Jackie Andrade

Imaginary relish and exquisite torture: The elaborated intrusion theory of desire

The authors argue that human desire involves conscious cognition that has strong affective connotation and is potentially involved in the determination of appetitive behavior rather than being epiphenomenal to it. Intrusive thoughts about appetitive targets are triggered automatically by external or physiological cues and by cognitive associates. When intrusions elicit significant pleasure or relief, cognitive elaboration usually ensues. Elaboration competes with concurrent cognitive tasks through retrieval of target-related information and its retention in working memory. Sensory images are especially important products of intrusion and elaboration because they simulate the sensory and emotional qualities of target acquisition. Desire images are momentarily rewarding but amplify awareness of somatic and emotional deficits. Effects of desires on behavior are moderated by competing incentives, target availability, and skills. The theory provides a coherent account of existing data and suggests new directions for research and treatment.

Working memory and the vividness of imagery

The working memory framework was used to investigate the factors determining the phenomenological vividness of images. Participants rated the vividness of visual or auditory images under control conditions or while performing tasks that differentially disrupted the visuospatial sketchpad and phonological loop subsystems of working memory. In Experiments 1, 2, and 6, participants imaged recently presented novel visual patterns and sequences of tones; ratings of vividness showed the predicted interaction between stimulus modality and concurrent task. The images in experiments 3, 4, 5, and 6 were based on long-term memory (LTM). They also showed an image modality by task interaction, with a clear effect of LTM variables (meaningfulness, activity, bizarreness, and stimulus familiarity), implicating both working memory and LTM in the experience of vividness.

A Comparison of ''Errorless'' and ''Trial-and-error'' Learning Methods for Teaching Individuals with Acquired Memory Deficits

We present nine experiments, in three study phases, which test the hypothesis that learning methods which prevent the making of errors (“errorless learning”) will lead to greater learning than “trial-and-error” learning methods amongst individuals who are memory impaired as a result of acquired brain injury. Results suggest that tasks and situations which facilitate retrieval of implicit memory for the learned material (such as learning names with a first letter cue) will benefit from errorless learning methods, whilst those that require the explicit recall of novel associations (such as learning routes or programming an electronic organiser) will not benefit from errorless learning. The more severely amnesic patients benefit to a greater extent from errorless learning methods than those who are less severely memory impaired, but this may only apply when the interval between learning and recall is relatively short.

5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors

We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19,600 anaesthetics (95% confidence interval 1:16,700-23,450). However, there was considerable variation across subtypes of techniques or subspecialities. The incidence with neuromuscular block (NMB) was ~1:8200 (1:7030-9700), and without, it was ~1:135,900 (1:78,600-299,000). The cases of AAGA reported to NAP5 were overwhelmingly cases of unintended awareness during NMB. The incidence of accidental awareness during Caesarean section was ~1:670 (1:380-1300). Two-thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental, rapid sequence induction, obesity, difficult airway management, NMB, and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One-third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, mostly due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex, age (younger adults, but not children), obesity, anaesthetist seniority (junior trainees), previous awareness, out-of-hours operating, emergencies, type of surgery (obstetric, cardiac, thoracic), and use of NMB. The following factors were not risk factors for accidental awareness: ASA physical status, race, and use or omission of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from NAP5--the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home.

Images of desire: Cognitive models of craving

Cognitive modelling of phenomena in clinical practice allows the operationalisation of otherwise diffuse descriptive terms such as craving or flashbacks. This supports the empirical investigation of the clinical phenomena and the development of targeted treatment interventions. This paper focuses on the cognitive processes underpinning craving, which is recognised as a motivating experience in substance dependence. We use a high‐level cognitive architecture, Interacting Cognitive Subsystems (ICS), to compare two theories of craving: Tiffanys theory, centred on the control of automated action schemata, and our own Elaborated Intrusion theory of craving. Data from a questionnaire study of the subjective aspects of everyday desires experienced by a large non‐clinical population are presented. Both the data and the high‐level modelling support the central claim of the Elaborated Intrusion theory that imagery is a key element of craving, providing the subjective experience and mediating much of the associated disruption of concurrent cognition.

Working memory in perspective

A.D. Baddeley, G.J. Hitch, Foreword. J. Andrade, An Introduction to Working Memory. Applied Perspectives. D.G. Pearson, Imagery and the Visuo-spatial Sketchpad. J. Andrade, The Contribution of Working Memory to Conscious Experience. A.-M. Adams, C. Willis, Language Processing and Working Memory: A Developmental Perspective. L.H. Phillips, C. Hamilton, The Working Memory Model in Adult Aging Research. C. Jarrold, Applying the Working Model to the Study of Atypical Development. R. Henson, Neural Working Memory. Theoretical Perspectives. M. Page, R. Henson, Computational Models of Short-term Memory: Modelling Serial Recall of Verbal Material. P. Lovatt, S.E. Avons, Re-evaluating the Word-length Effect. G. Ward, A Critique of the Working Memory Model. J.N. Towse, C.M.T Houston-Price, Reflections on the Concept of the Central Executive. J. May, Specifying the Central Executive May Require Complexity. Conclusion. J. Andrade, The Working Memory Model: Consensus, Controversy and Future Directions.

Insensitivity of visual short-term memory to irrelevant visual information

Several authors have hypothesized that visuo-spatial working memory is functionally analogous to verbal working memory. Irrelevant background speech impairs verbal short-term memory. We investigated whether irrelevant visual information has an analogous effect on visual short-term memory, using a dynamic visual noise (DVN) technique known to disrupt visual imagery (Quinn & McConnell, 1996b). Experiment 1 replicated the effect of DVN on pegword imagery. Experiments 2 and 3 showed no effect of DVN on recall of static matrix patterns, despite a significant effect of a concurrent spatial tapping task. Experiment 4 showed no effect of DVN on encoding or maintenance of arrays of matrix patterns, despite testing memory by a recognition procedure to encourage visual rather than spatial processing. Serial position curves showed a one-item recency effect typical of visual short-term memory. Experiment 5 showed no effect of DVN on short-term recognition of Chinese characters, despite effects of visual similarity and a concurrent colour memory task that confirmed visual processing of the characters. We conclude that irrelevant visual noise does not impair visual short-term memory. Visual working memory may not be functionally analogous to verbal working memory, and different cognitive processes may underlie visual short-term memory and visual imagery.

Tests of the elaborated intrusion theory of craving and desire: Features of alcohol craving during treatment for an alcohol disorder.

OBJECTIVES We tested predictions from the elaborated intrusion (EI) theory of desire, which distinguishes intrusive thoughts and elaborations, and emphasizes the importance of imagery. Secondarily, we undertook preliminary evaluations of the Alcohol Craving Experience (ACE) questionnaire, a new measure based on EI Theory. METHODS Participants (N = 232) were in correspondence-based treatment trials for alcohol abuse or dependence. The study used retrospective reports obtained early in treatment using the ACE, and daily self-monitoring of urges, craving, mood and alcohol consumption. RESULTS The ACE displayed high internal consistency and test - retest reliability and sound relationships with self-monitored craving, and was related to Baseline alcohol dependence, but not to consumption. Imagery during craving was experienced by 81%, with 2.3 senses involved on average. More frequent imagery was associated with longer episode durations and stronger craving. Transient intrusive thoughts were reported by 87% of respondents, and were more common if they frequently attempted to stop alcohol cognitions. Associations between average daily craving and weekly consumption were seen. Depression and negative mood were associated with more frequent, stronger and longer lasting desires for alcohol. CONCLUSIONS Results supported the distinction of automatic and controlled processes in craving, together with the importance of craving imagery. They were also consistent with prediction of consumption from cross-situational averages of craving, and with positive associations between craving and negative mood. However, this studys retrospective reporting and correlational design require that its results be interpreted cautiously. Research using ecological momentary measures and laboratory manipulations is needed before confident inferences about causality can be made.

Intrusive and non‐intrusive memories in a non‐clinical sample: The effects of mood and affect on imagery vividness

We studied the number, valence, and vividness of intrusive and non‐intrusive memories in two groups (N = 20) of pre‐screened non‐depressed mood and depressed mood undergraduate participants. They were asked to generate as many intrusive memories (IMs) as possible from the prior 2 weeks, together with pleasant and unpleasant non‐intrusive memories from the same period. They subsequently formed images of these memories and rated them on measures of vividness, valence, arousal, and overall affect, while having their heart rate, skin conductance, and electromyogram monitored. IMs were common, with participants generating a mean of 1.15 pleasant IMs and 1.60 unpleasant IMs, and there was some evidence that they were mood‐congruent. IMs were more vivid than non‐intrusive memories, a difference not due to either valence or arousal. We conclude that IMs are a general feature of human memory rather than just a symptom of certain clinical disorders.

Determinants of the vividness of visual imagery: the effects of delayed recall, stimulus affect and individual differences.

This study investigated the influence of emotion on vividness of imagery. A total of 80 undergraduate participants saw 25 pictures from the International Affective Picture System, representing different dimensions of valence and arousal. They rated each stimulus for valence, arousal, and emotionality. Each stimulus was then presented again, and participants formed an image of it, rating the image for vividness, valence, arousal, and emotionality. During a 15‐minute retention interval, participants completed several individual differences questionnaires. They then recalled each image from a verbal prompt and re‐rated its quality. Slides rated as extremely valenced and highly arousing were more vividly imaged than neutral slides. Low mood was also associated with more vivid imagery. The influence of stimulus variables was greater in the immediate imagery phase; that of individual differences tended to be greater in the delayed imagery phase. Of 29 participants, 7 reported intrusive memories of highly unpleasant stimuli at 1 year follow‐up.