What Almost Kills You Makes Your Memory Stronger: Cancer Diagnosis Memories Ψ Angeline Modesti Renato Puga John N. Bohannon III Butler University-Psychology

Introduction Flashbulb Memories (FBM) are vivid recollections of discovering shocking, consequential news such of the Challenger Explosion (Bohannon, 1988) FBM rely on verbal communication either from a person or the media (Bohannon, Gratz & Cross, 2007) as does a medical diagnoses Women who were diagnosed with cancer stated that their diagnostic consultation was a memorable event, with none of them indicating poor recall of the memory (Mager & Andrykowski, 2002) Information that is processed relevant to survival is remembered better than information that is processed in different contexts (Nairne, 2010; Otgaar, Smeets, & van Bergen, 2010).

Hypotheses If an evolutionary memory pathway exists to determine threat over and above arousal, then a cancer diagnosis should be more threatening, and also be a better remembered event, regardless of the effects of rehearsal and arousal at the time of encoding. If the arousal mechanism is the proximal cause of flashbulb characteristics in cancer diagnoses memories, then the three different kinds of consequentiality being studied should be equally remembered once the arousal levels of each event are equated (Howe & Otgaar, 2013). If the evolutionary age of the mechanisms alone determines memory, then the actual injuries with imagery and real immediate pain should be best recalled regardless of delay, rehearsal or rated arousal

Methods 44 current or previous cancer patients who were recruited on a national level Offered $5 Starbucks gift card for participation and entering into a drawing for a $50 Visa gift card Two part protocol that contained a free recall and probed recall section Data from Hillman et al. (2010): childhood injury memories (N=109) Data from Shaneyfelt, Minor, & Bohannon (2008): car accident memories (N=74)

Scoring Free recall narratives Probed recall Canonical features developed by Brown and Kulik (1977) Time, location, activity, author’s affect, other’s affect, others present, and aftermath Scored on a scale from 1-3 Probed recall Scored on a scale from 0-2 0 indicated no answer 1 indicated basic answer 2 indicated detailed answer Participant confidence rating of probed response 1=least confidence 5=most confidence

Example of Scoring There is no activity mentioned or implied. There is no activity mentioned or implied. 1 Any amount of activity is (1) implied OR (2) explicitly stated but vague: the scorer CANNOT physically imitate the activity of the narrator without any doubt. 2 One activity is (3) explicitly stated and specific: the scorer CAN physically imitate the activity of the narrator without any doubt. 3 Two or more activities are (3) explicitly stated and specific: the scorer CAN physically imitate the activity without any doubt.

Results *p < .0001 **p < .0518 Delay was marginally significant, F (4, 315) = 2.38, p < .0518 Affect was significant, F (4, 321) = 12.90, p < .0001 Cancer diagnosis memories were significantly higher than all of the other events Recounts were significant, F (4, 306) = 25.03, p < .0001 Cancer diagnosis memories had significantly higher numbers of recounts that all other memories Language input had significantly higher numbers of recounts Vividness was significant, F (4, 318) = 21.97, p < .0001 Car accident memories had significantly higher ratings than all of the other events Pain input had significantly higher ratings than all other input types Free Recall Narratives were significant , F (4, 315) = 7.49, p < .0001 Cancer diagnosis memories had significantly more detail than all other memories Probed Question Responses were significant, F (4, 324) = 13.22, p < .0001 Cancer diagnosis memories had significantly more detail than all other memories except for car accident memories Probed Question Confidence was significant, F (4, 323) = 15.23, p < .0001 Childhood injury memories had significantly higher confidence than all other events *p < .0001 **p < .0518 ***Car accident data was collected from Shaneyfelt, Minor, & Bohannon, 2008 ****Childhood injury memory was collected from Hillman et al., 2010

Conclusions Hypothesis 1 was confirmed for free recall narratives Car accident memories did not significantly differ from cancer diagnosis memories for probed response detail Hypothesis 2 was not supported Affect was not a determining factor in the level of detail in the free recall narratives Event type and number of recounts play a role in the quality of the memory For both free recall narratives and probed recall responses, the amount of detail significantly differed between events The level of consequentiality/threat plays a role in memory encoding Hypothesis 3 was not supported Car accident participants who received the input via a pain and visual mechanism did not have significantly different levels of detail from cancer diagnosis participants who received the input via a language mechanism in the probed response questions

The future Larger and more gender equal cancer patient population Look at how a specific type of cancer diagnosis may influence memory Patients were recruited from support groups where they would recount their diagnosis conversation often Pursue inverted “U” that was found in the current study that is representative of The Yerkes–Dodson law in how the level of affect at the time of encoding effects memory recall later on

References Bohannon III, J. N. (July 1988). Flashbulb memories for the space shuttle disaster: A tale of two theories. Cognition 22 (2): 179–196. Bohannon, J., Gratz, S. & Cross, V. (2007). The effects of affect and source on flashbulb memory. Applied Cognitive Psychology, 21, 1-12. Brown, R. & Kulik, J. (1977). Flashbulb memories. Cognition, 5, 73-99. Hillman, J., Atikingson, D., Hilliard, A., & Bohannon, J. (2010). Consistency in the memories of parents and children of traumatic childhood memories. Paper presented at APS, Boston. Howe, M. L. & Otgaar, H. (2013). Proximate mechanisms and the development of adaptive memory. Current Directions in Psychological Science, 22, 16-22. doi: 10.1177/0963721412469397 Mager M. W. & Andrykowkski A. M. (2002). Communication in the Cancer ‘Bad News’ Consultation: Patient Perceptions and Psychological Adjustment. Psycho-Oncology, 11, 35-46. Nairne, J. S. (2010). Adaptive memory: Evolutionary constraints on remembering. In B. H. Ross (Ed.), The psychology of leaning and motivation: Advances in research and theory (Vol. 53, pp. 1-32). San Diego, CA: Elsevier. Otgaar, H., Smeets, T., & van Bergen, S. (2010). Picturing survival memories: Enhance memory for fitness-relevant processing occurs for verbal and visual stimuli. Memory & Cognition, 38, 23-28. Shaneyfelt, K., Minor, S., & Bohannon, J. (2008). Flashbulb memory: Private memories for car accidents. Paper presented at SEPA, Charlotte, NC

Thank You! John N. Bohannon, III Renato Puga Other Lab Members Carol Montgomery CHASE Office

Questions?