Self-generation as a means of maximizing learning in multiple sclerosis: An application of the generation effect

Objective: To examine the generation effect, the observation that items generated by subjects are better remembered than items provided, as a means of maximizing new learning in multiple sclerosis (MS). Design: Prospective between-group design. Setting: Private, nonprofit research facility. Participants: Population-based sample of 31 subjects with MS (MS group) and 17 healthy controls (control group), matched for age and education. Intervention: Immediate, thirty-minute and 1-week assessments. Main Outcome Measures: Neuropsychologic tests assessing language, executive functioning, working memory, long-term memory, and the generation effect were administered. Recall and recognition of generation effect stimuli was tested immediately, 30 minutes, and 1-week after presentation. Results: Recall and recognition of generated stimuli were significantly higher than provided stimuli across testing sessions. This effect was observed equally across the control and MS groups. Recall performance for generated stimuli correlated significantly with indices of episodic memory, information processing, and language but not executive control. Memory for the source of the information was deficient for generated words compared with provided words. Conclusions: The generation effect was present in MS and control subjects and may be a viable way of maximizing new learning in MS.