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Subjective reports and theories about memory may have an influence on other beliefs and behaviours. Patients with schizophrenia suffer a wide range of deficits affecting their awareness of daily life, including memory. With the Metamemory Inventory in Adulthood (MIA) we ascertained patients' memory knowledge and thoughts about their own cognitive capacities and about several aspects of cognitive functioning: personal capacities, knowledge of processes, use of strategies, perceived change with ageing, anxiety, motivation and mastery. The participants' ratings were correlated with their intellectual, cognitive and psychiatric data. Patients felt they had a lower capacity and marginally lower mastery over their memory than comparison subjects. They reported less recourse to strategies, and higher levels of memory-related anxiety. However, their knowledge of basic memory processes, motivation to succeed, and perception of ageing effects were similar. So patients with schizophrenia do not suffer a general and non specific impairment of their metacognitive knowledge.

This study examined effects of intensive memory use during one's profession on metamemory beliefs. Fifty-one actors and 60 controls aged from 20 to 73 years were compared with the Metamemory Inventory in Adulthood. Both intensive job-related memory practice and younger age were associated with stronger memory self-efficacy beliefs. Irrespective of age, actors reported a higher stability of their memory with time and a higher controllability. No significant effect was found on metamemory knowledge. These findings show the relevance of the dissociation between metamemory knowledge and metamemory beliefs. Both memory practicing during occupation and age appear to influence only metamemory beliefs.

The aim of the study was to explore the processes underlying schizophrenia patients' reflections on their own memory. Cognitive deficits and insight problems are considered core symptoms of schizophrenia. Even when people fail to recall a solicited target, they can provide feeling of knowing (FOK) judgments that reflect their ability to judge the accessibility of the target in memory. The metamemory approach allows for direct and experimental quantification of the correspondence between the subjective judgments and the objective measures of memory performance. According to the accessibility hypothesis, FOK evaluations rely on the accessibility of partial and/or contextual information relevant to the memory target.The accessibility of partial information relating to a memory target was investigated in 21 patients and 21 healthy comparison subjects matched for age, gender, and level of education. The material to be learned consisted of four-letter nonsense tetragrams, with each letter providing partial information about the four-letter target.The results show that despite memory recall (p.01) and recognition impairments (p = .02) and lower FOK ratings (p.05), patients' metamemory judgments increased linearly with the amount of partial information recalled (from one letter to four letters, p.01). The products of memory retrieval were predictive of both their FOK judgments and their subsequent memory performance.Schizophrenia patients are as capable as comparison subjects of relying on the products of memory retrieval to monitor accurately their awareness of what they do or do not know. The finding may be of interest for cognitive remediation.

TOT states may be viewed as a temporary and reversible microamnesia. We investigated the effects of lorazepam on TOT states in response to general knowledge questions. The lorazepam participants produced more commission errors and more TOTs following commission errors than the placebo participants (although the rates did not change). The resolution of the TOTs was unimpaired by the drug. Neither feeling-of-knowing accuracy nor recognition were affected by lorazepam. The higher level of incorrect recalls produced by lorazepam participants may be due to the fact that they were more frequently temporarily unable to access a known item. For some of these items, the awareness of the retrieval failure resulted in a commission TOT (phenonemological TOT after a commission error). The resolution of the TOT conflict is discussed in the light of the anxiolytic and anticonflict effects of lorazepam. The data are discussed in terms of contemporary theories of TOTs and the effects that benzodiazepines have on semantic memory.

International audience; Background: Cognitive and introspection disturbances are considered core features of schizophrenia. In real life, people are usually free to choose which aspects of an event they recall, how much detail to volunteer, and what degree of confidence to impart. Their decision will depend on various situational and personal goals. The authors explored whether schizophrenia patients are able to achieve a compromise between accuracy and informativeness when reporting semantic information.Methods: Twenty-five patients and 23 healthy matched control subjects answered general knowledge questions requiring numerical answers (how high is the Eiffel tower?), freely at first and then through a metamemory-based control. In the second phase, they answered with respect to two predefined intervals, one narrow and one broad; attributed a confidence judgment to both answers; and afterward selected one of the two answers. Data were analyzed using analyses of variance with group as the between-subjects factor.Results: Patients reported information at a self-paced level of precision less accurately than healthy participants. However, they benefited remarkably from the framing of the response and from the metamemory processes of monitoring and control to the point of improving their memory reporting and matching healthy subjects' accuracy.Conclusions: In spite of their memory deficit during free reporting, after accuracy monitoring, patients strategically regulated the grain size of their memory reporting and proved able to manage the competing goals of accuracy and informativeness. These results give some cause for optimism as to the possibility for patients to adapt to everyday life situations.

International audience

Recent studies have shown that schizophrenia may be a disease affecting the states of consciousness. The present study is aimed at investigating metamemory, i.e., the knowledge about one's own memory capabilities, in patients with schizophrenia. The accuracy of the Confidence level (CL) in the correctness of the answers provided during a recall phase, and the predictability of the Feeling of Knowing (FOK) when recall fails were measured using a task consisting of general information questions and assessing semantic memory. Nineteen outpatients were paired with 19 control subjects with respect to age, sex, and education. Results showed that patients with schizophrenia exhibited an impaired semantic memory. CL ratings as well as CL and FOK accuracy were not significantly different in the schizophrenic and the control groups. However, FOK ratings were significantly reduced for the patient group, and discordant FOK judgments were also observed more frequently. Such results suggest that FOK judgments are impaired in patients with schizophrenia, which confirms that schizophrenia is an illness characterized by an impaired conscious awareness of one's own knowledge.

The effects of lorazepam (0.026 or 0.038 mg/kg), a benzodiazepine, and of a placebo on metamemory, i.e. knowledge about one's own memory capabilities, were investigated in 36 healthy volunteers. Accuracy of confidence levels (CL) in the correctness of recalled answers and accuracy of feeling of knowing (FOK) the answers when recall fails were measured using a sentence memory task assessing episodic memory and a task consisting of general information questions and assessing semantic memory. Lorazepam impaired episodic memory. Unexpectedly, it also impaired performance in both the recall and recognition phases of the task assessing semantic memory, suggesting that it decreased the ability to distinguish between correct and incorrect information. In episodic memory, lorazepam 0.038 mg/kg-treated subjects exhibited an impaired CL accuracy, compared to placebo-treated subjects, and their FOK accuracy was at chance. In semantic memory, their overall CL and FOK accuracy was apparently spared. However, these subjects selectively overestimated their CL judgements for incorrect answers; moreover, secondary analyses showed that FOK accuracy for a subset of low-accuracy items was virtually nil. These results suggest that lorazepam impairs metamemory for both episodic and semantic memory.

In addition to a wide range of deficits affecting their awareness of aspects of daily life, patients with schizophrenia also manifest deficits in terms of awareness of their memory capacity. This chapter will be devoted to metacognition as defined for the first time in 1976 by John Flavell as “one’s knowledge concerning one’s own cognitive processes”, and to the theoretical and experimental models developed in this field of research. More specifically, we shall be dealing with metamemory, which refers to the subjective awareness of one’s memory capacity and control over the related memory behavior. It allows for direct and experimental quantification of metacognitive accuracy, that is, the correspondence between the subjective (metacognitive judgments) and objective (actual memory performance) measures of performance, providing unique insight into patients’ cognitive functioning and how defects within may compromise normal functioning. Research in the field shows that rather than having a generalized, nonspecific defect in metamemory abilities, patients present both impaired and preserved aspects of memory-related metacognitive processes. Our finding that some abilities seem to be preserved in patients gives some cause for optimism for helping patients adapt to everyday life situations.

The feeling of knowing (FOK) predicts the likelihood of eventually recognizing currently unrecalled items. Koriat (1993, 1995) showed that retrieval of partial target information influences FOK ratings. Building on Koriat's view, the noncriterial-recollection hypothesis contends that contextual information influences FOKs (Brewer, Marsh, Clark-Foos, & Meeks, 2010). Our study assessed the validity of the noncriterial-recollection hypothesis by controlling the amount of potentially-retrievable contextual information presented to participants. We varied the amount of contextual information accompanying the name and image of imaginary animals. There were three information conditions: minimum (name and image), medium (name, image, and country), and maximum (name, image, country, diet and weight). Information condition did not affect recall accuracy. The minimum condition resulted in greater response output (recall and commission errors together). FOKs for unrecalled items were lower in the minimum condition than the other conditions. Consistent with the noncriterial-recollection hypothesis, FOKs were positively correlated with the retrieval of contextual information.

Schizophrenia is a common mental disease with a lifetime risk of about 1%. It has been closely linked to a wide range of cognitive deficits. In addition to cognitive deficits, patients with schizophrenia also manifest deficits in awareness of their memory capacity. The study of metamemory permits an experimental approach to metacognition in schizophrenia. Two studies with schizophrenia patients are reported. The first study is on FOK, a metamemory judgment that is expressed at the time of retrieval. The second study examines JOL, which is expressed at the time of learning and allows the studying of the strategic regulation of learning. Thus, the relationship between monitoring and control can be revealed. The findings of the two reported studies showed preservation of the accuracy of prospective metamemory judgments in schizophrenia. The first study demonstrated that the accuracy of FOK, the judgments elicited at the time of retrieval regarding the future recallability of unrecalled items, is preserved in an episodic task. Evidence from the second study indicates that the accuracy of judgments elicited at the time of encoding (i.e., JOLs) is also relatively preserved but the strategic regulation (i.e., control) of study time is impaired in schizophrenia.

Metamemory awareness refers to the ability to monitor and control how well information is processed depending on the loads and needs of the task at hand. There is some evidence that metamemory functions are impaired in schizophrenia at the time of memory retrieval. This study investigated whether patients with schizophrenia exhibit metamemory abnormalities during the encoding of new information. The frequency of item presentation was varied. Both memory control and memory monitoring were assessed using study-time allocation and Judgments of Learning (JOL), respectively. Repeated items were recalled better by both groups, but memory performance was lower in patients than controls. Patients' behavior patterns were abnormal in terms of the study-time allocated for each item according to presentation frequency. Patients' JOLs were lower than those of controls but remained sensitive to item repetition. Patients' predictive values on memory accuracy were no different to those measured in controls. In addition, none of the patients reported using efficient strategies to help memorize target items. The results show a dissociation between memory control, which was impaired, and memory monitoring, which was spared, in patients with schizophrenia during encoding of new information.

In Koriat’s accessibility model (Koriat, Psychol Rev, 100:609–639, 1993; Koriat, J Exp Psychol Gen, 124:311–333, 1995), when a person fails to recall a required target, he or she can nevertheless provide some partial information about the target. Moreover, individuals are able to provide feeling-of-knowing (FOK) judgments about the availability of the target in memory. The cues for the FOK evaluations reside in the products of the retrieval process itself. It was shown that the benzodiazepine lorazepam drug induces some impairment of memory. The effects of the amnesic benzodiazepine lorazepam on the total and partial recall of recently learned material and on FOK ratings were investigated in healthy volunteers. Twenty-eight healthy volunteers participated in the study: 14 of these received a capsule containing lorazepam (0.038 mg/kg) and 14 a placebo capsule. The material to be learned consisted of four-letter nonsense tetragrams with each letter providing partial information with regard to the four-letter target (Koriat, Psychol Rev, 100:609–639, 1993). The number of incorrect letters reported was higher for the lorazepam than for the placebo condition. The FOK magnitude was higher for the placebo participants than for the lorazepam participants. The predictive value of FOK for recognition was preserved by the drug. When studying four-letter nonsense letter strings, lorazepam participants present an impairment of episodic short-term memory and the drug has an effect on FOK estimates but not on the predictive accuracy of the FOK. The accessibility hypothesis of FOK was confirmed in this study and seems to retain some validity even under the effect of an amnesic drug.

The ability to monitor memory performance has considerable importance in everyday life and is among the proposed metamemory dimensions which has been widely investigated. The ability to monitor memory performance accurately was examined in 16 patients with schizophrenia and 16 control subjects by using a Feeling-of-Knowing task on episodic information. Feeling-of-Knowing judgments are predictions made about the likelihood of subsequent recognition of currently non-recallable information. Participants were given cued recall and recognition tests of 50 sentence-target words. Feeling-of-knowing judgments were made for non-recalled targets. Our results first confirm that schizophrenia is associated with episodic memory impairment. By using the Feeling-of-Knowing task, patients with schizophrenia were found to predict accurately their subsequent recognition performance, suggesting an interesting dissociation between a preserved metamemory and an altered memory.

We investigated the effects of lorazepam, a benzodiazepine, on the allocation of study time, memory, and judgment of learning, in a cognitive task where the repetition of word presentation was manipulated. The aim was to assess whether lorazepam would affect the learning processes and/or whether the participants would be aware of the amnesic difficulty. A total of 30 healthy volunteers participated in the study, 15 of whom received a capsule containing the lorazepam drug (0.038 mg/kg) and 15 a placebo capsule. First, the accuracy of delayed judgments of learning (JOL) was measured in both groups. For the JOL ratings, results showed that all the participants benefited from word repetition. Although the overall performance was lower in the lorazepam than in the placebo group, the accuracy of the JOL ratings was preserved by the drug. Second, all the participants benefited from the repetition of learning, although the performances of the lorazepam-treated subjects remained lower than those of the placebo participants. The repetition of learning had an effect on JOL in both groups. Finally, the time spent learning each (allocation study time) pair of words was measured. For the placebo group, results revealed that study time decreased significantly with the frequency of presentation. For the lorazepam group, no effect of presentation frequency was found. Overall, our findings suggest that the lorazepam drug has a differential effect on the monitoring and the control processes involved in a learning task. The implications of these findings are discussed within the theoretical framework of metacognition.

Introduction Cognitive deficits are today considered as core symptoms of schizophrenia. The most classical techniques aimed at enhancing learning and retention focus on repetition of learning, and are not very efficient on a long time scale. On the other hand, the subjective knowledge and feelings about memory provide the basis for regulating one's memory-related behavior. Metamemory refers to the subjective awareness of one's memory capacity (monitoring), and the control of the related memory behavior. The self monitoring approach is based on having learners judge which material have been learned or not well learned. It has been successfully used to enhance learning in young and older healthy participants. Monitoring ability has been shown to be relatively spared in schizophrenia. Aims The aim of this study was to assess the efficiency in patients with schizophrenia of this potential learning method, self-monitoring, including a single learning session, in comparison with relearning. Methods After a single word pair encoding phase (60 pairs), patients took part in a single session devoted to either re-study, or self-monitoring. The strength of the cue-target association was manipulated. 48 hours later, there was a final cued-recall test. Results Preliminary results show that, regarding difficult material, most of the patients having used the self-monitoring procedure had better levels of performance (8/10: performance > 50%) than those having re-studied (3/9: performance > 50%). Conclusions If the results are confirmed with greater patient's samples, then self-monitoring could represent an interesting and novel, less stressful learning strategy for patients with schizophrenia.

Lorazepam has been repeatedly shown to induce memory impairments. The effects of this benzodiazepine on the processes involved in the strategic regulation of memory accuracy have not as yet been explored. An experimental procedure that delineates the role of monitoring and control processes was used. Fifteen lorazepam and 15 placebo subjects were examined using a semantic memory task that combined both a forced- and a free-report option and a no-incentive and an incentive condition. Memory accuracy was lower in the lorazepam than in the placebo group. Lorazepam impaired control sensitivity (the extent to which volunteering of answers is affected by the confidence judgments). While the absolute aspect of monitoring was impaired (calibration scores), both the discriminative aspect (the ability to distinguish between correct and incorrect answers) and the response criterion setting (the confidence threshold set for volunteering a report) were spared. The pharmacological dissociation between monitoring effectiveness and control sensitivity indicates that these two components involve distinct processes.