kf case study conclusion

Psychology Memory Revision Notes

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

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What do the examiners look for?

• Accurate and detailed knowledge
• Clear, coherent, and focused answers
• Effective use of terminology (use the “technical terms”)

In application questions, examiners look for “effective application to the scenario,” which means that you need to describe the theory and explain the scenario using the theory making the links between the two very clear. If there is more than one individual in the scenario you must mention all of the characters to get to the top band.

Difference between AS and A level answers

The descriptions follow the same criteria; however, you have to use the issues and debates effectively in your answers. “Effectively” means that it needs to be clearly linked and explained in the context of the answer.

Read the model answers to get a clearer idea of what is needed.

The Multi-Store Model

The multistore model of memory was proposed by Atkinson and Shiffrin and is a structural model. They proposed that memory consisted of three stores: sensory register, short-term memory (STM), and long-term memory (LTM). Information passes from store to store in a linear way. Both STM and LTM are unitary stores.

Sensory memory is the information you get from your sense, your eyes, and ears. When attention is paid to something in the environment, it is then converted to short-term memory.

Information from short-term memory is transferred to long-term memory only if that information is rehearsed (i.e., repeated).

Maintenance rehearsal is repetition that keeps information in STM, but eventually, such repetition will create an LTM.

If maintenance rehearsal (repetition) does not occur, then information is forgotten and lost from short-term memory through the processes of displacement or decay.

Each store has its own characteristics in terms of encoding, capacity, and duration .

• Encoding is the way information is changed so that it can be stored in memory. There are three main ways in which information can be encoded (changed): 1. visual (picture), 2. acoustic (sound), and 3. semantic (meaning).
• Capacity concerns how much information can be stored.
• Duration refers to the period of time information can last in-memory stores.

Sensory register

• Duration: ¼ to ½ second
• Capacity: all sensory experience (v. larger capacity)
• Encoding: sense specific (e.g., different stores for each sense)

Short Term Memory

• Duration: 0-18 seconds
• Capacity: 7 +/- 2 items
• Encoding: mainly acoustic

Long Term Memory

• Duration: Unlimited
• Capacity: Unlimited
• Encoding: Mainly semantic (but can be visual and acoustic)

AO2 Scenario Question

The multi-store model of memory has been criticized in many ways. The following example illustrates a possible criticism.

Some students read through their revision notes lots of times before an examination but still, find it difficult to remember the information. However, the same students can remember the information in a celebrity magazine, even though they read it only once.

Explain why this can be used as a criticism of the multi-store model of memory.

“The MSM states that depth of memory trace in LTM is simply a result of the amount of rehearsal that takes place.

The MSM can be criticized for failing to account for how different types of material can result in different depth memory traces even though they’ve both been rehearsed for a similar amount of time.

For example, people may recall information they are interested in (e.g., information in celebrity magazines) more than the material they are not interested in (e.g., revision notes) despite the fact that they have both been rehearsed for a similar amount of time.

Therefore, the MSM’s view of long-term memory can be criticized for failing to take into account that material we may pay more attention to or is more meaningful/interesting to us may cause a deeper memory trace which is recalled more easily.”

One strength of the multistore model is that it gives us a good understanding of the structure and process of the STM. This is good because this allows researchers to expand on this model. This means researchers can do experiments to improve on this model and make it more valid, and they can prove what the stores actually do.

The model is supported by studies of amnesiacs: For example the patient H.M. case study. HM is still alive but has marked problems in long-term memory after brain surgery.

He has remembered little of personal (death of mother and father) or public events (Watergate, Vietnam War) that have occurred over the last 45 years. However, his short-term memory remains intact.

It has now become apparent that both short-term and long-term memory is more complicated than previously thought. For example, the Working Model of Memory proposed by Baddeley and Hitch (1974) showed that short-term memory is more than just one simple unitary store and comprises different components (e.g., central executive, Visuospatial, etc.).

The model suggests rehearsal helps to transfer information into LTM, but this is not essential. Why are we able to recall information which we did not rehearse (e.g., swimming) yet unable to recall information which we have rehearsed (e.g., reading your notes while revising)?

Therefore, the role of rehearsal as a means of transferring from STM to LTM is much less important than Atkinson and Shiffrin (1968) claimed in their model.

Research Study for both STM & LTM

Research studies can either be knowledge or evaluation:

• If you refer to the procedures and findings of a study, this shows knowledge and understanding (AO1).
• If you comment on what the studies show and what it supports and challenges the theory in question, this shows evaluation (AO3).

Glanzer and Cunitz showed that when participants are presented with a list of words, they tend to remember the first few and last few words and are more likely to forget those in the middle of the list, i.e., the serial position effect.

This supports the existence of separate LTM and STM stores because they observed a primacy and recency effect.

Words early on in the list were put into long-term memory (primacy effect) because the person has time to rehearse the word, and words from the end went into short-term memory (recency effect).

Other compelling evidence to support this distinction between STM and LTM is the case of KF (Shallice & Warrington, 1970), who had been in a motorcycle crash where he had sustained brain damage. His LTM seemed to be unaffected, but he was only able to recall the last bit of information he had heard in his STM.

Types of Long-Term Memory

One of the earliest and most influential distinctions of long-term memory was proposed by Tulving (1972).  He proposed a distinction between episodic, semantic, and procedural memory.

Procedural Memory

Procedural memory is a part of the implicit long-term memory responsible for knowing how to do things, i.e., a memory of motor skills. A part of long-term memory is responsible for knowing how to do things, i.e., the memory of motor skills.  It does not involve conscious (i.e., it’s unconscious-automatic) thought and is not declarative.

For example, procedural memory would involve knowledge of how to ride a bicycle.

Semantic Memory

Episodic memory.

Episodic memory is a part of the long-term memory responsible for storing information about events (i.e., episodes) that we have experienced in our lives.

It involves conscious thought and is declarative.  An example would be a memory of our 1st day at school.

Cohen and Squire (1980) drew a distinction between declarative knowledge and procedural knowledge .  Procedural knowledge involves “knowing how” to do things. It included skills such as “knowing how” to play the piano, ride a bike, tie your shoes, and other motor skills.

It does not involve conscious thought (i.e., it’s unconscious-automatic).  For example, we brush our teeth with little or no awareness of the skills involved.

Whereas declarative knowledge involves “knowing that”; for example, London is the capital of England, zebras are animals, your mum’s birthday, etc.  Recalling information from declarative memory involves some degree of conscious effort – information is consciously brought to mind and “declared.”

The knowledge that we hold in semantic and episodic memories focuses on “knowing that” something is the case (i.e., declarative).  For example, we might have a semantic memory for knowing that Paris is the capital of France, and we might have an episodic memory for knowing that we caught the bus to college today.

Evidence for the distinction between declarative and procedural memory has come from research on patients with amnesia . Typically, amnesic patients have great difficulty in retaining episodic and semantic information following the onset of amnesia.

Their memory for events and knowledge acquired before the onset of the condition tends to remain intact, but they can’t store new episodic or semantic memories. In other words, it appears that their ability to retain declarative information is impaired.

However, their procedural memory appears to be largely unaffected. They can recall skills they have already learned (e.g., riding a bike) and acquire new skills (e.g., learning to drive).

Working Memory Model

The working memory model (Baddeley and Hitch, 1974) replaced the idea of a unitary STM. It suggests a system involving active processing and short-term storage of information.

Key features include the central executive, the phonological loop, and the visuospatial sketchpad.

The central executive has a supervisory function and acts as a filter, determining which information is attended to.

It can process information in all sensory forms, direct information to other slave systems, and collects responses. It has limited capacity and deals with only one piece of information at a time.

One of the slave systems is the phonological loop which is a temporary storage system for holding auditory information in a speech-based form.

It has two parts: (1) the phonological store (inner ear), which stores words you hear; and (2) the articulatory process (inner voice), which allows maintenance rehearsal (repeating sounds or words to keep them in working memory while they are needed). The phonological loop plays a key role in the development of reading.

The second slave system is the Visuospatial sketchpad (VSS). The VSS is a temporary memory system for holding visual and spatial information. It has two parts: (1) the visual cache (which stores visual data about form and color) and (2) the inner scribe (which records the arrangement of objects in the visual field and rehearses and transfers information in the visual cache to the central executive).

The third slave system is the episodic buffer which acts as a “backup” (temporary) store for information that communicates with both long-term memory and the slave system components of working memory. One of its important functions is to recall material from LTM and integrate it into STM when working memory requires it.

Bryan has been driving for five years. Whilst driving, Bryan can hold conversations or listen to music with little difficulty.

Bob has had four driving lessons. Driving requires so much of Bob’s concentration that, during lessons, he often misses what his driving instructor is telling him. With reference to features of the working memory model, explain the different experiences of Bryan and Bob. (4 marks)

A tricky question – the answer lies in Bryan being able to divide the different components of his STM because he is experienced at driving and doesn’t need to devote all his attention to the task of driving (controlled by the visuospatial sketchpad).

“Because Bryan has been driving for five years it is an ‘automated’ task for him; it makes fewer attentional demands on his central executive, so he is free to perform other tasks (such as talking or listening to music) and thus is able to divide resources between his visuospatial sketch pad (driving) and phonological loop (talking and listening to music).

As Bob is inexperienced at driving, this is not the case for him – his central executive requires all of his attentional capacity for driving and thus cannot divide resources effectively between components of working memory.”

Working memory is supported by dual-task studies. It is easier to do two tasks at the same time if they use different processing systems (verbal and visual) than if they use the same slave system.

For example, participants would find it hard to do two visual tasks at the same time because they would be competing for the same limited resources of the visuospatial sketchpad. However, a visual task and a verbal task would use different components and so could be performed with minimum errors.

The KF Case Study supports the Working Memory Model. KF suffered brain damage from a motorcycle accident that damaged his short-term memory. KF’s impairment was mainly for verbal information – his memory for visual information was largely unaffected.

This shows that there are separate STM components for visual information (VSS) and verbal information (phonological loop). However, evidence from brain-damaged patients may not be reliable because it concerns unique cases with patients who have had traumatic experiences.

One limitation is the fact that little is known about how the central executive works. It is an important part of the model, but its exact role is unclear.

Another limitation is that the model does not explain the link between working memory and LTM.

Research Study for WM

• If you refer to the procedures and findings of a study, this shows knowledge and understanding.
• If you comment on what the studies show and what it supports and challenges the theory in question, this shows evaluation.

Baddeley and Hitch conducted an experiment in which participants were asked to perform two tasks at the same time (dual task technique). A digit span task required them to repeat a list of numbers, and a verbal reasoning task which required them to answer true or false to various questions (e.g., B is followed by A?).

Results : As the number of digits increased in the digit span tasks, participants took longer to answer the reasoning questions, but not much longer – only fractions of a second. And they didn’t make any more errors in the verbal reasoning tasks as the number of digits increased.

Conclusion : The verbal reasoning task made use of the central executive, and the digit span task made use of the phonological loop.

Explanations for Forgetting

Interference.

Interference is an explanation for forgetting from long-term memory – two sets of information become confused.

• Proactive interference (pro=forward) is where old learning prevents the recall of more recent information. When what we already know interferes with what we are currently learning – where old memories disrupt new memories.
• Retroactive interference (retro=backward) is where new learning prevents the recall of previously learned information. In other words, later learning interferes with earlier learning – where new memories disrupt old memories.

Proactive and retroactive Interference is thought to be more likely to occur where the memories are similar, for example: confusing old and new telephone numbers. Chandler (1989) stated that students who study similar subjects at the same time often experience interference. French and Spanish are similar types of material which makes interference more likely.

Semantic memory is more resistant to interference than other types of memory.

Postman (1960) provides evidence to support the interference theory of forgetting. A lab experiment was used, and participants were split into two groups. Both groups had to remember a list of paired words – e.g., cat – tree, jelly – moss, book – tractor.

The experimental group also had to learn another list of words where the second paired word is different – e.g., cat – glass, jelly- time, book – revolver. The control group was not given the second list.

All participants were asked to recall the words on the first list. The recall of the control group was more accurate than that of the experimental group. This suggests that learning items in the second list interfered with participants’ ability to recall the list. This is an example of retroactive interference.

Although proactive and retroactive interference is reliable and robust effects, there are a number of problems with interference theory as an explanation for forgetting.

First, interference theory tells us little about the cognitive processes involved in forgetting. Secondly, the majority of research into the role of interference in forgetting has been carried out in a laboratory using lists of words, a situation that is likely to occur fairly infrequently in everyday life (i.e., low ecological validity). As a result, it may not be possible to generalize from the findings.

Baddeley states that the tasks given to subjects are too close to each other and, in real life; these kinds of events are more spaced out. Nevertheless, recent research has attempted to address this by investigating “real-life” events and has provided support for interference theory. However, there is no doubt that interference plays a role in forgetting, but how much forgetting can be attributed to interference remains unclear.

Retrieval failure

Retrieval failure is where information is available in long-term memory but cannot be recalled because of the absence of appropriate cues.

When we store a new memory, we also store information about the situation and these are known as retrieval cues. When we come into the same situation again, these retrieval cues can trigger the memory of the situation.

Types of cues that have been studied by psychologists include context, state, and organization.

• Context – external cues in the environment, e.g., smell, place, etc. Evidence indicates that retrieval is more likely when the context at encoding matches the context at retrieval.
• State – bodily cues inside of us, e.g., physical, emotional, mood, drunk, etc. The basic idea behind state-dependent retrieval is that memory will be best when a person’s physical or psychological state is similar to encoding and retrieval.

For example, if someone tells you a joke on Saturday night after a few drinks, you”ll be more likely to remember it when you”re in a similar state – at a later date after a few more drinks. Stone cold sober on Monday morning, you”ll be more likely to forget the joke.

• Organization – Recall is improved if the organization gives a structure that provides triggers, e.g., categories.

According to retrieval-failure theory, forgetting occurs when information is available in LTM but is not accessible. Accessibility depends in large part on retrieval cues.

Forgetting is greatest when context and state are very different at encoding and retrieval. In this situation, retrieval cues are absent, and the likely result is cue-dependent forgetting.

Evaluation (AO3)

People tend to remember material better when there is a match between their mood at learning and at retrieval. The effects are stronger when the participants are in a positive mood than when they are in a negative mood. They are also greater when people try to remember events having personal relevance.

A number of experiments have indicated the importance of context-based (i.e., external) cues for retrieval. An interesting experiment conducted by Baddeley indicates the importance of context setting for retrieval.

Baddeley (1975) asked deep-sea divers to memorize a list of words. One group did this on the beach, and the other group underwater. When they were asked to remember the words, half of the beach learners remained on the beach, and the rest had to recall underwater.

Half of the underwater group remained there, and the others had to recall on the beach. The results show that those who had recalled in the same environment (i.e., context) and who had learned recalled 40% more words than those recalling in a different environment. This suggests that the retrieval of information is improved if it occurs in the context in which it was learned.

A study by Goodwin investigated the effect of alcohol on state-dependent (internal) retrieval. They found that when people encoded information when drunk, they were more likely to recall it in the same state.

For example, when they hid money and alcohol when drunk, they were unlikely to find them when sober. However, when they were drunk again, they often discovered the hiding place. Other studies found similar state-dependent effects when participants were given drugs such as marijuana.

The ecological validity of these experiments can be questioned, but their findings are supported by evidence from outside the laboratory. For example, many people say they can’t remember much about their childhood or their school days. But returning to the house in which they spent their childhood or attending a school reunion often provides retrieval cues that trigger a flood of memories.

Eyewitness Testimony

Misleading information.

Loftus and Palmer investigated how misleading information could distort eyewitness testimony accounts.

Procedure : Forty-five American students formed an opportunity sample. This was a laboratory experiment with five conditions, only one of which was experienced by each participant (an independent measures experimental design ).

Participants were shown slides of a car accident involving a number of cars and asked to describe what had happened as if they were eyewitnesses. They were then asked specific questions, including the question, “About how fast were the cars going when they (hit/smashed/collided/bumped/contacted ) each other?”

Findings : The estimated speed was affected by the verb used. The verb implied information about the speed, which systematically affected the participants’ memory of the accident.

Participants who were asked the “smashed” question thought the cars were going faster than those who were asked the “hit” question. The participants in the “smashed” condition reported the highest speeds, followed by “collided,” “bumped,” “hit,” and “contacted” in descending order.

The research lacks mundane realism, as the video clip does not have the same emotional impact as witnessing a real-life accident, and so the research lacks ecological validity.

A further problem with the study was the use of students as participants. Students are not representative of the general population in a number of ways. Importantly they may be less experienced drivers and, therefore, less confident in their ability to estimate speeds. This may have influenced them to be more swayed by the verb in the question.

A strength of the study is it’s easy to replicate (i.e., copy). This is because the method was a laboratory experiment that followed a standardized procedure.

The Yerkes-Dodson effect states that when anxiety is at low and high levels, EWT is less accurate than if anxiety is at a medium level. Recall improves as anxiety increases up to an optimal point and then declines.

When we are in a state of anxiety, we tend to focus on whatever is making us feel anxious or fearful, and we exclude other information about the situation. If a weapon is used to threaten a victim, their attention is likely to focus on it. Consequently, their recall of other information is likely to be poor.

Clifford and Scott (1978) found that people who saw a film of a violent attack remembered fewer of the 40 items of information about the event than a control group who saw a less stressful version. As witnessing a real crime is probably more stressful than taking part in an experiment, memory accuracy may well be even more affected in real life.

However, a study by Yuille and Cutshall (1986) contradicts the importance of stress in influencing eyewitness memory. Twenty-one witnesses observed a shooting incident in Canada outside a gun shop in which one person was killed and a 2nd seriously wounded. The incident took place on a major thoroughfare in the mid-afternoon.

All of the witnesses were interviewed by the investigating police, and 13 witnesses (aged 15-32 yrs) agreed to a research interview 4-5 months after the event. The witnesses were also asked to rate how stressed they had felt at the time of the incident using a 7-point scale. The eyewitness accounts provided in both the police and research interviews were analyzed and compared.

The results of the study showed the witnesses were highly accurate in their accounts, and there was little change in the amount or accuracy of recall after five months. The study also showed that stress levels did not have an effect on memory, contrary to lab findings.

All participants showed high levels of accuracy, indicating that stress had little effect on accuracy. However, very high anxiety was linked to better accuracy. Participants who reported the highest levels of stress were most accurate (about 88% accurate compared to 75% for the less-stressed group).

One strength of this study is that it had high ecological validity compared with lab studies which tend to control variables and use student populations as research participants.

One weakness of this study was that there was an extraneous variable. The witnesses who experienced the highest levels of stress were actually closer to the event (the shooting), and this may have helped with the accuracy of their memory recall.

Reduced accuracy of information may be due to surprise rather than anxiety – Pickel found that identification was least accurate in high surprise conditions rather than high threat conditions – The weapon focus effect may be related to surprise rather than anxiety; therefore, research may lack internal validity.

Real-world application: We can apply the Yerkes-Dodson effect to predict that stressful incidents will lead to witnesses having relatively inaccurate memories as their anxiety levels would be above the optimum – We can avoid an over-reliance on eyewitness testimony that may have been impacted by anxiety.

The Cognitive Interview

The cognitive interview is a police technique for interviewing witnesses to a crime which encourages them to recreate the original context in order to increase the accessibility of stored information.

The cognitive interview involves a number of techniques:

Context Reinstatement

Trying to mentally recreate an image of the situation, including details of the environment, such as the weather conditions, and the individual’s emotional state, including their feelings at the time of the incident. This makes memories accessible and provides emotional and contextual cues.

Recall from a Changed Perspective

Recall in reverse order, report everything.

The interviewer encourages the witness to report all details about the event, even though these details may seem unimportant. Memories are interconnected so that recollection of one item may then cue a whole lot of other memories.

The Enhanced Cognitive Interview

The main additional features are:-

• Encourage the witness to relax and speak slowly.
• Offer comments to help clarify witness statements.
• Adapt questions to suit the understanding of individual witnesses.

One limitation is the cognitive interview is that it’s time-consuming to conduct and takes much longer than a standard police interview. It is also time-consuming to train police officers to use this method. This means that it is unlikely that the “proper” version of the cognitive interview is used.

Another limitation is that some elements of the cognitive interview may be more valuable than others. For example, research has shown that using a combination of “report everything” and “context reinstatement” produced better recall than any of the conditions individually.

A final criticism is that police personnel have to be trained, and this can be expensive and time-consuming.

Geiselman (1985) set out to investigate the effectiveness of the cognitive interview. Participants viewed a film of a violent crime and, after 48 hours, were interviewed by a policeman using one of three methods: the cognitive interview, a standard interview used by the Los Angeles Police, or an interview using hypnosis.

The number of facts accurately recalled and the number of errors made was recorded. The average number of correctly recalled facts for the cognitive interview was 41.2. For hypnosis, it was 38.0, and for the standard interview, it was 29.4.

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Up Learn – A Level Psychology (AQA) – Memory

Evaluating the multi-store model of memory: patient kf case study.

The multi-store model predicts that if people have damage to their short-term memory, then they will also have damage to their long-term memory. But patients like patient KF have damage to their short-term memory without damage to their long-term memory. So, the first limitation of the multi-store model is that it isn’t supported by findings from case studies.

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More videos on The Working Memory Model

Introduction (free trial)

Limitations of the Multi-store Model: Patient KF Case Study

Limitations of the Multi-store Model: Short-term Memory Stores (free trial)

Limitations of the Multi-store Model: the Role of Rehearsal (free trial)

Progress Quiz: Limitations of the Multi-store Model (free trial)

The Working Memory Model

Phonological Loop (free trial)

Sub-components of the Phonological Loop (free trial)

Rehearsal and the Word-length Effect (free trial)

Visuo-spatial Sketchpad (free trial)

Sub-components of the Visuo-spatial Sketchpad (free trial)

Episodic Buffer (free trial)

What is Memory?

Types of memory, types of long-term memory, memory accuracy: how good is our memory, exam questions: memory.

Last time we saw the story of patient KF, a man with impaired short-term memory but no damage to his long-term memory, whose condition challenged the multi-store model of memory.

Now, we already saw earlier, that the multi-store model says…

The multi-store model says that we have three memory stores: the sensory register, the short-term memory store, and the long-term memory store.

Information flows unidirectionally through the stores. To pass into short-term memory, information in the sensory register has to be paid attention to.

And to pass into the long-term memory store, information in short-term memory has to be rehearsed.

So, according to the multi-store model, to be stored in long-term memory, information has to first go through short-term memory. If it’s rehearsed, the information is then transferred to long-term memory.

But if it isn’t rehearsed in short-term memory, the information simply fades away.

So, the multi-store model predicts that…

The multi-store model predicts that a person can have damage to their long-term memory without their short-term memory being affected…

…But if a person’s short-term memory is damaged, they lose both their short and their long-term memories… because without being able to rehearse information in short-term memory, it can’t be transferred to long-term memory!

But, we also saw last time that patient KF’s motorbike accident impaired his short-term memory, but left his long-term memory intact.

And later case studies of other patients like KF also revealed similar findings: patients can damage their short-term memory without damaging their long-term memory!

So, a first limitation of the multi-store model is that it isn’t supported by findings from case studies of patients like KF.

Now, we’ll look at two more limitations of the multi-store model next.

But first, to sum up…

To sum it up, the multi-store model predicts that if people have damage to their short-term memory, then they will also have damage to their long-term memory.

But patients like patient KF have damage to their short-term memory without damage to their long-term memory.

So, the first limitation of the multi-store model is that it isn’t supported by findings from case studies.

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Key Study: HM’s case study (Milner and Scoville, 1957)

Travis Dixon January 29, 2019 Biological Psychology , Cognitive Psychology , Key Studies

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HM’s case study is one of the most famous and important case studies in psychology, especially in cognitive psychology. It was the source of groundbreaking new knowledge on the role of the hippocampus in memory. 

Background Info

“Localization of function in the brain” means that different parts of the brain have different functions. Researchers have discovered this from over 100 years of research into the ways the brain works. One such study was Milner’s case study on Henry Molaison.

The memory problems that HM experienced after the removal of his hippocampus provided new knowledge on the role of the hippocampus in memory formation (image: wikicommons)

At the time of the first study by Milner, HM was 29 years old. He was a mechanic who had suffered from minor epileptic seizures from when he was ten years old and began suffering severe seizures as a teenager. These may have been a result of a bike accident when he was nine. His seizures were getting worse in severity, which resulted in HM being unable to work. Treatment for his epilepsy had been unsuccessful, so at the age of 27 HM (and his family) agreed to undergo a radical surgery that would remove a part of his brain called the hippocampus . Previous research suggested that this could help reduce his seizures, but the impact it had on his memory was unexpected. The Doctor performing the radical surgery believed it was justified because of the seriousness of his seizures and the failures of other methods to treat them.

Methods and Results

In one regard, the surgery was successful as it resulted in HM experiencing less seizures. However, immediately after the surgery, the hospital staff and HM’s family noticed that he was suffering from anterograde amnesia (an inability to form new memories after the time of damage to the brain):

Here are some examples of his memory loss described in the case study:

• He could remember something if he concentrated on it, but if he broke his concentration it was lost.
• After the surgery the family moved houses. They stayed on the same street, but a few blocks away. The family noticed that HM as incapable of remembering the new address, but could remember the old one perfectly well. He could also not find his way home alone.
• He could not find objects around the house, even if they never changed locations and he had used them recently. His mother had to always show him where the lawnmower was in the garage.
• He would do the same jigsaw puzzles or read the same magazines every day, without ever apparently getting bored and realising he had read them before. (HM loved to do crossword puzzles and thought they helped him to remember words).
• He once ate lunch in front of Milner but 30 minutes later was unable to say what he had eaten, or remember even eating any lunch at all.
• When interviewed almost two years after the surgery in 1955, HM gave the date as 1953 and said his age was 27. He talked constantly about events from his childhood and could not remember details of his surgery.

Later testing also showed that he had suffered some partial retrograde amnesia (an inability to recall memories from before the time of damage to the brain). For instance, he could not remember that one of his favourite uncles passed away three years prior to his surgery or any of his time spent in hospital for his surgery. He could, however, remember some unimportant events that occurred just before his admission to the hospital.

Brenda Milner studied HM for almost 50 years – but he never remembered her.

Results continued…

His memories from events prior to 1950 (three years before his surgery), however, were fine. There was also no observable difference to his personality or to his intelligence. In fact, he scored 112 points on his IQ after the surgery, compared with 104 previously. The IQ test suggested that his ability in arithmetic had apparently improved. It seemed that the only behaviour that was affected by the removal of the hippocampus was his memory. HM was described as a kind and gentle person and this did not change after his surgery.

The Star Tracing Task

In a follow up study, Milner designed a task that would test whether or not HMs procedural memory had been affected by the surgery. He was to trace an outline of a star, but he could only see the mirrored reflection. He did this once a day over a period of a few days and Milner observed that he became faster and faster. Each time he performed the task he had no memory of ever having done it before, but his performance kept improving. This is further evidence for localization of function – the hippocampus must play a role in declarative (explicit) memory but not procedural (implicit) memory.

Cognitive psychologists have categorized memories into different types. HM’s study suggests that the hippocampus is essential for explicit (conscious) and declarative memory, but not implicit (unconscious) procedural memory.

Was his memory 100% gone? Another follow-up study

Interestingly, HM showed signs of being able to remember famous people who had only become famous after his surgery, like Lee Harvey Oswald (who assassinated JFK in 1963). (Image: wikicommons)

Another fascinating follow-up study was conducted by two researchers who wanted to see if HM had learned anything about celebrities that became famous after his surgery. At first they tested his knowledge of celebrities from before his surgery, and he knew these just as well as controls. They then showed him two names at a time, one a famous name (e.g. Liza Minelli, Lee Harvey Oswald) and the other was a name randomly taken from the phonebook. He was asked to choose the famous name and he was correct on a significant number of trials (i.e. the statistics tests suggest he wasn’t just guessing). Even more incredible was that he remembered some details about these people when asked why they were famous. For example, he could remember that Lee Harvey Oswald assassinated the president. One explanation given for the memory of these facts is that there was an emotional component. E.g. He liked these people, or the assassination was so violent, that he could remember a few details. 

HM became a hugely important case study for neuro and cognitive Psychologists. He was interviewed and tested by over 100 psychologists during the 53 years after his operation. Directly after his surgery, he lived at home with his parents as he was unable to live independently. He moved to a nursing home in 1980 and stayed there until his death in 2008. HM donated his brain to science and it was sliced into 2,401 thin slices that will be scanned and published electronically.

Critical Thinking Considerations

• How does this case study demonstrate localization of function in the brain? (e.g.c reating new long-term memories; procedural memories; storing and retrieving long term memories; intelligence; personality) ( Application )
• What are the ethical considerations involved in this study? ( Analysis )
• What are the strengths and limitations of this case study? ( Evaluation )
• Why would ongoing studies of HM be important? (Think about memory, neuroplasticity and neurogenesis) ( Analysis/Synthesis/Evaluation )
• How can findings from this case study be used to support and/or challenge the Multi-store Model of Memory? ( Application / Synthesis/Evaluation )

Exam Tips This study can be used for the following topics: Localization – the role of the hippocampus in memory Techniques to study the brain – MRI has been used to find out the exact location and size of damage to HM’s brain Bio and cognitive approach research method s – case study Bio and cognitive approach ethical considerations – anonymity Emotion and cognition – the follow-up study on HM and memories of famous people could be used in an essay to support the idea that emotion affects memory Models of memory – the multi-store model : HM’s study provides evidence for the fact that our memories all aren’t formed and stored in one place but travel from store to store (because his transfer from STS to LTS was damaged – if it was all in one store this specific problem would not occur)

Milner, Brenda. Scoville, William Beecher. “Loss of Recent Memory after Bilateral Hippocampal Lesions”. The Journal of Neurology, Neurosurgery and Psychiatry. 1957; 20: 11 21. (Accessed from web.mit.edu )

The man who couldn’t remember”. nova science now. an interview with brenda corkin . 06.01.2009.       .

  Here’s a good video recreation documentary of HM’s case study…

Travis Dixon is an IB Psychology teacher, author, workshop leader, examiner and IA moderator.

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• He suffered brain damage as a result of a motor bike accident.
• his LTM was fine
• Forgetting auditory letters and digits was much greater than forgetting visual stimuli.
• he can only remember 2 digit numbers
• this shows that there are more than 1 store for STM
• Evaluation of the multi-store model as a weakness - only part of his short-term memory is affected. There is not just one short-term memory… supports working model.

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How to write the conclusion of your case study

You worked on an amazing UX project. You documented every detail and deliverable and when the time came, you began to write a UX case study about it. In the case study, you highlighted how you worked through a Design Thinking process to get to the end result; so, can you stop there and now move on to the next thing? Well, no! There’s just one more bit left to finish up and make the perfect case study. So, get ready; we will now explore how you can write the perfect conclusion to wrap it all up and leave a lasting great impression.

Every start has an end – we’re not just repeating the famous quote here, because for case studies, a proper end is your last and final chance to leave a lasting great (at the very least, good) impression with whoever is reading your work (typically, recruiters!). Many junior UX designers often forget about the conclusion part of the case study, but this is a costly mistake to make. A well-written case study must end with an appropriate final section, in which you should summarize the key takeaways that you want others to remember about you and your work. Let’s see why.

Last impressions are just as important as first ones

We’ll go to some length here to convince you about the importance of last impressions, especially as we can understand the reason behind not wanting to pay very much attention to the end of your case study, after all the hard work you put into writing the process section. You are tired, and anyone who’s read your work should already have a good idea about your skills, anyway. Surely—you could be forgiven for thinking, at least—all that awesome material you put in the start and middle sections must have built up the momentum to take your work into orbit and make the recruiter’s last impression of you a lasting—and very good—one, and all you need to do now is take your leave. However, psychologist Saul McLeod (2008) explains how early work by experimental psychology pioneers Atkinson & Shriffin (1968) demonstrated that when humans are presented with information, they tend to remember the first and last elements and are more likely to forget the middle ones.

This is known as the “ serial position effect ” (more technically, the tendency to remember the first elements is known as the “ primacy effect ”, while the tendency to remember the last elements is known as the “ recency effect ”). Further work in human experiences discovered that the last few things we see or hear at the end of an experience can generate the most powerful memories that come back to us when we come across a situation or when we think about it. For example, let’s say you stayed in a hotel room that left a bit to be desired. Maybe the room was a little cramped, or the towels were not so soft. But if the receptionist, as you leave, shakes your hand warmly, smiles and thanks you sincerely for your custom, and goes out of his way to help you with your luggage, or to get you a taxi, you will remember that person’s kind demeanor more than you will remember the fact that the room facilities could be improved.

A good ending to your case study can help people forget some of the not-so-good points about your case study middle. For example, if you missed out a few crucial details but can demonstrate some truly interesting takeaways, they can always just ask you about these in an interview. Inversely, a bad ending leaves the recruiter with some doubt that will linger. Did this person learn nothing interesting from all this work? Did their work have no impact at all? Did they even write the case study themselves? A bad last impression can certainly undo much of the hard work you’ve put into writing the complicated middle part of your case study.

What to put in your case study conclusions

A case study ending is your opportunity to bring some closure to the story that you are writing. So, you can use it to mention the status of the project (e.g., is it ongoing or has it ended?) and then to demonstrate the impact that your work has had. By presenting some quantifiable results (e.g., data from end evaluations, analytics, key performance indicators ), you can demonstrate this impact. You can also discuss what you learned from this project, making you wiser than the next applicant – for example, something about a special category of users that the company might be interested in developing products for, or something that is cutting-edge and that advances the frontiers of science or practice.

As you can see, there are a few good ways in which you can end your case study. Next, we will outline four options that can be part of your ending: lessons learned, the impact of the project, reflections, and acknowledgements.

Lessons learned

A recruiter wants to see how you improve yourself by learning from the projects you work on. You can discuss interesting insights that you learned from user research or the evaluation of your designs – for example, surprising behaviors that you found out about the technology use in a group of users who are not typically considered to be big proponents of technology (e.g., older adults), or, perhaps, the reasons a particular design pattern didn’t work as well as expected under the context of your project.

Another thing you can discuss is your opinion on what the most difficult challenge of the project was, and comment on how you managed to overcome it. You can also discuss here things that you found out about yourself as a professional – for example, that you enjoyed taking on a UX role that you didn’t have previous experience with, or that you were able to overcome some personal limitations or build on your existing skills in a new way.

Impact of the project

Showing impact is always good. How did you measure the impact of your work? By using analytics, evaluation results, and even testimonials from your customers or users, or even your development or marketing team, you can demonstrate that your methodical approach to work brought about some positive change. Use before-after comparison data to demonstrate the extent of your impact. Verbatim positive quotes from your users or other project stakeholders are worth their weight (or rather, sentence length) in gold. Don’t go overboard, but mix and match the best evidence for the quality of your work to keep the end section brief and to the point.

Copyright holder: Andreas Komninos, Interaction Design Foundation. Copyright terms and license: CC BY-SA 3.0

User reviews from app stores are a great source of obtaining testimonials to include in your case studies. Overall app ratings and download volumes are also great bits of information to show impact.

An excerpt from a case study ending section. Here, text and accompanying charts are used to demonstrate the impact of the work done by the UX professional.

Reflections on your experiences

You can include some information that shows you have a clear understanding of how further work can build on the success of what you’ve already done. This demonstrates forward thinking and exploratory desire. Something else you can reflect on is your choices during the project. In every project, there might be things you could do differently or improve upon. But be aware that the natural question that follows such statements is this: “Well, so why haven’t you done it?”

Don’t shoot yourself in the foot by listing all the things you wish you could have done, but focus on what you’ve actually done and lay out future directions. For example, if you’ve done the user research in an ongoing project, don’t say, “ After all this user research, it would have been great to progress to a prototype, but it’s not yet done ”; instead, say, “ This user research is now enabling developers to quickly progress to the prototyping stage. ”

Acknowledgments

The end of the case study section is where you should put in your acknowledgments to any other members of your team, if this wasn’t a personal project. Your goal by doing so is to highlight your team spirit and humility in recognizing that great projects are most typically the result of collaboration . Be careful here, because it’s easy to make the waters muddy by not being explicit about what YOU did. So, for example, don’t write something like “ I couldn’t have done it without John X. and Jane Y. ”, but instead say this: “ My user research and prototype design fed into the development work carried out by John X. User testing was carried out by Jane Y., whose findings informed further re-design that I did on the prototypes. ”

What is a good length for a UX case study ending?

UX case studies must be kept short, and, when considering the length of your beginning, process and conclusion sections, it’s the beginning and the conclusion sections that should be the shortest of all. In some case studies, you can keep the ending to two or three short phrases. Other, longer case studies about more complex projects may require a slightly longer section.

Remember, though, that the end section is your chance for a last, short but impactful impression. If the hotel receptionist from our early example started to say goodbye and then went on and on to ask you about your experience, sharing with you the comments of other clients, or started talking to you about where you are going next, and why, and maybe if he had been there himself, started to tell you all about where to go and what to see, well… you get the point. Keep it short, sincere and focused. And certainly, don’t try to make the project sound more important than it was. Recruiters are not stupid – they’ve been there and done that, so they know.

Putting it all together

In the example below, we will show how you can address the points above using text. We are going to focus on the three main questions here, so you can see an example of this in action, for a longer case study.

An example ending section for a longer case study, addressing all aspects: Lessons, impact, reflection and acknowledgments.

Here is how we might structure the text for a shorter version of the same case study, focusing on the bare essentials:

An example ending section for a shorter case study, addressing the most critical aspects: Lessons, impact and reflection. Acknowledgments are being sacrificed for the sake of brevity here, but perhaps that’s OK – you might mention it in the middle part of the case study.

The Take Away

The end part of your case study needs as much care and attention as the rest of it does. You shouldn’t neglect it just because it’s the last thing in the case study. It’s not hard work if you know the basics, and here, we’ve given you the pointers you need to ensure that you don’t miss out anything important. The end part of the case study should leave your recruiters with a good (hopefully, very good) last impression of you and your work, so give it the thorough consideration it needs, to ensure it doesn’t undo all the hard work you’ve put into the case study.

References & Where to Learn More

Copyright holder: Andrew Hurley, Flickr. Copyright terms and license: CC BY-SA 2.0

Atkinson, R. C., & Shiffrin, R. M. (1968). Chapter: Human memory : A proposed system and its control processes. In Spence, K. W., & Spence, J. T. The psychology of learning and motivation (Volume 2). New York: Academic Press. pp. 89–195.

McLeod, S. (2008). Serial Position Effect

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Klippel–Feil syndrome: Should additional examination be conducted?

• Original Article
• Published: 27 April 2024

Cite this article

• Elif Evrim Ekin   ORCID: orcid.org/0000-0003-1290-6291 1 &
• Muhittin Emre Altunrende   ORCID: orcid.org/0000-0003-3345-5821 2  

Klippel–Feil syndrome (KF) is a rare disease defined as single or multi-level cervical vertebra fusion. KF could be accompanied by other spinal anomalies or isolated, and in which case necessity of whole spine screening is not clearly known. KF is investigated in terms of prevalence, gender distribution, fusion types, and frequency of accompanying anomalies according to types of KF.

Approval from our hospital’s ethics committee was received for this single-center, retrospective study. Considering the exclusion criteria among the 40,901 cervical spine MRIs, 40,450 patients were included in the study. It was re-evaluated for KF, fusion level, classification, cervical scoliosis, and other musculoskeletal and spinal anomalies.

125 (0.309%) of 40,450 patients is diagnosed with KF, which is more common in women ( P  < 0.001). Single fused segment 106 (84.8%), multilevel fused segments 8 (6.4%), contiguous fused segments 11 (8.8%) are observed. Upper level KF is detected in 13 (10.4%) patients. The frequency of additional anomaly is significantly higher in upper level KF compared to other level fusions ( P  < 0.001, Chi-square t). The cervical scoliosis is diagnosed 34 (27%). In KF patients with scoliosis, the frequency of additional anomalies was significantly higher ( P  < 0.001, Chi-square t).

Klippel–Feil prevalence is 0.309%, it is frequently observed in women, and at C2–C3 level. Additional anomalies are especially associated with ‘contiguous fused segments’ and ‘upper level’ types. Klippel–Feil with scoliosis is an indicator of increased risk for associated anomalies, and examination of the whole spine is recommended.

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Ekin, E.E., Altunrende, M.E. Klippel–Feil syndrome: Should additional examination be conducted?. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08281-y

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Received : 09 December 2023

Revised : 09 December 2023

Accepted : 16 April 2024

Published : 27 April 2024

DOI : https://doi.org/10.1007/s00586-024-08281-y

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