Şizofrenide otobiyografik bellek: Hastalık ve başarı anılarının özgüllüğü, işlevleri ve fenomenolojik özellikleri

Year 2024, , 1 - 17, 25.04.2024

Emirhan Emir , Aysu Mutlutürk

https://doi.org/10.57127/kpd.26024438.1274975

Abstract

Şizofreni hastalarının hastalık temalı anılarını sağlıklı insanlardan daha sık, başarı ile ilgili anılarını ise nadiren hatırladıkları gözlemlenmektedir. Ancak bugüne kadar şizofreni hastalarının bu hatırlama örüntüsüne konu olan hastalık ve başarı anılarını nasıl ve ne amaçla hatırladıklarını anlamaya yönelik bir araştırma yapılmamıştır. Bu çalışmanın amacı, şizofreni hastalarının hastalık ve başarı temalı anılarını özgüllük, anıdan anlam çıkarma, bellek işlevleri, fenomenolojik özellikler ve anının merkeziyeti bazında karşılaştırmalı olarak incelemektir. Araştırmada şizofreni hastası katılımcılardan (n = 30) hastalık ve başarı ile ilgili birer anı anlatmaları ve her anıyı işlevleri (Yaşam Deneyimleri Hakkında Düşünme Ölçeği/YDHDÖ), fenomenolojik özellikleri (Otobiyografik Anı Anketi/OAA) ve anının merkeziliği (Olayların Merkeziliği Ölçeği/OMÖ) bakımından değerlendirmeleri istenmiştir. Bulgular, hastalık anılarının başarı anılarına kıyasla (1) daha özgül anlatılarla aktarıldığını; (2) daha olumsuz duygularla, zamanda geriye dönme hissinin daha yoğun deneyimlenerek ve sınırlı mekân bilgisi eşliğinde hatırlandığını göstermektedir. Ayrıca şizofreni hastalarında hem hastalık hem de başarı anılarının benlik ve sosyal işlevlerden ziyade yönlendirme işlevine hizmet ettiği bulunmuştur. Anı türüne göre bellek işlevleri, anının merkeziyeti ve anıdan anlam çıkarma bakımından farklılaşma saptanmamıştır. Bu bulgular, şizofreni hastalarının hastalık temalı anılarını bellekte daha erişilebilir durumda tutabildiklerine ve bu anılar söz konusu olduğunda güçlü bir bilinçli hatırlama deneyimi yaşayabildiklerine işaret etmektedir. Anı türünden bağımsız olarak, anıların benlik ve sosyal işlevlerle daha az ilişkilendirilmesi ve anlam çıkarma düzeyinin çok düşük olması, şizofreni hastalarının anılarını benlikle ilişkilendirme ve anlamlandırma süreçlerinde sorunlar yaşayabildiklerini gösteren diğer çalışmaları destekler niteliktedir. Bulguların şizofreni hastalarının deneyimlerini benliklerine nasıl entegre ettiklerini ve şizofreninin altında yatan mekanizmaları anlamak bakımından ufuk açıcı olması ümit edilmektedir.

Keywords

anlam çıkarma, bellek işlevleri, fenomenolojik özellikler, otobiyografik bellek, özgüllük, şizofreni

Ethical Statement

Bu çalışma İstanbul Medipol Üniversitesi Etik kurlu (22.03.2022, Karar no:32) ve İstanbul İl Sağlık Müdürlüğü 01.08.2022 tarih ve 2022/14 sayılı kararınca uygun görülmüştür.

Autobiographical memory in schizophrenia: Specificity, functions and phenomenological characteristics of illness- and achievement-related memories

Abstract

Research has shown that people with schizophrenia remember illness-related memories more frequently than healthy controls and rarely remember achievement-related memories. To date, to the best of our knowledge, no research has been conducted to understand how and with what function schizophrenia patients remember their illness- and achievement-related memories. This study aimed to investigate this issue focusing on specificity, meaning-making, functions, phenomenology, and centrality of illness- and achievement-related memories. A group of schizophrenic patients (n = 30) were asked to report their memories related to their illness and achievements and evaluate each memory in terms of functions, phenomenology, and centrality. Results showed that compared to achievement-related memories, illness-related memories (1) were more specific; (2) included more negative emotions, more intense experience of traveling back in time and less information about the spatial layout. It was also found that both illness- and achievement-related memories served the directive function more than the self and the social functions. However, memory type did not impact memory functions, meaning-making, and the centrality of the event. These findings suggest that illness-related memories may be more accessible and lead to an increased conscious recollection among patients with schizophrenia. The fact that both types of memories served the self and the social functions less and included less meaning-making may support the previous findings that patients with schizophrenia may have problems in making sense of their memories and associating them with the self. We believe that our findings may provide insights into how schizophrenia patients integrate their experiences into the self, and the mechanisms underlying schizophrenia.

Keywords

autobiographical memory, meaning-making, memory functions, phenomenology, schizophrenia, specificity

Ethical Statement

This study was approved by İstanbul Medipol University Ethics Committee with the decision dated 22.03.2022 (Decision no: 32) and Istanbul Provincial Health Directorate (Date: 01.08.2022, no: 2022/14).

References

• Alea, N. ve Bluck, S. (2003). Why are you telling me that? A conceptual model of the social function of autobiographical memory. Memory, 11(2), 165-178.
• Aleman, A., Hijman, R., De Haan, E. H. ve Kahn, R. S. (1999). Memory impairment in schizophrenia: A meta-analysis. American Journal of Psychiatry, 156(9), 1358-1366.
• Angermeyer, M. C. ve Dietrich, S. (2006). Public beliefs about and attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scandinavica, 113(3), 163-179.
• Angermeyer, M. C. ve Matschinger, H. (2003). The stigma of mental illness: Effects of labelling on public attitudes towards people with mental disorder. Acta Psychiatrica Scandinavica, 108(4), 304-309.
• Baddeley, A. (2012). Reflections on autobiographical memory. D. Berntsen ve D. C. Rubin (Ed.), Understanding autobiographical memory: Theories and approaches içinde (s. 70-87). Cambridge University Press.
• Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. ve Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
• Bennouna-Greene, M., Berna, F., Conway, M. A., Rathbone, C. J., Vidailhet, P. ve Danion, J.M. (2012). Self-images and related autobiographical memories in schizophrenia. Consciousness and Cognition, 21(1), 247-257.
• Berna, F., Bennouna-Greene, M., Potheegadoo, J., Verry, P., Conway, M. A. ve Danion, J. M. (2011). Self-defining memories related to illness and their integration into the self in patients with schizophrenia. Psychiatry Research, 189(1), 49-54.
• Berntsen, D. ve Rubin, D. C. (2006). The Centrality of Event Scale: A measure of integrating a trauma into one's identity and its relation to post-traumatic stress disorder symptoms. Behaviour Research and Therapy, 44(2), 219-231.
• Biondolillo, M. J. ve Pillemer, D. B. (2015). Using memories to motivate future behaviour: An experimental exercise intervention. Memory, 23(3), 390-402.
• Blagov, P. S. ve Singer, J. A. (2004). Four dimensions of self-defining memories (content, specificity, meaning, affect) and their relationship to self-restraint, distress, and defensiveness. Journal of Personality, 72, 481-511.
• Bleuler, E. (1950). Dementia praecox or the group of schizophrenias (Çev. J. Zinkin). International Universities Press.
• Bluck, S. (2003). Autobiographical memory: Exploring its functions in everyday life. Memory, 11(2), 113-123.
• Bluck, S., Alea, N., Habermas, T. ve Rubin, D. C. (2005). A tale of three functions: The self–reported uses of autobiographical memory. Social Cognition, 23(1), 91-117.
• Bluck, S. ve Habermas, T. (2000). The life story schema. Motivation and Emotion, 24(2), 121-147.
• Bowins, B. ve Shugar, G. (1998). Delusions and self-esteem. Canadian Journal of Psychiatry, 43, 154-158.
• Boyacıoğlu, İ. ve Aktaş, Ç. (2018). Olayların Merkeziliği Ölçeği: Geçerlik ve güvenirlik çalışması. Türk Psikoloji Yazıları, 21(41), 17-26.
• Brewer, W. F. (1986). What is autobiographical memory? D. C. Rubin (Ed.), Autobiographical memory içinde (s. 25-49). Cambridge University Press.
• Buchanan, R. W. (2007). Persistent negative symptoms in schizophrenia: An overview. Schizophrenia Bulletin, 33(4), 1013-1022.
• Cohen, G. (1998). The effects of aging on autobiographical memory. C. P. Thompson, D. J. Herrmann, D. Bruce, J. Don Read, D. G. Payne ve M. P. Toglia (Ed.), Autobiographical memory: Theoretical and applied perspectives içinde (s. 105-123). Lawrence Erlbaum Associates.
• Comblain, C., D'Argembeau, A. ve Van der Linden, M. (2005). Phenomenal characteristics of autobiographical memories for emotional and neutral events in older and younger adults. Experimental Aging Research, 31(2), 173-189.
• Conway, M. A. (1996). Autobiographical knowledge and autobiographical memories. D. C. Rubin (Ed.), Remembering our past: Studies in autobiographical memory içinde (s. 67-93). Cambridge University Press.
• Conway, M. A. ve Pleydell-Pearce, C. W. (2000). The construction of autobiographical memories in the self-memory system. Psychological Review, 107(2), 261-288.
• Conway, M. A., Singer, J. A. ve Tagini, A. (2004). The self and autobiographical memory: Correspondence and coherence. Social Cognition, 22(5: Special issue), 491-529.
• Conway, M. A. ve Holmes, A. (2004). Psychosocial stages and the accessibility of autobiographical memories across the life cycle. Journal of Personality, 72(3), 461-480.
• Cuervo-Lombard, C., Jovenin, N., Hedelin, G. U. Y., Rizzo-Peter, L., Conway, M. A. ve Danion, J. M. (2007). Autobiographical memory of adolescence and early adulthood events: An investigation in schizophrenia. Journal of the International Neuropsychological Society, 13(2), 335-343.
• Danion, J. M., Cuervo, C., Piolino, P., Huron, C., Riutort, M., Peretti, C. S. ve Eustache, F. (2005). Conscious recollection in autobiographical memory: An investigation in schizophrenia. Consciousness and Cognition, 14(3), 535-547.
• D'Argembeau, A., Comblain, C. ve Van der Linden, M. (2003). Phenomenal characteristics of autobiographical memories for positive, negative, and neutral events. Applied Cognitive Psychology: The Official Journal of the Society for Applied Research in Memory and Cognition, 17(3), 281-294.
• D'Argembeau, A., Raffard, S. ve Van der Linden, M. (2008). Remembering the past and imagining the future in schizophrenia. Journal Of Abnormal Psychology, 117(1), 247-251.
• D'Argembeau, A. ve Van der Linden, M. (2008). Remembering pride and shame: Self-enhancement and the phenomenology of autobiographical memory. Memory, 16(5), 538-547.
• Demiray, B. ve Janssen, S. M. (2015). The self‐enhancement function of autobiographical memory. Applied Cognitive Psychology, 29(1), 49-60.
• Drake, R. J., Dunn, G., Tarrier, N., Bentall, R. P., Haddock, G. ve Lewis, S. W. (2007). Insight as a predictor of the outcome of first-episode nonaffective psychosis in a prospective cohort study in England. The Journal of Clinical Psychiatry, 68(1), 81-86.
• Eich, E., Handy, T. C., Holmes, E. A., Lerner, J. ve McIsaac, H. K. (2012). Field and observer perspectives in autobiographical memory. Social Thinking and Interpersonal Behavior, 3078(March), 163-182.
• Elvevåg, B., Kerbs, K. M., Malley, J. D., Seeley, E. ve Goldberg, T. E. (2003). Autobiographical memory in schizophrenia: An examination of the distribution of memories. Neuropsychology, 17(3), 402-409.
• Feinstein, A., Goldberg, T. E., Nowlin, B. ve Weinberger, D. R. (1998). Types and characteristics of remote memory impairment in schizophrenia. Schizophrenia Research, 30(2), 155-163.
• Folstein, M. F., Folstein, S. E. ve McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198.
• Freeman, D., Garety, P., Fowler, D., Kuipers, E., Dunn, G., Bebbington, P. ve Hadley, C. (1998). The London–Anglia randomized controlled trial of cognitive–behaviour therapy for psychosis: IV. Self-esteem and persecutory delusions. British Journal of Clinical Psychology, 37, 415-430.
• Geraerts, E., Dritschel, B., Kreplin, U., Miyagawa, L. ve Waddington, J. (2012). Reduced specificity of negative autobiographical memories in repressive coping. Journal Of Behavior Therapy and Experimental Psychiatry, 43, S32-S36.
• Güngen, C., Ertan, T., Eker, E., Yaşar, R. ve Engin, F. (2002). Standardize Mini Mental Test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi, 13(4), 273-281.
• Habermas, T. ve Bluck, S. (2000). Getting a life: The emergence of the life story in adolescence. Psychological Bulletin, 126(5), 748-769.
• Heinrichs, R. W. ve Zakzanis, K. K. (1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12(3), 426-445.
• Hisli, N. (1989). Beck Depresyon Envanteri’nin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi, 7(23), 3-13.
• Insel, T. (2010). Rethinking schizophrenia. Nature, 468, 187-193.
• Janssen, S. M. ve Murre, J. M. (2008). Reminiscence bump in autobiographical memory: Unexplained by novelty, emotionality, valence, or importance of personal events. The Quarterly Journal of Experimental Psychology, 61(12), 1847-1860.
• Kay, S. R., Fiszbein, A. ve Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia bulletin, 13(2), 261-276.
• Kostakoğlu, A. E., Batur, S., Tiryaki, A. ve Göğüş, A. (1999). Pozitif ve Negatif Sendrom Ölçeğinin (PANSS) Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türk Psikoloji Dergisi, 14(44), 23-32.
• Landis, J. R. ve Koch, G. G. (1977). An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics, 363-374.
• Lecomte, T., Cyr, M., Lesage, A. D., Wilde, J., Leclerc, C. ve Ricard, N. (1999). Efficacy of a self-esteem module in the empowerment of individuals with schizophrenia. Journal of Nervous and Mental Disease, 187, 406-413.
• Lincoln, T. M., Lüllmann, E. ve Rief, W. (2007). Correlates and long-term consequences of poor insight in patients with schizophrenia. A systematic review. Schizophrenia Bulletin, 33(6), 1324-1342.
• Lysaker, P. H., Carcione, A., Dimaggio, G., Johannesen, J. K., Nicolò, G., Procacci, M. ve Semerari, A. (2005). Metacognition amidst narratives of self and illness in schizophrenia: Associations with neurocognition, symptoms, insight and quality of life. Acta Psychiatrica Scandinavica, 112(1), 64-71.
• Lysaker, P. H. ve Lysaker, J. T. (2002). Narrative structure in psychosis: Schizophrenia and disruptions in the dialogical self. Theory ve Psychology, 12(2), 207-220.
• McLeod, H. J., Wood, N. ve Brewin, C. R. (2006). Autobiographical memory deficits in schizophrenia. Cognition and Emotion, 20(3-4), 536-547.
• Mutlutürk, A. ve Tekcan, A. İ. (2016). Remembering and telling self-consistent and self-discrepant memories. Memory, 24(4), 513-525.
• Nelson, K. (1993). The psychological and social origins of autobiographical memory. Psychological Science, 4(1), 7-14.
• Neumann, A., Blairy, S., Lecompte, D. ve Philippot, P. (2007). Specificity deficit in the recollection of emotional memories in schizophrenia. Consciousness and Cognition, 16(2), 469-484.
• Öner, S. ve Gülgöz, S. (2018). Autobiographical remembe-ring regulates emotions: A functional perspective. Memory, 26(1), 15-28.
• Öztürk, M. O. ve Uluşahin, A. (2014). Ruh sağlığı ve bozuklukları. Nobel Tıp Kitabevleri.
• Pasupathi, M., Lucas, S. ve Coombs, A. (2002). Conversational functions of autobiographical remembering: Long-married couples talk about conflicts and pleasant topics. Discourse Processes, 34(2), 163-192.
• Pernot-Marino, E., Schuster, C., Hedelin, G., Berna, F., Zimmermann, M. A. ve Danion, J. M. (2010). True and false autobiographical memories in schizophrenia: Preliminary results of a diary study. Psychiatry Research, 179(1), 1-5.
• Pillemer, D. (2003). Directive functions of autobiographical memory: The guiding power of the specific episode. Memory, 11(2), 193-202.
• Pillemer, D. B., Goldsmith, L. R., Panter, A. T. ve White, S. H. (1988). Very long-term memories of the first year in college. Journal of Experimental Psychology: Learning, Memory, and Cognition, 14(4), 709-715.
• Pillemer, D. B., Rhinehart, E. D. ve White, S. H. (1986). Memories of life transition: The first years in college. Human Learning, 5, 109-123.
• Pillemer, D. B. ve Kuwabara, K. J. (2012). Directive functions of autobiographical memory: Theory and method. D. Berntsen ve D. C. Rubin (Ed.), Understanding autobiographical memory: Theories and approaches içinde (s. 181-201). Cambridge University Press.
• Potheegadoo, J., Cuervo-Lombard, C., Berna, F. ve Danion, J. M. (2012). Distorted perception of the subjective temporal distance of autobiographical events in patients with schizophrenia. Consciousness and Cognition, 21(1), 90-99.
• Raes, F., Hermans, D., Williams, J. M. G., Beyers, W., Eelen, P. ve Brunfaut, E. (2006). Reduced autobiographical memory specificity and rumination in predicting the course of depression. Journal of abnormal psychology, 115(4), 699.
• Raffard, S., D'Argembeau, A., Lardi, C., Bayard, S., Boulenger, J. P., Boulenger, J. P. ve Van Der Linden, M. (2009). Exploring self-defining memories in schizophrenia. Memory, 17(1), 26-38.
• Raffard, S., D’Argembeau, A., Lardi, C., Bayard, S., Boulenger, J. P. ve Van der Linden, M. (2010). Narrative identity in schizophrenia. Consciousness and Cognition, 19(1), 328-340.
• Rasmussen, A. S. ve Berntsen, D. (2009). Emotional valence and the functions. Memory & Cognition, 37(4), 477-492.
• Rasmussen, A. S. ve Berntsen, D. (2010). Personality traits and autobiographical memory: Openness is positively related to the experience and usage of recollections. Memory, 18(7), 774-786.
• Riutort, M., Cuervo, C., Danion, J. M., Peretti, C. S. ve Salamé, P. (2003). Reduced levels of specific autobiographical memories in schizophrenia. Psychiatry Research, 117(1), 35-45.
• Rubin, D. C. ve Kozin, M. (1984). Vivid memories. Cognition, 16(1), 81-95.
• Rubin, D. C., Schrauf, R. W. ve Greenberg, D. L. (2003). Belief and recollection of autobiographical memories. Memory & Cognition, 31(6), 887-901.
• Rubin, D. C., Schrauf, R. W., Gulgoz, S. ve Naka, M. (2007). Cross-cultural variability of component processses in autobiographical remembering: Japan, Turkey, and the USA. Memory, 15(5), 536-547.
• Rubin, D. C. ve Siegler, I. C. (2004). Facets of personality and the phenomenology of autobiographical memory. Applied Cognitive Psychology: The Official Journal of the Society for Applied Research in Memory and Cognition, 18(7), 913-930.
• Segalovich, J., Doron, A., Behrbalk, P., Kurs, R. ve Romem, P. (2013). Internalization of stigma and self-esteem as it affects the capacity for intimacy among patients with schizophrenia. Archives of Psychiatric Nursing, 27(5), 231-234.
• Silverstone, P. H. (1991). Low self-esteem in different psychiatric conditions. British Journal of Clinical Psychology, 30, 185-188.
• Singer, J. A. ve Blagov, P. S. (2000). Classification system and scoring manual for self-defining autobiographical memories (Yayınlanmamış çalışma) Connecticut College.
• Singer, J. A. ve Moffitt, K. H. (1991). An experimental investigation of generality and specificity in memory narratives. Imagination, Cognition, and Personality, 10, 235-258.
• Sutin, A. R. ve Gillath, O. (2009). Autobiographical memory phenomenology and content mediate attachment style and psychological distress. Journal of Counseling Psychology, 56(3), 351-364.
• Sutin, A. R. ve Robins, R. W. (2007). Phenomenology of autobiographical memories: The memory experiences questionnaire. Memory, 15(4), 390-411.
• Talarico, J. M., LaBar, K. S. ve Rubin, D. C. (2004). Emotional intensity predicts autobiographical memory experience. Memory & Cognition, 32(7), 1118-1132.
• Tulving, E. (1985). Memory and consciousness. Canadian Psychology/Psychologie Canadienne, 26(1), 1-12.
• Tulving, E. (2001). Origin of autonoesis in episodic memory. H. L. Roediger III, J. S. Nairne, I. Neath ve A. M. Surprenant (Ed.), The nature of remembering: Essays in honor of Robert G. Crowder (s. 17-34). American Psychological Association.
• Webster, J. D. (1995). Adult age differences in reminiscence functions. B. K. Haight ve J. D. Webster (Ed.), The art and science of reminiscing: Theory, researchs, methods, and applications içinde (s. 89-102). Taylor ve Francis.
• Wheeler, M. A., Stuss, D. T. ve Tulving, E. (1997). Toward a theory of episodic memory: The frontal lobes and autonoetic consciousness. Psychological Bulletin, 121(3), 331-354.
• Werner, P., Aviv, A. ve Barak, Y. (2008). Self-stigma, self-esteem and age in persons with schizophrenia. International Psychogeriatrics, 20(1), 174-187.
• Williams, J. M. G., Barnhofer, T., Crane, C., Herman, D., Raes, F., Watkins, E. ve Dalgleish, T. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133(1), 122-148.
• Wilson, A. ve Ross, M. (2003). The identity function of autobiographical memory: Time is on our side. Memory, 11(2), 137-149.
• Wood, W. ve Conway, M. (2006). Subjective impact, meaning making and current and recalled emotions for self defining memories. Journal of Personality, 74, 811-846.
• Zaragoza Scherman, A., Salgado, S., Shao, Z. ve Berntsen, D. (2015). Event centrality of positive and negative autobiographical memories to identity and life story across cultures. Memory, 23(8), 1152-1171.