Evaluating verbal learning and memory in patients with an at-risk mental state or first episode psychosis using structural equation modelling

Abstract

BackgroundVerbal learning and memory are impaired not only in patients with a first episode of psychosis (FEP) but also–to a lower extent–in those with an at-risk mental state for psychosis (ARMS). However, little is known about the specific nature of these impairments. Hence, we aimed to study learning and memory processes in ARMS and FEP patients by making use of structural equation modelling.MethodsVerbal learning was assessed with the California Verbal Learning Test (CVLT) in 98 FEP patients, 126 ARMS patients and 68 healthy controls (HC) as part of the Basel early detection of psychosis (FePsy) study. The four-factorial CFA model of Donders was used to estimate test performance on latent variables of the CVLT and growth curve analysis was used to model the learning curve. The latter allows disentangling initial recall, which is strongly determined by attentional processes, from the learning rate.ResultsThe CFA model revealed that ARMS and FEP patients were impaired in Attention Span, Learning Efficiency and Delayed Memory and that FEP patients were additionally impaired in Inaccurate Memory. Additionally, ARMS-NT, but not ARMS-T, performed significantly worse than HC on Learning Efficiency. The growth curve model indicated that FEP patients were impaired in both initial recall and learning rate and that ARMS patients were only impaired in the learning rate.ConclusionsSince impairments were more pronounced in the learning rate than the initial recall, our results suggest that the lower scores in the CVLT reported in previous studies are more strongly driven by impairments in the rate of learning than by attentional processes.

Verbal memory and voxel based morphometry in first episode non-affective psychosis: A process oriented approach.

“…Keywords: first episode psychosis, verbal memory, voxel based morphometry, orbitofrontal cortex Supplemental materials: http://dx.doi.org/10.1037/neu0000540.supp Deficits in verbal memory have been reported by the vast majority of published research in schizophrenia (Heinrichs, Parlar, & Pinnock, 2017;Mesholam-Gately, Giuliano, Goff, Faraone, & Seidman, 2009;Schaefer, Giangrande, Weinberger, & Dickinson, 2013;Toulopoulouand & Murray, 2004) and have also been detected in first episode psychosis (FEP) patients, confirming they are already present at the early stages of the illness (Bilder et al, 2000;Egloff et al, 2018;Fatouros-Bergman, Cervenka, Flyckt, Edman, & Farde, 2014;Hill, Beers, Kmiec, Keshavan, & Sweeney, 2004;Jordan et al, 2018;Sheffield, Karcher, & Barch, 2018). They can even represent vulnerability markers for psychosis (Carrión et al, 2018;Fusar-Poli et al, 2012;Koutsouleris et al, 2012;Lencz et al, 2006).…”

Food memory test to evaluate memory function

“…Therefore, they structuralize overall cognitive function and help with a subject’s diagnosis and anticipated prognosis [ 3 , 4 ]. Common memory function tests include sub-questions of the Mini-Mental State Examination, the verbal learning test (VLT), and the Rey Complex Figure Test (RCFT) [ 5 , 6 ]. However, they are sophisticated and time consuming, and it is difficult to perform them quickly at bedside or in an outpatient clinic.…”