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Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder

Published online by Cambridge University Press:  06 April 2017

George C. Nitzburg ,
Armando Cuesta-Diaz ,
Luz H. Ospina ,
Manuela Russo ,
Megan Shanahan ,
Mercedes Perez-Rodriguez ,
Emmett Larsen ,
Sandra Mulaimovic  and
Katherine E. Burdick
George C. Nitzburg*
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Armando Cuesta-Diaz
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Luz H. Ospina
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Manuela Russo
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Megan Shanahan
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Mercedes Perez-Rodriguez
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Emmett Larsen
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Sandra Mulaimovic
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York
Katherine E. Burdick
Affiliation:
Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, New York The James J. Peters VA Hospital, Bronx, New York
*
Correspondence and reprint requests to: George Nitzburg, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029. E-mail: [email protected]
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Abstract

Background: Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. Methods: The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Results: Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. Conclusions: VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or “chunking” techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358–366)

Keywords

Cognitive deficitsCognitive remediationFunctional remediationMood disorderSemantic clusteringSerial clustering
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 23 , Issue 4 , April 2017 , pp. 358 - 366
Copyright
Copyright © The International Neuropsychological Society 2017 

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References

Alonso, J., Petukhova, M., Vilagut, G., Chatterji, S., Heeringa, S., Üstün, T.B., & Kessler, R.C. (2011). Days out of role due to common physical and mental conditions: Results from the WHO World Mental Health surveys. Molecular Psychiatry, 16(12), 1234–1246.Google Scholar
Altman, E.G., Hedeker, D.R., Janicak, P.G., Peterson, J.L., & Davis, J.M. (1994). The clinician-administered rating scale for mania (CARS-M): Development, reliability, and validity. Biological Psychiatry, 36(2), 124–134.CrossRefGoogle ScholarPubMed
Altschuler, L.L., Bearden, C.E., Green, M.F., van Gorp, W., & Mintz, J. (2008). A relationship between neurocognitive impairment and functional impairment in bipolar disorder: A pilot study. Psychiatry Research, 157(1), 289–293.CrossRefGoogle Scholar
Atre-Vaidya, N., Taylor, M.A., Seidenberg, M., Reed, R., Perrine, A., & Glick-Oberwise, F. (1998). Cognitive deficits, psychopathology, and psychosocial functioning in bipolar mood disorder. Cognitive and Behavioral Neurology, 11(3), 120–126.Google Scholar
Arts, B., Jabben, N., Krabbendam, L., & Van Os, J. (2008). Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychological Medicine, 38(06), 771–785.Google Scholar
Baron, R.M., & Kenny, D.A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173.Google Scholar
Bearden, C.E., Glahn, D.C., Monkul, E.S., Barrett, J., Najt, P., Kaur, S., & Soares, J.C. (2006). Sources of declarative memory impairment in bipolar disorder: Mnemonic processes and clinical features. Journal of Psychiatric Research, 40(1), 47–58.Google Scholar
Bonnin, C.M., Martinez-Aran, A., Torrent, C., Pacchiarotti, I., Rosa, A.R., Franco, C., & Vieta, E. (2010). Clinical and neurocognitive predictors of functional outcome in bipolar euthymic patients: A long-term, follow-up study. Journal of Affective Disorders, 121(1), 156–160.Google Scholar
Bora, E., Yucel, M., & Pantelis, C. (2009). Cognitive endophenotypes of bipolar disorder: A meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. Journal of Affective Disorders, 113(1), 1–20.CrossRefGoogle ScholarPubMed
Bourne, C., Aydemir, Ö., Balanzá‐Martínez, V., Bora, E., Brissos, S., Cavanagh, J. T. O., & Goodwin, G.M. (2013). Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: An individual patient data meta‐analysis. Acta Psychiatrica Scandinavica, 128(3), 149–162.Google Scholar
Burdick, K.E., Goldberg, J.F., & Harrow, M. (2010). Neurocognitive dysfunction and psychosocial outcome in patients with bipolar I disorder at 15‐year follow‐up. Acta Psychiatrica Scandinavica, 122(6), 499–506.Google Scholar
Chang, J.S., Choi, S., Ha, K., Ha, T.H., Cho, H.S., Choi, J.E., & Moon, E. (2011). Differential pattern of semantic memory organization between bipolar I and II disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 35(4), 1053–1058.Google Scholar
Cunningham, J.M., Pliskin, N.H., Cassisi, J.E., Tsang, B., & Rao, S.M. (1997). Relationship between confabulation and measures of memory and executive function. Journal of Clinical and Experimental Neuropsychology, 19(6), 867–877.Google Scholar
Deckersbach, T., McMurrich, S., Ogutha, J., Savage, C.R., Sachs, G., & Rauch, S.L. (2004). Characteristics of non-verbal memory impairment in bipolar disorder: The role of encoding strategies. Psychological Medicine, 34(05), 823–832.Google Scholar
Deckersbach, T., Nierenberg, A.A., Kessler, R., Lund, H.G., Ametrano, R.M., Sachs, G., & Dougherty, D. (2010). RESEARCH: Cognitive rehabilitation for bipolar disorder: An open trial for employed patients with residual depressive symptoms. CNS Neuroscience & Therapeutics, 16(5), 298–307.Google Scholar
Deckersbach, T., Savage, C.R., Reilly‐Harrington, N., Clark, L., Sachs, G., & Rauch, S.L. (2004). Episodic memory impairment in bipolar disorder and obsessive–compulsive disorder: The role of memory strategies. Bipolar Disorders, 6(3), 233–244.Google Scholar
Deese, J., & Kaufman, R.A. (1957). Serial effects in recall of unorganized and sequentially organized verbal material. Journal of Experimental Psychology, 54(3), 180.Google Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (1987). The California Verbal Learning Test. New York: Psychological Corporation.Google Scholar
Delis, D.C., Kaplan, E., Kramer, J.H., & Ober, R.A. (2001). The California Verbal Learning Test—2nd Edition, Adult Version: A Comprehensive Assessment of Verbal Learning and Memory. San Antonio, TX: The Psychological Corporation.Google Scholar
Duff, K., Schoenberg, M.R., Scott, J.G., & Adams, R.L. (2005). The relationship between executive functioning and verbal and visual learning and memory. Archives of Clinical Neuropsychology, 20(1), 111–122.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B. (1995). Structured clinical interview for DSM-IV axis I disorders. New York: New York State Psychiatric Institute.Google Scholar
Fossati, P., Amar, G., Raoux, N., Ergis, A.M., & Allilaire, J.F. (1999). Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. Psychiatry Research, 89(3), 171–187.Google Scholar
Fuentes, I., Rizo-Méndez, A., & Jarne-Esparcia, A. (2016). Low compliance to pharmacological treatment is linked to cognitive impairment in euthymic phase of bipolar disorder. Journal of Affective Disorders, 195, 215–220.Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, & Psychiatry, 23(1), 56–62.Google Scholar
Kapczinski, F., Magalhães, P.V.S., Balanzá‐Martinez, V., Dias, V.V., Frangou, S., Gama, C.S., & Berk, M. (2014). Staging systems in bipolar disorder: An international society for bipolar disorders task force report. Acta Psychiatrica Scandinavica, 130(5), 354–363.CrossRefGoogle ScholarPubMed
Kieseppä, T., Tuulio-Henriksson, A., Haukka, J., Van Erp, T., Glahn, D., Cannon, T.D., & Lönnqvist, J. (2005). Memory and verbal learning functions in twins with bipolar-I disorder, and the role of information-processing speed. Psychological Medicine, 35(02), 205–215.Google Scholar
Kurtz, M.M., & Gerraty, R.T. (2009). A meta-analytic investigation of neurocognitive deficits in bipolar illness: Profile and effects of clinical state. Neuropsychology, 23(5), 551.Google Scholar
Lee, R.S., Hermens, D.F., Scott, J., Redoblado-Hodge, M.A., Naismith, S.L., Lagopoulos, J., & Hickie, I.B. (2014). A meta-analysis of neuropsychological functioning in first-episode bipolar disorders. Journal of Psychiatric Research, 57, 1–11.Google Scholar
Leow, A., Ajilore, O., Zhan, L., Arienzo, D., GadElkarim, J., Zhang, A., & Altshuler, L. (2013). Impaired inter-hemispheric integration in bipolar disorder revealed with brain network analyses. Biological Psychiatry, 73(2), 183–193.Google Scholar
Martínez-Arán, A., Torrent, C., Solé, B., Bonnín, C.M., Rosa, A.R., Sánchez-Moreno, J., & Vieta, E. (2011). Functional remediation for bipolar disorder. Clinical Practice and Epidemiology in Mental Health, 7, 112–116.CrossRefGoogle ScholarPubMed
Martínez‐Arán, A., Vieta, E., Colom, F., Torrent, C., Sánchez‐Moreno, J., Reinares, M., & Salamero, M. (2004). Cognitive impairment in euthymic bipolar patients: Implications for clinical and functional outcome. Bipolar Disorders, 6(3), 224–232.CrossRefGoogle ScholarPubMed
Martínez-Arán, A., Vieta, E., Reinares, M., Colom, F., Torrent, C., Sánchez-Moreno, J., & Salamero, M. (2004). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry, 161(2), 262–270.CrossRefGoogle ScholarPubMed
Martinez-Aran, A., Vieta, E., Torrent, C., Sanchez-Moreno, J., Goikolea, J.M., Salamero, M., & Ayuso-Mateos, J.L. (2007). Functional outcome in bipolar disorder: The role of clinical and cognitive factors. Bipolar Disorders, 9(1‐2), 103–113.Google Scholar
Medalia, A., & Choi, J. (2009). Cognitive remediation in schizophrenia. Neuropsychology Review, 19(3), 353–364.Google Scholar
Medalia, A., & Freilich, B. (2008). The Neuropsychological Educational Approach to Cognitive Remediation (NEAR) model: Practice principles and outcome studies. American Journal of Psychiatric Rehabilitation, 11(2), 123–143.Google Scholar
Orellana, G., & Slachevsky, A. (2013). Executive functioning in schizophrenia. Frontiers in Psychiatry, 4, 35.Google Scholar
Petrides, M., Alivisatos, B., & Evans, A.C. (1995). Functional activation of the human ventrolateral frontal cortex during mnemonic retrieval of verbal information. Proceedings of the National Academy of Sciences of the United States of America, 92(13), 5803–5807.CrossRefGoogle ScholarPubMed
Phillips, M.L., & Swartz, H.A. (2014). A critical appraisal of neuroimaging studies of bipolar disorder: Toward a new conceptualization of underlying neural circuitry and a road map for future research. American Journal of Psychiatry, 171(8), 829–843.Google Scholar
Radanovic, M., Nunes, P.V., Forlenza, O.V., Ladeira, R.B., & Gattaz, W.F. (2013). Cognitive–linguistic deficits in euthymic elderly patients with bipolar disorder. Journal of Affective Disorders, 150(2), 691–694.Google Scholar
Robinson, L.J., & Ferrier, I.N. (2006). Evolution of cognitive impairment in bipolar disorder: A systematic review of cross‐sectional evidence. Bipolar Disorders, 8(2), 103–116.Google Scholar
Robinson, L.J., Thompson, J.M., Gallagher, P., Goswami, U., Young, A.H., Ferrier, I.N., & Moore, P.B. (2006). A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. Journal of Affective Disorders, 93(1), 105–115.CrossRefGoogle ScholarPubMed
Robinson, L.J., Thompson, J.M., Gallagher, P., Gray, J.M., Young, A.H., & Ferrier, I.N. (2013). Performance monitoring and executive control of attention in euthymic bipolar disorder: Employing the CPT-AX paradigm. Psychiatry Research, 210(2), 457–464.CrossRefGoogle ScholarPubMed
Shuell, T.J. (1975). On sense and nonsense in measuring organization in free recall: Oops, pardon me, my assumptions are showing. Psychological Bulletin, 82(5), 720.Google Scholar
Spearing, M.K., Post, R.M., Leverich, G.S., Brandt, D., & Nolen, W. (1997). Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): The CGI-BP. Psychiatry Research, 73(3), 159–171.Google Scholar
Stricker, J.L., Brown, G.G., Wixted, J., Baldo, J.V., & Delis, D.C. (2002). California Verbal Learning Test–Second Edition: Background, rationale, and formulae. Journal of the International Neuropsychological Society, 8, 425–435.CrossRefGoogle ScholarPubMed
Swann, A.C., Lijffijt, M., Lane, S.D., Steinberg, J.L., & Moeller, F.G. (2009). Severity of bipolar disorder is associated with impairment of response inhibition. Journal of Affective Disorders, 116(1), 30–36.CrossRefGoogle ScholarPubMed
Tabarés-Seisdedos, R., Balanzá-Martínez, V., Sánchez-Moreno, J., Martinez-Aran, A., Salazar- Fraile, J., Selva-Vera, G., & Vieta, E. (2008). Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up. Journal of Affective Disorders, 109(3), 286–299.CrossRefGoogle ScholarPubMed
Thompson, J.M., Gray, J.M., Crawford, J.R., Hughes, J.H., Young, A.H., & Ferrier, I.N. (2009). Differential deficit in executive control in euthymic bipolar disorder. Journal of Abnormal Psychology, 118(1), 146.Google Scholar
Torrent, C., del Mar Bonnin, C., Martínez-Arán, A., Valle, J., Amann, B.L., González-Pinto, A., & Vieta, E. (2013). Efficacy of functional remediation in bipolar disorder: A multicenter randomized controlled study. American Journal of Psychiatry, 170, 852–859.Google Scholar
Torres, I.J., Boudreau, V.G., & Yatham, L.N. (2007). Neuropsychological functioning in euthymic bipolar disorder: A meta‐analysis. Acta Psychiatrica Scandinavica, 116(s434), 17–26.Google Scholar
Torres, I.J., DeFreitas, C.M., DeFreitas, V.G., Bond, D.J., Kunz, M., Honer, W.G., & Yatham, L.N. (2011). Relationship between cognitive functioning and 6-month clinical and functional outcome in patients with first manic episode bipolar I disorder. Psychological medicine, 41(05), 971–982.Google Scholar
Tse, S., Chan, S., Ng, K.L., & Yatham, L.N. (2014). Meta‐analysis of predictors of favorable employment outcomes among individuals with bipolar disorder. Bipolar Disorders, 16(3), 217–229.Google Scholar
van Gorp, W.G., Altshuler, L., Theberge, D.C., & Mintz, J. (1999). Declarative and procedural memory in bipolar disorder. Biological Psychiatry, 46(4), 525–531.CrossRefGoogle ScholarPubMed
Van Rheenen, T.E., & Rossell, S.L. (2014). Investigation of the component processes involved in verbal declarative memory function in bipolar disorder: Utility of the Hopkins Verbal Learning Test-Revised. Journal of the International Neuropsychological Society, 20(07), 727–735.Google Scholar
Wilkinson, G.S. Wide Range Achievement Test–Revision 3 1993 Wilmington, DE: Jastak Association.Google Scholar
Wingo, A.P., Harvey, P.D., & Baldessarini, R.J. (2009). Neurocognitive impairment in bipolar disorder patients: Functional implications. Bipolar Disorders, 11(2), 113–125.Google Scholar
Wykes, T., Huddy, V., Cellard, C., McGurk, S.R., & Czobor, P. (2011). A meta-analysis of cognitive remediation for schizophrenia: Methodology and effect sizes. American Journal of Psychiatry, 168(5), 472–485.Google Scholar