PerceptualandMotor Skills, 1991, 72, 1295-1298.

O Perceptual and Motor Skills 1991

SERIAL-POSITION EFFECTS IN PARAGRAPH RECALL FOLLOWING MILD CLOSED-HEAD INJURY ' STUART HALL AND R. A. BORNSTEIN Neuropsychoiogy Laboratory, Ohio Stute University College of Medicine Summary.-Serial-position effects were examined on a contextual memory task (paragraph recall) for patients with minor to mild closed-head injury and normal controls. Analysis indicated that at immediate recall, both normals and dosed-head-injury patients have primacy and recency effects. With regard to total recall, however, the dosed-head-injury patients remembered significantly fewer items than normal controls. The poorer performance of the minor to mild closed-head-injury group was not related to the duration from injury to neuropsychological evaluation and appears to be a lasting feature of memory performance following such injury. The pattern of serial-position effects was different between the groups. Normal controls showed slight recency and primacy effects and relatively better recall for the middle portions of the story, while patients with minor to mild closed-head injuries have prominent recency and primacy effects. Potential explanations for this pattern of performance are discussed.

Serial-position effects are one of the most robust effects in studies of learning and memory. These effects have been demonstrated in normals as well as in patients with amnestic disorders. Amnestic patients tend to show a decrement in the primacy effect and preservation of the recency effect (Baddeley & Warrington, 1970; Vallar & Papagno, 1986). Bigler, Rosa, Schultz, Hall, and Harris (1989) reported that patients with dementia of the Alzheimer's type also show a reduction of the primacy effect with preservation of the recency effect typical of amnestic patients on a list-learning task. I n addition, Bigler, et aL. (1989) observed primacy and recency effects in patients with moderate closed-head injury. The present study was designed to examine serial-position effects in a contextual memory task (paragraph recall) as opposed to list-learning tasks employed in most previous studies of this phenomenon. Patients with minor to mild closed-head injury and normal controls were studied. Earlier investigations have been plagued by a lack of appropriate controls. This investigation addressed this shortcoming by using controls matched for age and education.

METHOD Twenty-two patients with a diagnosis of minor to mild closed-head injury were matched with 22 normal controls so that there was no significant

'Correspondence re arding this article should be addressed to R. A. Bornstein, Ph.D., Neuropsych~log~ Laforatory, Department of Psychiatry, Ohio State University, 473 West 12th Avenue, Columbus, OH 43210.

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difference between the groups in terms of age (t = 0.51, p > .05) or education (t= 0.67, p > .05; see Table 1). The ages of the control and closed-head-injury groups ranged from 21 to 60 years of age and 20 to 62 years of age, respectively. The normal controls were recruited by newspaper advertisements and paid for their participation. They had no history of substance abuse, neurological disease, or psychiatric disorder. For the closed-head-injury group, 73% had minor closed-head injuries (no loss of consciousness or posttraumatic amnesia), and 27% had mild closed-head injuries (posttraumatic amnesia .05).

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SERIAL POSITION EFFECTS IN CONTEXTUAL MEMORY

TABLE 1 MEAN AGE,EDUCATLON, NUMBEROF ITEMS RECALLED AND PERCENTAGE RECALLED FOR INJURIES AND CONTROL SUBJECTS PATIENTS WITHMINORTOMILDCLOSW-HEAD Measure Age, yr.

Education, yr. Recall Raw Scores First Third Middle Third Last Thitd Percentage First Third Middle Third Last Third

Head-injured Patients M SD

Controls M

SD

34.32 14.64

13.29 2.28

32.36 15.04

12.18 1.76

5.32 3.00 4.54

1.61 1.40 1.71

6.27 5.63 5.82

1.45 1.05 1.50

66.5 33.8 56.8

DISCUSSION These results demonstrate that on a paragraph-recall task both normals and patients with minor to mild closed-head injury show primacy and recency effects at immediate recall. I t appears that serial-position effects may be present in contextual memory paradigms and are not exclusive to list-learning tasks. Although both normal controls and closed-head-injury patients showed primacy and recency effects, the total recall of the closed-head-injury patients on each third is significantly less. The poorer over-all performance of the patient group does not appear related to differences in age or intellectual ability since the groups were matched for age and education, which are highly correlated with performance on intellectual tasks (Finlayson, Johnson, & Reitan, 1977; Bornstein, 1983). Therefore, minor to mild injuries appear sufficient to produce significantly poorer memory performance (see Hall & Bornstein, in press). Also, a low and nonsignificant correlation was found between verbal memory performance and the duration from injury to neuropsychological evaluation for the closed-head-injury group. Therefore, poor memory performance appears to be a lasting feature following minor to mild closed-head injury. The pattern of serial-position effects was different for normal controls and minor to mild closed-head-injury patients. The serial-position effects for the patient group were characterized by prominent recency and primacy effects, with less recall of material from the middle portion of the story. The normal controls, although showing slight recency and primacy effects, tend to recall relatively more material from the middle of the story. This pattern of performance may reflect the effect of the contextual nature of the task and that salient events occurring in the middle portion of the story facilitate

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their recall in normal controls. The minor to mild closed-head injury patients may not benefit from the context of the story in the same way as controls. Their recall of the middle portion is not facilitated, and they show more prominent recency and primacy effects. An alternative explanation for this pattern of performance is that the middle portion of the story is subject to poorer recall by normal controls. The detrimental effects of minor to mild closed-head injury on verbal memory may result in less recall of the "vulnerable" middle portion of the story which serves to accentuate the typical serial-position effect (see Hall & Bornstein, in press). The present study indicates that investigating serial-position effects may provide an interesting direction for research. Well-controlled studies of serial-position effects in patients with a variety of neurological disorders associated with memory dysfunction remain to be conducted. Different aspects of memory performance such as delayed recall should be studied. The findings of such research would be useful clinically and may provide important information about the nature of memory dysfunction in these groups. REFERENCES A,, & WARRINGTON, E . Amnesia and the distinction between long- and short-term BADDELEY, memory. Journal of Wrbal Learning and Wrbal Behavior, 1970, 9, 176-189. BARTH,J., MACCIOCCHI, S., GIORDANI, R., RIMEL, R., JANE,J., & BOLL,T. Neuropsychological sequelae of minor head injury. Neurosurgery, 1983, 13, 529-533. BECKER,D., GROSSMAN, R., MCLAURIN,R., & CAVENESS, W. Head injuries-panel 3. Archives of Neurology, 1979, 36, 750-758. BIGLER,E., ROSA, L., SCHULTZ,F., HALL, S., & HARRIS, J. Rev-auditory verbal learning and Rey-Osterrieth complex figure design performance in ~\lzhe~mer'sdisease and closed-head injury. Journal of Clinical Psychology, 1989, 45, 277-280 BORNSTEIN, R. Relationship of a e and education to neuropsychological performance in patients with symptomatic carotidgartery disease. Journal of Clinical Psychology, 1983, 39, 470478. FINLAYSON, M., JOHNSON, K., & REITAN,R. Relationship of level of education to neuropsychological measures in brain-damaged and non-brain-damaged adults. Journal of Consulting and Clinical Psychology, 1977, 45, 536-542. HALL,S., & BORNSTEIN, R. The relationship between intelligence and memory following mild closed-head injury: greater impairment in memory than intelligence. Journal of Neurosurgery, in press. LEZAK,M. Memor functions. In M. Lezak, Neuropsychological assessment. (2nd ed.) New York: 0 x f o r J ~ n i v e tPress, 1983. Pp. 414-474. VALLAR, G., & PAPAGNO, C. Phonological short-term store and the nature of the recency effect: evidence from neuropsychology. Brain and Cognitjon, 1986, 5, 428-442. WECHSLER, D. Manualfor the Wechsler Memory Scak-Revised. San Antonio, T X : Psychological Gorp., 1987.

Accepted June 12, 1991.

Serial-position effects in paragraph recall following mild closed-head injury.

Serial-position effects were examined on a contextual memory task (paragraph recall) for patients with minor to mild closed-head injury and normal con...
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