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Handbook of Memory Disorders

October 20, 1995

This is a book that was waiting to be written. One can take both pleasure and relief in the result. It is very broad in its coverage, readable, and on the whole authoritative. There are lots of books on amnesia, both of neurological and "functional" origins, but none that covers the whole range or, indeed, goes well beyond amnesia per se; this one will have an assured and deserved success.

There are four sections - Theoretical Background, Varieties of Memory Disorder, Assessment, Management of Memory Problems. Inevitably, with 42 authors, there is unevenness, especially in depth. The "theoretical background" section is, in fact, relatively atheoretical: Alan Baddeley here is more comfortable with description and definitions, which will at least be useful to those who are confronted with the plethora of terms used in the literature and in popularisations - episodic, declarative, working, semantic, priming, etc. Baddeley does venture some opinions, but ducks down smartly before controversy can develop: for example, "my own view is that semantic memory consists of the accumulation of many episodes". The other chapter in this section, by Tranel and Damasio, reviews some of the evidence on the neurobiological aspects of human memory, especially (but not only) on the hippocampal complex and temporal neocortex, and long term potentiation. It is a reasonable account of current dogma, but cannot be said to be a critical treatment, nor perhaps could it be.

The section on varieties of memory disorder (one should insist on the term being in the plural) is rich and informative. O'Connor et al's account of different neuropsychological syndromes is excellent. John Hodges presents a useful and up-to-date review of retrograde amnesia in relation to various clinical neurological conditions, and his chapter with Karalyn Patterson on semantic memory is equally informative and cautious.

The chapter on memory changes in normal ageing (Gus Craik et al) is bound to be of interest to an increasing number of readers, although one still does not quite get the answer to the most common complaint of even the middle-aged: "I can recognise your face, but forget your name." (Maurice Bowra, the ex-warden of Wadham, is reputed to have overcome this difficulty disarmingly by saying "I remember your name but I forget your face" - which gave him time for rapid escape.) The chapters on the transient global amnesia, closed head injuries, the dementias, schizophrenia, and depression and anxiety, give added breadth and interest. It is especially useful to have the review on short-term memory disorders by Vallar and Papagno.

The chapter by John Kihlstrom and Dan Schacter on functional disorders of autobiographic memory is sophisticated and replete with detail concerning dissociative and multiple personality disorders in relation to a host of issues, such as explicit versus implicit memory and the transfer of learned material across dissociated states. These authors are among the few who have actually injected some scientific and experimental analysis into this puzzling area which, of course, nowadays attracts much public curiosity, not to say concern.

Predictably, the section of assessment is largely handbookish, especially the very useful chapter by Andrew Mayes. But the chapter by Mike Kopelman on the assessment of psychogenic amnesia (which Kihlstrom and Schacter call "functional") grapples fascinatingly with the challenging difficulties of a differential diagnosis between organic and psychogenic memory disorders, and between simulated and "authentic" amnesias. Kopelman's final conclusion is cautious and exposes the dilemma of trying to make diagnoses based on deviations from a supposed norm.

The final section on management contains some wise and commonsensical advice for treatment of patients with memory and associated disorders. All of the chapters are useful but reveal that measures, both psychological and pharmacological, are still largely palliative and substitutive rather than corrective. Barbara Wilson reviews a number of determined and varied efforts. The chapter by Elizabeth Glisky on computers in memory rehabilitation is sensible, cautious, and discusses areas of potential development, and Prigatano injects important reminders about personality and social aspects as important contexts for rehabilitation.

In this section is the only chapter that is out of character with the rest of the book, by Rourke and Tsatsanis on children with learning disabilities. They use the opportunity to review four studies from their own research on capacities such as arithmetic and spelling, and to make inferences about memory capacities in different groups of learning-disabled children.

The final chapter by Bonanno on functional memory problems is remarkable, especially in the light of much current debate about repression and trauma. He provides a humane and sensible alternative to theories of repression (if something is wrong with you now it must be because something 'orrible is locked in your unconscious which must be released), which he judges to be "outmoded". He instead gives an account of therapy in terms of accessibility, and how this can lead into narrative reconstructions, a position compatible with much that is known experimentally about the reconstructive aspects of long-term memory.

The book has some surprising omissions: there is very little on interference effects in forgetting, which must be a factor in ageing as well as in brain damage, nothing on animal work in relation to issues such as retrograde amnesia, among others. There is nothing on normal developmental aspects, and phenomena such as infantile amnesia. Finally why, in a self-designated handbook, is there no author index? But these are minor matters, and the book is already very large: this is a work of wide and authoritative scope that deserves to have a long life before it becomes just a reconstructed memory.

Lawrence Weiskrantz is emeritus professor of psychology, University of Oxford.

Handbook of Memory Disorders

Editor - Alan D. Baddeley, Barbara A. Wilson and Fraser N. Watts
ISBN - 0 471 95078 5
Publisher - John Wiley & Sons
Price - £49.95
Pages - 651

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