AUTOBIOGRAPHICAL MEMORY AND PROBLEM SOLVING IN BIPOLAR DISORDER

AUTOBIOGRAPHICAL MEMORY AND PROBLEM SOLVING IN BIPOLAR DISORDER Marie Boulanger*, Aurélie Lejeune & Sylvie Blairy University of Liege, Belgium INTRODUCTION Autobiographical memory (AM) is an entity that encompasses the individuals' past personal experiences. AM plays an active role in : 1. Problem solving : AM deficit is closely related to impairment in social problems solving. This relation has been largely documented among parasuicide patients, depressed patients and Bipolar Disorder population (Evans et al. , 1992; Mansell & Lam, 2004, Williams et al. , 2005). The remembering of past experiences allows to generate appropriate solutions to problems; 2. Projection into the future : Impairments in the recollection of specific past events are correlated to impairments in the generation of specific future events in schizophrenia patients (D’Argembeau et al. , 2008 ; Williams et al. , 1996). Furthermore, the same neural regions are activated during the generation of past as well as future events (Addis et al. , 2007; Okuda et al. , 2003). In short, the retrieving of specific past memories enables to generate specific goals and plans and to solve problems. Therefore, AM deficit should be accompanied by a poor vision of the future that can lead to hopelessness and sometimes lead to suicide. Thus Williams et al. (1996) showed that suicidal patients retrieved fewer specifics memories than the control group did. Bipolar disorder (BD) is accompanied by deficit in AM ( Scott & al. , 2000; Mansell & Lam, 2004), suicidal attempts and suicide (Ilgen et al. , 2009). Thus, it is important to investigate (1) the abilities of bipolar patients to generate specific events (past as well as future events) and theirs relationships with the abilities to solve problems, (2) the relationship between AM and the abilities to generate future events. Figure 1. Relation between AM, Problem solving and imagining future events. Problem solving Hopelessness / Hope Goals & Plans Autobiographical Memory Projection into the future The purpose of this study was to investigate the deficits in AM and its links with the projection into the specific future events and problem solving. METHOD RESULTS Participants The analyses did not reveal any significant difference between two groups for age, sex and education levels. • 19 patients (8 ♂) fulfilled the DSM-IV criteria for bipolar disorder (bipolar I or bipolar II). 19 healthy subjects (8 ♂) • 1. For the past task: a significant group by memory interaction Exclusion criteria for all subjects included (1) alcoholism or other drug abuse, (2) organic cerebral diseases, (3) neurological diagnosis and (4) benzodiazepines treatment. emerged (F(2, 72) = 4. 7; p=. 012) which indicates that the patients with BD recollected less specific events and more overgeneral events than controls (respectively, t(36) = 2, 37; p=. 029; t(36) = 2. 31; p=. 026) (see table 1). Table 1. Mean specificity to past version Te. MA Dependant measures 1) A validated French versions (Neumann & Philippot, of the AMT (Williams & Broadbent, 1986). A past version: participants were asked to retrieve specific personal events in response to ten cue words. A future version: participants were asked to generate specific personal events that could occur to them in the future in response to ten cue words. unpublished manuscript) 2) The Optional Thinking Test (OTT, Platt & Spivack, 1977). Measures the ability of individuals to conceive in the face of four everyday problems. Participants were asked to generate the most appropriate solutions. 2. For the future task: a significant group by memory interaction 3. emerged (F(2, 72) = 8. 79; p<. 001) which indicates that the patients 4. with BD were less specific and more overgeneral than controls 5. when they project into the future (respectively, t(36) = 3. 96; p<. 001; 6. t(36) = 2. 78; p=. 008) (see table 2). Correlations Table 2. Mean specificity to future version Te. MA § The number of generated past specific events is correlated to the number of generated future specific events across all participants (r(38) =. 55; ρ=. 55). • Among all participants, a significant correlations between the number of generated past specific events and the numbers of genertated future specific events with the numbers of generated appropriate solutions emerged (r(38) =. 55; p=. 001; r(38) =. 41; p=. 01, respectively). However, the results do not reveal any significant difference between the capacity to generate solutions to social problems between bipolar patients and healthy subjects DISCUSSION 1. The present study is the first one to investigate the ability to generate specific past as well as future events in patients with bipolar disorders. The results are in line with the results of study with bipolar patients (Scott & al. , 2000 and Mansell & Lam, 2004) and the results of previous studies with patients having an emotional disorders that is: AM performance in patients with BD is effectively impaired in comparison to healthy individuals for past as well as future events. 2. Furthermore, the results showed a relationship between past specificity and future specificity across all participants. According to Addis et al. (2007) such as Suddendorf & Corballis (2007) the past enables to simulate mentally the future. Each new envisaged specific future situation is constructed from the memory of details of past experiences. The results of the present study support this notion. 3. Finally, this study is also the first to investigate the relationships between the abilities to generate specific events (past and future) among bipolar patients and to show that a relationship between these cognitive abilities and the abilities to generate appropriate solutions to problems. Consequences, the reduced capacities to generate personal specific life events is particularly clinically relevant. Indeed, according to Williams et al. (1996), difficulty in imagining the future may contribute to impairments in problem solving and to suicidal behaviors. Regarding the important role that plays the inability to imagine the future in suicidal ideations, more systematic measure of this ability should be taken in both research and clinical fields. *Correspondence to adress to Marie Boulanger, Departement of Cognitive Science, University of Liège, Boulevard du Rectorat 3 (B 33), 4000 Liège, Belgium. E-mail: marie. boulanger@ulg. ac. be Addis, Wong & Schacter (2007). Remembering the past and imagining the future: common and distinct neural substrates during event construction and elaboration. Neuropsychologia, 45, 1363 -1377. D’Argembeau, Raffard, & Van der Linden (2008). Remembering the past and imagining the future in schizophrenia. Journal of Abnormal Psychology, 117(1), 247 -251. Evans, Williams, O’Loughlin, & Howells (1992). Autobiographical memory and problem-solving strategies of parasuicide patients. Psychological Medicine, 22, 399 -405. Mansell, & Lam (2004). 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