The value of case studies in informing our understanding of dissociations and interactions in memory was recognized early on by Endel Tulving, whose comprehensive work with the amnesic case K.C. helped to confirm distinctions between episodic and semantic memory. Following in this tradition, we examined memory and the use of cognitive strategies in the developmental amnesic case H.C., a young woman with structural abnormalities in the extended hippocampal system (Rosenbaum et al., 2014). H.C. was tested on two tasks, transitivity and transverse patterning, that each required learning the relations among items, and for the former, also examined the ability to make inferences across sets of relations. H.C. was tested across multiple sessions and demonstrated two seemingly contradictory patterns of performance: evidence of gradual learning, yet an inability to flexibly switch to a cognitive strategy that may otherwise benefit performance. Specifically, on the transitivity task, H.C. showed gradual learning of novel relations that led to successful inferential performance. On transverse patterning, H.C. showed some gradual learning of the relations among the objects across sessions, and expressed knowledge that the task followed 'rock-paper-scissors' rules. However, H.C. did not benefit from a unitization strategy, which had shown previous success with other amnesic cases (D'Angelo et al., 2015; Ryan, Moses, Barense, & Rosenbaum, 2013). H.C.'s over-reliance on 'rock-paper-scissors' rules, even in the face of alternate strategies, is suggestive of an inability to enact cognitive flexibility. Poor performance thus may have resulted from interference from the experimentally presented strategy on her self-imposed strategy. The present findings echo work reported by Tulving in case K.C. (Tulving, Hayman, & Macdonald, 1991). Whereas neurologically intact individuals may rely on the functions of the hippocampal system to rapidly learn new information and resolve interference, some individuals with hippocampal amnesia may learn information gradually, but such learning is particularly prone to interference, resulting in an inability to flexibly adapt to changes in the learning conditions in order to optimize performance.

中文翻译：

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健忘症中的逐步学习和不灵活的策略使用：来自案例HC的证据

恩德尔·图尔文（Endel Tulving）早就认识到案例研究在告知我们对记忆中的分离和相互作用的理解方面的价值，他与记忆删除案例KC的全面合作有助于确认情节性记忆与语义记忆之间的区别。遵循这一传统，我们检查了发育性遗忘症HC的记忆和认知策略的使用，HC是一名年轻女性，其海马扩展系统结构异常（Rosenbaum等人，2014）。HC在传递性和横向模式这两个任务上进行了测试，每个任务都需要学习项目之间的关系，对于前者，还研究了跨关系集进行推理的能力。HC在多个会话中进行了测试，并显示了两种看似矛盾的表现方式：循序渐进的学习证据，但仍无法灵活地转换为可能会给绩效带来好处的认知策略。具体而言，在传递性任务上，HC逐渐学习了新颖的关系，从而成功地推论了表演。在横向构图方面，HC显示了跨会话逐渐了解对象之间的关系，并表示知道该任务遵循“剪刀石头布”的规则。但是，HC并没有从统一策略中受益，该策略曾在其他遗忘症病例中显示过成功（D'Angelo等人，2015； Ryan，Moses，Barense和Rosenbaum，2013）。即使面对替代策略，HC仍然过分依赖“剪刀石头布”的规则，这表明无法发挥认知上的灵活性。因此，实验性策略对其自我强加策略的干扰可能会导致性能不佳。目前的发现与Tulving在KC案中的报道相呼应（Tulving，Hayman，＆Macdonald，1991）。神经功能完好的个体可能依赖海马系统的功能来快速学习新信息并解决干扰，而一些海马健忘症患者可能会逐渐学习信息，但是这种学习特别容易受到干扰，导致无法灵活地适应变化在学习条件上以优化表现。