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Pu WW hammmwmamummmaaw WWhmamfiSfimmmnu-ammnh «ma-W'mmmwmmhnmmmwmm hmuuaummumMmmwrm-um unmmmm,m.m,wmmummm ��.fi‘ V mum mum. mm am-ammummmrmmmam ummmmmmmnmw hr mum iii. W mumt WM AM}. 1955. www.mmmmarumwanm mnmwmmmwmmumummuw mmmu‘mummm‘ WW. 8. mMMMMWWWhNWW‘ mu m in nan-mm m :15 7.» WW Mmemm 3» mm .mumwmummmwbmmmmwm «mmgmumflormwmwmmwu mummuuwotmmumm 9'9me”. mammmmdmuuatmummmmum murwmwmuwuwmmmnr ammmxmysa. ��Dr. Fink January 18, 1955 To: All Department Heads 'Re: Annual Report Please prepare Report all - l95h of your data for the 195h Annual at the earliest possible date. All tables and other information should be turned in to Mrs. Bailey, Office Manager, on or before February 10. uith your statistical data, Dr. Miller requests that in addition to any tables or general statistics which you will furnish, that you write a succinct out— line of the'work of your department for the calendar which comments in appeared the to similar l9Sh, year Along the last Annual Report for your department. Please submit all data in three copies. I think that will be Report in.March of this With everyone's cooperation, able to publish the Annual year. a report of I vities of the hospital similar to the would like you to Janua RY 19 meeting. make all research'acti— one given Maurice Bachrach Administrator. Mled at the �(33L Biochemical Research Material assistance was offered the laboratories during 1954 in the form of enlarged quarters, and by the award of a two-year grant from the National Institutes of Health. The program initiated the previous year by Dr. Harry Goldenberg, Director of Laboratories, was continued along the following lines: Clinical Methodoloww It has become abundantly clear that the clinical laboratory can no longer cope with the special problems of mental disease using ther standard chemical tests carried out in general hospitals. Consequently increased attention has been directed towards providing the clinical laboratory with procedures for testing adrenal and carbohydrate metabolic function as well as for determining the course of drug and shock therapy. Reference has previously been made to ketosteroid and corticoid analyses. A new direct colorimetric test for hormone conjugates is nearing completion. Rapid micromethods have alib been perfected for two standard analyses, viz. blood phosphorus and which have hitherto been subject to large experimental phosphatase, A simple technique is also being investigated for following errors. the course of chlorpromazine excretion in urine. Metabolism of Steroid Sulfate Conjugates Impetus to our earlier studies on the metabolism of sulfuric acid—bound steroid hormones has been furnished by an InStitute of Health Grant which makes provision for much needed equipment and simple personnel. At the outset of the grant period a remarkably method was discovered for the colorimetric assay of steroid sulfates, based on the use of basic dyes. Further inquiry shows that, aside from its use in enzyme research, the method offers great promise for the assay of bound steroids in blood and urine as an index of these lines. Studies along continuing are stress. physiological Mechanism of Action of Lysergic Acid Diethylamide and from drawn have been vitro conclusions inc preliminary ig which induces LSD mode 25, a of of drug action on the vivo studies in a—transient psychotic state: (l) LSD 25 is a powerful inhibitor of human serum cholinesterase. (2) Parallel with a definitive response by the individual receiving LSD 25 there is a rise 11),..38rum alpha keto acids. Hormone Assay with Enzyme Systems There appears to be little doubt but that hormones are implicated The in establishing deterrent prime mental aberrations. and emotional in of for of assay suitable procedures this relationship is the lack . �function. Were such procedures available it should be possible to catalog mental illness on a chemical basis and suggest corrective action as an adjunct to the psychiatric services. Since the effect of hormones on various organs is mediated via enzyme systems, an extended study has been undertaken into the The hormone for systems isolated enzyme of‘using assay. possibilitywould involve incubating the test fluid with the appropriate procedure enzyme system in a test tube, and then determining the degree to which the enzymes are altered by the hormone in question by measuring conditions the release of a colored product. To determine the choice of makuxx been necessary to for carrying out these measurements it has The on two mathematical studies. papers out detailed first carry in Several manuScripts are more been have published. this'subject of preparation. various stages hormone Bibliography Goldenberg, Harry "Rectification of Nonlinear Beer's 690 (1954). Goldenberg, Harry Law Plots”, Anal. Chem., gg, "Rectification of Nonlinear Enzyme Activity Curves. Arch. Ricchem. and Biophys., §§, 288 (1954). I. Preliminary" �.; and Research of the of Publications Department Psychology ;/ Research in the Department of Psychology was oriented around several themes including: Refinement of psychological tests, the persis— tent problem of schizophrenia, and the effect of maturation and agang as measured by objective criteria. Certain aspects of the Rorschach test were dealt with more objectively by a series of papers by Dr. Gurvitz and Mr. Eichler and Mr. Feinberg. These set up for the first time objective adult standards for evaluating many Rorschach criteria which were not available previously. Further data was made available to experimenters illustrating the normal process of aging and maturation to further extend the cancept that if people grow older there are decrements in intellectual functioning and personality ingegration. In two new papers to be presented at the Eastern Psychological Association meeting, further progress was made in diagnosing schizophrenia by teens of psychological tests. The past and current research in psychology at Hillside has continued to attract attention both in terms of the acceptability of papers in both scientific meetings and professional journals, and also in terms of the many hundreds of requests for reprints sent in by psychiatrists, psychologists and social workers. These papers and research projects have also served as a training medium for psychological internes in the Department of Psychology and the past year was noteworthy for the fact that each one of the psychological internes or staff members presented at least once at a psychological convention or participated in some published research.project. ��RESEARCH During the calendar year l9Sh two projects were in process. their families pay for hospitalization a) Study of rates which patients and as correlated with time Spent in the hospital. b) The adjustment of applicants referred by psychiatrists found unsuitable for admission to Hillside Hospital during period 1951/1953. This latter study is a series of studies which is being done to determine the adjustments in the community and the use of community resources for applicants who have applied for admission to Hillside HOSpital but were found unsuitable. It is planned to continue this series during the year 1955. In addition, the joint project with the Jewish Community Services of long Island concerning the placement of discharged patients in private residence continues. W3 research project is being set up at the Altro'work Shop to which patients discharged from Hillside Hespital go in order to learn work habits. A Publications: )/ <3'“>( '21” ,~ 63‘” 7 s====r ;) Vocational Adjustment for the Emotionally Disturbed Authors: Roland Baxt, Abraham.Lurie, and Joseph .A. Miller, . - M.D. Presentations at conferences: a) [pulse Pinsky presented a paper at the National Conference of Jewish Communal Service in May, 1951;, called, "The Impact of Medical Crisis on the Family". b) AL:hd ‘ Abraham Lurie Spoke at the National Conference of Social‘Wbrk in may, 195h, "The Implications for Psychiatric Social‘work of Team‘work Relationship Between Social'workers and Psychologists". �MEMORANDUM FROM THE CREATIVE THERAPY DEPARTMENT WWW 1955 Study on the constructive and/or destructive use of passive and active aggression as a differential test for determining schizophrenic responses. Data for this research project had been gathered for the past three years. Their sifting and clinical evaluation is planned in the near future. The test is carried out within the C.T. program and consists of 16 specific proand number of jects EZ/r #290 a sub-tests. “a 707 Ernest Zierer �Fsbmary 2, 1955 Memorandum from: Dr. To: Subject: Fink M. Bondsr, M. D. 24.1). Anmsl Report of Hillsids Hospitals and medical services with other Coordination md cooperation with the psydxiatrio staff past you. With in. slsotmoncsphalogmm, for the of laboratory sstsblishnsnt tho crossed use of this facility and of the consultation faoilitin m was incrsssed during the: ands by members of the resident and attsndim staff. the answered attending by 19 consultations ssrs the yes“: hiring neurology oer-vies, and 1:0 consultations in addition vsrs anmrsd by the rssidaxt neurologist. In the slootrosnoophahgramio laboratory 111:8 this nun":- 75 constituted consultstion taken rsoords wars the 0! records. maindsr, follow-up ”cords vars taken. rsqnssts and 01' in tho oourss of two invsstigations - one in tho effects of electro- shosk on brain function; and the second on the relationship between treatinsulin the of and the rssults can function brain in changes mt. Evaluation of the organic mental mamas provided the major with three Thurs were patients consultations. nourologio Icons for the clinic. followed in sud who controlled wars disordsrs leisurs Four logic nonrafurther for another institution to transfsrod sore pstiants work—up and troatmnt. when direction another in The neurologic service nto consultation prior for aimissions olinis nods tbs tron qussts ms was extended hospital admission. your and Sm such oomltstions were dons during the svnlustion butts:for s an upper-unity ssrvioo providsd this �of the patients problems before autumn“. introduced to you in 1953 to evaluate organic m natal The " mail test" which was mm richly used during the put year, syndmmlg . �Fobmary 15', 1955 modem Annual Report of Wt of Neurology, 11111:“. Hospital — moperation with the psychiatric star! and other mdical gen-ion by when of the neurology was increased during the year. 63th Fortyunino «nomination: by the attending neurologists, and «agitation: 1:0 additionfl were answered by the supervising neuropaychiatriut. the eiootroenmphalographie laboratory 111:8 ream-ch mm m. In this 01' lumber, 75 constim‘bod consultation requests and follow-up rewards. Evaluation of the organic mantel syndrome provided the major focus for ammlog‘io consultations. more were three patients with mime disorders who were controlled and followed in the patients mm tranatemd to work-up and treatment. Hillsido in 1953 was The «3111116. Four guard hospitals for further nonmlogie «um»; first“ which to: introduced at mm widely used to evaluate organic mental and» must. {the mmlogic service uni also extended when rogue“; worn man from the admissions clinic for consultation prior to hospital admission. such consultations were answer-ad during the your and Sm this service provided boron admission. Under tom an opporhnity for a batter evaluation of patients of a U.S.P.H.S. grant, the electroencephalographic laboratory was swarmed for taohirboscopy, and a number of basic nouns. physiological problems were smdiod. f ’13:“ ��_ my}- 1955 Neurology hmommmwumammmwumh mes in the visiting a... was noon almond by mm. Wynn». tndmtharrfi m supervising mailman In th. metro-n mphdographic laboratory, 210 mom an am, of which 7!; war; consultaticn "quests. For the most put, the consultations in!" on)» momentum (6); pain syndma (3) and axiom cum tit-onion (7); men-1 wt: >nenrnlng1c mum (10). 'th wk). test for organic bran dim” Wmtinflpt’dnnu. activities mar-aura: ”sued mm... «momma-mt uflmofuorganicmtalayfimflfl ingpmmo. mmormmmmommsmemzm “Wmtmmmum var. mammotmmpaum fonmddnringthairtmmtflth aerial Wanndawmtem. numfltamsoam.tunmnn¢mdnmmm ammunmummmmmmmmamm mummifiufornm �"... u. p.-.. “N... . . N, ~ mm .mu—mww." wwmmw’mwm. ., W, .vnx— “‘Wn" .7 m as: u.- momma! Dr. H1110? TO: Dr. H. Fink RESEARCH SERVICE, smcrmmmya-pm-m. Dummmtharmmhthemmamanumwmume . in organizing an mom nhctmshook 2mm, the and the mam, the mm m Scrpuil project. Considerable mm electron-Museum laboratczy, and sum Public Health Bunion for adds! lamb Grant “97. penis“ w mm in project with Dr. spout in letting up WMar by the equipment mud thu no , Fonoving discussion with Dr. Embers and Dr. known, Dr. LnQuor Wimudtoviaitiflllgidumdmmmm..Dr.LIQm15mchup of the Luann unit at Grandma: State Hospital. a: March 9th, Dr's. numbers, mum and melt mum cm:- to as Dr. hQuor'I mam unit. m intended in his that. Vinita, the use or split mm mm: to induce com. mm. This '11]. be mm RobertluhnandnvaeuvisiudDr. hulfloehandnr. thhtric Imtituto chitin-$133M. Wflaittonr. WWW Dr. undue for the nut Following Med research emanate. at. Dr. Blmbarga suggestion din- mud a similar project ban, and the protocol was prumtod at the nut numb can-dun mating. nth» w. purponoracqmmuthmmaentnumh with Dr. Ismail m most helpful as m. second Our b. has had dmidunbla experience in psychoplvaicq. tachniquu. SW8 ut his ham and dime.“ withhmthemdforimmudmndsforthocmmm. Iupmssodtohiu (h March 17th I Visited Dr. Ismail thodllinbflityofhlvingmummeo that Dr. filmmldbo thoDuunPoundntionorthoPnaidcntamifm Public mppomw ‘19de that ��mm: Glon om, no: Ia-k KEPITAI. April 28, 1955 to, Dr. Josoph S.A.Hillor,llodioal Dix-sates M8 Dr. Kl! Pink 8i: subJoot: ' hospital, Honth Promos Ropu-t and Room-noun". Atthsondstthofirstsixnouthsasbirootorotnosoomhatth 1 should libs to dosoribo tho prosont stoto of our rosoaroh program, thhnsfathofluturo,anitonkowonoouasndationsforsrosm asparagus. I: Prosoat m dotinitivo report of tho rosooroh aotivitioo of tho dspsrtnsnts of tho hospital was prooontod to tho nsdioal Board on April It, 1955. by tho chairman of tho Itososroh Omittoo. A tho prosont tins, tho staff assisting tho Dirootor inoludos two it psychologists and a part-tins sscrotary ( supportod by norm and Dausn Foundation grants); and o half-tins no toohnioian. Port-tins roooorch ootivitios aro cox-riot! out in tho various sorvicod sports-onto. In tho Doportuont at Ioborotorios, two toohnioians oro assisting Dr.Goldonborg, undo:- tho tons of a noon-oh grant of tho USPRS. Of tho psychiatric staff, two supss‘visim psyohiatrists and two rosidonts aro ootivoly oncogod in part-tins rosoaroh. Of tho ottonding staff, tour labors of tho Hodicol Board as in diroct collaboration with hospital psrsonnol in spocitio projects. is octivo in tho following projootst a. Following on tho sumoay of tho 1951; proJoot on thorolotion of altsrod brain mnotion to following olootroohook thorapy, a oooond projoot has boon undsrtoksn to asaosa tho chorootomlogioal and bioehonioal factors in impromnt. b. An snluotion of sorposil so a thoropoutio ogont hao boon undortakon as an intomopsrtaontal projsot, with tho sotivo oooporotion of tho .diool dopu-tmnt, onporvisim psychiatrist and a rosidont psychiatrist. has Dinotor imam. o. dosslopuont of moan-so of abivolonoo, both as a chorootonologiosl factor and a symptom of psychiatric choc-ponsation. “his study is in conjunction with a lambs: of tho Hodiool Board. d. and taoMstoooopio ”physiological of tho new, is now noaring oonplotian. Dnfiont Tho 'l'ho laboratory, built with funds Tho hm m'ass stimlata's, nocosoary for tachis- mt. mublod. oscilloooops, and roloy and lons tosoopy havo boon dolivorsd, on?! are being boon outlinoo and will begin by slid-Mu. Projects hovs �4-2Bimltonoomly with thou motto, I havo boon participant in a nunbor of tho dopartnontol projocto at the hoopitalp oooporatod with tho fibcultun Study Omittoo in tho dmlop-ont of its protocol; and havo mlnatod throo protocola which uoro oubnittod to tho Roaoaroh Conittoo from outoido loot-coo, and out. opooifio roommdationa on oooh. now mum problou of mohiatry involvo all aopooto of tho moo, oonroo, for thoo'pocitio tonic tron-int and provontion of tho Nor poyohoooo. an! innmatory poychoooo, nothing is known of tho otioloy of ochioophronia, involutional paycheck or antic-domain illnooo. Itch duoription of tho oouroo of thooo illnooooo io availablo, but thio haa boon of littlo bola": in troatnont or promotion moot in ioolatod inotonooo. mutant io omit-idol; and W at boot, poi-ital". ' " control roam for hospitalisation in loot pationto in tho dmlomontvo! owning tonsion and anxiow, and pmhotio thoughto. lutorporoonal rolaticnohipo havo boom diotortod, culmination blurrod, and otfootivo activity oo to throotod oolf-prooorvation. rho vat-1m porchiotric thorapioo oo availablo today attack difforont aopoota of thooo problouo. A prion-y goal io tho doovoaoo in tonoion and musty, and tho ovum-o of mohotio idoation. hob offal-t in «pound ot chaining intorporoonalxolatimohipo and oodoo of omnioation; and nontual ”education and oupport d tho pationt in dirootim his ootivitioo along «room ohannolo that lood to on! meiot- prooorvotim. Tho m1 alto 0'thMom. “ti-toot“: intho njority or ma‘ont nothoda portion.- in at loaot town-11y atomim tho poyohotio rollovine tonnion and indnoim a roturn to non offoctivo In this prooooo, tho following nothodo are pennant at tho hoopitoln Ont 1. W. By 2. By 3. By hoopitolilation, thoe pationt ' is ”poo-om pm, and ioolatod ' tron bio » .diootion, barbitnratoo, oorpooil, and chlorpronaoino, and by olootz-oohook and ubnlatory insulin trootnonto, ton-ion and anxioty are roduood. dmg W oo olootroohock, olootz-onaroooio and inmlin cola thorapy pontwtio idoation in omod by altoring brain function. It. 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W. ’ neopo, ' ' 06.000 to 10,000. on twmpuyeholoyuflanm mammal. mmwamm,mummmpommwrortu nothoda and smut-hum at thbut Newt. smart. duign ' with tho soul- of thy . ‘ 'thryrumn-Sfifioommhwo «Wotan. ”mam Mat-311W W, build can. mmuw “Wham cm; with tho parallel-exist inc m maul-d) mat: MW ”Wham cup-rd..in ohmic“ magnum" mum m. b. mum: a); 1ft!» hbontcry u asp-aloe to m. manna-n whatnot-chain studio’s. Wlmmmmtdflummool con-urn. Salary to 30,900. mg. Mtg ",3‘ an an -, o :7 . sup-n13. abducts-Inna; Ia and: null-1 than“ 1‘0 and Wm a- 85,200 W 1mm wWad cum W We m, um ”hum 1M www.mmupmdmwmmw mum mm: rem um mm mm Wwamn‘tarofthu “hm; wtocmmmumumhmungmmm unioapnjocum toba-Iunhyflu ”Mummhmm; alum d. And-mt - Social WI 3.5. (Seaman-k) with yum work. on use-sing funny nhtiennhipu. Pinon-1 ambit: 11' pmiou mun-ch «pox-hm. with or mum-nu it should be Mufly might-d. Aid-tut. u to napouihdhty for on binary tad to obtain {tantalum ad to the only you. of durum] to with tho mm of f1” 1- in amusing mum, m1 new mammal Ihichhcwmoorgwuththnpm «mammal-am follow up contact. undo. For :11 fellow-up touting an! thc 1:111 like tin mos-cry contact- tad arrangunufor Hindu-actor. “0mm Tho wot-hr to th- aws-Itch amo- I111. 11‘ t1.- 13 mm]... cooperate with the Dix-actor 3350:3111 8mm. in flint prawn 5% WtuWNIIMMWtMDMrMMIWO. aim-Monongooor WmomMmuwW-innm �hme-mlmm,aw0uommmwm anuslupus. alum; m “not. In. "can!”mum «a! £11m; “parts WM mmmegaMnmmp—m. ”00 I;thMtum-mhmmutbm. ‘9 ”‘mo “’m‘ 1 .“ ”m m1. PM W, 2. Gallop M00, WW1. m.mehw. huststthubmmm” uthmmmnngarmm mamwmmusimmmm.mmmmwnm «.memgmummmmmormgwmua mmmpamgmw,mnmmm1mm. mrmdwmmmmmuémm. fimmmfimgmmmw 81 1'' m.ummumniymowu‘mumma bmmamtimingfumtimmdukolomm mum-norm. plmning haiblo, it is mud-d 0h“ W stummmormmmmmuwaecmmm of . nun-buds» of 060,000 870,000; and with . 3 luau-uh 1955-56 by Ommhfll] flat 836.100. mmnwwmmmbmm-ufl, lab-1M. Wily We!” lam, 3.0. I955. �HILLSIDE HOSPITAL Glen Oaks, New York April 28, 1955 Tb: Dr. Joseph S.A. Miller, Medical Director From: Dr. Max Fink Six Month Progress Report and Recommendations. Subject: At the end of the first six months as Director of Research at the hospital, I should like to describe the present state of our research program, our plans for the future, and to make specific recommendations for a research department. I: Present 'A Proggam definitive report of the research activities of the departments of the hospital was presented to the Medical Board on April h, 1955, by the chairman of the Research Committee. At the present time, the staff assisting the Director includes two psychologists and a part-time secretary (supported by USPHS and Dazian Foundation grants); and a half~time EEG technician. Part-time research activities are carried out in the various service departments. In the Department of Laboratories, two technicians are assisting Dr. Goldenberg, under the terms of a research grant of the USPHS. Of the psychiatric staff, two supervising psychiatrists and two residents are actively engaged in part-time research. Of the attending staff, four members of the medical Board are in direct collaboration with hospital personnel in Specific projects. The Director is active in the following projects: a. Following on the summary of the l95h project on the relation of altered brain function to improvement following electroshock therapy, a second project has been undertaken to assess the characterological and biochemical factors in improvement. evaluation of serpasil as a therapeutic agent has been undertaken as an interdepartmental project, with the active cooperation of the medical department, supervising psychiatrist and a resident psychiatrist. b. An c. development of measures of ambivalence, both as a characterological factor and a symptom of psychiatric decompensation. This study is in conjunction with a member of the Medical Board. d. neurophysiological and-tachistoscopic laboratory, built with funds of the USPHS, is now nearing completion. The two Grass stimulators, DuMont oscilloscope, and relay and lens systems necessary for tachistoscopy have been delivered, and are being assembled. Projects have been outlined and will begin by mid-May. The The v' / �-2... Simultaneously with these efforts, I have been a participant in a number of the departmental projects at the hospital; cooperated with the Subculture Study Committee in the development of its protocol; and have evaluated three protocols which were submitted to the Research Committee from outside sources, and made specific recommendations on each. II. Future Programs Present problems of psychiatry involve all aspects of the cause, course, treatment and prevention of the major psychoses. Except for the specific toxic and inflammatory psychoses, nothing is known of the etiology of schizophrenia, involutional psychosis or manic-depressive illness. Much description of the course of these illnesses is available, but this has been of little help in treatment or prevention except in isolated instances. Treatment is empirical, and at best, primitive. central reason for hospitalization in most patients is the devel~ opment of overwhelming tension and anxiety, and psychotic thoughts. Interpersonal relationships have become distorted, communication blurred, and effective activity so minimal as to threaten self-preservation. The various psychiatric therapies available today attack different aspects of these problems. A primary goal is the decrease in tension and anxiety, and the erasure of psychotic ideation. Much effort is expended at clarifying interpersonal relationships and modes of communication; and eventual reeducation and support of the patient in directing his activities along effective channels that lead to self- and social- preservation. The present methods are apparently satisfactory in the majority of patients in at least temporarily stemming the psychotic process, relieving tension and inducing a return to more effective functioning. In this process, the following methods are prominent at the hospital: Our 1. By hospitalization, the patient is separated environment. and isolated from his 2. By drug medication, as barbiturates, serpasil, and chlorpromaline, and by electroshock and ambulatory insulin treatments, tension and anxiety symptoms are reduced. 3. By electroshock, electronarcosis and insulin coma therapy psychotic ideation is erased by altering brain function. b. By group and 5. By social activities, environment, better and group therapy communication is fostered. in a permissive individual psychotherapy interpersonal relationships are fostered along realistic lines. 6. By environmental manipulation, job reeducation, and help, effective functioning is strengthened. Our social service research program is devoted to studying these processes. A. To Understand the'flay Therapy'Horks: disciplines are constructively applied at the hospital, the effectiveness of any has not been sufficiently assessed, nor has the mode While these �.3mode of of the lhe study evaluated.r present been adequately of operation has Electroshock of our interest. example an electroshock of is operation By assessing in many from patients. depression psychotic resulted in improvement be works will electroshock the various possibilities it understood. If this is accomplished, then some ideas about the mental and The understanding of become clear. may in depression physiological processes A plan for a of service. research the electroshock treatment is the first goal similar study of insulin coma therapy is now in preparation; and others at the environment as a therapeutic of the hospital a study planning hospital are is hoped that the way mechanism. B. Relationship of Character Structure to Diagnosis: child— of the the demonstrate importance to devoted been study has hood environment in the development of character, behaviour patterns under stress conditions and the neuroses. Other investigators are actively involved in assess— of adult in the variety result that childhood relationships the in the factors ing behaviour patterns. It is not possible to carry out such studies at Hillside, but the important relationship between character and the type of mental illness of behavioural to of the character patterns the relation the patient shows; change which we call 'improvement'; and the aspects of character that resist treatment methods can be assessed. A prototype of such studies is now in progresselectroshock in therapy. improvement to basic of character the in aspects much C. Biochemical and Physiological Factors in Mental Illness: ill for long periods, appear to take on a stereoPersons who have been and chemistry in their reflected which is ultimately typed behaviour pattern, by neurologic, 'non—reactor' and patterns such of 'reactor' Study physiology. the failures in assessing methods important and are drug biochemical physiologic, and physical illness between psychiatric the relations of present therapies; Such and a improvement. between therapies 'organic' and the relation illness; to drugs EST and reaction where second project, the in incorporated study is and of long short terms in be assessed will electroencephalogram changes in the term improvement rates. (Follow—up): Results Treatment of D. Continuing Evaluations suffer treatment of generally of present the results studies Follow-up of the evaluation done an without are only; one therapy because they assess control to standard and compared not are improvement; for subject‘s potentialities followcontinuing a be to organize possible With may active support, it groups. evaluated on admission; assessed are the in hospital which patients up program, in followed a and over then methods at discharge; and psychiatric by psychologic number of years with an evaluation as to sustained change and reasons for failure. much would have at discharge, the to predictions Such an evaluation, if compared base—line for and a provide of choice therapies, present merit in assessing the the evaluation of any future therapeutic methods. III. Recommendation of problems the methods in attacking of suggested In this outline the treatment best; as one made to specific specify no effort have I psychiatry, is that fragmentary so it knowledge is Present the specific. or one etiology as of psychoses. the major to the eticlogy make as only a to poor guess possible A multidisciplinary approach with full freedom to follow many leads is the best of a establishment recommend the would For I be this offered. reason, that can �- u - Research Service, with full-time personnel devoted to such studies. I would suggest that such a service have "research" as its function; that it be independent of the service departments of the hospital; and that it have a basic budget which would assure continuation regardless of the availability of outside research funds. A. The Research Service should have the following organization: 1. Director of Research -- Responsible to the Medical Director. 2. Research Associates in Psychiatry and Psychology. 3. Research Assistants: a. b. c. d. Psychology Neurophysiology Psychiatry Social Service h. Secretarial and clinical personnel. 5. Technicians. B. Annual Budget recommendations for the Research Service: 1. Director 2. Associate in Psychiatry " in Psychology b. Assistant in Psychiatry " 5. in Psychology “ 6. in Neurophysiology " 7. in Social Service 8. Secretary 9. Technician n 10. - Lab EEG (1/2 time) $20,000 12,000 8,000 6,000 5,200 5,200 h,000 2,760 h,000 1,300 Equipment: As warranted Consumable Supplies Travel Overhead: As decided by Administrator. - $25,000. - 20,000. - 10,000. - 10,000. — - - 8,h00. 10,000. 6,000. 3,300. 6,000. 1,800. 2,h00. 1,000. available as a continuing commitment to the Medical Director for long range planning of the Research Service. These funds should be made For the budget year 1955-1956. I should like to make the specific recommendation that the following are the minimum requirements: 1. 2. 3. h. 5. Director Research Assistant " " Secretary Consumable Supplies 6. Travel 7. Overhead 8. EEG - Psychiatry - Psychology & Equipment Technician (in Operating budget) $15,000. 7,500. 7,200. 3,000. 2,h00. 1,0000 - $36,100. 1,600. $37,700. �0. Space: Problems of space at the hospital are acute, and will provide an increasing measure of difficulty as the service is developed. It is suggested that in the next capital outlay by the hospital for construction, some allowances be made. for the Research Service ‘ D. Relation with Other Departments: activities of the Research Service are to be those designated by the Director. Interdepartmental projects will be carried out by the Research Service, or in those instances where approval of the Research Committee is obtained, by the departments involved. Supervision of such interdepartmental projects will lie with the Research Director. The Interdepartmental projects are to be fostered by the Director. Prior approval by the Research Committee and the Medical Director is required. Such projects as are consistent with the service functions of the departments involved W111 be fostered. Presentations and reports are to be approved by the Research Committee prior to publication. E. Job Description: 1. Director of Research: objectives of the Director of Research will be to: (l) Organize and maintain an active program of research and a Research Service; (2) Promote, supervise and integrate research activities at the Hospital; (3) Educate hospital personnel in research methods and progress; and (h) Administer research funds. The The director of research will: a. Organize a central project or series of projects appropriate to the unique character of the Hospital and integrate this into the activities (therapeutic) of the Hospital. Progress reports will be submitted to the Medical Director and to each meeting of the Research Committee of the Medical Board; and such data as is approved for presentation will be submitted by the Director or his delegate at the appropriate scientific society. all staff to plan and carry out individual research projects. Third year residents in psychiatry are to be specifically encouraged to undertake research projects under his direct supervision, or that of an attending psychiatrist. For these residents, and any other professional members of the staff, the director of research is to assist in the planning of b. Encourage members of the the project; in its integration into the hospital program; and in both technically and financially. its support 0. Carry on such educational activities as the supervision of third year residents in research; monthly seminars in research problems and progress; and periodical reports of important psychiatric meetings. The director will maintain a calendar of meetings and lectures; stimulate attendance thereto; and foster the He such of is also to invite such meetings. at Hospital activities presentation guest lecturers and seminar leaders as are available. d. Administer all research funds with the approval of the Medical Director. This includes the stimulation of fund sources; the application for funds; and their allocation to hospital projects. �2. Research Associate: Director in all projects at the hospital; to assume responsibility for specified projects; and to carry on such independent investigations as his training and experience dictate. Tb work with the Associate in Psychiatry is to be a qualified diplomats in psychiatry, with extensive experience both in psychoanalytic psychiatry and in descriptive psychiatry. By training or experience, the associate should have teaching qualifications; and some training in research methods. A. Such an assume responsibility for that portion of the functions of the service assigned to him by the director; assume responsibility in the director's absence; attend conferences, meetings and assume teaching functions as recommended by the director. He range — will Salary to be determined by qualification and experience. Probable $12,000 to 20,000. B. Such an Associate in Psychology is to be a qualified psychologist with at least 10 years experience. Psychoanalytic experience is preferable. The equivalent in academic standing of Associate Professor is the guide line. research associate in psychology is to assume responsibility for those functions of the Research Service assigned to him by the director. An evaluation of testing methods. statistical evaluation of results. and a of the research of of aspects contr0l the.functioning procedure in all rigorous service are his responsibility. The research associate in psychology may be chosen from the research assistants. Salary range - $8,000 to 10,000. The will: organize and supervise projects in the department; supervise projects of the resident psychiatric staff; assist such department heads as request aid in organizing departmental projects; advise the director of new research possibilities; attend conferences, write reports and papers, and carry on such administrative activities as the Director may require. Both Research Associates Board at Appointments to Research Associate are to be made by the Medical the recommendation of the Medical Director and the Director of Research. 3. Research Assistants: assist the director in his research activities and carry on the work of the department. Each assistant is to be responsible to the director, and will carry on such tests, procedures, write such reports, and present those To papers designated by the Director. Assistants are to be qualified by training and experience for the specified jobs named. They are to be appointed by the Medical Director at the nomination of the Director of Research. a. Assistant in Psychiatry: For such psychiatristswho have had three or more years of formal psychiatric training but not yet certified, the opportunity to work for one or more years on a Research Service may provide the stimulation for continuation in research and also provide the director with the assistance of personnel intermediate in experience between the resident and the associate. The assistant in psychiatry can assume responsibility for the selection �-7of the patients for the various projects; evaluate changes in behaviour with treatment; assess the importance of intrapsychic and environmental factors in the present behaviour of the patient. the assistant.vill assume responsibility for those aspects of the problems under investigation as are within his scope, and assigned by the director. He will write such reports, papers and make such presentations as the director may suggest. He will make such tests, learn such technics and work with those members of the research service or the service departments of the hospital as his projects permit. Salary is dependent on experience. Probable range $6,000 to 1C,000. b. Assistant in Psychology: Graduate in psychology with a minimum of doctorate. Preferable experience in research methods and publication experience with some specialization in laboratory methods. Equivalent academic status of assistant professor. The assistant in psychology is to carry on such psychologic and laboratory tests, and make such statistical and methodological evaluations as the projects of the service require; and to make such reports and presentations as the director may suggest. He is to direct the laboratory technicians, organize their work and assume responsibility for the maintenance of all testing equipment and materials. In the design of projects, he is to assume responsibility for the application of the best methods and design commensurate with the goals of the project. Salary range ~ $5,200 to 8,h00. c. Assistant in Neurophysiology: M.D. or Ph.D., with a minimum of three years experience in electroencephalography or neurophysiology. To supervise and coordinate all neurophysiological studies, now being organized; develop and build electrophysiological equipment; assume responsibility fer such animal studies as are organized; cooperate with the psychologist in coordinated neuropsychological investigations; and supervise technicians in electrical methods. This position can be filled only if the laboratory is expanded to include more basic studies. Personnel can then be recruited from medical school training centers. Salary range - $5,200 to 10,000. d. Assistant ~ Social Service: B.S. (Soc. Work) with minimum of five years experience in field or administrative work. Emphasis on interviewing technics and assessing family relationships. Personal analysis recommended. If previous research experience with psychiatrists or psychiatric clinics is noted, it should be heavily weighted. Assistant is to assume responsibility for interviewing relatives of patients and develop technics of assessing premorbid characteristics based on history and interview; to obtain histories from relatives and patient relevant to the early years of development; to cooperate with the psychologist in assessing the personality of the subjects; and to coordinate research testing in the various projects. Patients seen during their hospitalization in any of the research service projects are to be seen by the social worker prior to discharge, and eVery effort at follow up contact made. For all follOWbup testing and evaluation, the assistant will make the necessary contacts and arrangements for the director. The social worker assigned to the research service will, if time is available, cooperate with the Director of Social Service in those interdepartmental projects which he may have organized with the approval of the director of research. Assistant is to be selected by the Director of Social Service. Salary range proportionate to experience in research. Range - $h,000 to 6,000. �e. Technicians: EEG -~ High l. fundamentals school graduate, although two years college preferred. To learn the of electroencephalography; make the necessary measurements and place electrodes; obtain artefact free records; maintain card files; type reports; keep records in systematic way; and maintain equipment. Technician is to be responsible to the assistant in neurophysiology or the director. Salary -- if untrained, $52,600; if trained, $33,060 to 353,600. 2. Lab. Technicianp-Neurophysiology. College graduate, preferably with some engineering or physics experience. To assist the assistant in neurophysiology and/or the assistant in psychology, in the development and maintenance of electrical equipment; to assist in the handling of animals; to cooperate in the experimental procedures; to build, adjust and design special equipment. Salary range dependent on training-- Rangefi .000 to 6,000. IV. Summary: Research Director is actively involved in a number of studies of the mechanism of treatment. To maintain a continuing function and make long term planning feasible, it is recommended that a Research Service be established; that be an integral part of hospital organization with a continuing annual budget. it A proposed organization is included in this report, with a projected annual budget of $60,000 ~ $70,000; and with a minimum budget 1955-56 of $36,100. The This report approved by the Research Committee April 27, 1955. Respectfully submitted, Max Fink, MoDo Director of Research �HILLSIDE HOSPITAL Glen Oaks, New York April 28, 1955 Th: Dr. Joseph S.A. Miller, Medical Director From: Dr. Max subject: Six Fink Month Progress Report and Recommendations. first six months as Director of Research at the hospital, I should like to describe the present state of our research program, our plans for the future, and to make specific recommendations for a research At the end of the department. I: Present A Program definitive report of the research activities of the departments of the hospital was presented to the Medical Board on April 5, 1955, by the chairman of the Research Committee. At the present time, the staff assisting the Director includes two psychologists and a part-time secretary (supported by USPHS and Dazian Foundation grants); and a half-time EEG technician. Part-time research activities are carried out in the various service departments. In the Department of Laboratories, two technicians are assisting Dr. Goldenberg, under the terms of a research grant of the USPHS. Of the psychiatric staff, two supervising psychiatrists and two residents are actively engaged in part—time research. Of the attending staff, four members of the l"ledical Board are in direct collaboration with hospital personnel in specific projects. The Director is active in the following projects: a. Following on the summary of the l9Sh project on the relation of altered brain function to improvement following electroshock therapy, a second project has been undertaken to assess the characterological and biochemical factors in improvement. b. evaluation of serpasil as a therapeutic agent has been undertaken as an interdepartmental project, with the active cooperation of the medical department, supervising psychiatrist and a resident psychiatrist. c. development of measures of ambivalence, both as a characterological factor and a symptom of psychiatric decompensation. This study is in Dmedical member of the with Board. a conjunction d. neurophysiological and tachistoscopic laboratory, built with funds of the USPHS, is now nearing completion. The two Grass stimulators, DuMont oscilloscope, and relay and lens systems necessary for tachistoscopy have been delivered, and are being assembled. Projects have been outlined and will begin by mid-May. An The The �-2... Simultaneously with these efforts, I have been a participant in a number of the departmental projects at the hospital; cooperated with the Subculture Study Committee in the development of its protocol; and have evaluated three protocols which were submitted to the Research Committee from outside sources, and made specific recommendations on each. II. Future Programs Present problems of psychiatry involve all aspects of the cause, course, treatment and prevention of the major psychoses. Except for the specific toxic and inflammatory psychoses, nothing is known of the etiology of schizophrenia, involutional psychosis or manic-depressive illness. Much description of the course of these illnesses is available, but this has been of little help in treatment or prevention except in isolated instances. Treatment is empirical, and at best, primitive. The central reason for hospitalization in most patients is the devel- opment of overwhelming tension and anxiety, and psychotic thoughts. Interpersonal relationships have become distorted, communication blurred, and effective activity so minimal as to threaten self-preservation. The various psychiatric therapies available today attack different aspects of these problems. A primary goal is the decrease in tension and anxiety, and the erasure of psychotic ideation. Much effort is expended at clarifying interpersonal relationships and modes of commun— ication; and eventual reeducation and support of the patient in directing his activities along effective channels that lead to self- and social- preservation. present methods are apparently satisfactory in the majority of patients in at least temporarily stemming the psychotic process, relieving tension and inducing a return to more effective functioning. In this process, the following methods are prominent at the hospital: Our 1. By hOSpitalization, the patient is separated and isolated from his environment. 2. By drug medication, as barbiturates, serpasil, and chlorpromaaine, and by electroshock and ambulatory insulin treatments, tension and anxiety symptoms are reduced. ' 3. By electroshock, electronarcosis and insulin coma therapy psychotic ideation is erased by altering brain function. ' b. By group and social activities, and group therapy in a permissive environment, better communication is fostered. 5. By individual psychotherapy interpersonal relationships are fostered along realistic lines. 6. By environmental manipulation, job reeducation, and social service help, effective functioning is strengthened. Our A. To research program is devoted to studying these processes. Understand the Hay Therapy Vorks: disciplines are constructively applied at the hospital, the effectiveness of any has not been sufficiently assessed; nor has the mode While these �.3mode of of The the study evaluated. present been adequately of operation has Electroshock of interest. our example an electroshock of is operation By assessing in many from patients. depression psychotic improvement resulted in be works will electroshock the way that hoped is the various possibilities and mental about the ideas some then accomplished, understood. If this is it The of become understanding clear. may in depression physiological processes A plan for a of service. the research electroshock treatment is the first goal similar study of insulin coma therapy is now in preparation; and others at the environment as a therapeutic of the hospital study a planning hospital are mechanism. B. Relationship of Character Structure to Diagnosis: study has been devoted to demonstrate the importance of the childhood environment in the development of character, behaviour patterns under stress involved in assessOther actively are and investigators the neuroses. conditions of adult the in variety result that childhood relationships the in factors the ing behaviour patterns. It is not pOSSible to carry out such studies at Hillside, mental of illness and the between type character the but important relationship of behavioural to of the patterns character the relation shows; the patient of character that resist and the aspects 'improvement‘; we which call change A be prototype of such studies is now in progressmethods assessed. can treatment electroshock therapy. in improvement to basic of character the in aspects Much C. Biochemical and Physiological Factors in Mental Illness: ill for long periods, appear to take on a stereoPersons who have been and chemistry in their reflected which is ultimately typed behaviour pattern, by 'non—reactor‘ neurologic, and patterns of such 'reactor' Study physiology. the failures in assessing methods important and are drug biochemical physiologic, and physical illness between psychiatric the relations of present therapies; Such a and improvement. between therapies 'organic' and the relation illness; and to drugs EST reaction where second project, study is incorporated in the and of long short terms in be assessed will electroencephalogram the changes in term improvement rates. D. Continuing Evaluations of Treatment Results (Follow~up): suffer treatment generally of of present the results studies Follow-up of the evaluation done an without because they assess one therapy only; are control standard to compared and not are improvement; subject's potentialities for followa continuing be to organize possible may With active support, it groups. evaluated on admission; assessed the are in which hospital patients up program, in followed a and over then methods at discharge; and psychiatric by psychologic number of years with an evaluation as to sustained change and reasons for failure. much would have at discharge, Such an evaluation, if compared to the predictions for base-line and a provide of therapies, choice present merit in assessing the the evaluation of any future therapeutic methods. III. Recommendation of problems the methods in attacking of suggested In this outline the treatment best; as one made to specific specify no effort have I psychiatry, is that fragmentary so it knowledge is Present the specific. or one etiology as of the psychoses. major to the etiology make as only a to guess poor possible A multidisciplinary approach with full freedom to follow many leads is the best of a establishment recommend the would For I this reason, that can be offered. �- h - Research Service, with full-time personnel devoted to such studies. I would be indesuggest that such a service have "research" as its function; that have a basic pendent of the service departments of the hospital; and that budget which would assure continuation regardless of the availability of outside it it research funds. A. The Research Service should have the following organization: 1. Director of Research -- Responsible to the Medical Director. 2. Research Associates in Psychiatry and Psychology. 3. Research Assistants: a. Psychology b. Neurophysiology c. Psychiatry d. Social Service h. Secretarial and clinical personnel. 5. Technicians. B. Annual Budget recommendations for the Research Service: 1. Director 2. Associate in Psychiatry " 3. in Psychology b. Assistant in Psychiatry " 5. in Psychology " 6. in Neurophysiology " 7. in Social Service 8. Secretary 9. Technician " 10. — Lab EEG $20,000 - $25,000. 12,000 - 20,000. 8,000 - 10,000. 6,000 - 10,000. 5,200 - 8,h00. 5,200 - 10,000. h,000 - 6,000. 2,760 - 3,300. h,000 - 6,000. 1,300 - 1,800. (1/2 time) warranted Consumable Supplies Travel Overhead: As decided by Administrator. Equipment: As 2,h00. 1,000. available as a continuing commitment to the Medical Director for long range planning of the Research Service. For the budget year 1955-1956. I should like to make the specific These funds should be made recommendation 1. 2. 3. h. 5. 6. that the following are the Director Research Assistant " " Secretary Consumable Supplies Travel minimum - Psychiatry Psychology ~ & Equipment 7. Overhead 8. EEG Technician (in Operating budget) requirements: $15,000. 7,500. 7,200. 3,000. 2,h00. 1,000. - $36,100. 1,600. $37,700. �C. Space: Problems of space at the hospital are acute, and will provide an increasing measure of difficulty as the service is developed. It is suggested that in the next capital outlay by the hospital for construction, some allowances be made. for the Research Service ' D. Relation with Other Departments: activities of the Research Service are to be those designated by the Director. Interdepartmental projects will be carried out by the Research Service, or in those instances where approval of the Research Committee is obtained, by the departments involved. Supervision of such interdepartmental projects will lie with the Research Director. The Interdepartmental projects are to be fostered by the Director. Prior approval by the Research Committee and the Medical Director is required. Such projects as are consistent with the service functions of the departments involved will be fostered. Presentations and reports are to be approved by the Research Committee prior to publication. E. Job Description: 1. Director of Research: objectives of the Director of Research will be to: (l) Organize and maintain an active program of research and a Research Service; (2) Promote, supervise and integrate research activities at the Hospital; (3) Educate hospital personnel in research methods and progress; and (h) Administer research funds. The The director of research will: a. Organize a central project or series of projects appropriate to the unique character of the Hospital and integrate this into the activities (therapeutic) of the Hospital. Progress reports will be submitted to the Medical Director and to each meeting of the Research Committee of the Medical Board; and such data as is approved for presentation will be submitted by the Director or his delegate at the appropriate scientific society. staff to plan and carry out individual research projects. Third year residents in psychiatry are to be specifically encouraged to undertake research projects under his direct supervision, or that of an attending psychiatrist. For these residents, and any other professional members of the staff, the director of research is to assist in the planning of b. Encourage all members of the the project; in its integration into the hospital program; and in both technically and financially. its support c. Carry on such educational activities as the supervision of third year residents in research; monthly seminars in research problems and progress; and The director will maintain of meetings. important psychiatric periodical reports a calendar of meetings and lectures; stimulate attendance thereto; and foster the He such of is also to invite such meetings. at Hospital activities presentation guest lecturers and seminar leaders as are available. d. Administer all research funds with the approval of the Medical Director. This includes the stimulation of fund sources; the application for funds; and their allocation to hospital projects. �2. Research Associate: Director in all projects at the hospital; to assume responsibility for specified projects; and to carry on such independent investigations as his training and experience dictate. Tb work with the Associate in Psychiatry is to be a qualified diplomats in psychiatry, with extensive experience both in psychoanalytic psychiatry and in descriptive psychiatry. By training or experience, the associate should have teaching qualifications; and some training in research methods. A. Such an assume responsibility for that portion of the functions of the service assigned to him by the director; assume responsibility in the director‘s absence; attend conferences, meetings and assume teaching functions as recommended by the director. will He Salary to be determined by qualification and experience. Probable range - $12,000 to 20,000. ‘ B. Such an Associate in Psychology is to be a qualified psychologist with at least 10 years experience. Psychoanalytic experience is preferable. The equivalent in academic standing of Associate Professor is the guide line. research associate in psychology is to assume responsibility for those functions of the Research Service assigned to him by the director. An evaluation of testing methods, statistical evaluation of results. and a rigorous control of procedure in all aspects of the functioning of the research service are his responsibility. The research associate in psychology may be chosen from the research assistants. Salary range - b8,000 to 10,000. The will: organize and supervise projects in the department; supervise projects of the resident psychiatric staff; assist such department heads as request aid in organizing departmental projects; advise the director of new research possibilities; attend conferences, write reports and papers, and carry on such administrative activities as the Director may require. Both Research Associates Board at Appointments to Research Associate are to be made by the Medical the recommendation of the Medical Director and the Director of Research. 3. Research Assistants: assist the director in his research activities and carry on the work of the department. Each assistant is to be responsible to the director, and will carry on such tests, procedures, write such reports, and present those To papers designated by the Director. Assistants are to be qualified by training and experience for the specified jobs named. They are to be appointed by the Medical Director at the nomination of the Director of Research. a. Assistant in Psychiatry: For such psychiatristswho have had three or more years of formal psychiatric training but not yet certified, the opportunity to work for one or more years on a Research Service may provide the stimulation for continuation in research and also provide the director with the assistance of personnel intermediate in experience between the resident and the associate. The assistant in psychiatry can assume responsibility for the selection �-7of the patients for the various projects; evaluate changes in behaviour with treatment; assess the importance of intrapsychic and environmental factors in the present behaviour of the patient. the assistant will assume responsibility for those aspects of the problems under investigation as are within his scope, and assigned by the director. He will write such reports, papers and make such presentations as the director may suggest. He will make such tests, learn such technics and work with those members of the research service or the service departments of the hospital as his projects permit. Salary is dependent on experience. Probable range $6,000 to 10,000. b. Assistant in Psychology: Graduate in psychology with a minimum of doctorate. Preferable experience in research methods and publication experience with some specialization in laboratory methods. Equivalent academic status of assistant professor. The assistant in psychology is to carry on such psychologic and laboratory tests, and make such statistical and methodological evaluations as the projects of the service require; and to make such reports and presentations as the director may suggest. He is to direct the laboratory technicians, organize their work and assume responsibility for the maintenance of all testing equipment and materials. In the design of projects, he is to assume responsibility for the application of the best methods and design commensurate with the goals of the project. Salary range - $5,200 to 8,hOO. minimum M.D. of with a Ph.D., or Assistant in Neurophvsiology: c. three years experience in electroencephalography or neurophysiology. To supervise and coordinate all neurophysiological studies, now being organized; develop and build electrophysiological equipment; assume responsibility for such animal studies as are organized; cooperate with the psychologist in coordinated neuropsychological investigations; and supervise technicians in electrical methods. This position can be filled only if the laboratory is expanded to include more basic studies. Personnel can then be recruited from medical school training centers. Salary range - $5,200 to 10,000. d. Assistant - Social Service: B.S. (Soc. Work) with minimum of five years experience in field or administrative work. Emphasis on interviewing technics and assessing family relationships. Personal analysis recommended. If previous research experience with psychiatrists or psychiatric clinics is noted, it should be heavily weighted. Assistant is to assume reaponsibility for interviewing relatives of patients and develop technics of assessing premorbid characteristics based on history and interview; to obtain histories from relatives and patient relevant to the early years of development; to cooparate with the psychologist in assessing the personality of the subjects; and to coordinate research testing in the various projects, Patients seen during their hospitalization in any of the research service projects are to be seen by the social worker prior to discharge, and every effort at follow up contact made. For all followbup testing and evaluation, the assistant will make the necessary contacts and arrangements for the director. The social worker assigned to the research service will, if time is available, cooperate with the Director of Social Service in those interdepartmental projects which he may have organized with the approval of the director of research. Assistant is to be selected by the Director of Social Service. Salary range proportionate to experience in research. Range - th,000 to 6,000. �e. Technicians: l. EEG -- High school graduate, although two years college preferred. learn the fundamentals of electroencephalography; make the necessary measure— ments and place electrodes; obtain artefact free records; maintain card files; type reports; keep records in systematic way; and maintain equipment. Technician is to be responsible to the assistant in neurophysiology or the director. To Salary -- if untrained, $2,600; if trained, $3,000 to $3,600. 2. Lab. Technician--Neurophysiology. College graduate, preferably with some engineering or physics experience. To assist the assistant in neurophysiology and/or the assistant in psychology, in the development and maintenance of electrical equipment; to assist in the handling of animals; to cooperate in the experimental procedures; to build, adjust and design special equipment. Salary range dependent on training-~ Range$h,000 to 6,000. IV. Summary: Research Director is actively involved in a number of studies of the mechanism of treatment. To maintain a continuing function and make long term planning feasible, it is recommended that a Research Service be established; that be an integral part of hospital organization with a continuing annual budget. it A proposed organization is included in this report, with a projected annual budget of 3,560,000 - $570,000; and with a minimum budget 1955—56 of $536,100. The This report approved by the Research Committee April 27, 1955. Respectfully submitted, Max Fink, M.D. Director of Research �Viva—v Wu'I-v-r “IV 11; 1955 mom DR. M. FINE SUBJECT: MOW REPORT, RESEARCH SERVICE «- APRIL 1. My louder ectiviw this month has been the planning and preeentim to the Director, the Research Committee end to the Medical Affairs a plan for a research department. This was discussed at length at the hoepdtel. and then presented to the Research Omittee, April 27th and approved. It was later presented on May 3rd to the Medical Affairs Oomittee. 2. Research pro cots underm: a. BM 2: theetndy ienowinmllewingendueam followingconoeoutive patients with all our indiciee of change. (30th " b. Ambivilence: Our equipment for techietoecopy hue been set up. Correlations between clinical evaluations between embivilunce made by Dr. Tmohow and tween, and the laboratory studies using the techietoecope and the TAT test, are new in pmgmee. \ electrouetimuletore and oscilloscope have been coordineted and preliminary measurements are being made in the alteration in tactile perception in electnoehock patients. (I. Serpaeil project continues despite some difficulties in the choice of patients. c. The ' e. Subculture: This comittee has continued ite work despite a number of hwering developments. This eppointment of Dr. Navarro to the adolescent pavilion hue limited the amount or time available for this project. Simlteneouely, Dr. Outwits announced that because of the pressure of other activities, he would be unable to devote the mountfl‘ time previously outin- eted to the project. For the meanwhile, the committee elucidating a protocol. is continuing and in Projects begun: Dr's Ledemn end Emberg have begun a study or the use of divided insulin doses and their effect on come levels. 3‘. attended: Dr. Knhn attended the Eastern Psychological Asediction nee e in Philedelphin, Ind participated in a panel and presented a paper based npm his work at the hunt Sinai Hoepital. I attended the April meeting of the New York Neurologic Society. 1;. ' p 3 " 5. Pipers published: In the Joumel or the Hillside Hospital, the ”th1 Test in Mental Petientc' by Dr. Kuhn, Weinetein and myself. . �MEMORANDUM Dr. Joseph so A. Miller, Mono FROM: Dr. Max Fink SUBJECT; Monthly report, Reaearoh Service T08 1. Activities of - Boy of the Research Service during the month have been attendance at various psychiatric matings; the presentation of papers; and tho continuation of ongoing projects. members 2. Papers Presented: (c) The paper entitled "RelatiOn of want in Eleotroshockfl was read, ~ Kwalwasser. To . and Learning to Improve» the Electroahcck Rosearoh Association Changes in Memory hy title, by Mr. Karin, Dr. Fink, and Dr. This paper received the Annual Prize Award of the association. (b) To the American Psychiatric Association, the paper entitled "Relationship Betucon Altered Brain Function and Denial in Electroshook Therapy“ was presented by Dr. Kahn and Dr. ?ink. ‘(c) the resident's meeting of tho New York Neurologic Socioty, Dr. Grnubert road the paper 'Daluaional Rodnplication of Parts of the Body After Insulin Coma Thorapygfi To final manuscripts of these three paperc Committee, at the end of the month. The 3. Meetings uttendod: were sent to the Resoarch or the Research Service attended the following meetings: Amorican Psychosomatic Society, American Psychiatric Association, Electroshock Ecuooroh Association - all at Atlantic City. Also the Nowhers York Neurologic Society and the American Psychopathological Association in New York City. ‘ How h. Notes regarding ongoing projects: a. Further data has been con llected for the two projects - EST # 2 and Ambivalence. b. Serposil: Some difficulties in the selection were cleared in conferences with Dr. Loderman and Dr; Blumberg. Later on in the month Dr. Laderman requcsted that he be relieved of working on this project except in the aupervisony role since he has to many other activities. The project will continue with Dr; chhspress assuming the major psychiatric role. 0. Subculture: Furthor work in preparing a protocol has continued during the month despite the hampering difficulty of the nooignaticn of Dr. Gurvito and the increased activities of Dr. Navarre. It is my anticipaticn that a satisfactony protocol may be available by the and of the month. up �S. New Projects: Following an initial meeting with Dr. Loon Helium: of the Sloan Kettering Institute on April 25th further dismsions were held at the hospital between Dr. Goldenberg and myself and a second visit to the institute was made on May 23rd. With the elucidation of their program, our own protocol is being prepared and will be submitted to the Research Committee and Medical Dimctor within the next few days. ‘ The Annual Prim Award of $100.00 was donated to the the Electmshock Research urea]. Strauss Research Fund, Association for also renewal mquest for tho grant. of the 0.3. Public Health Service were submitted on May 3rd. 6. Funds: 7. Papers Published: None. �DOW 0! 310011-131.” eeeeeeseeeeeeeeeeeeeeeeeeeeeeee Dr. 8. mm MW 1. PROGRESS mom, m Gold“ 19” WtionctchlorpromeineendSeryuilinSem,Urineend embroepdnel Fluid. Wire inthodhesbemdevelopedrorthe detemiutionor drugesnd rented elheloidel compounds in blood end urine. The procedure involves extinction orthe buiriedi‘luidwith heptsneendreextraetionottheecupoundfromthe heptsne leyer with hydrochloric acid. an mixing the acid solution with methyl orange e complex is formed which dissolved in ethyl.” dichloride to give I: soln. whose color in directly proportionel to the amount of chlorpromssine, eerpcsil, or other elkeloid origindqureeent intheteettluid. Adeteiled etudyhes eleo bean nude or the specificity of the melytiecl method. Prelim-:7 results obtained with serum of petiente indicate an «trench rapid rate of dieeppesrsnee or the mister-ed meterinl. Studies are being mderteken to determine whether this 1e due to repid elimination, detonticetion, or both, and whether the degree or retention of the drugs can be correlated in em we: with their clinical effectiveneee. 2. Inhibition of Sena Cholinestereee by Hallucinogen» stub wee reemd or en intereeting observation that had been made in our lobe. lest Sept... 195:. but not subsequmtly followed up became of leek of personnel. it that time it was noted that LSD 25 is e potmt inhibitor of mm 11;. The cholinesterese. question eroee as to whether thie phenomenon correlates in may we; with the echisogenic ection of LSD 25, end whether hallucinogenic in general have 1 eimer effect on cholineetereee from serum, cells, end brain. serum Prelilinery results with serum cholineetereee indicate a perelleliem between hallucinogenic eetivity of the 3 druge teeted, listed in the order or decreasing activity, '13., lysergic acid diethylenide > lyeergie seid monoethylamide > mecsline, end their ability to inhibit the anyone. 3. Steroid 3mm. Conjugate Studies. einple method hec been found for eliminating the protein and alkaloid interference with steroid sulfate cnelyeis or biological fluids. Procedure involves eddition of alkali to diesoeiete steroid sulfate bound to protein, followed by extraction with lipid oolvente end treatment with e eulronie eeid resin to remove excess bees as well a: tree alkaloid. Progreee along theee lines has been extremely rapid and fruitful. It hes also been discovered that the home sulfates ere synthesized by the liver. Chromtomphic end paper electrophoretio methods are being adopted ee companion tools to our dye teehnie in order to establish the identity or the component hormone conjugates. A �mm .1..qu MW “mm.o 1. Papa of biological fluids to Maniac tho 1nd alkaloidol drugo, prosciu- in mm... Italics “mid on 2. Preparation for following out. to ho conduct-d on blood and urino or tor urinary “mid studios hy Slow-Kauai.“ mend opp-oval): steroid sum». uhloido, phosphorus, plating ' fum- W151" chemo-two, ma poooihly total War; of 1W Wm. W, 2.xuuam1cmmmmmmummnmidmum; 1. K. Board with! ham Education “pm to orients." 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Title A name given to the resource Research Files and Unpublished Works 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 Progress and annual reports; research activities (folder title 1/2). Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context mfp-03-01-001-0-002 Date A point or period of time associated with an event in the lifecycle of the resource 1955 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> Subject The topic of the resource <a href="http://id.loc.gov/authorities/subjects/sh85113021">Research Files</a> and Unpublished Works -- Hillside Hospital, Glen Oaks, NY, 1953-1965 Relation A related resource The Max Fink Collection Description An account of the resource Annual report - research; Biochemical research; Research and pUblications of the Department of Psychology; Annual Report of Department of Neurology, Hillside Hospital; Letters to Dr. Miller (Budget); Research Progress Report Rights Information about rights held in and over the resource <a title="IN COPYRIGHT - EDUCATIONAL USE PERMITTED" href="http://rightsstatements.org/vocab/InC-EDU/1.0/" target="_blank">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a> Source A related resource from which the described resource is derived Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York). Language A language of the resource en-US Format The file format, physical medium, or dimensions of the resource application/pdf Publisher An entity responsible for making the resource available Contributor An entity responsible for making contributions to the resource Research