Abstract
We investigated the feasibility of a short intervention using the Method of Loci (MoL), a well-known visuospatial mnemonic, to improve episodic memory recall performance in schizophrenia. The MoL training protocol comprised encoding and recall of two lists of items (words and images), a training session and practice with MoL. Then, participants had the opportunity to put into practice the newly learned MoL and were instructed to encode and recall two new lists of items using. This approach was first validated with healthy individuals (N = 71). Subsequently, five individuals with schizophrenia completed the protocol. Improvement in healthy individuals was observed for the word list (Wilcoxon effect size r = 0.15). No significant memory improvement was denoted in the schizophrenia group, possibly due to participants' difficulties using the method efficiently and due to fatigue. The MoL seems to require episodic memory, working memory monitoring and executive functions, making it suboptimal for a population with impairments in all those domains. Future research should examine the use of other strategies, better suited for individuals with cognitive impairments like those found in schizophrenia.
Highlights
Episodic memory, one’s ability to remember past events (Tulving, 1972), is severely impaired in schizophrenia (Feldmann et al, 2002; Berna et al, 2016), and such deficits are associated with compromised daily living activities and poor psychosocial functioning (Lepage et al, 2014)
Strategy Use Prior to Method of Loci (MoL) Training When asked whether and subsequently which strategies they used to learn items in the pre-test, on average 56% of participants reported as primary strategy making sentences or making a song using list items, 32% imagined items interacting in some way, 23% considered how objects were related to each other, 13% associated items to personal memories, 13% used repetition, and 13% used other strategies, such as visualizing the items, memorizing the first letter of the item’s name, organizing items in alphabetical order, making an acronym or grouping objects into one or more rooms
In the Memory Strategy Questionnaire (MSQ), the most often used strategy reported was “repetition” (“I repeated the name of the items to myself in my head”), followed by “personal memories” (“I used prior personal memories associated with the items”), “items related” (“I considered how the items could be related to each other”), and “making sentences” (“I constructed a sentence with the two items”)
Summary
One’s ability to remember past events (Tulving, 1972), is severely impaired in schizophrenia (Feldmann et al, 2002; Berna et al, 2016), and such deficits are associated with compromised daily living activities and poor psychosocial functioning (Lepage et al, 2014). People with schizophrenia fail to spontaneously generate efficient strategies that improve memory recall (Iddon et al, 1998). The use of encoding strategies (e.g., forming a story, mental imagery, or using categories to link words) in non-clinical individuals often results in a richer memory-trace that subsequently increases recollection when compared to thinking about the word’s visual features or using repetition (Bower, 1970; Tulving, 1972; Craik, 2002). When explicitly instructed to use similar strategies, individuals with schizophrenia can significantly improve their episodic memory. MoL Healthy Individuals and Schizophrenia performance (McClain, 1983; Ragland et al, 2003; BonnerJackson et al, 2005; Bonner-Jackson and Barch, 2011; Guimond and Lepage, 2016)
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