http://exhibits.library.stonybrook.edu/mfp/files/original/8d591c235c58b9d455d7cbdd43d00916.pdf ebb607fbcf115668ef8fa3c0792cd5b3 PDF Text Text PSYCHOLOGICAL FACTORS AFFECTING INDIVIDUAL DIFFERENCES IN BEHAVIORAL RESPONSE TO CONVULSIVE THERAPY MAX FINK, M.D., ROBERT L. KAHN, PHD. AND MAX POLLACK, PHD. Reprinted from THE JOURNAL or NERVOUS Volume 128, N0. 3, March Printed in U.S.A. AND MENTAL DIBEABE 1959 �JOURNAL OF NERVOUS AND MENTAL DISEASE Volume 128, No. 3, March 1959 Reprinted from THE Printed in U.S.A. PSYCHOLOGICAL FACTORS AFFECTING INDIVIDUAL DIFFERENCES IN BEHAVIORAL RESPONSE TO CONVULSIVE THERAPY1 MAX FINK, MD.,2 ROBERT L. KAHN, PHD. AND MAX POLLACK, PHD. INTRODUCTION While convulsive therapy is generally considered specific for the symptomatic re— lief of depression and agitation, and for the relief of such “illnesses” as manic-depressive and involutional psychotic reactions, the behavioral response to such therapy is highly variable. In initial attempts at understanding this behavioral variability, differences in physiologic response were sought. Neurophysiologic change was measured in various ways (4). The quantitative measures of induced EEG delta activity (1) and changes in language after amobarbital (3, 7) provided the best indices. Considerable variability in these indices among patients with equivalent numbers of treatment was observed. We concluded that the development of an alteration in brain function, as measured by a high degree of EEG delta activity (1) and positive amobarbital tests (7) was a prerequisite to behavioral change in convulsive therapy. It was apparent, however, that such changes, although necessary, were not sufficient for improvement (2). Indeed, among patients with maximal neu— rophysiologic change, all patterns of behavioral adaptation were manifest, and ratings of improvement ranged from “re— covered” to “unimproved” and “worse.” Equating segments of the observed popu— lation according to nosologic or sympto— matic categories also failed to explain the variability in behavioral response. While among patients in the manic-depressive and 1Aided in part by Grants M-927 and MY-2092 National Institute of Mental Health, US. Public Health Service. Read at the Section of Convulsive Disorders and Brain Function, American Psychiatric Association, San Francisco, May, 1958. EThe Department of Experimental Psychiatry, Hillside Hospital, Glen Oaks, Long Island, New York. involutional depressive groups a higher inci— dence of hypomanic and euphoric modes of adaptation were observed, and thus ratings of “recovered” and “much improved” were more frequent, there still were many subjects in these groups who manifested paranoid and somatization modes, and were rated “unimproved.” In the investigations of convulsive therapy, various tests of perceptual organization and indices of sociologic background have been studied which reflect the individual differences in the subjects. Of these, some measures correlated highly with the behavioral response to convulsive therapy. The psychological measures employed have been Rorschach responses (11), “explicit verbal denial” tendencies as measured in structured interviews with family members (12), and scores on the California F Scale (8, 10). The sociologic variables have been chronologic age, years of education and place of birth. It is the purpose of this report to summarize the observations of the relationship between these indices and the variability of the behavioral response to convulsive therapy as reflected in evalua— tions of improvement. METHODS The population has been consecutive referrals for convulsive therapy in a voluntary, non-profit, urban psychiatric hospital. Patients were generally Jewish, of low and middle socio-economic classes with a mean educational level of 10.5 years. Ages ranged from 16 to 67 with a mean of 41 years. Diagnoses included schizophrenia, manicdepressive, psychoneurotic and involutional depressive reactions. As segments of the population were studied by various procedures at different times, the tables reflect 243 �244 FINK, KAHN AND POLLACK the different numbers of subjects that were included in each procedure. All patients received electroconvulsive therapy three times a week, using either unidirectional or alternating current instruments. The various psychological tests were administered Within the week prior to treat— ment. We have previously described the be— havioral changes in convulsive therapy as variations of five modes of adaptation (euphoric, hypomanic, somatization, paranoid withdrawal and panic), and emphasized that the evaluations of “improvement” in convulsive therapy are value judgments of the induced behavioral changes (2). Patients who manifest euphoric and hypomanic adaptive modes are those generally rated as “much improved” and “recovered” by therapists and administrator, while those who manifest paranoid-withdrawal, somatization or panic modes are generally regarded as “unimproved” or “worse.” For this report, evaluations of the patient’s behavior and ratings of improvement were made either two to three weeks after termination of treatment (Tables 1, 2, 3) or at the time of discharge from the hospital (Table 4). TABLE 1 Relation of Rorschach Factors to Clinical Response in Convulsive Therapy Much Improved N Moderately Improved and Unimproved Movement 39 11 (28%) 28 (72%) No Human Movement 48 28 (58%) 20 (42%) Human (M) x2 = 676* p < Form Color (FC) No Form Color 34 7 53 32 Both M and FC Either M or F0 Neither M nor FC 24 4 25 10 38 25 (21%) 27 (79%) (60%) 21 (40%) x2 = 11.57* p < .001 I X2 * .01 (17%) 20 (40%) 15 (66%) 13 = 14.83 p < (83%) (60%) (34%) .001 With Yates’ correction for discontinuity OBSERVATIONS RORSCHACH TEST PATTERNS The Rorschach tests were administered in conventional fashion and scored according to established criteria (13) for specific factors as number and type of movement, color, form, shading and total number of whole responses. For each of these factors, significant differences were observed be— tween the group of patients rated as “much improved” and the combined groups of those patients evaluated as “moderately improved” and “unimproved.” Subjects with human movement responses were evaluated as “much improved” significantly less often than subjects without such responses. The presence of form color responses was significantly correlated with lack of improvement, and when this factor was combined with human movement, the ratings were significantly poorer than when neither form color nor human movement were reported (Table 1). Similarly, patients rated “much improved” gave fewer total responses, fewer total movement responses and fewer content categories; but the per cent whole, popular and form responses were signifi— cantly greater than in the groups rated as “unimproved” and “moderately improved” (Table 2). “DENIAL PERSONALITY” SCORE In their study of denial of illness, Weinstein and Kahn (14, 16) described the characteristics of an “explicit verbal denial” personality type.3 In an initial group of convulsive therapy patients, the hypothesis was tested that those patients who most closely approximated this personality type would be most likely to be rated as “much improved.” “Denial personality” scores were 3“They were people with compulsive drives, a great need for prestige and the esteem of others, and a record of always having denied felt inadequacies. ...Life experiences had been valued not for their intrinsic satisfactions but as a means of maintaining prestige and “security.” (14). �245 PERSONALITY ASPECTS OF CONVULSIVE THERAPY established pretreatment in independent structured family interviews. Fifteen spe— cific areas of behavior were assessed and scores of 0, 1, and 2 were assigned for each of these areas according to whether the subject least, moderately or most approximated the characteristics of the “explicit verbal denial” personality type. In interviews with relatives of 47 patients, scores ranged from zero to twenty-five, with a median of eleven. Subjects with scores above eleven were classed into a high denial group, while those with scores below, into a low denial group. Patients with high denial personality scores were most likely to be rated as “much improved,” with only one patient rated as “unimproved.” Of patients with low denial scores, clinical ratings occurred on a chance basis in each evaluation category (Table 3). The difference in the denial scores be— tween the much and moderately improved patients, when compared to the unimproved patients, is statistically significant at the one per cent level (12). In a further elaboration of these personality types, studies of the total in—patient population were undertaken. Certain sociologic and psychological factors were studied in all patients in residence on March 7, 1957. These included the California F Scale, age, years of education and place of birth (8). TABLE 2 Relation of Rorschach Factors to Clinical Response in Convulsive Therapy Dif— N Mean S. D. ference Number of Responses Much Improved 3813.00 6.7 Moderate, Unimproved 48 19.5 12.8 52 ' 7*... 6 Per Cent Whole Responses 38 37.6 21.013 Much Improved ' 23 ' 0*... Moderate,Unimproved 4824.4 18.2 Per Cent Popular Responses Much Improved Moderate,Unimproved Number Movement sponses Much Improved 38 37.7 21.6 11 1 2 8** ' ' 48 26.6 14.3 Re- Moderate,Unimproved 38 2.3 48 4.9 Number Content Categories 38 3.8 Much Improved Moderate, Unimproved Per Cent Form Responses Much Improved Moderate,Unimproved 4.9 48 2.7 5 1 2.2 2.3 2 ' 62 ' 7,“. 1 ' 12 ' 1* 38 71.8 19.0 9 ' 92 ' 2* 48 61.9 21.4 Significant at .01 level Significant at .05 level ** * TABLE 3 Relation of Denial Personality Scores to Clinical Response in Electroshock Mod- N CALIFORNIA F SCALE The California F Scale consists of a series of extreme or stereotyped statements con— cerning social and personal attitudes. The subject reads each statement and then reports the extent of his agreement or disagreement. Originally presented as a guide to a subject’s capacity for ethnocentrism and authoritarianism, the method has recently been explored as a measure of stereotypy and rigidity in communication (8, 10). The test was presented to all patients prior to treatment and scored on a scale of ten to seventy. The figures represent maximal dis- t Personality Score High Denial—(11—25) Low Denial—(040) 24 23 NEE] erately ImImproved proved proved 14 7 9 9 l-| 7 agreement (low score) and maximal agree— ment (high score) with the statements. There was a significant relationship (p < .05) between the pretreatment test scores and evaluations of the clinical response to convulsive therapy (Table 4). For patients rated as “recovered,” the mean F score was 53.1, while for those rated as “unimproved” �246 FINK, KAHN AND POLLACK TABLE 4 Relation of Social Factors to Discharge Ratings in Convulsive Therapy N Recovered Much Improved Improved and proved Unim— 8 26 23 $3 “*3 a ‘3 >§ E5 2 2 2 a. &° 53.151.6 9.4 50 41.843.810.6 35 39.732.312.3 17 the score was 39.7, reflecting greater degrees of agreement with the stereotyped statements of the test for the “recovered” group. SOCIOLOGIC FACTORS When analyses were made of the relation between improvement ratings in convulsive therapy and age, years of education and place of birth, significant relationships were observed for each of these variables. The “recovered” patients were significantly older (p < .001) and had significantly fewer years of schooling (p < .05) than the “unimproved” group. While a larger percentage of the “recovered” patients than the “unimproved” patients was foreign-born (50 per cent vs. 17 per cent), the differences were not significant. In each category, the “much improved” subjects fell in between (Table 4). DISCUSSION We have noted that measures of perceptual organization, personality traits and sociologic data are related to the degree of improvement shown by subjects with cone vulsive therapy. These observations pr0v vide an understanding of the individual variability in the behavioral response to convulsive therapy under conditions of ap~ parently equivalent degrees of altered brain function. In their studies of patients with brain disease, Weinstein and Kahn described be— havioral patterns as ludic behavior (15), increased smiling and laughter, denial of illness, minimization and displacement of symptoms, and altered sexual behavior achieving prominence in the milieu of a1— tered brain function. They suggested that the manifestation of these behavioral patterns also provided the basis for the evaluation of improvement in convulsive therapy (16). In these studies of patients in con— vulsive therapy the same patterns of laughing and smiling, denial, displacement, minimization and altered sexual activity do indeed occur in the milieu of the induced altered orientation and discrimination (2). It is the patients demonstrating these altered behavior patterns who are rated as “recovered” or “much improved”; while those patients failing to show these patterns or doing so transiently are evaluated as “unimproved” or “improved.” Recent studies of changes in language with convulsive therapy have further amplified an understanding of these behavioral responses. Alteration in syntactic aspects of language has been related to clinical ratings (9). Patients evaluated as “recovered” and “much improved” demonstrated significantly greater use of the past or future tense and the third person mode with qualifica— tion, evasion, denial, displacement, clichés, and cryptic and stereotyped expressions during treatment than did “unimproved” patients. More recently, Jaffe et al. (6) reported that formal speech patterns also were characteristically altered. In dyadic interactive speech analyses (5), increased repetitiveness and stereotypy were associated with syntactic language changes during convulsive therapy. In the studies reported here, aspects of personality organization have been defined which are related to the type of behavioral response incident to convulsive therapy. The Rorschach patterns of the more favorably rated group are generally associated with greater degrees of conventionality and stereotypy, and little introspectiveness, imagination, empathy and creativity. Similarly, the higher F scores of the more favorably rated group is consistent with greater �PERSONALITY ASPECTS OF CONVULSIVE THERAPY degrees of ethnocentrism, authoritarianism, rigidity and conventionality. In present day urban culture older patients generally have less formal education and a greater number are foreign born than younger patients. These sociologic factors are also associated with greater adherence to conformist ideologies and ethnocentric identification. We may conclude that those patients who ap— proximate the “explicit verbal denial” personality type, and who are non—empathic, non-introspective, stereotyped, rigid and conventional are most likely to manifest the euphoric and hypomanic modes of behavior under the conditions of altered brain function induced by repeated convulsions. Such patients also rely primarily on nonverbal patterns of communication, and with treatment evince increasing use of the lan— guage patterns of repetitiveness, denial, displacement and third person. These changes in language and behavior are the cues to which psychiatrists and administrators respond in their evaluations, and thus provide the basis for the clinical ratings of “re— covered” and “much improved” (9). In contrast, those subjects who are em— pathic and introspective, who are not rigid, conventional or stereotyped, and who rely primarily on verbal patterns of communica— tion are less likely to manifest the ludic behavioral modes of euphoria and hypomania. With the induced alteration in brain function they manifest increased somatiza— tion, withdrawal, projection, anxiety, panic and intellectualization. Their speech is pre— dominantly in the present tense and in the first person mode without displacement, denial or clichés. Clinically, such patients are rated as “unimproved” or “worse.” Thus, while altered brain function is essential for a behavioral change in convulsive therapy, individual differences in personality organization provide the basis for the variability in the types of behavioral changes and in the clinical ratings of improvement. In another report (12) it was suggested that the personality attributes 247 which provide the background for improve— ment with convulsive therapy also provide the basis for the depressive adaptation ini— tially. It was noted that numerous authors had described a characteristic pre-depressive personality type, with a prominence of the features of perfectionism, rigidity, con— scientiousness, and stereotypy. The social factors, Rorschach and F scale patterns described here also support such a suggestion. Ludic patterns of depression and mania are more prominent in older, less educated sub— jects. The conventionality, rigidity and stereotypy associated with the findings on the F scale and the Rorschach test are also prominent in depressive illnesses. It is probable that the depressive psychotic reaction and the euphoric-hypomanic behavioral re— sponse in convulsive therapy may be as— pects under different neurophysiologic con— ditions of an adaptive pattern in subjects with a personality organization marked by stereotypy, rigidity, conventionality and poor capacity for introspection and em- pathy. CONCLUSION In studies of convulsive therapy, differences in personality organization and sociologic aspects of history have been related to differences in behavioral response. Persons who are stereotyped, rigid, non-empathic and non-introspective, as defined by explicit criteria in Rorschach, F Scale and structured family interviews, and who are less edu— cated, older and foreign born are more likely to manifest behavioral modes of euphoria and hypomania and to be evaluated as “recovered” and “much improved.” Patients who are introspective, empathic, non-stereotyped, native born, better educated and young are more likely to manifest somatiza— tion, paranoid—withdrawal and panic modes of behavior with convulsive therapy, and to be rated as “unimproved” or “worse.” While an induced alteration in brain func— tion is necessary for behavioral change in the convulsive therapy process, personality �248 FINK, KAHN AND POLLACK organization and sociologic factors are de— terminants of the type of behavioral change, and of the clinical ratings of degree of improvement. 1. REFERENCES FINK, M. AND KAHN, R. L. Relation of EEG delta activity to behavioral response in electroshock: quantitative serial studies. A. M. A. Arch. Neurol. & Psychiat, 78: 516— 525, 1957. 2. FINK, M. AND KAHN, R. L. Behavioral patterns of induced states of altered brain function. Presented at the NY. Divisional Meeting A.P.A., Nov. 1957. 3. FINK, M., KAHN, R. L. AND GREEN, M. A. Experimental studies of the electroshock proc— ess. Dis. Nerv. System, 19: 113—118, 1958. 4. FINK, M., KAHN, R. L. AND KORIN, H. Relation of tests of altered brain function to behavioral change following induced convulsions. In Proceedings I nternat. Congress N eurologic Sciences, Brussels, 1958 (In press). 5. JAFFE, J. Language of the dyad. Psychiatry, 21: 249—258,1958. 6. JAFFE, J., KAHN, R. L. 7. AND . 216—228, 1957. . KAHN, R. L. AND FINK, M. Changes in lan- guage during electroshock therapy. In Psychopathology of Communication, Hoch, P. and Zubin, J., eds. Grune & Stratton, New York, 1958. 10. KAHN, R. L. AND FINK, M. The relation of F score to behavioral and physiologic response with altered brain function. Presented at Eastern Psychological Assoc, Phila., April, 1958. 11. KAHN, R. L. 12. 13. 14. FINK, M. Com- munication patterns with altered brain function. Presented at Eastern Psychological Assoc., Phila., April, 1958. KAHN, R. L., FINK, M. AND WEINSTEIN, E. A. Relation of amobarbital test to clinical im— provement in electroshock. A. M. A. Arch. Neurol. & Psychiat, 76: 23—29, 1956. KAHN, R. L., POLLACK, M. AND FINK, M. Social factors in selection of therapy in a voluntary mental hospital. J. Hillside Hosp., 6: 15. 16. M. Prognostic application of psychological techniques in convulsive therapy. Dis. Nerv. System (In press). KAHN, R. L. AND FINK, M. Personality factors in behavioral response to electroshock therapy. Conf. Neurol. (In press). KLOPFER, B. AND KELLEY, D. The Rorschach Technique. World Book Co., New York, 1942. WEINSTEIN, E. A. AND KAHN, R. L. Personality factors in denial of illness. A. M. A. Arch. Neurol. & Psychiat., 69: 355—367, 1953. WEINSTEIN, E. A. AND KAHN, R. L. Ludic behavior in patients with brain disease. J. Hillside Hosp., 3: 98—106, 1954. WEINSTEIN, E. A. AND KAHN, R. L. Denial of Illness. C. C. Thomas, Springfield, Ill., 1955. AND POLLACK, ��m.v..ww.. _._’—_w L. ����unma‘mww ”WNW. mwmmmmmmem M'Wt Wmemwmmg mmmmmm a .‘ Wmimfimxmtmmwwu mummmammmmhum MWWFW(%M}§ mwmmm mwmmatmmmmum. mum umwamm‘ ‘ “at“ - ��wmmmwummumtmm Wm»m:mwwm,m,rm WWWMrotmm. mmdmu fluMWu’MWWWaWWM «in» ' m W “W“ mwmmmmmvmmm mm w «- and “mmuwmawmmmuWa-m WMWMMmemuImeW (ma). mm,mummww”tw mmmwwcmm. mm ‘ ��ms s: 3 {8 a 5 M 3.5:: flat? 8.2. h! 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Punt _ �Psychologic Variables and Neurophysiologic Reaponsivity In Convulsive Therapy Max Fink 14.13., Robert L. Kahn Ph. 13., PollacK Ph.D., Max Eric Karp B.A. and George Krauthamer Ph.D. / MiConsecutive referrals for convulsive therapy of psychologic were studied by a measures prior to treatment, and by variety; electro- encephalogram prior to and at weekly intervals during treatment. Alterations in brain function, as reflected Wm and amplitude were examined EEG frequency, modulation, pattern variables’W in relation to these and improvement on in by changes to behavioral change and a clinical gating of teminatMtreafmren‘t . Significant relationships ”if”; were observed induced change and the following pre-treatment variables: EEG (W m W (a) Educational level > ‘ between the degree of -”M(b) . i5- Rorschach criteria ' (c) ‘ (d) . 0} . Mnemr, 8.4,, M Ma... {@3/apmaw {magmg /,~:.,W2M7/5,,+. - «1' Jul deft“ WW 4% significant relationship ia-legiesee existed between alteration of brain function and treatmet induced behavioral change. degree Metfffrfifififrtmm_.._.a,._m.,...,hz:€.5...» 7‘» «9 a' “W” ' delta a ~- . A clinical rating of improve“be!” 0 ,mx fwfl’ A h #5.» da » - QC . (Hréy 50’4”“? “flaw mentm‘honever, was contingent” upon high degree delta activity4ude pretreatment psychologic pattem‘W) , sociologic status and environmental '- “)2, «Km , expectationxr. Conclusions: fi’ehavioral change was related to electrographic change. while—a— rating of "improved" socio—psychologic 0b Iivz'taa-additionally dependent upon a factors. Mor-eover, neurophysiologic (rate figme of change) to induced convulsions \ pretreatment psychologic variables. ,1' , ' constillation responsivity of 46“ significantly related to ’4' �l' “ s —2- W .. Past studies of the relation of electrographic change to behavioral change M have yielded con radictony results. These variations in outcome may be due to differences in the personality characteristics of the populatioz%tudied since L... patternsm related not only to the type and duration of socio-pscyhologic induced behavioral change but to the degree of electrographic change as well. ) , present results underline the fact that a univariate analysis of neurophysiologic and. behavioral relationships is no lonser adeouate to the problems of experimental psychiatry, and the application methods of The multivariate analysis is From / recommended. the Department of Experimental Psychiatry, Hillside Hospital Glen Uaks, _ of” L.I., 3/31/60 1,12 ‘W'o Am. N.Y. EEG �Peychologic Verieblee end Heurephyeielogic neeponeivity In Convaleive Therepy H.D., Robert L. Kehn Pb. B., Hex Polleek Ph. 9., Eric Kerp 8.1. end Gear‘s Kreuthemer Ph. D. Hex Fink caneecutive reterrele for convulsive therepy were etudied by e veriety of psycholcgic neeeuree prier to treetnent, end by electreeneephelogrene priortc end et weekly intervals during treat» sent. Alterations in brein funetian, ee reflected EEG by changes in frequency, modulation, pattern and emplitude were exemined in relation ta these verieblee, retinx of impraveuent an and to behavioral chense and e elinieel termination at treatment. aignificent relationship: (ch12) degree otinduced EEG change end the were cheerved between the tellewin; pro-treatment verieblee: / (e) Educetianel level (b) Borechack criterie at Movenent, cola: end number at reepanaee Embedded figures tent 5c) d) Alphe index A eignificent reletionnhip also existed between ulteretien of brain functien and treatment induceé behavioral change. a: behavioral chenge clinicel retina wee The releted to the degree at doth activity. degree A of improvement an the ether hand, wee contingent net only upan high degree delta activity but 1139 upen pretreatment �-2psycholozic puttcrna, acciolugic atatuu and :nvironmontal czpoetu» tians. In convulsiva thornpy, bchuvieral china. 1: concluaianl: rolntnd tn oloctrojruphic ahango. ally doplndont upon n A rgtin; at "iaprovod" is udditienu conttullutien of nocia-puychalogic fucters. Haruovor, nourophyniologie rolponnivity (rate or dogrco or chug.) to induced convulntian any :13» be ainnitiauntly rulgtod to prttrtat~ meat 0! p'ycholugic itriabloa. Putt studio: at tn. rclution or uloctroxrnphic chums. to bchnvieral chancc 1n aonvnlaivo thar¢py hgvo yieldod contradietery results. Thoad variations in outeon. may be due to dirtcraneca in the per-antlity ehnrtgtoristtel at the papulntinns atadiad sine. aocio~puychelogic pattorno may be relatud act only ta th. type tad durntion of induced behavioral chang¢,but to the dagrue a! cloetron graphic chance as well. The proutnt ralultu undarlino tho itct that a univtriato unllyais or nouraphyaiologic and bah;vioru1 rolatianahipa is no lengur aduqutto to the prablonl a! prorinonttl psychiatry, und the npplication or methods or From rocommandad. the Dopnrtuqnt of Exporinontnl Psychiatry, Hillaido Hospital Glon Oaks, 1v: nultivaridn analysis in h/l/éc 3.1. L.I., Am. 320 �‘ ,é?" /' / (o 1/, "y .4 Psychologic Variables and Neurophysiologic Responsivity In Convulsive Therapy Max Fink M.D., Robert L. Kahn Ph. D., Max Pollack Ph. D., Eric Karp B.A. and George Krauthamer Ph. D. Consecutive referrals for convulsive therapy were studied fig: a. variety of psychologic measures préer—te treatment, by a and by electroencephalograms priogflb and at weekly intervals during treatment. Alterations in brain function, as reflected 91/ ~EEG “fig; r5313r «35? a». in affflzf‘flgfi" Qi’e‘u frequency, modulation, pattern and amplitudeflwere examined in relation to these variables, rating of improvement on and to behavioral change and degree ofinduced a ébg: m Educationa Rorschacfi e \.of reaponses Embedded figures test Alpha index 0 "d A and the 25% a clinical termination of treatment. Significant relationships (chizi xi, 3F 5.3,“,change of 2‘33; by changes were observed between the following pre— treatment variables: A, ovement,A color, and number of significant relationship also existed between alteration brain function Aand treatment induced behavioral change imbald£££§§WW, WW C56Mamet, (Wheg “Mbehaxlnnalxchangemuas.relaxed.tewthedegreeofwdglfi33%;:gfirw £17MM4/sgéf “3...: W clanaeelwrati“g“cfimimprgyementan“: an s: {:Lflflu 49; ‘odZEfMM,4 9% only upon high degree 3%”;ng Clzbwi ,1? W4 'Mcthermnafidwwwas My»: delta activity but also upon y A 'x contingent not pretreatment �\ -2psychologic patterns, sociologic status and environmental expectae tions. Conclusions: In convulsive therapy, behavioral change is i related to electrographic change. ally dependent upon a A ' is addition— rating of aou:;;:::ew3‘ constgllation of socio—psychologic factors. Moreover, neurophysiologic responsivity (rate or degree of chage) to induced convul€2§0n§may also be significantly related to pretreat— ment ,/ psychologic variables. Past studies of the relation of electrographic change to behavioral change in convulsive therapy have yielded contradictory results. 'These variations in outcome may be due to differences in the personality characteristics of the populations studied)since socio—psychologic Kflwaaah patterns meynbe related not only to the type and duration of induced behavioral change,but to the degree of electro— graphic change as well. dwadfiffffl present results mad-niIl-Iib-ifliit thatdfl‘univariate analysis or ngfisflb 4o of neurophysiologic and behavioral relationships gfikno longerfiadequate The \ tojthe problems of experimental psychiatry, ’ and the . application of 1 methods of multivarian analysis is recommended. From the Department of Experimental Psychiatry, Glen Oaks, L. I. 1v: h/1/60 Am. N. Y. EEG Hillside HOSpital - �01:? ////’ m ' Individual Differences in Neurophysiologic Responsivity to Convulsive Therapy Previous studies indicated that an alteration in brain function was requisite to/tkéfbehavioral change and ratings of improvement in convulsive therapy. has been The type of behavioral change related to various perceptual,psychologic, and social aspects of the individual's history and behavior.The present study demonstrates significant relationships between the degree of 037' -convulsive neurophysiolegic change and amobarbital test (EEG slow wave activity response) and pro-treatment perceptual{MW‘ 4, , ' personality functioning (educational level, Rorschach, figure5 \ . {A 1‘ 1 groun While Mylo “W“; ’/ f relationshipeztsfiuu'n neurophysiolegic “a. 3mm meeewnefi a-dL J3 ”(a[7w // ,3 5‘ 1%?!” ”Z personality measures have generally not been-establisheéi these observations indiate that the rate and degree of change] in neurophysiologic .m (mm/Me may indeed be related to personality cognitive Illfllllflr(perceptualenillI-Ig style). 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For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Published Works Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Psychological factors affecting individual differences in behavioral response to convulsive therapy. J Nerv Ment Dis. 1959 Mar;128(3):243-8. Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context mfp-02-01-003-36-002 Date A point or period of time associated with an event in the lifecycle of the resource 1959 Creator An entity primarily responsible for making the resource <a title="Fink, Max, 1923-" href="http://id.loc.gov/authorities/names/n79039548" target="_blank">Fink, Max, 1923-</a>; Kahn, Robert L.; Pollack, Max Subject The topic of the resource Published Works -- Articles and Reviews Relation A related resource The Max Fink Collection Description An account of the resource 3 items. 1: Reprint from THE JOURNAL or NERVOUS AND MENTAL DISEASE Volume 128, N0. 3, March 1959. 2: [preprint]. 3: 2 drafts and one abstract. 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