Remediating reduced memory specificity in bipolar disorder: A case study using a Computerized Memory Specificity Training
Computerized memory drills boost recall detail in adults with bipolar I, yet can briefly lower mood, so clinicians must monitor affect each session.
01Research in Context
What this study did
Martens et al. (2019) tested a laptop program called c-MeST with one adult who had rapid-cycling bipolar I.
The program asked the person to type quick, specific memories after cue words.
The team used an ABAB design: program on, off, on, off, while counting memory detail and mood each day.
What they found
Memory detail rose when c-MeST was on and fell when it stopped.
Surprise: brief dips in mood showed up during training blocks, then bounced back to baseline.
The authors call the result “mixed”: memory gains yes, but short mood drops need watching.
How this fits with other research
Tassé et al. (2013) and Gandhi et al. (2022) also used computerized memory drills with positive results, but their kids with Down syndrome or ASD saw no mood side-effects.
Porter et al. (2008) reviewed 14 bipolar trials and found that adding any psychosocial tool can help, yet none stood out as safest—so the mood dip here is a new red flag.
Wang et al. (2025) pooled 15 studies of cognitive games in autism and found gains without harms; the mood swing seen in Martens’ adult may be specific to bipolar disorder.
Why it matters
If you serve adults with bipolar disorder, c-MeST can sharpen recall, but you should track mood each session.
Add a brief mood rating scale before and after the game; pause training if scores drop two days in a row.
Share the graph with the client so they see the link between practice and feeling—this keeps them in the driver’s seat.
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02At a glance
03Original abstract
Reduced autobiographical memory specificity (rAMS) is a vulnerability factor found across unipolar depression (UD), posttraumatic stress disorder (PTSD), eating disorder, schizophrenia, and bipolar disorder (BD). A group delivered psychological therapy training called Memory Specificity Training (MeST) remediates rAMS in UD and PTSD, with additional downstream effects on related psychological processes and symptoms. Its impact in BD is unknown. In this case study, we examined the impact of a computerized version of MeST (c‐MeST) on improving AMS and related symptoms and processes in participant with rapid cycling type I BD. An experimental case study with an ABA design was used. During baseline (14 days, Phase A), the training phase (nine sessions across 17 days, Phase B), and a 1‐month follow‐up (Phase A), memory specificity, depressive symptoms, and related processes and symptoms were repeatedly measured. Memory specificity increased significantly after the participant completed c‐MeST. Session‐to‐session scores indicated that AMS improved most from the in‐person baseline assessment to the first online session. All other measures of processes and symptoms deteriorated during the training phase but regressed to baseline during follow‐up. Memory specificity was improved as indicated by increased AMS from pre‐intervention measurement to 1‐month follow‐up. Other improvements in symptoms were not observed. Rather, some related maladaptive psychological processes and symptoms worsened during the training phase and regressed to baseline during follow‐up.
Brain and Behavior, 2019 · doi:10.1002/brb3.1468