Existe-t-il vraiment une psychopathologie du rabâchage chez le sujet agé ?

International audienceRepetitive talk has not been widely studied from the semeiotic and neuro-psychological angle, although it is a marker in the loss of control of the environment with old age. In this study a group of elderly, anxious subjects, a group of elderly subjects with cognitive disturbances and a group of elderly controls were compared. A quantitative analysis of repetitive speech, using the SRI (Stereotyping Rating Inventory) was performed, followed by a qualitative analysis, using indicators of memory, executive functions (updating; flexibility; inhibition) personality, anxiety and depression. Among subjects with cognitive and anxious disturbances, repetitive talk comprised stories (more than 2 or 3 sentences) or sentences, but there was no repetition of words or songs. The encounter with others is affected by this repetitive talk, and results from the fact that either the discourse is centered on completed events (because of difficulties in updating in the cognitive disturbance group), or it incorporates superfluous, diffuse events, also resulting from an impairment in updating abilities, but also from inhibition and mental flexibility problems in the group of anxious subjects.Le rabâchage, pris au sens de discours répétitif, a été peu étudié au plan sémiolo-gique et neuropsychologique, même s'il représente une étape charnière de la perte du contrôle de l'environnement, avec la vieillesse. Dans ce travail sont comparés un groupe de sujets âgés anxieux et un groupe de sujets âgés ayant des troubles cognitifs et un groupe de sujets âgés contrôles. Il a été fait une analyse quantitative du discours répétitif, au moyen du Stereotyping Rating Inventory (SRI) et une analyse qualitative du discours répétitif, au moyen d'indicateurs de mémoire, de fonctions exécutives (mise à jour, flexibilité, inhibition), de personnalité et d'anxiété-dépression. Pour ceux ayant des troubles cognitifs et les anxieux, le rabâchage est plutôt composé d'histoires (plus de 2 ou 3 phrases) ou de phrases mais pas de répétition concer-nant des mots ou des chansons. L'altération de la rencontre avec l'autre, du fait de ces discours répétitifs, se fait soit parce qu'il est centré sur des évènements terminés (par atteinte des capa-cités de mise à jour, en ce qui concerne notre groupe ayant des troubles cognitifs), soit parce qu'il intègre dans le discours des évènements superflus, diffluents, issus d'une atteinte des capacités de mise à jour, mais aussi d'inhibition et de flexibilité mentale, dans notre groupe d'anxieux

Functional independence within the self-memory system: new insights from two cases of developmental amnesia.

Neuropsychological and neuroimaging data suggest that the self-memory system can be fractionated into three functionally independent systems processing personal information at several levels of abstraction, including episodic memories of one's life (episodic autobiographical memory, EAM), semantic knowledge of facts about one's life (semantic autobiographical memory, SAM), and semantic knowledge of one's personality [conceptual self, (CS)]. Through the study of two developmental amnesic patients suffering of neonatal brain injuries, we explored how the different facets of the self-memory system develop when growing up with bilateral hippocampal atrophy. Neuropsychological evaluations showed that both of them suffered from dramatic episodic learning disability with no sense of recollection (Remember/Know procedure), whereas their semantic abilities differed, being completely preserved (Valentine) or not (Jocelyn). Magnetic resonance imaging, including quantitative volumetric measurements of the hippocampus and adjacent (entorhinal, perirhinal, and temporopolar) cortex, showed severe bilateral atrophy of the hippocampus in both patients, with additional atrophy of adjacent cortex in Jocelyn. Exploration of EAM and SAM according to lifetime periods covering the entire lifespan (TEMPAu task, Piolino et al., 2009) showed that both patients had marked impairments in EAM, as they lacked specificity, details and sense of recollection, whereas SAM was completely normal in Valentine, but impaired in Jocelyn. Finally, measures of patients' CS (Tennessee Self-Concept Scale, Fitts and Warren, 1996), checked by their mothers, were generally within normal range, but both patients showed a more positive self-concept than healthy controls. These two new cases support a modular account of the medial-temporal lobe with episodic memory and recollection depending on the hippocampus, and semantic memory and familiarity on adjacent cortices. Furthermore, they highlight developmental episodic and semantic functional independence within the self-memory system suggesting that SAM and CS may be acquired without episodic memories

Memory

Intrusive traumatic recollections suggest an inability in Posttraumatic Stress Disorder (PTSD) to control and notably to inhibit memories for trauma-related information. Supported by inhibitory deficits found on experimental settings in PTSD, memory functioning and memory biases in the disorder were usually explained through inhibitory and control deficits in the processing of trauma-related information. The present study aimed to directly assess this hypothesis by investigating memory control abilities for emotional information in PTSD. For this purpose, 34 patients diagnosed with PTSD were compared to 37 non-PTSD controls on an item-cued directed forgetting paradigm for emotional words combined with a Remember/Know recognition procedure. Results revealed enhanced amounts of Remember recognitions for trauma-related words in PTSD. Moreover, we replicated findings of memory control impairments in the disorder. However, such impairments only occurred for non-trauma-related words. Accordingly, it appeared that PTSD patients presented preserved memory control abilities for trauma-related words, at the expenses of other emotional valences. Surprisingly, PTSD patients presented a preserved ability to control and notably to inhibit their memory functioning for trauma-related material. In addition to potential theoretical and clinical relevance, these results are discussed in the light of resource reallocation hypotheses and vigilant-avoidant theories of information processing in PTSD