[Did entry into nursing home during the health crisis favor the emergence of traumatic symptoms in the elderly?: Entry into nursing home and Covid]. / L'entrée en Ehpad, durant la crise sanitaire, a-t-elle favorisé l'émergence de symptômes traumatiques chez le sujet âgé ?

Our aim is to explore the possible emergence of traumatic symptoms and the identity-related repercussions of the restrictions on elderly, who entered into nursing homes during the Covid-19 health crisis in France. Twenty-five subjects institutionalised before the health crisis and twenty-six subjects institutionalised during the periods of lockdown into nursing homes completed scales assessing anxiety-depressive symptomatology, traumatic symptoms and identity. Anxiety and depression symptoms were similar between the groups. The institutionalised group showed a significantly higher prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria D and E on the Post traumatic Stress Disorder Checklist version DSM-5 (PCL-5) during lockdown. Entry into an institution during the health crisis would have favored the emergence of traumatic symptoms in the participants. Consideration of the ethical issues raised by this study could make it possible to offer more individualised support to elderly during their transition to a new home.

Exploring Characteristics of Self-Defining Memories in Older Adults.

The aim of this descriptive study was to investigate the Self-Defining Memories (SDMs) in a large sample of 181 older adults (65-90 years; mean age = 73.0 years) and to target the relationships between their different dimensions. The sampling method was nonprobabilistic, based on voluntary participation. Participants were asked to recall three SDMs. They also completed the Mini-Mental State Examination, the Hospital Anxiety and Depression Scale, and a Self-esteem Scale. Almost half of the SDMs were specific and more than a quarter were integrated. Specificity, tension, redemption, contamination sequences, and affective response varied regarding thematic content. Specificity was positively correlated to tension whereas autobiographical reasoning was positively correlated to redemption and negatively linked to emotional response and depression. This research highlighted that identity is constituted by the main types of events that make up a life: interpersonal relationships, life-threatening events, achievement, and leisure.

A cross-sectional study using self-defining memories to explore personal identity throughout adulthood.

Little research has examined changes in personal identity over different periods of adult development. The aim of the present cross-sectional study was to target these changes through the characterization of the main dimensions in self-defining memories (SDMs; thematic content, specificity, integrative meaning, tension, contamination/redemption, and emotion) and their interactions. Our final sample was composed of 652 healthy French adults aged from 18 to 97 years, divided into four age groups: young adults (n = 163, M = 23.7 years), middle-aged adults (n = 135, M = 44.0 years), young-old adults (n = 178, M = 64.5 years), and old-old adults (n = 176, M = 79.6 years). Participants were asked to recollect three SDMs. A similar pattern of thematic content was observed throughout adulthood, except for relationship narratives were more frequent in the two younger groups. The findings highlighted that specific and integrated SDMs decreased with age and that tension and contaminative sequences were the most frequent in young adults. Redemptive memories did not significantly differ whatever the age of participants. No clear positivity effect was observed with aging. Finally, an analysis of the correlations among the main SDMs' dimensions showed that specificity correlated positively with tension in young adults and integrative meaning with redemption in young and middle-aged participants. We found no significant correlation between specificity and integration in any age group. For the first time, this study sheds new light on lifelong identity adjustments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How do "Young-old" Adults Project their Self? A Study of Self-defining Future Projections in Normal Ageing.

BACKGROUND: Self-defining future projections (SDFP) are mental representations of plausible and highly significant future events that provide core information of one's understanding of self. OBJECTIVE: We explored SDFPs in a large sample of older adults and aimed to target the interrelations between the main dimensions of SDFPs. Moreover, correlations between these dimensions and clinical and cognitive variables were examined. METHODS: We recruited 87 young-old adults (60-75 years) with normal cognitive functioning who were asked to generate three SDFPs. RESULTS: We found integrative meaning as a salient dimension and older individuals preferentially generated projections containing leisure or relationship events. Anxiety and self-esteem were correlated with integrative meaning and high executive functioning was found to be protective towards the simulation of future events containing dependence and death or end-of-life events. CONCLUSION: This study will contribute to the understanding of personal goals and identity in normal ageing.

Self-Concept and Temporality in Institutionalized Elders.

The current investigation examined the self-concept and temporality in institutionalized and non-institutionalized elderly. Sixty-two participants divided into two groups according to their place of residence participated in the study. The analysis focused on psychopathological scales, on self-concept assessment, its positive or negative valence, its development and the time perspective. The results showed that the institutionalized group was defined more with descriptive evaluations, emotional states, and peripheral information. The non-institutionalized group described themselves more with traits and specific attributes. For some identity statements, the emotional valence between the two groups was significantly different. The institutionalized group is not turned towards a particular temporal perspective, unlike the non-institutionalized who is more forward-looking. Findings suggest that there are differences in self-expression and temporality in our sample. This exploratory study emphasizes the importance of taking into account the self of institutionalized elderly and the temporality in which they are projected upon entering an institution.

Apathy Is the Best Dimension to Consider for Awareness Assessment in Alzheimer's Disease.

Previous studies have reported the major role of apathy in awareness assessment among Alzheimer's patients using the patient-caregiver discrepancy method, whatever the awareness dimension assessed. Using the Apathy Evaluation Scales among other awareness scales, we report that apathy is the sole awareness dimension distinguishing healthy controls (25), mild (57) and moderate-to-moderately-severe (11) Alzheimer's patients. A linear regression showed that the Mini-Mental State Examination score used as a risk factor for non-awareness was the only factor associated with awareness of apathy and was the best predictor. This suggests that apathy is the most discriminant dimension for awareness assessment in Alzheimer's disease.

Characteristics of Self-Defining Memories in Middle-Aged and Older Adults.

BACKGROUND: Self-Defining Memories (SDMs) are a specific type of autobiographical memory, which play a key role in the construction of personal identity. ; Objective: We investigated the characteristics of SDMs in elderly subjects. The originality of the present study is to compare our elderly group to middle-aged subjects instead of young adults, as previously reported in the literature, to understand the age-related modifications in SDMs. ; Methods: We recruited 41 elderly subjects with normal cognitive functioning and 37 middle-aged adults. They were matched for education level and verbal knowledge. ; Results: Older participants recalled the same number of specific memories than middle-aged participants. SDMs were predominantly constituted of episodic characteristics, with specific details, in both the groups. However, middle-aged subjects gave more integrative meaning of SDMs and more redemptive events than older participants. The two samples differed in three content dimensions (exploration/recreation, relationship contents, and not classifiable). As predicted, older participants reported memories that were more positive, on average, than the middle-aged participants' memories. ; Conclusion: Our study added some contributions to the understanding of the consequences of aging on the sense of self. Future research should explore the continuity of SDMs characteristics across the lifespan.

Self-defining memories in female patients with anorexia nervosa.

OBJECTIVE: Overgeneral autobiographical memory (AM) was reported in patients with anorexia nervosa (AN) using AM cueing tasks that did not directly indexes memories that are personally important to the individual, that is, self-defining memories (SDMs). The aim of this study is to investigate characteristics of SDMs in females with AN. METHOD: A total of 46 outpatients with chronic AN and 52 healthy controls (HC) were asked to recall three SDMs. RESULTS: Compared to HC, patients with AN presented less specific SDMs, but have preserved ability to give meaning to their memories. Patients' SDMs were associated with more negative emotions, more tension (i.e. explicit expression of discomfort, disagreement or unease) and more contamination (i.e. transformation in the memory narrative from a positive to a negative affective state). Content of SDMs differed between patients with AN and HC. Finally, no difference was found in SDMs characteristics between the two subtypes of anorexia nervosa (restricting type and binge eating / purging type). DISCUSSION: Patients with AN recalled overgeneral SDMs with negative content and emotions. In this context, a clinical intervention based on SDMs together with cognitive and emotional remedial therapies could help patients with AN to improve emotion processing and redefine their identity in a more positive way.

Modelling Awareness in Alzheimer's Disease.

This study aimed to provide a model of awareness in Alzheimer's disease using the stage of the disease as a risk factor. Awareness was assessed using three methods (patient-caregiver discrepancy, prediction-performance discrepancy, clinical rating). Twenty-five healthy control subjects and sixty-one patients participated, with measures of cognition, apathy, depression, and awareness. These measures were introduced into a manual backward regression. Confounding factors impacting at least 15% of the exposure factor estimate were maintained in the model. Except for the prediction performance discrepancy, also presenting cognitive associations, the other awareness assessments suggested a major role of depression and apathy as impacting factors.

The Proust Machine: What a Public Science Event Tells Us About Autobiographical Memory and the Five Senses.

Our senses are constantly stimulated in our daily lives but we have only a limited understanding of how they affect our cognitive processes and, especially, our autobiographical memory. Capitalizing on a public science event, we conducted the first empirical study that aimed to compare the relative influence of the five senses on the access, temporal distribution, and phenomenological characteristics of autobiographical memories in a sample of about 400 participants. We found that the access and the phenomenological features of memories varied as a function of the type of sensory cues, but not their temporal distribution. With regard to their influence on autobiographical memory, an overlap between some senses was found, with on one hand, olfaction and taste and, on the other, vision, audition, and touch. We discuss these findings in the light of theories of perception, memory, and the self, and consider methodological implications of the sensory cuing technique in memory research, as well as clinical implications for research in psychopathological and neuropsychological populations.

Peritraumatic Assessment of Autobiographical Memory After Exposure to a Traumatic Event.

Posttraumatic stress disorder (PTSD) is commonly acknowledged to be associated with reduced specificity of autobiographical memory (AM). However, very few studies have assessed AM in the peritraumatic phase. The aim of the present study was to examine whether the AM impairment reported in PTSD is present a few days after a traumatic event. We assessed AM in 41 participants who had recently been exposed to trauma, and 34 controls who had never experienced a traumatic situation. The trauma-exposed participants also completed the Impact of Event Scale-R (IES-R), the Inventory of Peritraumatic Distress, and the Peritraumatic Dissociative Experiences Questionnaire. Results showed that autobiographical memories cued by negative words were significantly less specific in the group of trauma-exposed participants than in the control group (p = .008; d = 0.40). Thus, mild AM impairment was already present three days after trauma exposure, long before acute PTSD set in.

Giving meaning to illness: An investigation of self-defining memories in patients with relapsing-remitting multiple sclerosis patients.

Multiple sclerosis (MS) patients are often unable to adequately fulfill their established roles due to physical disabilities and cognitive changes, making this chronic illness particularly threatening to personal identity. Twenty-five MS patients and 25 healthy controls were asked to recall five self-defining memories (SDM). Overall characteristics of SDM did not differ between patients and controls; MS patients displayed preserved capacity to draw meaning upon past events. Moreover, almost two-thirds of MS patients mentioned at least one illness related SDM and about 25% of patients' SDM referred to MS. These memories were experienced as more negative and associated with more tension than other SDM but led toward more positive emotion and less negative emotion over time; they were also more central and more integrated to the personal identity. We concluded that self-challenging events due to MS may trigger both cognitive and emotional processes enabling the integration of illness in patients' self-representations.

Preserved anterograde and remote memory in drug-responsive temporal lobe epileptic patients.

PURPOSE: To investigate cognition, particularly anterograde and remote memory, in patients suffering from unilateral drug-responsive mesial temporal lobe epilepsy (mTLE) patients and to compare their performance with that observed in drug-resistant mTLE patients. METHODS: Sixteen drug-responsive mTLE patients, with only infrequent seizures in their lifetime, were matched for demographic and clinical variables to 18 patients suffering from drug-resistant unilateral mTLE. A comprehensive neuropsychological examination, including baseline, anterograde memory tasks, and a large range of remote memory tests was carried out. RESULTS: Patients with drug-responsive epilepsy obtained average scores on every anterograde memory test. Although in general, they obtained lower scores than the healthy controls on remote memory tests, the differences failed to reach significance. Moreover, the drug-responsive group performed significantly better than the drug-resistant group on anterograde recall tests and an episodic autobiographical memory test. Performance was not significantly different between the patient groups in personal semantics or memory for public events. CONCLUSION: Our results show that a mild clinical course of mTLE with no cognitive deficits can occur notwithstanding hippocampal sclerosis. The differences in cognitive function between the two groups are likely due to distinct pathophysiology of the underlying cause of epilepsy. Drug-resistant seizures and cognitive deficits may be the consequence of a more severe underlying cerebral process. Better understanding of the variety of pathogenesis of mTLE could help to answer this open question.

The influence of seizure frequency on anterograde and remote memory in mesial temporal lobe epilepsy.

PURPOSE: Seizure frequency, although considered as an important factor in memory impairment in mesial temporal epilepsy (mTLE), is mostly confounded with other clinical variables, making it unclear to what extent recurrent seizures actually interfere with memory. The present study focuses on the influence of seizure frequency, studied as a main variable, on anterograde and remote memory. METHODS: Seventy-one patients with unilateral mTLE were divided into two subgroups, as a function of their seizure frequency (monthly versus weekly seizures). Other seizure-related variables were controlled, namely, lateralisation and type of lesion, age at onset, years of ongoing seizures, etiologic factors, and number of AED. A comprehensive neuropsychological examination, including anterograde memory (verbal and non verbal recognition memory and free recall) tasks together with a large range of tests exploring different domains of remote memory, was carried out. RESULTS: Despite similar results on IQ, executive functions and attention, the low seizure-frequency group performed significantly better than the high seizure-frequency group on anterograde memory tests. Loss of autobiographical episodes and public-events memory, concomitant with spared personal semantic knowledge, was observed in both patient groups compared with healthy subjects. A worsening effect of high seizure frequency was recorded for autobiographical incidents and news-events memory, but unexpectedly, not for memory for famous people. CONCLUSION: The study of seizure frequency as the main variable leads us to suggest that high seizure frequency, itself, potentiates the effects of mesial temporal lobe damage on episodic memory deficits.

One-year postoperative autobiographical memory following unilateral temporal lobectomy for control of intractable epilepsy.

PURPOSE: To examine the effects of temporal lobectomy (TL), particularly concerning its lateralization. METHODS: Patients completed autobiographical memory tests, preoperatively and 1-year postoperatively. RESULTS: (a) right TL (RTL) patients recalled significantly more memories from the year after surgery than from the year before TL; (b) their pre to postoperative improvement on autobiographical memory scores was positively correlated to improvement of delayed story recall scores; and (c) 1 year after surgery, performance on recent personal memory recall was normalized for RTL patients only. CONCLUSION: We suggest that, in the absence of recurrent seizures, the relative integrity of the left hemisphere together with residual right hemisphere structures sustains postoperative autobiographical memory consolidation, at least 1 year postoperatively.

Remote memory in temporal lobe epilepsy.

PURPOSE: The present study aims at characterizing remote memory in patients with temporal lobe epilepsy (TLE); it also considers the impact of its most important variables (lateralization of the lesion, duration of epilepsy, age at onset, and seizure frequency) on remote memory. METHODS: We examined the performance of 38 patients with unilateral TLE (19 right TLE and 19 left TLE) and 35 healthy subjects on six remote memory tasks. Memory for personal events was assessed by using the Autobiographical Memory Interview and the Modified Crovitz Test. Memory for public events was evaluated by means of photographs of famous faces and famous scenes, questions about famous events, and the Dead/Alive Test. RESULTS: Both right-TLE and left-TLE groups had impaired memory for autobiographic episodes and public events relative to normal subjects. In contrast, personal semantic memory was preserved. In addition, an effect of laterality was recorded, with right-TLE patients obtaining significantly better scores than left-TLE patients on every test. Duration of epilepsy, age at onset, and seizure frequency did not influence performance on remote memory measures. CONCLUSIONS: The comprehensive neuropsychological study of 38 TLE patients showed that this neurologic condition affects remote memory systems differently. We discuss the different factors that could account for this pattern of performance on the bases of both functional brain organization and memory theories.