awareness of and a concern for the good of others. Psychotherapy.

Learning by Self-control

Behaviors are learned by initial model-based learning and operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy. We create our expectation patterns for ourselves accordingly. The intrinsic factors of self-control, self-criticism, and self-confirmation now replace outside reinforcement and punishment.

Example: A child is taught that leisure activities can only be enjoyed after achieving something. As adults, these individuals take a break only when their self-imposed work plans for the day are met MET Preoperative Care.

Habituation, Dehabituation, and Sensitization

Table: Habituation, dehabituation, and sensitization
Habituation Adaptation to a recurrent impulse: The intensity of reaction decreases with repetition (though no habituation to pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways). Contact lenses, tactile impulses of clothing
Dehabituation “Weaning from habituation”: recurrence of the reaction after habituation through an interspersed, different impulse If the permanent siren sound of an ambulance suddenly changes, we notice the already faded out sound again.
Sensitization Opposite of habituation: an increase in reaction intensity, which increases with repetition

Theories of Attitude and Behavior Change

The elaboration likelihood model is a dual-process theory describing changes in attitude and behavior.

Table: Key elements of persuasiveness
Message characteristics Source characteristics Target characteristics
Logic and number of key points, length, and grammatical complexity Level of expertise, knowledge, and trustworthiness Self-esteem, intelligence, and mood (of the individual receiving the message)

Elaboration likelihood model

The model proposes 2 major routes for persuasion:

  • Central route: People are persuaded by the content of the argument.
  • Peripheral route: focuses on superficial or secondary characteristics

Individuals will choose the central route only when they are both motivated and not distracted. Processing via the central route will have longer-lasting persuasion compared with that via the peripheral route.

Social-cognitive theory

The social-cognitive theory incorporates elements of cognition, learning, and social influence. It is a theory of behavioral change that emphasizes the interaction between people and their environment. Social factors, observational learning, and environmental factors can influence attitude change.

Reciprocal determination is an interaction between an individual’s behavior, personal factors, and the environment (situational factors). The 3 ways in which individuals and environments interact are as follows:

  • Individuals choose their environment, which, in turn, shapes them (i.e., neighborhood, campus).
  • Personality shapes how individuals interpret and respond to their environment.
  • The individual’s personality influences the situation to which they react to.

Clinical Reference: Application of Learning Models in Therapies

Step 1: Development of fear

Behavior therapy is used especially in the case of anxiety Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with anxiety disorders. Generalized Anxiety Disorder disorders ( phobia Phobia A phobia can be defined as an irrational fear that results in avoidance of the feared subject, activity, or situation. Social Anxiety Disorder). Classical conditioning processes play a major role in the development of fear, whereas sustainability is achieved by operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy. The linking of stimulus and reaction (such as the fear of black cars winding up in an accident) can be prevented for years by avoiding the anxiety-inducing stimulus.

Step 2: Analysis of behavior

A therapist will create an analysis of behavior using the “SORCC model,” e.g., the fear of black cars.

  • S: stimulus: the sight of a black car
  • O: organism: negative experience with a black car in childhood
  • R: reaction: strong anxiety Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with anxiety disorders. Generalized Anxiety Disorder, avoidance, and stimulus control
  • C: contingency: the power of the connection between R and C
  • C: consequence: easing of fear through avoidance ( negative reinforcement Negative reinforcement Psychotherapy). Behavior modification may be initiated if the therapist makes a clear diagnosis with regard to the circumstances leading to a particular fear. Erasing of fear can be achieved if the affected individual confronts the object that causes fear and recognizes that it does not pose any danger. To this end, confrontation therapies are used.

Step 3: Confrontation procedure

Systematic desensitization Systematic desensitization A behavior therapy technique in which deep muscle relaxation is used to inhibit the effects of graded anxiety-evoking stimuli. Psychotherapy

Systematic desensitization Systematic desensitization A behavior therapy technique in which deep muscle relaxation is used to inhibit the effects of graded anxiety-evoking stimuli. Psychotherapy describes a procedure in the following 3 steps:

  • Relaxation training: learning to consciously relax in situations of fear, e.g., by using the progressive muscle-relaxation technique (devised by Jacobson)
  • Fear hierarchy: ranking situations depending on the threat level
  • Confrontation in situ or in vivo: In a relaxed condition, the individual is presented with confrontational situations at various levels of the fear hierarchy until they can stay relaxed while being confronted with the object of fear at the highest level.

Flooding Flooding Psychotherapy

Stimulus saturation is not a stepwise process. It involves a sudden, intense confrontation with the object/situation of fear. Flooding Flooding Psychotherapy proves to the afflicted individual that no real danger can be caused by the stimulus.

Cognition

Cognition is perceived (Latin. cognoscere = experience, recognize) as a complex comprising perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment, consciousness, thinking, recognition, and memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment.

Attention Attention Focusing on certain aspects of current experience to the exclusion of others. It is the act of heeding or taking notice or concentrating. Psychiatric Assessment and perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment

Attention Attention Focusing on certain aspects of current experience to the exclusion of others. It is the act of heeding or taking notice or concentrating. Psychiatric Assessment: heightened vigilance and selective focus of perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment, thinking, and action = condition of intense consciousness

Perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment: We gain information about the outer and inner worlds through perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment. Exteroception is the term for the perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment of the environment through the senses, whereas interoception refers to the inner perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment of physiological processes.

Perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment can be selective, strengthened, subliminal, or impaired. Perception Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Psychiatric Assessment disorders include the following:

  • Agnosia: Sensory Sensory Neurons which conduct nerve impulses to the central nervous system. Nervous System: Histology organs are intact; however, the individual is unable to perceive objects (e.g., an apple is described as a round red thing).
  • Prosopagnosia: the inability to recognize faces

Memory

A classic model used to describe the human memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment system is the information-processing model, which is similar to the functions of a computer. To remember any event, we must do the following 3 things:

  • Encode information into our brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification
  • Retain that information in storage
  • Retrieve that information (“retrieval”)

Like any other model, the information-processing model is useful but has some limitations Limitations Conflict of Interest. We are capable of parallel processing, and the model of connectionism considers memories as derivations or products of interconnected neural networks. Every time we learn something new or recall a stored memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment, we create new neural connections that strengthen the neural pathways.

The process of memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment formation has been explained by another classic, although imperfect, 3-stage model:

  1. Information to be remembered is 1st recorded as a fleeting sensory memory (also called “ultra short–term memory”): Visual impulses of the environment are saved in the iconographic memory for 1 second and auditory information in the echoic memory for 2 seconds.
  2. After this 1st stage, the information is processed into short-term memory, also known as working memory,” where it is encoded by rehearsal. This is not just a temporary stage; it is subject to considerable active processing to make sense of the input and link to older memories. In short-term memory, 7 + 2 elements can be retained for up to 20 seconds by most individuals.
  3. Finally, the information moves into long-term memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment for later retrieval. Some information can reach this final stage directly by automatic processing during sensory Sensory Neurons which conduct nerve impulses to the central nervous system. Nervous System: Histology memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment stage. Long-term memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment can be retained for minutes to years.

Episodic memory Episodic memory Type of declarative memory, consisting of personal memory in contrast to general knowledge. Dissociative Amnesia is defined as the ability to recall and mentally re-experience specific episodes from the past.

Semantic memory Semantic memory Memory of facts, concepts, objects, words, and definitions. Dissociative Amnesia is the memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment for generic, context-free knowledge.

Amnesia and memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment disorders

Table: The most important forms of amnesia
Anterograde amnesia Anterograde amnesia Loss of the ability to form new memories beyond a certain point in time. This condition may be organic or psychogenic in origin. Organically induced anterograde amnesia may follow craniocerebral trauma; seizures; anoxia; and other conditions which adversely affect neural structures associated with memory formation (e.g., the hippocampus; fornix (brain); mammillary bodies; and anterior thalamic nuclei). Wernicke Encephalopathy and Korsakoff Syndrome A type of memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment loss in which new memories cannot be formed. If severe, the ability to learn or retain any new information is permanently lost.
Retrograde amnesia Retrograde amnesia Loss of the ability to recall information that had been previously encoded in memory prior to a specified or approximate point in time. This process may be organic or psychogenic in origin. Organic forms may be associated with craniocerebral trauma; cerebrovascular accidents; seizures; dementia; and a wide variety of other conditions that impair cerebral function. Wernicke Encephalopathy and Korsakoff Syndrome A type of amnesia in which memories formed before the event that caused the amnesia cannot be recalled. It usually affects recently stored memories, and not memories from years ago.
Dissociative amnesia Dissociative amnesia Dissociative amnesia is a dissociative disorder characterized by temporary memory gaps in response to stressful events. Dissociative amnesia can be subclassified as generalized versus localized or continuous versus systematized. Dissociative Amnesia Occurs when an individual blocks out certain information, e.g., information associated with a stressful or traumatic event Traumatic event An emotionally painful, shocking, stressful, and sometimes life-threatening experience. It can result from witnessing distressing events such as natural disasters, physical or sexual abuse, and terrorism or other acts of violence. Posttraumatic Stress Disorder (PTSD), such that they are unable to remember important personal information. There are gaps in memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment for prolonged periods of time, or memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment gaps involving the traumatic event Traumatic event An emotionally painful, shocking, stressful, and sometimes life-threatening experience. It can result from witnessing distressing events such as natural disasters, physical or sexual abuse, and terrorism or other acts of violence. Posttraumatic Stress Disorder (PTSD).

Most important memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment disorders

  • Korsakoff syndrome Korsakoff syndrome An acquired cognitive disorder characterized by inattentiveness and the inability to form short term memories. This disorder is frequently associated with chronic alcoholism; but it may also result from dietary deficiencies; craniocerebral trauma; neoplasms; cerebrovascular disorders; encephalitis; epilepsy; and other conditions. Wernicke Encephalopathy and Korsakoff Syndrome (Korsakoff amnesic syndrome): a memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment disorder resulting from vitamin B1 Vitamin B1 Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals Water-soluble Vitamins and their Deficiencies ( thiamine Thiamine Also known as thiamine or thiamin, it is a vitamin C12H17N4OSCl of the vitamin B complex that is essential to normal metabolism and nerve function and is widespread in plants and animals Water-soluble Vitamins and their Deficiencies) deficiency mostly caused by chronic alcohol abuse. Korsakoff syndrome Korsakoff syndrome An acquired cognitive disorder characterized by inattentiveness and the inability to form short term memories. This disorder is frequently associated with chronic alcoholism; but it may also result from dietary deficiencies; craniocerebral trauma; neoplasms; cerebrovascular disorders; encephalitis; epilepsy; and other conditions. Wernicke Encephalopathy and Korsakoff Syndrome damages nerve cells and supporting cells in the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification and spinal cord Spinal cord The spinal cord is the major conduction pathway connecting the brain to the body; it is part of the CNS. In cross section, the spinal cord is divided into an H-shaped area of gray matter (consisting of synapsing neuronal cell bodies) and a surrounding area of white matter (consisting of ascending and descending tracts of myelinated axons). Spinal Cord: Anatomy, as well as the part of the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification involved with memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment. It is a persistent amnesic disorder characterized by confusion, neurologic abnormalities, and confabulation Confabulation Memory fabrication to make up for memory lapses Wernicke Encephalopathy and Korsakoff Syndrome ( memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment gaps are rerecorded with imaginary stories).
  • Dementia Dementia Major neurocognitive disorders (NCD), also known as dementia, are a group of diseases characterized by decline in a person’s memory and executive function. These disorders are progressive and persistent diseases that are the leading cause of disability among elderly people worldwide. Major Neurocognitive Disorders: loss of cognitive brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification functions, including memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment. Reasons for dementia Dementia Major neurocognitive disorders (NCD), also known as dementia, are a group of diseases characterized by decline in a person’s memory and executive function. These disorders are progressive and persistent diseases that are the leading cause of disability among elderly people worldwide. Major Neurocognitive Disorders can be alcohol use disorder Alcohol use disorder Alcohol is one of the most commonly used addictive substances in the world. Alcohol use disorder (AUD) is defined as pathologic consumption of alcohol leading to impaired daily functioning. Acute alcohol intoxication presents with impairment in speech and motor functions and can be managed in most cases with supportive care. Alcohol Use Disorder, drug abuse, or brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification lesions (as in the case of strokes). Most cases of dementia Dementia Major neurocognitive disorders (NCD), also known as dementia, are a group of diseases characterized by decline in a person’s memory and executive function. These disorders are progressive and persistent diseases that are the leading cause of disability among elderly people worldwide. Major Neurocognitive Disorders are caused by Alzheimer disease Alzheimer disease As the most common cause of dementia, Alzheimer disease affects not only many individuals but also their families. Alzheimer disease is a progressive neurodegenerative disease that causes brain atrophy and presents with a decline in memory, cognition, and social skills. Alzheimer Disease.
  • Perseveration Perseveration Neurological Examination: persistence of certain memory Memory Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. Psychiatric Assessment contents, thought repetitions, and language contents (reasons: fatigue Fatigue The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. Fibromyalgia, drugs, organic degenerative conditions)

Speech and Language

Language and speech are used for interpersonal communication Communication The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups. Decision-making Capacity and Legal Competence of thoughts, desires, and feelings. The Broca and Wernicke areas in the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification are responsible for language generation and speech comprehension, respectively. Central aphasia Aphasia A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. Ischemic Stroke is a speech disorder. Both speech comprehension and language production are impaired in global aphasia Aphasia A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. Ischemic Stroke.

Table: Broca area and Wernicke area
Function Affected area of the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification Type of aphasia Aphasia A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. Ischemic Stroke
Broca area Language production (speaking) Frontal Frontal The bone that forms the frontal aspect of the skull. Its flat part forms the forehead, articulating inferiorly with the nasal bone and the cheek bone on each side of the face. Skull: Anatomy convolutions of the dominant hemisphere (on the left side for right-handed individuals) Motor Motor Neurons which send impulses peripherally to activate muscles or secretory cells. Nervous System: Histology, expressive aphasia Expressive aphasia An aphasia characterized by impairment of expressive language (speech, writing, signs) and relative preservation of receptive language abilities (i.e., comprehension). This condition is caused by lesions of the motor association cortex in the frontal lobe (broca area and adjacent cortical and white matter regions). Geriatric Changes (Speech comprehension is intact; familiar songs can be sung.)
Wernicke area Speech comprehension Usually involves the posterior region of the superior temporal gyrus of the dominant hemisphere, but may also extend into the adjacent parietal lobe Parietal lobe Upper central part of the cerebral hemisphere. It is located posterior to central sulcus, anterior to the occipital lobe, and superior to the temporal lobes. Cerebral Cortex: Anatomy Sensory Sensory Neurons which conduct nerve impulses to the central nervous system. Nervous System: Histology, recipient aphasia Aphasia A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. Ischemic Stroke (impaired speech comprehension)
Broca's and wernicke's areas

Image: “Figure 1” by Phil Schatz. License: CC BY 4.0

Theories of language development

Language acquisition is the process by which children learn to understand and speak their native language. Theories used to explain language development include the following:

  • Nativist theory
  • Empiricist theory
  • Behaviorist theory

Nativist theory by Noam Chomsky

  • The nativist theory suggests that all children have an innate language activation device (LAD).
  • LAD is an area of the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification that has a set of universal syntactic rules for all languages.
  • The idea was later renamed universal grammar; however, other researchers realized that children learn grammar as they listen to the patterns of speech they hear.
  • LAD provides children the ability to construct novel sentences using learned vocabulary.
  • Linguistic input alone is insufficient to explain how a language is learned.
  • Certain rules must be innate in the brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification (i.e., nouns, verbs, adjectives).

Empiricist

  • General brain Brain The part of central nervous system that is contained within the skull (cranium). Arising from the neural tube, the embryonic brain is comprised of three major parts including prosencephalon (the forebrain); mesencephalon (the midbrain); and rhombencephalon (the hindbrain). The developed brain consists of cerebrum; cerebellum; and other structures in the brain stem. Nervous System: Anatomy, Structure, and Classification processes are sufficient for language acquisition; LAD is not needed.
  • The child needs to be actively engaged in the environment.
  • Parents or caregivers will interact using child-directed speech.

Behaviorist theory by B.F. Skinner

  • Suggests language acquisition through operant conditioning Operant conditioning Learning situations in which the sequence responses of the subject are instrumental in producing reinforcement. When the correct response occurs, which involves the selection from among a repertoire of responses, the subject is immediately reinforced. Psychotherapy
  • Uses positive reinforcement Positive reinforcement Psychotherapy when imitating stimuli and correct responses

Positive reinforcement Positive reinforcement Psychotherapy accomplishes the following:

  • Conditions infants to associate a sound with a stimulus
  • Encourages imitative behavior
Table: Summary of language development
Month (approximate) Stage
4 Babbles speech sounds (“ah-goo”)
10 Babbling resembles household language (“ma-ma”)
12 One-word speech (“Kitty!”)
24 Two-word speech (“Get ball”)
24+ Rapidly starts to speak complete sentences

References

  1. No authorship indicated. (2003). Journal of Experimental Psychology: Learning, Memory, and Cognition: Editor. Journal of Experimental Psychology: Learning, Memory, and Cognition, 29(3), C2-C2. doi:10.1037/0278-7393.29.3.c2
  2. Shimazu K. (2006). NT-3 facilitates hippocampal plasticity and learning and memory by regulating neurogenesis. Learning & Memory, 13(3), 307-315. doi:10.1101/lm.76006
  3. Smythies JR. (1966). The neurological foundations of psychiatry: an outline of the mechanisms of emotion, memory, learning and the organization of behavior, with particular regard to the limbic system. Oxford: Blackwell.
  4. Twining K, Staveley-Taylor H, Latham J, Newman K. Films for the Humanities & Sciences (Firm), Films Media Group, &Uniview Worldwide. (2005). Memory. New York, NY: Films Media Group.

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