Aging impacts memory for perceptual,but not narrative,event details

Memory is well known to decline over the course of healthy aging. However, memory is not a monolith and draws from different kinds of representations. Historically, much of our understanding of age-related memory decline stems from recognition of isolated studied items. In contrast, real-life events are often remembered as narratives, and this kind of information is generally missed in typical recognition memory studies. Here, we designed a task to tax mnemonic discrimination of event details, directly contrasting perceptual and narrative memory. Older and younger adults watched an episode of a television show and later completed an old/new recognition test featuring targets, novel foils, and similar lures in narrative and perceptual domains. While we observed no age-related differences on basic recognition of repeated targets and novel foils, older adults showed a deficit in correctly rejecting perceptual, but not narrative, lures. These findings provide insight into the vulnerability of different memory domains in aging and may be useful in characterizing individuals at risk for pathological cognitive decline.

Memory decline is among the most commonly reported cognitive changes with aging (Craik 1994; Bäckman et al. 2001; Salthouse 2003). In particular, older adults appear to show marked decline in the ability to support episodic memories for specific events and instances (Nilsson 2003; Salthouse 2003; Hedden and Gabrieli 2004). Older adults reliably show deficits when freely recalling studied information (Craik and McDowd 1987; Gutchess et al. 2006) or remembering specific item–context pairings (Old and Naveh-Benjamin 2008; Craik et al. 2010). In contrast, older adults do not consistently show deficiencies in old/new recognition memory. This and related evidence have led to the view that older adults have preserved memory for gist, but loss of specific details (Schacter et al. 1997; Abadie et al. 2021; Grilli and Sheldon 2022). That is, older adults tend to remember a general understanding of the overall experience but are disadvantaged at maintaining precise, high-fidelity details (Radvansky et al. 2001). However, it is not well understood whether such relative loss of detailed memory extends across information domains.The Mnemonic Similarity Task (MST) is a recognition paradigm that is specifically designed to tax high-fidelity memory representations (Kirwan and Stark 2007; Stark et al. 2013, 2019). MST performance depends on maintaining similar representations in memory as distinct and nonoverlapping (Yassa and Stark 2011). This is thought to rely on pattern separation in the hippocampus (McClelland et al. 1995; Norman and O''Reilly 2003; Leutgeb et al. 2007; Bakker et al. 2008), a process that is strongly impacted in the aging brain (Wilson et al. 2006; Burke et al. 2010). Typical MST paradigms involve an incidental encoding task, such as making indoor or outdoor judgments for pictures of everyday objects, and then a surprise recognition memory test. In the memory test, participants are tasked to identify exact repetitions of previously encoded objects (targets), new objects (foils), and objects that are perceptually similar to images encountered during the encoding task (lures) as old or new. Older adults are more likely to endorse similar lures as previously studied items (Toner et al. 2009; Holden et al. 2013), which correlates with aberrant structural and functional properties of the human hippocampus and surrounding cortical regions (Yassa et al. 2011a; Reagh et al. 2018). The MST therefore offers mechanistic insights into high-fidelity recognition-based memory in the human brain.Nonetheless, studies using the MST have often limited their scope to detecting visual changes among isolated items. Other recognition studies that have incorporated discrimination of highly similar information in more complex formats, such as source memory discrimination, also report age-related deficits (Schacter et al. 1991; Chalfonte and Johnson 1996; Naveh-Benjamin et al. 2003; Dennis et al. 2008). For instance, older adults had difficulty assessing the source of a word when it originated from two female speakers compared with across gender speakers (Ferguson et al. 1992). These studies, however, largely assess recognition memory processes for isolated items—snapshots of perceptual experience in the context of a laboratory experiment. Moreover, there is growing evidence that aging does not equally impact all domains of information that are involved in constructing a memory. For instance, recent work suggests that aging distinctly influences medial temporal lobe circuits underlying memory for items versus contexts or space (Reagh et al. 2016, 2018; Berron et al. 2018).Real-world memories are not made of isolated pieces of information, but instead are structured and bridged together by meaning (Schank 1975; Conway and Rubin 2019; Cohn-Sheehy et al. 2022). Prior studies have shown that older adults are relatively impaired at detecting and remembering perceptual changes in everyday events, suggesting that basic findings from MST paradigms likely translate to real-world deficits (Wahlheim and Zacks 2019). However, a critical component of human memory is information about narratives, whether autobiographical or fictional (Radvansky et al. 2005; León 2016). Narratives tend to be organized to follow an ideal internal structure that can be relied on (Mandler and Johnson 1977; Thorndyke 1977). Studies that use narratives to test memory typically task participants with recalling information from a story or event. This has led to the idea that aging impacts recall more drastically than recognition (Danckert and Craik 2013). Interestingly, similar to studies of recognition memory, recall performance in aging has been characterized by loss of specific details and emphasis on information that capture the central idea of an experience (Addis et al. 2008). This may be due to the unconstrained nature of recall tasks or because self-initiated recall may be more taxing for older adults. Thus, the extent to which narrative details are truly lost versus not voluntarily retrieved in aging remains unclear. In line with this idea, tasks designed to drive participants to recall events in terms of specific details have shown enhancement effects in older adults (Madore et al. 2014). To our knowledge, however, there has not been an investigation into whether recognition of highly specific narrative details is affected in aging similarly to perceptual details.Testing of narrative and perceptual domains alongside one another in a controlled and highly similar way allows us to gain a better understanding into the processing of different types of information in memory. Memory is not a unitary phenomenon, and memory performance can often be based on multiple processes and types of representations. This approach offers unique insights into the aging brain, as it has been previously proposed that information about narratives and situations may be preferentially encoded differently in distinct cortical pathways to the hippocampus compared with more perceptually focused information (Ranganath and Ritchey 2012; Reagh and Ranganath 2018). Other emerging neural evidence suggests that specific networks specialize in cognitive processes that are relevant for gist and detailed memory (Robin and Moscovitch 2017; Sekeres et al. 2018). Given that these brain networks may be distinctly vulnerable to age-related pathologies (Jagust 2018; Maass et al. 2019), these insights may further offer us clues into pathological aging.Here, we designed a task to simultaneously tax mnemonic discrimination in perceptual and narrative domains. This task is analogous to traditional MST paradigms composed of an incidental encoding task followed by a recognition test. However, with the goal of tapping into mechanisms involved in encoding of the meaningful, continuous, and dynamic world that we live in, the incidental encoding task consists of watching a television sitcom (HBO''s Curb Your Enthusiasm, S01E07: “AAMCO”) (see Fig. 1A). Television shows offer a unique methodology that balances realistic scenarios while directing our attention to specific perceptual and narrative details. After encoding, participants completed an old/new recognition test featuring targets, foils, and similar lures in the perceptual domain, as well as a novel variant testing mnemonic discrimination of narrative details. This allowed us to test detailed memory for perceptual and narrative information using an ecologically valid yet constrained approach. That is, encoding involves an immersive stimulus that hinges on meaningful and nonarbitrary narrative organization. Additionally, although retrieval is akin to a standard recognition test, it assesses memory along two dimensions that may provide insight into how we process different memory representations for lifelike events. Unlike prior studies testing narrative understanding, here we critically tested narrative memory in terms of basic recognition (targets and foils) as well as high-fidelity narrative details (lures). Performance was compared across younger and older adults for both information domains.Open in a separate windowFigure 1.(A) Participants viewed a 26-min episode of a sitcom. (B) Old/new recognition task based on narrative or perceptual details, with order of test domain counterbalanced across participants. Each recognition task consisted of 30 targets (described or depicted moments from the video encoded), similar lures (moments described or depicted as being similar to the video encoded), and novel foils (described or depicted moments not from the video encoded).We predicted no differences in basic recognition of repeated targets and novel foils across age groups based on prior MST results (Stark et al. 2013, 2019; Toner et al. 2009; Holden et al. 2013). In line with prior work showing decreased performance in perceptual lures among older adults (Toner et al. 2009; Holden et al. 2013; Stark et al. 2013, 2019), we further predicted greater age-related deficits in perceptual lure discrimination than narrative lure discrimination. Relatively intact memory for narrative details may reflect being able to rely on narrative structure or the meaning of events.     

Changes in meaning in life across the course of psychodynamic psychotherapy

Using the Meaning in Life Questionnaire (MLQ), we studied Presence and Search for meaning for 34 adult clients in psychodynamic psychotherapy. Clients completed the MLQ and Outcome Questionnaire (OQ) before intake and after every eight sessions. Variance in Presence scores was mostly attributable to clients; variance in Search scores was mostly attributable to clients and therapists. Clients initially high in Presence decreased and then increased back to initial levels; clients initially low in Presence increased and then decreased back to initial levels. Clients initially low in Search increased and then leveled off; clients initially high in Search decreased and then leveled off. In lagged cross panel analyses, when clients decreased in psychological distress during one eight-week time period, they increased in Presence during the next eight-week time period; when they increased in psychological distress during one eight-week time period, they increased in search in the next time period. Excerpts from post-therapy interviews illustrate the process of working with meaning in life in psychotherapy. Implications for practice and training are discussed.     

Family-Based Intervention with High-Risk Infants and Their Families

A model of family-based intervention for high-risk infants hospitalized in the neonatal intensive care unit and their families is presented. The theoretical underpinnings, principles, and nature of the intervention are described. The adaptation of the model from a clinical–research demonstration project to a clinical consultation service is highlighted, with particular emphasis on the practical application of the model. Domains of the intervention include infant behavior, family organization and functioning, caregiving environment, and home discharge/community resources. Three case illustrations are provided to demonstrate the breadth of the intervention and how it can be individualized based upon the presentation of the infant and family.     

Determinants of maternal self-esteem in the neonatal period

The purpose of this study was to determine whether maternal perceptions of infant health and behavior made a unique contribution in understanding maternal self-esteem beyond what could be achieved from objective measures. The Perception of Infant Health (POIH) questionnaire and the Bates ICQ captured the perception of infant health and temperament. Standard medical variables including the Hobel Medical Risk Summary measured the objective aspect of infant health. The Brazelton Neonatal Behavioral Assessment (NBAS) measured objective infant behavior. The Maternal Self-Report Inventory measured self-esteem. Eighty mother-infant dyads, which included healthy, middle socioeconomic class mothers of both full-term, neurologically normal and preterm infants with a range of medical problems were studied. Negative maternal perceptions of infant health and behavior as well as poorer objective health status were associated with decreased maternal self-esteem. Perceptual variables of temperament and health made a unique contribution to maternal self-esteem scores. Regression analysis indicated fussy/difficult, POIH, and NBAS autonomic scores explained a significant amount of variance in maternal self-esteem.     

A clinical interview for parents of high-risk infants: Concept and applications

The birth and hospitalization of a preterm infant are stressful and emotionally demanding experiences for parents. The Clinical Interview for Parents of High-Risk Infants (CLIP) is a semistruc tured clinical interview that may be used as a one-time assessment or as a cornerstone for ongoing psychosocial work with parents. The interview assesses early parental adaptation and alerts the clinician to areas of concern as identified by the parents. The interview enables parents to consolidate emotionally their experiences relative to the infant's high-risk status. The CLIP has utility both for planning psychosocial care in the intensive care nursery, and for discharge preparation. The rationale underlying the design of the CLIP is presented, the interview is described, and clinical applications are discussed.     

Children's strategic compensation for size underconstancy: Dependence on distance and relation to reasoning ability

When asked to judge the size of a distant object, older children are more likely than younger ones to report deliberately inflating their judgements to compensate for size underconstancy (Granrud, in press). The current investigation examined whether use of this strategy depends on object distance and whether it is related to individual differences in reasoning, knowledge about size perception, or cognitive style. In two studies, children in Grades 1–3 estimated the size of a distant (61 m away) and near (6.1 m away) disc. In each, half of the children reported inflating their judgement of the distant disc to compensate for a tendency to underestimate its size, but only a few reported using this strategy for the near disc. Self-reported strategy users tended to either judge the distant disc accurately or to overestimate its size, whereas the other children tended to underestimate its size. Strategy reporters obtained higher scores on a test of verbal reasoning, but did not differ from the other children in reflectivity-impulsivity. In Study 1, strategy reporters also showed a better understanding of how distance affects the apparent size of objects in photographs. This understanding was strongly related to verbal reasoning ability. In Study 2, visuospatial reasoning ability was also found to predict who would report strategy use, and this predictive relation was independent of verbal reasoning ability.     

Keeping the illusion of control under control: Ceilings, floors, and imperfect calibration

Prior research has claimed that people exaggerate probabilities of success by overestimating personal control in situations that are heavily or completely chance-determined. We examine whether such overestimation of control persists in situations where people do have control. Our results suggest a simple model that accounts for prior findings on illusory control as well as for situations where actual control is high: People make imperfect estimates of their level of control. By focusing on situations marked by low control, prior research has created the illusion that people generally overestimate their level of control. Across three studies, we show that when they have a great deal of control, people under-estimate it. Implications for research on perceived control and co-variation assessment are discussed.     

Leveling Up Your Game: The Use of Video Games as a Therapeutic Modality

This article introduces and begins to explore the use of video game technology in a therapeutic setting, providing context, rationale, and an introduction to the culture of video game players. Through the lens of play therapy, authors seek to create an awareness of the potential effectiveness of video games as a means of fostering safe self-exploration for the client. An introductory course on gaming culture and terminology is offered to better aid in the therapist’s integration and facilitation of this new modality into practice.     

Infant crying,risk status and social support in families of preterm and term infants

Infant crying influences the caregiver and the broader caregiving environment. In this study, cry acoustics were recorded and acoustically analyzed from a sample of fullterm and preterm infants at 40 weeks gestational age, along with the medical risk and socioeconomic status (SES) of the family. Following factor analysis of the cry acoustics, cry factors, along with medical risk and SES were used to predict patterns of social support in the informal (family, friends) and formal (health care providers) social support networks at 44 weeks gestational age. One cry factor, temporal patterning, indicative of the influence of respiratory factors on the infant's cry, predicted a significant amount of variance in the amount of support from the informal network, beyond that predicted from medical risk and SES. Medical risk alone predicted the amount of contact with the formal network, and SES predicted satisfaction with help from the formal network. There were different patterns of relationship between cry acoustics and social support for families with term and preterm infants, indicating that caregivers may interpret and respond to different information in the acoustics of their infants' cries. These findings have implications for understanding how infant crying and behavior influence the caregiving environment and for the clinical management of early cry problems in families with infants differing in risk status. © 1998 John Wiley & Sons, Ltd.