Nelson Butters, David P. Salmon, William C. Heindel

San Diego Veterans Administration Medical Center and University of
California School of Medicine at San Diego

Luria's neuropsychology exemplified the enormous advantages of the pro-
cess-achievement approach to clinical phenomena ( Luria, 1966a). Rather than
focusing on an easily quantifiable achievement or failure, Luria searched for the
cognitive processes (and neurological substrates) that were responsible for
patients' overall performance. This emphasis on underlying processes led to his
descriptions of the various forms of perseveration associated with anterior cere-
bral damage and to his enumeration of the factors that can contribute to the
impaired constructional abilities of left- and right- hemisphere patients ( Luria,
1966b, 1976). In recent years, Kaplan and her associates ( Albert & Kaplan,
1980; Milberg, Hebben, & Kaplan, 1986) have also championed the process-
achievement approach to neuropsychological phenomena and have stressed that
close scrutiny of error patterns is often vital to a full understanding of the
cognitive factors involved in patients' impaired performances.

The purpose of the present chapter is to review recent studies from our
laboratory in which the process-achievement approach has been used to dif-
ferentiate the global memory impairments manifested by patients with various
forms of amnesia and dementia. Although actuarial approaches to neuropsychol-
ogy have suggested that the severe memory deficits of such patient populations
are highly similar when assessed with standardized tests of memory, in-
vestigations applying the concepts and models of cognitive neuropsychology
have often noted important differences among these superficially (i.e., quantita-
tively) comparable retention deficiencies. For example, two patients, both with
memory quotients of 75, may be distinguished from each other by the roles that
storage, retrieval, and encoding mechanisms play in their respective im-
pairments. It is obvious that any extension of neuropsychology into the realm of

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