Russell M. Bauer - US grants

Recent neuropsychological and cognitive-psychological research with normals and brain-damaged subjects has indicated that overt processes of stimulus identification can be dissociated from covert processes of stimulus recognition. Several studies have revealed positive evidence of covert recognition (e.g., autonomic discrimination, rudimentay lexical categorization) in the absence of overt verbal identification. This suggests that there are covert aspects of information-processing which are neither directly nor accurately reflected in verbal report data. The overall objective of the proposed research is to determine whether similar dissociations characterize the memory-recognition performance of alcoholic amnesics and three groups of controls. It is known that alcoholic amnesics show memory benefit ("savings") in repeated presentations of tasks they do not overtly remember previously performing. In this context, the purpose of the proposed studies is to determine whether such patients can covertly "recognize" learned material that they have overtly forgotten. This will be approached by studying dissociations and correlations between autonomic and verbal recognition indices in alcoholic Korsakoff patients, nonalcoholic amnesics, long-term alcoholics, and normal controls. Four paradigms widely used in memory research (simple recognition, rate-of-forgetting, temporal-gradient remote memory assessment, and levels-of-processing) will be employed to study the relationship between verbal and autonomic (i.e., electrodermal) indices of recognition under differing conditions. If it is the case that, in alcoholic Korsakoff patients and controls, autonomic evidence of learning occurs in the absence of overt verbal report, then several critical issues are raised. First, amnesic failures in memory paradigms may be more related to deficits in demonstrating knowledge than to having knowledge about learned stimuli. Second, the question, "does the patient remember" may be answered in different ways depending upon which response system is used to index memory performance. Third, the relationship between covert and overt recognition indices will have to be accounted for in theoretic models of amnesic memory defects.

Recent neuropsychological and cognitive-psychological research with normals and brain-damaged subjects has indicated that overt processes of stimulus identification can be dissociated from covert processes of stimulus recognition. Several studies have revealed positive evidence of covert recognition (e.g., autonomic discrimination, rudimentay lexical categorization) in the absence of overt verbal identification. This suggests that there are covert aspects of information-processing which are neither directly nor accurately reflected in verbal report data. The overall objective of the proposed research is to determine whether similar dissociations characterize the memory-recognition performance of alcoholic amnesics and three groups of controls. It is known that alcoholic amnesics show memory benefit ("savings") in repeated presentations of tasks they do not overtly remember previously performing. In this context, the purpose of the proposed studies is to determine whether such patients can covertly "recognize" learned material that they have overtly forgotten. This will be approached by studying dissociations and correlations between autonomic and verbal recognition indices in alcoholic Korsakoff patients, nonalcoholic amnesics, long-term alcoholics, and normal controls. Four paradigms widely used in memory research (simple recognition, rate-of-forgetting, temporal-gradient remote memory assessment, and levels-of-processing) will be employed to study the relationship between verbal and autonomic (i.e., electrodermal) indices of recognition under differing conditions. If it is the case that, in alcoholic Korsakoff patients and controls, autonomic evidence of learning occurs in the absence of overt verbal report, then several critical issues are raised. First, amnesic failures in memory paradigms may be more related to deficits in demonstrating knowledge than to having knowledge about learned stimuli. Second, the question, "does the patient remember" may be answered in different ways depending upon which response system is used to index memory performance. Third, the relationship between covert and overt recognition indices will have to be accounted for in theoretic models of amnesic memory defects.

Project Summary This proposal aims to develop a National Neuropsychology Network (NNN), starting with four clinical research sites in California, Florida, Georgia, and Wisconsin. The NNN aims to gather clinical diagnostic information following a shared protocol, collect item-level data on representative neuropsychological (NP) instruments, and deposit these data in the NIMH Data Archive (NDA; https://data-archive.nimh.nih.gov/), more specifically in the Research Domains Criteria database (RDoCdb). The infrastructure established in the network focuses on point- of-testing data acquisition, using iPads, leveraging existing technology developed by a leading test vendor (Q- interactive, from Pearson), and developing additional software to collect specific additional measures that are widely used in clinical neuropsychology laboratories and clinics but which are not available elsewhere. The NNN will collect data on more than 10,000 cases over 4 years, representing a broad range of neuropsychiatric disorders, reflecting populations seen nationwide, and then deposit all data in RDoCdb. Data analyses will specify the latent constructs underlying each test, the factors represented by larger batteries, and create proposals for new individual tests and batteries. Novel tests (short forms and adaptive tests) will be suggested based on item-response theory modeling of each test, with desired precision of measurement for evidence- based clinical decision-making. Novel battery proposals will be informed by examining the positive and negative predictive power of each test to contribute to key differential diagnostic questions that arise in NP assessment. Both battery and individual test proposals will focus on efficiency, and are expected to yield at least a doubling of efficiency. The NNN aims to serve as a nucleus and template for additional network nodes, that will in its next generation offer a national platform for co-norming novel tests, expanding to other languages, and ultimately designing new procedures that are validated with respect to both brain function and real world adaptive capacities.