Understanding and Managing Working Memory Impairment in Schizophrenia: A Literature Review

QUESTION

Literature Review Outline – Video Game Example

Once you know what you’re writing about, have an effective thesis statement, and a solid collection of work to reference, it’s time to begin outlining your literature review.

I – INTRODUCTION

• a. Summary of topic. Give a brief overview of your chosen field, and introduce the topic you’ve decided to discuss within that field. In staying with our example, you could talk about the game industry’s general lack of female characters, and the way male audiences are favored over female ones.
• b. Thesis statement. Here, you will offer up your thesis statement, wrapping up your summary of the topic and identifying the trend you’re going to examine. Just as our sample thesis statement did previously, you would use this area to identify a possible changing point for the game industry, and how certain independent game developers are working to change the status quo.

II – FIRST THEME Here, you’ll provide an overview of your first theme, discuss the way it emerges in your chosen field, and discuss relevant texts as reference. Let’s say here you choose to discuss the acknowledgement of female characters in video games over the last few years.

• a. Sub-theme. You need to break your theme up into parts, to make it easily comprehensible. That is, after all, the point of this. Here, you’ll discuss a facet of your theme, and talk about how that one part helps make up the whole. In sticking with our example, we could talk about ways game developers have chosen to simply add female playable characters in addition to males, and cite the appropriate texts that have examined this trend.
• b. Sub-theme. Continue citing facets of your primary theme. Here, perhaps you could talk about the ways games have chosen to create female characters with practical designs, keeping them equal to their male counterparts. You could cite relevant developer logs, journals, essays, and lectures about this topic.
• c. Sub-theme. Have as many body paragraphs as you need to discuss your point.

III – SECOND THEME Have as many main body paragraphs as you need to cover all aspects of your theme. Continue the example from above.

IV – CONCLUSION You want your conclusion to be a couple paragraphs long, in which you wrap up your discussion, and also point out some of the strengths and weaknesses of the literature and texts you’ve chosen to examine.

ANSWER

Understanding and Managing Working Memory Impairment in Schizophrenia: A Literature Review

Introduction

Schizophrenia is one of the less common mental disorders that affect human beings. It is a psychological impairment which affects the way a person behaves, feels, and thinks. A person suffering from the mental disorder looks and acts in a way that shows they have lost touch with reality. The disorder has negative, positive, and cognitive symptoms and is mostly associated with problems with an individual’s working memory. When a person suffering from schizophrenia learns or acquires new information, they are unable to put it to use immediately and have problems with paying attention and focusing. The main symptoms of the mental disorder that can be easily noted include problems with paying attention and problems with the working memory. In addition, patients with schizophrenia show symptoms such as reduced speaking and agitated body movements. Understanding the symptoms of schizophrenia is important for the identification of the mental disorder during its early stages and for the development of ways of handling patients suffering from the disorder.

Schizophrenia is a severe psychological disorder that affects several people in society. There are a number of factors that have been found to contribute to the mental disorder, and the various symptoms of the disorder have been listed by medical and psychology specialists. In order to understand the mental disorder and ensure effective management and handling of its patients, it is important to identify the various symptoms and effects of the disorder and identify their severity and how they affect the patients. Several researchers have conducted studies on the mental disorder, its symptoms, and how it affects the lives of its patients psychologically and physically. In this paper, past research on mental disorder and how it affects its patients is reviewed to gather information on the disorder and better understand it. The paper will largely focus on the loss of working memory in schizophrenia patients. It is hypothesized that the loss of working memory is the most significant and disabling cognitive symptom in schizophrenia patients and can be minimized. The following literature review attempts to support this hypothesis.

Literature Review

A number of researchers have carried out vast studies into the factors that contribute to schizophrenia, its symptoms, and its management. The shortfall in anticipatory pleasure in people with schizophrenia was investigated by Painter and Kring (2016). Since there are a number of processes that influence anticipatory pleasure, with these processes being related, the study by Painter and Kring (2016) sought to understand the extent to which each of these processes or facets are disrupted. In the study, people with and without schizophrenia disorder were asked to give memory and prospection stories in response to certain cues. The prospections were divided into those that followed a memory activity and those that followed the control activity.

The authors found that schizophrenia patients recalled memories that were the same in the experience and content as the controls, even though they would describe them in a way that was not very clear. It was also noted that schizophrenia patients had a low likelihood of referencing the past adequately in their prospection. They provided less detail in prospections. The loss of working memory came out as the most significant symptom in schizophrenia. The people with the disorder also reported levels of positive emotion that were similar in prospections which followed memory activities (Painter & Kring, 2016). The findings of this research clearly showed that schizophrenia patients have a hard time recalling past experiences and creating prospections that are detailed. This is a serious problem since a lot of the pleasure or joy that human beings experience in their lives comes from anticipating of good things which have not occurred yet.

The authors found evidence that asking schizophrenia patients to remember and describe their memories before asking them for prospections results in a higher likelihood of them referencing from the past. This may also improve the patients’ anticipatory pleasure or happiness. This study provides recommendations on how to improve anticipatory pleasure in people with schizophrenia. The effect of reward or gifts on the working memory in people with schizophrenia was investigated in a study by Cho et al. (2018). The study sought to understand the interface between cognition and reward processing in schizophrenia, processes which are both affected by schizophrenia. The research was an attempt to understand the influence that rewards have on schizophrenia patients in order to understand the symptoms management and treatment goals in managing the mental disorder.

The effects of rewards on working memory was analyzed through the presentation of the potential for monetary rewards in two ways: before each working memory test or contextually in a block of working memory tests (Cho et al., 2018). It was found that rewards given contextually do not result in an improvement in the performance of the working memory, while those presented in a test by test way improve the functioning of the working memory (WM) in schizophrenia. The results and findings of Cho et al. (2018) proved that the WM of schizophrenia patients can be boosted using rewards that are in the short-run, but not in the long-run. The motivated behavior in the patents is controlled by the strength of reward. The research suggested that schizophrenia patients have a problem in keeping future rewards in their mind for long time periods. They, however, remember a reward that can be achieved in the short-term and get motivated, which boosts their working memory.

The decrease in cognition, memory, and motivation in schizophrenia was demonstrated. It was shown that the working memory may be improved by rewards. The WM deficits in patients with schizophrenia were also investigated by Zilles et al. (2010). They investigated the heterogeneity between varying working memory activities since earlier research had not specified the activities used. Process-specific and circuit-specific WM activities were applied for investigation. In both working memory categories of tasks, it was noted that there was an impairment in the functioning of working memory in schizophrenia patients. In addition, it was identified that some patients showed varying patterns in selective impairment.

The study proved that schizophrenia patients show working memory impairments from a dysfunction of the neural networks. However, the impairment pattern varies with each patient. The authors identified that there was a variance for tasks that only needed patients to maintain verbal information. This calls for future research into the variation in the pattern of impairment. In order to understand whether WM training promotes the usage of strategies on tasks that involve untrained WM, Dunning and Holmes (2014) administered controlled tests on patients with schizophrenia. The study investigated how adaptive computerized training relates to improvement in untrained WM tasks, investigating whether training enhances the use of memory-related strategies. The participants were provided with tests of WM prior to acquiring WM training, either adaptive or non-adaptive. A different group of participants did the tests with no training.

The study found that adaptive training resulted in selective improvement in the untrained WM tests and a rise in the application of strategy, such as grouping, for verbal and visual tasks in the short-run. Dunning and Holmes (2014) demonstrated that training improves WM and that it may result in an improvement in the use of strategy for WM tasks. By increasing the amount of memory training, the capability of WM in schizophrenia patients may be improved. A meta-analysis on WM in schizophrenia was applied by Forbes, Carrick, McIntosh, and Lawrie (2009) to understand the extent of the problem. The authors had observed that the deterioration in working memory had gained the attention of many researchers and was being treated as the most significant feature in the neuropsychology of schizophrenia.

Despite the vast research on the issue, there was no clear explanation of the extent of the deficit. The authors conducted a review of the studies that had involved a comparison of the WM in patients of schizophrenia and control subjects who were healthy. Forbes et al. (2009) found a notable relationship with all the WM measures, which showed a deficit or impairment in Schizophrenia. The meta-analysis conducted showed that the impairment in the working memory could not just be detailed through showing differences in the intelligence quotient between control groups and schizophrenia patients. The research involved a number of working memory domains, with huge deficits in the working memory identified in all the domains for schizophrenia patients.

The relationship between the speed of memory processing, WM span, and memory impairment in schizophrenia was measured in a study by Brébion et al. (2011. The effects of the two elements on patients with schizophrenia was investigated through conducting varied visual and verbal memory tests. During the study, regression analyses on varied memory tests were conducted through the use of speed in processing and the span of WM as the independent variables. The study found that the speed of processing could be used to predict the level of deep and superficial memory in the visual and verbal working memory, while the working memory span could be used to measure the performance of deep memory. The study by Brébion et al. (2011) revealed that a decrease in the speed of memory processing results in visual and verbal memory deficits in schizophrenia patients.

Conclusion

While the research by Forbes et al. (2009) identified a similarity in the results obtained by various studies, the authors could only partly explain it. There is, therefore, need for further research into the issue of working memory and how it can be managed in schizophrenia. The studies by Brébion et al. (2011), Zilles et al. (2010) and Painter & Kring (2016) all show that the impairment of the working memory is a significant symptom in schizophrenia. Effort should be focused on effectively managing these symptoms, as the reviewed research proposes. Through short-term rewards and asking patients to remember their past experiences are some of the ways suggested by researchers for managing schizophrenia patients’ working memory deficiency. In addition, the study by Dunning and Holmes (2014) showed that working memory in patients with schizophrenia may be boosted through training activities. A decrease in the working memory capabilities is the major problem in patients with schizophrenia and can be managed by the provision of motivation through rewarding and through working memory training activities.

References

Brébion, G., Bressan, R. A., Pilowsky, L. S., & David, A. S. (2011). Processing speed and working memory span: their differential role in superficial and deep memory processes in schizophrenia. Journal of the International Neuropsychological Society, 17(3), 485-493.

Cho, Y. T., Lam, N. H., Starc, M., Santamauro, N., Savic, A., Diehl, C. K., … & Murray, J. D. (2018). Effects of reward on spatial working memory in schizophrenia. Journal of abnormal psychology, 127(7), 695.

Dunning, D. L., & Holmes, J. (2014). Does working memory training promote the use of strategies on untrained working memory tasks?. Memory & cognition, 42(6), 854-862.

Forbes, N. F., Carrick, L. A., McIntosh, A. M., & Lawrie, S. M. (2009). Working memory in schizophrenia: a meta-analysis. Psychological medicine, 39(6), 889-905.

Painter, J. M., & Kring, A. M. (2016). Toward an understanding of anticipatory pleasure deficits in schizophrenia: Memory, prospection, and emotion experience. Journal of abnormal psychology, 125(3), 442.

Zilles, D., Gruber, E., Falkai, P., & Gruber, O. (2010). Patients with schizophrenia show deficits of working memory maintenance components in circuit-specific tasks. European archives of psychiatry and clinical neuroscience, 260(7), 519-525.