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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the analyses of incomplete longitudinal clinical trial data, there has been a shift, away from simple methods that are valid only if the data are missing completely at random, to more principled ignorable analyses, which are valid under the less restrictive missing at random assumption. The availability of the necessary standard statistical software nowadays allows for such analyses in practice. While the possibility of data missing not at random (MNAR) cannot be ruled out, it is argued that analyses valid under MNAR are not well suited for the primary analysis in clinical trials. Rather than either forgetting about or blindly shifting to an MNAR framework, the optimal place for MNAR analyses is within a sensitivity-analysis context. One such route for sensitivity analysis is to consider, next to selection models, pattern-mixture models or shared-parameter models. The latter can also be extended to a latent-class mixture model, the approach taken in this article. The performance of the so-obtained flexible model is assessed through simulations and the model is applied to data from a depression trial.
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PMID:A latent-class mixture model for incomplete longitudinal Gaussian data. 1760 89

Subjective memory complaints (SMCs) are part of the diagnostic criteria for Mild Cognitive Impairment (MCI), yet little is known about their etiology. In some previous studies, no direct relation has been found between SMCs and objective memory performance, yet significant correlations have been identified between SMCs and psychological factors such as depression and anxiety. In the current study, we examined whether negative affect moderated the relation between objective memory functioning and SMCs in a sample of healthy, non-demented participants aged 65 and older. As predicted, several negative affect measures moderated the relationship between objective cognitive functioning and SMCs. In the absence of objective memory impairment as indexed by the Rey Auditory Verbal Learning Test (RAVLT) and the Dementia Rating Scale-2nd Edition (DRS-2), higher levels of negative affect were associated with increased levels of SMCs. Moreover, a lower order negative affect factor, anxiety sensitivity, significantly moderated the relation between objective memory functioning and SMCs, after controlling for higher order measures of general negative affectivity. Findings suggest that negative affect, particularly anxiety sensitivity, distorts the subjective appraisal of one's own memory, such that people high on negative affect factors report more episodes of forgetting, even in the absence of objective cognitive impairments.
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PMID:The moderating role of negative affect on objective verbal memory performance and subjective memory complaints in healthy older adults. 1828 30

Quality healthcare outcomes depend upon patients' adherence to recommended treatment regimens. Patient nonadherence can be a pervasive threat to health and wellbeing and carry an appreciable economic burden as well. In some disease conditions, more than 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. While no single intervention strategy can improve the adherence of all patients, decades of research studies agree that successful attempts to improve patient adherence depend upon a set of key factors. These include realistic assessment of patients' knowledge and understanding of the regimen, clear and effective communication between health professionals and their patients, and the nurturance of trust in the therapeutic relationship. Patients must be given the opportunity to tell the story of their unique illness experiences. Knowing the patient as a person allows the health professional to understand elements that are crucial to the patient's adherence: beliefs, attitudes, subjective norms, cultural context, social supports, and emotional health challenges, particularly depression. Physician-patient partnerships are essential when choosing amongst various therapeutic options to maximize adherence. Mutual collaboration fosters greater patient satisfaction, reduces the risks of nonadherence, and improves patients' healthcare outcomes.
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PMID:The challenge of patient adherence. 1836 May 59

An item-cued directed forgetting paradigm was used to investigate the ability to control episodic memory and selectively encode complex coloured pictures. A series of photographs was presented to 21 participants who were instructed to either remember or forget each picture after it was presented. Memory performance was later tested with a recognition task where all presented items had to be retrieved, regardless of the initial instructions. A directed forgetting effect--that is, better recognition of "to-be-remembered" than of "to-be-forgotten" pictures--was observed, although its size was smaller than previously reported for words or line drawings. The magnitude of the directed forgetting effect correlated negatively with participants' depression and dissociation scores. The results indicate that, at least in an item method, directed forgetting occurs for complex pictures as well as words and simple line drawings. Furthermore, people with higher levels of dissociative or depressive symptoms exhibit altered memory encoding patterns.
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PMID:Directed forgetting of complex pictures in an item method paradigm. 1860 77

Subjects with depression exhibit deficits in prefrontal function. We posited that as a result, in a supraspan memory test, they would be impaired in their ability to inhibit recall of irrelevant words, and because of consequent overload of working and episodic memory capacity, would be impaired in their ability to recall relevant words. We tested this hypothesis in 30 inpatients and outpatients with a diagnosis of major depressive disorder and 30 controls subjects using a form of the Directed Forgetting Paradigm using exclusively neutral words. The depressed subjects did exhibit deficits in prefrontal function. All subjects were given four lists of 24 items each, in which half the words were followed by the instruction and half by the instruction Our hypothesis found support in a significant group by item type interaction effect exhibited when subjects were instructed to recall only those items followed by the instruction: depressed subjects recalled relatively more words to be forgotten and relatively fewer words to be remembered. A control experiment suggested that these results could not be accounted for by a differential effect of depression on memory encoding.
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PMID:Directed forgetting in depression. 1876 86

Non-verbal memory impairment in Alzheimer-type dementia: Forgetting or acquisition?. The research aims to compare patients diagnosed with early Alzheimer's disease (AD) and unipolar major depression (D) with a healthy control group (HS) on diverse nonverbal memory tasks (NVM), recall of position, and recognition of abstracts designs. All participants completed a global protocol for diagnosis of dementia. The patients with early AD (n= 27) and D (n= 19) were compared with the healthy subject group (n= 30) on a standardised visuospatial learning test. The AD patients scored significantly lower than HS and D on NVM tasks, but there were no significant differences between AD and D on position recall. Furthermore, the AD group did not show faster forgetting rates on position recall or design recognition in comparison to HS and D groups. These results are interpreted in terms of neurocognitive processes that explain NVM impairment in AD and depression.
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PMID:[Non-verbal memory impairment in Alzheimer-type dementia: Forgetting or acquisition?]. 1917 50

In this study, the authors investigated whether training participants to use cognitive strategies can aid forgetting in depression. Participants diagnosed with major depressive disorder (MDD) and never-depressed participants learned to associate neutral cue words with a positive or negative target word and were then instructed not to think about the negative targets when shown their cues. The authors compared 3 different conditions: an unaided condition, a positive-substitute condition, and a negative-substitute condition. In the substitute conditions, participants were instructed to use new targets to keep from thinking about the original targets. After the training phase, participants were instructed to recall all targets when presented with the cues. MDD participants, in contrast with control participants, did not exhibit forgetting of negative words in the unaided condition. In both the negative and positive substitute conditions, however, MDD participants showed successful forgetting of negative words and a clear practice effect. In contrast, negative substitute words did not aid forgetting by the control participants. These findings suggest that training depressed individuals to use cognitive strategies can increase forgetting of negative words.
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PMID:Training forgetting of negative material in depression. 1922 12

Medial temporal lobe structures are responsible for recording the continuous stream of autobiographical memories that define our unique personal history. Remarkably, these areas can construct durable memories from brief exposures to the constantly changing activity patterns arriving from antecedent cortical areas. Using a computer model of the hippocampal Schaffer collateral pathway that incorporates evidence for dendritic spikes in CA1 pyramidal neurons, we searched for biologically-plausible long-term potentiation (LTP) and homeostatic depression (HD) rules that maximize "online" learning capacity. We found memory utilization is most efficient when (1) very few synapses are modified to store each pattern, (2) LTP, the learning operation, is dendrite-specific and gated by distinct pre- and postsynaptic thresholds, (3) HD, the forgetting operation, co-occurs with LTP and targets least-recently potentiated synapses, and (4) both LTP and HD are all-or-none, leading de facto to binary-valued synaptic weights. In networks containing up to 40 million synapses, the learning scheme led to order-of-magnitude capacity increases compared to conventional plasticity rules.
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PMID:Capacity-enhancing synaptic learning rules in a medial temporal lobe online learning model. 1937 65

Research into the cognitive consequences of chronic excessive alcohol use continues to grow. Despite this, little research has investigated what impact excessive alcohol use might have upon everyday remembering. An important aspect of everyday remembering is prospective memory (PM), which refers to the cognitive ability of remembering to carry out an intended action at some future point in time. The majority of the studies which have focused on what impact excessive alcohol use has upon PM in teenagers and young adults have consistently found that the excessive drinkers reported more lapses in their short term (e.g., forgetting to lock one's door upon leaving home) and long term (e.g., forgetting to post a letter on time) aspects of everyday PM, when compared to low-dose alcohol users or non-users. It is concluded from this review that PM deficits should be added to the growing list of neuropsychological sequelae associated with excessive alcohol use. The magnitude of the effects of alcohol on PM depends upon the amount of alcohol consumed and how long one has been drinking. Major limitations of these studies include their reliance upon the use of self-report measures of PM, the issue of polydrug use complicating the picture, the need to control for the co-morbidity of other conditions--such as depression, and better drug-screening methods. Therefore, further studies need to employ objective measures alongside self-report measures of PM, incorporate better controls for the use of other drugs and mood states, as well as extending the focus of the research to study what effect different patterns of alcohol use might have upon PM, e.g., what impact binge drinking has upon everyday PM. These findings have educational and applied relevance within the alcohol field.
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PMID:The impact of excessive alcohol use on prospective memory: a brief review. 1963 Jul 3

Mood-congruent cognitive biases constitute critical factors for the vulnerability to depression and its maintenance. One important aspect is impaired memory for positive information during depression and after recovery. To elucidate its state (during depression only) and trait (during depression and recovery) related neural bases, we investigated medication free depressed, recovered, and healthy individuals with functional MRI while they memorized and recognized happy and neutral face stimuli. The imaging results revealed group differences in mood-incongruent successful memory encoding and retrieval activity already in the absence of significant memory performance differences. State effects were observed in the amygdala and posterior cingulate cortex. Whereas the amygdala was generally involved in memory formation, its activity predicted subsequent forgetting of neutral faces in depressed patients. Furthermore, the amygdala and posterior cingulate cortex were involved in memory retrieval of happy faces in depressed patients only. Trait effects were observed in the fusiform gyrus and prefrontal cortex. The fusiform gyrus was involved in memory formation and retrieval of happy faces in both patient groups, whereas it was involved in memory formation and retrieval of neutral faces in healthy individuals. Similar trait effects were observed during memory retrieval in the orbitofrontal cortex and left inferior frontal gyrus. Thus, while memory processing of positive information in the amygdala and posterior cingulate cortex is biased during depression only, memory processing in the fusiform gyrus and prefrontal cortex is biased also after recovery. These distinct neural mechanisms may respectively constitute symptom maintenance and cognitive vulnerability factors for depression.
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PMID:Neural state and trait bases of mood-incongruent memory formation and retrieval in first-episode major depression. 2000 14


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