Inferring semantic organization from refractory access dysphasia: Further replication in the domains of geography and proper nouns but not concrete and abstract concepts

Abstract

Patients with “refractory access dysphasia” have been a source of unique insight into the organization of previously unexplored domains of semantic knowledge (i.e., proper nouns, geography, concrete and abstract concepts). However, much of the relevant data have been based on the performance of a small number of patients. Here, we present 2 patients who both display a “refractory access” pattern of performance on spoken-word–written-word matching tasks and test their performance in the domains of famous people, geography, and abstract and concrete words. While these patients show performance similar to that for the previously reported patients in the domains of famous people and geography, they show a very different pattern of performance with abstract and concrete nouns. We discuss possible reasons why patients may differ in performance and evidence for and against the “differential frameworks” hypothesis for the organization of concrete and abstract concepts.

Keywords:

• Semantic organization
• Refractory access
• Abstract concepts

Notes

¹H.A. indicated he had once been interested in baseball and film but had lost interest in contemporary fare; thus he was presented with mid-twentieth-century baseball players and actors.

²Given that Crutch and Warrington (2010b) have reported facilitation on reading tasks using abstract and concrete stimuli in associatively or semantically related arrays, two-tailed tests were used in Experiment 4.

³Many have included the absence of frequency effects among the core features of refractory access dysphasia. However, the predicted status of frequency effects in refractory access patients is somewhat unclear. Some have argued for weakened or attenuated frequency effects (in comparison to exaggerated effects of frequency seen in patients with storage deficits) or even an absence of effects (i.e., no statistically significant effects). However, there have been refractory access patients reported with significant frequency effects (Warrington & McCarthy, 1983), with an absence of frequency effects (Hamilton & Coslett, 2008) and even reversed frequency effects (Crutch & Warrington, 2005).