L-RECAP: A new way to explore personal memories of everyday events after a traumatic brain injury

Memory difficulties are common after a Traumatic Brain Injury (TBI) and can affect many aspects of daily life. However, traditional validated memory assessments do not address the complexity of memory functioning as described by current theoretical models and do not reflect patients’ everyday memory performance. To address this issue,we propose a novel memory assessment, called L-RECAP (Liège–Recall of Events via Continuous Assessment of Personal experiences), designed to align with current conceptions of memory of everyday events, and we explore its sensitivity to memory difficulties occurring after a TBI. To do so, 32 TBI patients and their matched healthy controls were asked to answer questions sent on their smartphone 5 times a day, every day for one week. Questions were about their current activities, including people present, emotions, location, and subjective ratings of memorability, frequency, duration, importance, and appreciation of the event. At the end of the week, five events from different days were selected for high memorability, high importance, and low frequency. Participants were asked to verbally report these personal experiences in as much detail as possible. Episodic richness and specificity were assessed using a scoring grid inspired by the one used in Levine et al. (2002), measuring the quantity and quality of the different elements reported (time, place, people, perceptual and internal details). Moreover, a significant contribution of L-RECAP is that it allows calculating an accuracy score – which is typically missing in traditional autobiographical memory evaluations – by comparing participants’ recall to the real-time data recorded in the app (day, time, location, people, and mood). The subjective experience of remembering was also assessed by asking participants to rate the vividness, feeling of reliving, coherence, and visual aspects of these memories on visual analogical scales. Mann-Whitney U tests demonstrated a significant group effect on the accuracy score of L-RECAP , but not on the other scores. To explore whether this absence of significant effects could be explained by the heterogeneity within the clinical group, which is composed of patients with mild to severe TBI, we performed ANOVAs with duration of LOC and APT as covariates. LOC duration showed a significant effect on accuracy, specificity, and phenomenology scores. More specifically, longer LOC durations were associated with lower performance across all measures. These results demonstrated the discriminant validity of the L-RECAP accuracy scores, as well as the specificity and phenomenology scores when looking at the LOC duration. However, it remains difficult to determine the exact LOC duration threshold after which memory difficulties emerge. Moreover, given the notable interindividual variability, it seems necessary to compare patients’ individual performance with normative data to determine the presence of memory difficulties in daily life. These findings support the utility of the tool as an ecologically valid measure of everyday memory, with potential applications in both clinical assessment and research contexts.