Aylin Yüken

PSYC431- Human Memory

Article Review: Alzheimer’s Disease
Sami Gülgöz
14.01.2021

Article Review: Discrepancy between Subjective Autobiographical Reliving and Objective

Recall: The Past as Seen by Alzheimer’s Disease Patients

a) What were the research questions?

In Alzheimer’s patients, they have lack of sense of self and identity because they
cannot remember their autobiographical memories specifically. They cannot produce
specific, episodic personal events. They have a diminished ability to mentally retrieve
their past events. The researchers ask that do the Alzheimer’s disease (AD) patients
demonstrate a discrepancy between subjective autobiographical reliving and objective
recall? What is the difference between the AD patients and the control group (the
control group consists of old people which do not have AD) in terms of subjective
reliving and objective recall? Here, discrepancy means higher level of subjective
reliving and objective recall.

b) What did the authors hypothesize?

In this study, the authors examined whether AD patients may demonstrate a
discrepancy between subjective autobiographical reliving and objective recall.
Especially, they expected high subjective reliving and low objective recall in AD
patients. They hypothesized that the AD patients are below in the subjective reliving
and the objective recall of their episodic memories because they cannot produce their
episodic memories and they cannot remember their memories specifically. The AD
patients give high value to their subjective autobiographical experiences.

c) How did they justify their hypotheses?

They compare their hypotheses with their findings and other studies. Other studies
show that the AD patients cannot remember their autobiographical memories and they
also cannot produce their episodic memories. These information helps them to
 hypothesize their ideas. They also use different tasks in order to assess the
participants’ cognitive abilities and different scales in their study. They show the
results in the tables and graphics and then they discuss and compare them.

d) What did they do to obtain data?

They asked 31 AD patients (they are probable mild AD and there were 22 women and
9 men) and 35 controls in order to retrieve three autobiographical memories. They
voluntarily participated this study. The control participants were often spouses or
companions od AD participants. They were matched with the AD patients according
to age. And the AD participants were recruited from local retirement homes. Also they
freely consented to participate and were able to withdraw whenever they wished. Their
cognitive characteristics were assessed with different tasks. For the General cognitive
functioning, they used the Mini Mental State Exam. In order to assess Episodic
memory, they used a French version of the episodic task of Grober and Buschke
(1987) in which the participants had to retain 16 words, each describing an item
belonging to a different semantic memory. In order to assess Working Memory,
participants were asked to repeat a string of single digits in the same order or in
reverse order. To assess Inhibition, they used the Stroop task. Then, to assess
Flexibility, they used the Plus-Minus task that included three lists, each containing 20
numbers. In each number, they made some mathematical operations. To assess
Depression, they used the Hospital Anxiety and Depression Scale which consists of
seven items that were scored by participants on a four-points scale ranging. They
showed the results in the table. Participants’ memories were cued as the experimenter
asked each participant to “recount in detail a family event”, “recount in detail a
professional event”, and “recount in detail a holiday event”. Participants were
instructed to be precise and specific, the authors wanted them to give detail as possible
as. The authors gave participants 3 minutes to describe their memories and they
wanted from participants that they should structure their memories accordingly. The
authors assessed subjective reliving by asking participants to rate 10 items on a five-
point scale. (0 points equals not at all, 4 points equal extremely). The maximum score
was 40 points. For each memory, participants were asked to rate its subjective
characteristics. These subjective characteristics consist of these:
 Language (I or other people are talking)
 Reliving (I feel as though I am reliving the original event)
  Remembering (I can actually remember it rather than just knowing that it
happened)
 Travel back in time (I feel that I am traveling back to the time it happened)
 Realness (I believe the event in my memory really occurred in the way I
remember it)
 Visual and auditory imagery (I can see it in my mind, and I can hear it in my
mind)
 Emotion (I can feel now the emotions I felt then)
 Importance (this memory is significant for my life)
 Rehearsal and spatiotemporal specificity (since this event happened, I have
thought or talked about it)
 Vividness
These 10 subjective items were derived from the Autobiographical Memory
Questionnaire. The authors thought that some AD participants had difficulties with
subjective ratings. Then, in the objective recall part, the authors assessed objective
autobiographical recall with the TEMPau scale which was derived from classic
autobiographical evaluations. For each retrieved event, they attributed that
 0 points if there was no memory or only general information about a theme
such as “in my childhood”.
 1 point for a repeated or an extended event for example “my mother
accompanied me every day to the school”.
 2 points for an event situated in time and/or space for example “my mother
accompanied me every day to the school that was far away from home”.
 3 points for a specific event lasting less than 24 h and situated in time and
space for example “one day we arrived late at school”.
 4 points for a specific event situated in time and space enriched with
phenomenological details such as feelings, thoughts, or visual imagery for
example “the teacher was very angry, but my mother explained to her why we
were late”.
The maximum specificity score for each memory was 4 points.
e) What did they find?
The authors found that there is a poorer subjective reliving in AD than in control
groups. It means that the control group could retrieve their autobiographical memories
better. Analyses also showed poorer objective recall in AD than in control group.
Similarly, the control participants gave more specific details about their episodic
memories. Analyses showed more discrepancy between subjective reliving and
objective recall in AD patients. It means that AD patients know their memories, they
do not retrieve them exactly. They could know something about their memories but
actually they could not retrieve them because their brain regions were damaged, so
AD patients could not remember their memories specifically. In control participants,
there is no discrepancy. This shows that they could remember their autobiographical
memories more accurately and specifically. There is no difference between their
subjective reliving and objective recall in control participants. The authors
demonstrated that AD patients tended to show a high level of subjective reliving but a
low of objective recall. They also showed the results of the tasks in the table.
According to this table, older adults are better in the Mini-Mental State Examination,
in episodic and working memory tasks.

f) How did they interpret their findings theoretically?

In the discussion part, the authors argued about their findings and they said that other
researchs about objective autobiographical specificity and subjective reliving in the
disease supported their findings. They found that the AD patients lose the specificity
of their autobiographical memories and they said that, if so, in the AD patients, the
loss of specificity leads to semantization of their memories, the AD patients shown an
ability to mentally relieve past events. They have a sense of “having experienced this
before”. Because the AD patients’ neurons are damaged and they cannot remember
their memories specifically, so they tend to relive their past events mentally, but they
cannot do it as control participants. AD patients seem to attribute a high value to their
subjective experience. The authors think that the discrepancy in AD patients because
of a potential genuine consciousness experience in which mild AD patients can, to
some extent, experience some subjective features of the past. They found that some
phenomenological features such as emotion and importance can be fairly experienced
by mild AD patients. This shows that the AD patients preserve some
phenomenological features of their memories. On the other hand, there is a decline in
 other phenomenological features such as reliving and travel in time. The authors
thought that it can be due to some difficulties in verbalizing the subjective experience
because the AD patients have difficulties to retrieve episodic information. On the other
hand, their findings are different from other authors who consider that anosognosia
accounts for the discrepancy. Anosognosia means that patients do not their sickness.
The authors do not explain their findings with this account because these patients
know their sickness and they could rate their reliving. And AD patients can
demonstrate some implicit awareness of their deficits despite total or partial lack of
verbal acknowledgement. This supports the AD patients may have some insight into
their subjective experiences. They also tend to provide subjective ratings which are
higher than objective ratings. Thus, the authors mentioned about their study’s some
limitations and its results and some strengthens. They show their findings in the tables
and graphics and compare these findings with other studies.

g) What is your view on the significance, validity, sufficiency, and appropriateness

of this research in terms of the authors’ conclusions and its implications for
memory research?
I believe that this study is significant in order to show that there a discrepancy between
subjective reliving and objective recall in AD, they demonstrated their hypotheses. I
think, doing this study with 31 AD patients and 35 control participants is enough to
demonstrate their findings. I mean that if they have done this study in other countries,
they would receive the similar findings. So, it is appropriate and sufficient to show
some impairments in AD patients’ autobiographical memory. They also mentioned
about some limitations and strengthens in their study. For example, the one limitation
this study is that it is the inclusion of spouses in the control groups because they
struggle with caregiver burden and distress. Paying attention to possible limitations is
also good for the next studies. According to their view, the discrepancy in AD patients
represents potential positive features of introspection in them. I believe that this
research shows important demonstrations about AD patients’ subjective reliving and
objective recall. However, after reading this research, I thought that this would be
important that the researchers used spouses in the control group, and this would be an
advantage. For example, if the researchers have asked to control group whether they
have common experience or specific episodic memories with the AD patients. I
believe that according to this, the researchers would understand the accuracy of these
specific events. They also would understand whether AD patients answer questions
accurately or they add something unreal because they might think that they gave real
and accurate answers, but they might give wrong answers. It is hard to understand the
answers are accurate or not. I thought that this can be a weakness but, I strongly
believe that this study demonstrated too significant data about the AD patients. They
also say that there is not any previous study which assessing whether there is a
discrepancy between subjective autobiographical reliving and objective recall in AD
patients. I think, this also shows this study’s importance.