Metamemory without the memory: are people aware of midazolam-induced amnesia? (original) (raw)

Abstract

Rationale

Midazolam is a benzodiazepine which produces a dense anterograde amnesia, while permitting relatively well-preserved short-term memory, semantic retrieval, and other higher cognitive functions. Given these preserved abilities, we were interested in whether or not participants given midazolam would be aware of this anterograde amnesia.

Method

In the present experiment, participants were given midazolam in one testing session and a saline placebo in another. Participants provided judgments-of-learning (JOLs) immediately following study of cue-target pairs. During the test phase of the experiment, confidence levels and feeling-of-knowing (FOK) judgments were collected.

Results

Although cued recall performance was substantially impaired in the midazolam condition, mean JOLs were unaffected, indicating participants had little insight into their impairment during the study phase. Participants were relatively accurate in confidence levels and FOK judgments in the midazolam condition.

Conclusion

When studying items under the influence of midazolam, participants are unaware that their memory will be impaired. Implications for clinical practice and pharmacological studies of amnesia are discussed.

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References

• Bacon E, Danion J, Kauffmann-Muller F, Schelstraete M, Bruant A, Sellal F, Grange D (1998) Confidence level and feeling of knowing for episodic and semantic memory: and investigation of lorazepam effects on metamemory. Psychopharmacology 138:318–325
  Article CAS PubMed Google Scholar
• Dunlosky J, Nelson TO (1992) Similarity between the cue for judgments of learning (JOL) and the cue for test is not the primary determinant of JOL accuracy. J Mem Lang 36:34–49
  Article Google Scholar
• Dunlosky J, Domoto PK, Wang ML, Ishikawa T, Roberson I, Nelson TO, Ramsay DS (1998) Inhalation of 30% nitrous oxide impairs people’s learning without impairing people’s judgments of what will be remembered. Exp Clin Psychopharmacol 6:77–86
  Article CAS PubMed Google Scholar
• Evers AS, Maze M (2004) Anesthetic pharmacology: physiologic principles and clinical practice. Churchill Livingstone, Philadelphia
  Google Scholar
• Greenblatt DJ, Abernethy DR, Locniskar A, Harmatz JS, Limjuco RA, Shader RI (1984) Effect of age, gender and obesity on midazolam kinetics. Anesthesiology 61:27–35
  CAS PubMed Google Scholar
• Hart JT (1967) Memory and the memory-monitoring process. J Verb Learn Verb Behav 6:685–691
  Google Scholar
• Hennesy M, Kirkby K, Montgomery I (1991) Comparison of the amnesic effects of midazolam and diazepam. Psychopharmacology 103:545–550
  PubMed Google Scholar
• Hirshman E, Passannante A, Henzler A (1999) The effect of midazolam on implicit memory tests. Brain Cogn 41:351–364
  Article CAS PubMed Google Scholar
• Hirshman E, Passannante A, Arndt J (2001) Midazolam amnesia and conceptual processing in implicit memory. J Exp Psychol Gen 130:453–465
  Article CAS PubMed Google Scholar
• Jackson J, Louwerens J, Cnossen F, de Jong H (1993) Testing the effects of hypnotics on memory via the telephone: fact or fiction? Psychopharmacology 111:127–133
  CAS PubMed Google Scholar
• Knoester PD, Jonker DM, van der Hoeven RTM, Vermeij TAC, Edelbroek PM, Brekelmans GJ, de Haan GJ (2002) Pharmacokinetics and pharmacodynamics of midazolam administered as a concentrated intranasal spray. A study in healthy volunteers. Br J Clin Pharmacol 53:501–507
  Article CAS PubMed Google Scholar
• Koriat A (1997) Monitoring one’s own knowledge during study: a cue-utilization approach to judgments of learning. J Exp Psychol Gen 126:349–370
  Article Google Scholar
• Koriat A, Goldsmith M (1996) Monitoring and control processes in the strategic regulation of memory accuracy. Psychol Rev 103:490–517
  Article CAS PubMed Google Scholar
• Lovelace EA (1984) Metamemory: monitoring future recallability during study. J Exp Psychol Learn Mem Cogn 10:756–766
  Article Google Scholar
• Mandema JW, Tuk B, van Steveninck AL, Breimer DD, Cohen AF, Danhof M (1992) Pharmacokinetic-pharmacodynamic modeling of the central nervous system effects of midazolam and its main metabolite alpha-hydroxymidazolam in healthy volunteers. Clin Pharmacol Ther 51:715–728
  CAS PubMed Google Scholar
• Metcalfe J, Shimamura AP (1994) Metacognition: knowing about knowing. MIT, Cambridge, Mass.
• Mewaldt SP, Hinrichs JV, Ghoneim MM (1983) Diazepam and memory: support for duplex model of memory. Mem Cognit 11:557–564
  CAS PubMed Google Scholar
• Mintzer MZ, Griffiths RR (2003) Lorazepam and scopolamine: a single-dose comparison of effects on human memory and attentional processes. Exp Clin Psychopharmacol 11:56–72
  Article CAS PubMed Google Scholar
• Nelson TO (1984) A comparison of measures of the accuracy of feeling-of-knowing predictions. Psychol Bull 995:109–133
  Google Scholar
• Nelson TO, Narens L (1990) Metamemory: a theoretical framework and new findings. Psychol Learn Motiv 26:125–173
  Google Scholar
• Nelson TO, McSpadden M, Fromme K, Marlatt GA (1986) Effects of alcohol intoxication on metamemory and on retrieval from long-term memory. J Exp Psychol Gen 115:247–254
  Article CAS PubMed Google Scholar
• Nelson TO, Graf A, Dunlosky J, Marlatt A, Walker D, Luce K (1998) Effect of acute alcohol intoxication on recall and on judgments of learning during the acquisition of new information. In: Mazzoni G, Nelson TO (eds) Metacognition and cognitive neuropsychology: monitoring and control processes. Erlbaum, Mahwah, pp 161–180
• Polster M, McCarthy R, O’Sullivan G, Gray P, Park G (1993) Midazolam-induced amnesia: implications for the implicit/explicit memory distinction. Brain Cogn 22:244–265
  Article CAS PubMed Google Scholar
• Rivas-Vazquez RA (2003) Benzodiazepines in contemporary clinical practice. Prof Psychol Res Pr 34:324–328
  Article Google Scholar
• Schwartz BL (1994) Sources of information in metamemory: judgments of learning and feelings of knowing. Psychon Bull Rev 1:357–375
  Google Scholar
• Schwartz BL, Benjamin AS, Bjork RA (1997) The inferential and experiential bases of metamemory. Curr Dir Psychol Sci 6:132–137
  Article Google Scholar
• Shimamura A, Squire L (1988) Long-term memory in amnesia: cued recall, recognition memory, and confidence ratings. J Exp Psychol Learn Mem Cogn 14:763–770
  Article CAS PubMed Google Scholar
• Stafford RS, Ausiollo JC, Misra B, Saglam D (2000) National patterns of depression treatment in primary care. Prim Care Companion J Clin Psychiatry 2:211–216
  PubMed Google Scholar
• Stoelting RK (1991) Pharmacology and physiology in anesthetic practice. Lippincott, Philadelphia
• Veselis R, Reinsel R, Feschenko V, Wronski M (1997) The comparative amnestic effects of midazolam, propofol, thiopental, and fentanyl at equisedatie concentrations. Anesthesiology 87:749–764
  Article CAS PubMed Google Scholar
• Weingartner HJ, Joyce, EM, Sirocco KY, Adams CM, Eckardt, MJ, George T, Lister RJ (1993) Specific memory and sedative effects of the benzodiazepine triazolam. J Psychopharmacol 7:305–315
  CAS Google Scholar

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Acknowledgements

The work presented here was supported by a grant from the National Science Foundation to Elliot Hirshman.

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Authors and Affiliations

1. Department of Psychology, George Washington University, 2125 G Street NW, Washington, DC 20052, USA
   Paul Merritt & Elliot Hirshman
2. Department of Anesthesiology and Critical Care Medicine, George Washington University, 900 23rd St. NW, Washington, DC 20037, USA
   John Hsu & Michael Berrigan
3. Department of Psychology, Texas A & M University–Corpus Christi, 6300 Ocean Drive, Corpus Christi, TX 78412, USA
   Paul Merritt

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1. Paul Merritt
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2. Elliot Hirshman
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3. John Hsu
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4. Michael Berrigan
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Correspondence toPaul Merritt.

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Merritt, P., Hirshman, E., Hsu, J. et al. Metamemory without the memory: are people aware of midazolam-induced amnesia?.Psychopharmacology 177, 336–343 (2005). https://doi.org/10.1007/s00213-004-1958-8

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• Received: 19 March 2004
• Accepted: 05 June 2004
• Published: 28 July 2004
• Issue Date: January 2005
• DOI: https://doi.org/10.1007/s00213-004-1958-8

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