Using the Process Dissociation Procedure: The Meaning and Value of Comparable Base Rates

There is abundant evidence that memory impairment in dementia in patients with Alzheimer’s disease (AD) is related to explicit, conscious forms of memory, whereas implicit, unconscious forms of memory function remain relatively intact or are less severely affected. Only a few studies have been performed on spatial memory function in AD, showing that AD patients’ explicit spatial memory is impaired, possibly related to hippocampal dysfunction. However, studies on implicit spatial memory in AD are lacking. The current study set out to investigate implicit and explicit spatial memory in AD patients (n = 18) using an ecologically valid computer task, in which participants had to remember the locations of various objects in common rooms. The contribution of implicit and explicit memory functions was estimated by means of the process dissociation procedure. The results show that explicit spatial memory is impaired in AD patients compared with a control group (n = 21). However, no group difference was found on implicit spatial function. This indicates that spared implicit memory in AD extends to the spatial domain, while the explicit spatial memory function deteriorates. Clinically, this finding might be relevant, in that an intact implicit memory function might be helpful in overcoming problems in explicit processing.

Conscious recall and implicit memory have been shown to depend on hypnotic state as measured by electroencephalographic (EEG) bispectral index (BIS). A third expression of memory (unconscious-controlled memory) was recently observed after moderate to light sedation (BIS, 70-80). The present study investigated memory function during deep sedation (BIS, 60-70). As memory effects are small, the authors studied potential predictors of individual differences in memory performance. Memory function and speed of information processing were assessed in 56 outpatients before surgery. During propofol anesthesia supplemented with alfentanil, patients heard a series of words while anesthesia was titrated to BIS, 60-70. In between words, response to command was assessed using the Isolated Forearm Technique. The authors tested memory with a word stem completion task and process dissociation procedure to distinguish explicit from implicit effects. Mean (+/- SD) BIS during word presentation was 64.0 +/- 3. Patients with conscious recall of verbal commands (n = 9) did not recall or recognize presented words. Even so, the process dissociation procedure revealed evidence of memory by a significantly higher hit rate in the inclusion condition (0.26) than in the exclusion condition (0.12). Patients without conscious recall showed no evidence of memory for presented words. Hit scores correlated significantly with scores in the preoperative memory test (r = 0.35). The authors found evidence of weak explicit memory function during anesthesia titrated to BIS, 60-70. The observations strongly suggest that postoperative memory relates to awareness during anesthesia, but the nature of this relation remains unclear. Memory seems more likely in patients with good preoperative memory performance.

In the absence of explicit memories such as the recall and recognition of intraoperative events, memory of auditory information played during general anesthesia has been demonstrated with several tests of implicit memory. In contrast to explicit memory, which requires conscious recollection, implicit memory does not require recollection of previous experiences and is evidenced by a priming effect on task performance. The authors evaluated the effect of a standardized anesthetic technique on implicit memory, first using a word stem completion task, and then a reading speed task in a subsequent study. While undergoing lumbar disc surgery, 60 patients were exposed to auditory materials via headphones in two successive experiments. A balanced intravenous technique with propofol and alfentanil infusions and a nitrous oxide-oxygen mixture was used to maintain adequate anesthesia. In the first experiment, 30 patients were exposed randomly to one of the two lists of 34 repeated German nouns; in the second experiment, 30 patients were exposed to one of two tapes containing two short stories. Thirty control patients for each experiment heard the tapes without receiving anesthesia. All patients were tested for implicit memory 6-8 h later: A word stem completion task for the words and a reading speed task for the stories were used as measures of implicit memory. The control group completed the word stems significantly more often with the words that they had heard previously, but no such effect was found in the anesthetized group. However, both the control and patient groups showed a decreased reading time of about 40 ms per word for the previously presented stories compared with the new stories. The patients had no explicit memory of intraoperative events. Implicit memory was demonstrated after anesthesia by the reading speed task but not by the word stem completion task. Some methodologic aspects, such as using low frequency words or varying study and test modalities, may account for the negative results of the word stem completion task. Another explanation is that anesthesia with propofol, alfentanil, and nitrous oxide suppressed the word priming but not the reading speed measure of implicit memory. The reading speed paradigm seems to provide a stable and reliable measurement of implicit memory.

Implicit and explicit memory bias in anxiety: A conceptual replication

Encoding and retrieval are two important phases of memory.Encoding produces memory engraved and retrieval reactivates previously encoded information.The approach to the relationship between encoding and retrieval is meaningful for the better understanding of the nature of memory.As for explicit memory,the relation of encoding and retrieval has been investigated by many researchers who have found out that the performance of a secondary task during encoding reduced the later memory performance,but the division of the attention in the same way during retrieval had virtually no effect on memory performance,which indicated an asymmetry between encoding and retrieval processes.With respect to implicit memory,an asymmetry was also found in one of our previous studies(Meng Guo,2006),but the asymmetry is somewhat different from that in explicit memory,that is,the performance of a concurrent task during encoding had no effect on later task performance,but interference during retrieval disrupted priming,and reduced task performance.In order to clarify the issues we conducted an ERP experiment.The experiment was conducted with 16 undergraduate students as subjects and Chinese characters as stimuli.The experiment adopted a study-to-test paradigm,in which participants performed a "shallow"(color) study task or a "deep"(pleasant) study task,followed by either a lexical decision(implicit) test(section 1) or a recognition(explicit) test(section 2).In interference task participants were asked to account the total number of "+" in a regulated orientation which appeared with a word,and was performed concurrently with either the encoding or the retrieval phase of the memory task for encoding interference condition or retrieval interference condition.The results showed that:(1) the effects of interference to encoding in implicit memory test were different from that to retrieval.Interference during encoding had virtually no effect on N400 or P600 old/new ERP components,but interference during retrieval significantly reduced N400 old/new and P600 old/new components,which abolished behavior priming.(2) The effects of interference to encoding on ERP components in explicit memory test were different from that to retrieval.Interference during encoding had significant influence on later P600 old/new effect,but interference during retrieval did not produce such effect.The results confirmed the finding of Meng Guo(2006),that is,interference during encoding had effect on explicit memory,but left implicit memory intact.Interference during retrieval affected implicit memory,but had little effect on explicit memory.So the relationship between encoding and retrieval was different between implicit and explicit memory,thus providing further evidence on the dissociation between implicit and explicit memory.

Although patients with Alzheimer dementia (AD) have impaired explicit memory, more automatic, implicit aspects of learning and memory may be relatively preserved. However, neuropsychological tests for the assessment of implicit memory are lacking. This study examines a newly developed test, the Implicit Memory Test, in 28 patients with severe AD (mini-mental state examination 5 to 12) and 22 cognitively unimpaired matched controls (mini-mental state examination 25 to 29). The Implicit Memory Test consists of visually presented word (stem-completion) and picture (fragmented picture identification) subtests, each comprising 3 learning trials and a delayed test. Explicit memory was also assessed, using the verbal paired-associate learning subtest from the Wechsler Memory Scale and the Visual Association Test. Patients with AD obtained a floor performance on both explicit memory tests, whereas a significant learning curve was found for both the stem-completion and the fragmented pictures subtests of the Implicit Memory Test. Delayed testing on the fragmented pictures subtest showed a preserved performance that may have been mediated by implicit learning. Delayed performance on the stem-completion subtest, however, showed clear memory decay that suggests contamination by explicit memory function, at least in the controls. These findings extend the earlier results on word-stem completion and fragmented picture identification in patients with mild-to-moderate AD and indicate that residual learning capacity can be assessed in severe AD.

Background and objectives: Implicit (unconscious) and explicit (conscious) memory associations with drugs have been examined primarily using verbal cues. However, drug seeking, drug use behaviors, and relapse in chronic cocaine and other drug users are frequently triggered by viewing substance-related visual cues in the environment. We thus examined implicit and explicit memory for drug picture cues to understand the relative extent to which conscious and unconscious memory facilitation of visual drug cues occurs during cocaine dependence. Methods: Memory for drug-related and neutral picture cues was assessed in 14 inpatient cocaine-dependent polydrug users and a comparison group of 21 young adults with limited drug experience (n = 35). Participants completed picture cue exposure, free recall and recognition tasks to assess explicit memory, and a repetition priming task to assess implicit memory. Results: Drug cues, compared to neutral cues, were better explicitly recalled and implicitly primed, and especially so in the cocaine group. In contrast, neutral cues were better explicitly recognized, and especially in the control group. Conclusion: Certain forms of explicit and implicit memory for drug cues were enhanced in cocaine users compared to controls when memory was tested a short time following cue exposure. Enhanced unconscious memory processing of drug cues in chronic cocaine users may be a behavioral manifestation of heightened drug cue salience that supports drug seeking and taking. There may be value in expanding intervention techniques to utilize cocaine users’ implicit memory system.

Perceptual identification task points to continuity between implicit memory and recall

The author introduces implicit (versus explicit) memory to examine advertising effects on brand choice. Whereas explicit memory is demonstrated by the conscious recollection of an event, implicit memory is inferred by an improvement in some task performance as the result of having experienced the event. This research shows that memory-based choice benefits from advertising that enhances conceptually driven implicit memory whereas stimulus-based choice benefits from advertising that enhances perceptually driven implicit memory. The findings provide evidence that the two types of implicit memory and explicit memory are distinct constructs of memory; the findings also suggest that implicit memory measures may be more useful indicators of advertising effectiveness than explicit memory measures.

It is well documented that explicit (declarative, conscious) memory declines in normal aging. Studies have shown a progressive reduction in this form of memory with age, and healthy older adults (typically aged 65+ years) usually perform worse than younger adults (typically aged 18–30 years) on laboratory tests of explicit memory such as recall and recognition. In contrast, it is less clear whether implicit (procedural, unconscious) memory declines or remains stable in normal aging. Implicit memory is evident when previous experiences affect (e.g., facilitate) performance on tasks that do not require conscious recollection of those experiences. This can manifest in rehearsed motor skills, such as playing a musical instrument, but is typically indexed in the laboratory by the greater ease with which previously studied information is processed relative to non-studied information (e.g., repetition priming). While a vast amount of research has accumulated to suggest that implicit memory remains relatively stable over the adult lifespan, and is similar in samples of young and older adults, other studies have in contrast revealed that implicit memory is subject to age-related decline. Improving methods for determining whether implicit memory declines or remains stable with age is an important goal for future research, as the issue not only has significant implications for an aging society regarding interventions likely to ameliorate the effects of age-related explicit memory decline, but can also inform our theoretical understanding of human memory systems.

Explicit and implicit memory in the elderly: Evidence for double dissociation involving medial temporal- and frontal-lobe functions.

Recognition memory is considered to be supported by two different memory processes, i.e., the explicit recollection of information about a previous event and an implicit process of recognition based on an acontextual sense of familiarity. Both types of memory supposedly rely on distinct memory systems. Sleep is known to enhance the consolidation of memories, with the different sleep stages affecting different types of memory. In the present study, we used the process-dissociation procedure to compare the effects of sleep on estimates of explicit (recollection) and implicit (familiarity) memory formation on a word-list discrimination task. Subjects studied two lists of words before a 3-h retention interval of sleep or wakefulness, and recognition was tested afterward. The retention intervals were positioned either in the early night when sleep is dominated by slow-wave sleep (SWS), or in the late night, when sleep is dominated by REM sleep. Sleep enhanced explicit recognition memory, as compared with wakefulness (P < 0.05), whereas familiarity was not affected by sleep. Moreover, explicit recognition was particularly enhanced after sleep in the early-night retention interval, and especially when the words were presented with the same contextual features as during learning, i.e., in the same font (P < 0.05). The data indicate that in a task that allows separating the contribution of explicit and implicit memory, sleep particularly supports explicit memory formation. The mechanism of this effect appears to be linked to SWS.

Recent studies investigating the relationship between depth of anesthesia and implicit memory have conflicting results. Limitations of these studies include lack of standardization in surgical procedures and failure to control depth of anesthesia prospectively. We assessed implicit memory function at two different (BIS-guided and pro-spectively controlled) anesthetic depths during surgical stimulus. A list of words was played via headphones to 37 patients during orthopedic surgery under general anesthesia. The Bispectral (BIS) Index was monitored and patients were randomized to remain in a deeper (BIS 40-45) or lighter (BIS 55-60) plane of surgical anesthesia during word presentation. Postoperatively, implicit memory performance was tested using a simple auditory word-stem completion test for presented as well as non-presented words. Absence of explicit memory was evaluated by asking four standard questions regarding intraoperative awareness. All patients received sevoflu-rane and fentanyl for general anesthesia. There was no evidence of implicit memory in either study group. Hit rates for presented and non-presented words were 0.23 ± 0.14 and 0.25 ± 0.09, respectively. No explicit memory was reported by any patient. Depth of anesthesia did not affect implicit memory formation in anesthetized pa-tients undergoing surgery. General anesthesia, even at a higher BIS range, appears to abolish implicit memory as assessed by a simple word-stem completion test.

High doses of opioid associated with low doses of hypnotic is a popular anaesthetic technique since the use of remifentanil has become widespread. This type of anaesthesia could result in a higher incidence of implicit memory. Ten patients were anaesthetised with a target-controlled infusion of remifentanil (target concentration of 8 ng mL(-1)) combined with a target-controlled infusion of propofol with progressive stepwise increases until loss of consciousness was reached. A tape containing 20 words was then played to the patients. Bispectral index (BIS, Aspect Medical Systems, Newton, MA, USA) was continuously monitored during the whole study period. Implicit and explicit memories were tested between 2 and 4 h after recovery. Loss of consciousness was obtained with a mean calculated propofol plasma concentration of 1.3 +/- 0.4 microg mL(-1). At this low hypnotic concentration no implicit or explicit memory was found in the three postoperative memory tests. Median (range) BIS value during word presentation was 93 (80-98). In our group of young American Society of Anesthesiologists (ASA) I/II patients, no explicit or implicit memory was found when the calculated concentration of propofol combined with a high concentration of remifentanil was maintained at the level associated with loss of consciousness with high BIS values.

In this study, three experiments are presented that investigate the reliability of memory measures. In Experiment 1, the well-known dissociation between explicit (recall, recognition) and implicit memory (picture clarification) as a function of age in a sample of 335 persons aged between 65 and 95 was replicated. Test-retest reliability was significantly lower in implicit than in explicit measures. In Experiment 2, parallel-test reliabilities in a student sample confirmed the finding of Experiment 1. In Experiment 3, the reliability of cued recall and word stem completion was investigated. There were significant priming effects and a dissociation between explicit and implicit memory as a function of levels of processing. However, the reliability of implicit memory measures was again substantially lower than in explicit tests in all test conditions. As a consequence, differential reliabilities of direct and indirect memory tests should be considered as a possible determinant of dissociations between explicit and implicit memory as a function of experimental or quasi-experimental manipulations.