http://exhibits.library.stonybrook.edu/mfp/files/original/866335cd8b6a0e848ec4f05bda1e57d7.pdf 610411ecffe18c07ab2ae5b0c8adcc8c PDF Text Text ZJ’W 4r 9, I; /y’7'.rf [E Wsfi%w‘> In a series of investigations of the role of neurophysiologic factors in the changes in behavior induced by convulsive therapy, that an alteration in brain function prerequisite, for behavioral it was concluded necessary, though not a sufficient was a change and "improvement" ( ). Changes in brain function were measured by a variety of indices, of which alteration in the waking was EEG induces a the most satisfactory shift in the EEG ( ). convulsive therapy consistently Spectrum to slower frequencies, with the development of runs and bursts of high voltage delta activity. m frequencyI? per-cent ‘ The degree and rate of development frequ However, there is'uide variability in the I‘ A voltageandr‘degree ,t/ ~e£-~h2rstr time treatment process [lay activity different subjects. With-equal—numbers—and developed ’7 at various stages of delta activity have been related to the age of the subject of treatment 1 Yet, when 1’ ), and mode ), frequency of induction (electrical, chemical, photo-chemical). the degree of delta these factors are held constant, variability in activity is it” ( ( of the still manifest (. ). Previous experience has danonstrated that both the behavioral reSponse Y and ratings of improvement to convulsive therapy a perceptualm processes as may be related to various " . number and type of Rorschach responses ( ), �score on the California F scale ( , ( ), and errors on figure-ground tasks dud. ); and to such sociologic factors as age, education level, place of fail.‘ W‘ M treatment m to explain the degree of the EEG the variability, this W W“? their perceptual-psychologic afifiability wt mm “a“ pie-treatment ofA W subjects, Ma ‘ ‘ EEG M“ characteristics WWWWMWW» Was“ can—ad. this M. It is the purpose of j study m~--~m to elate pre-treatment. SUBJECTS AND METHOD : W Gonsecutive patients referred for convulsive therapy in a voluntary psychiatric hospital were studied. 22 to so with a median of 149 c and depressive, schizophrenifi The patients ranged in age from years; and were diagnosed as suffering from psychotic cyclothymic reactions. While the range of conventionally applied diagnostic categories was ML 5" broad, the population exhibit} the cannon characteristics. MAI. (7414:444aA4;€7 a single ethnic f“ �OBSERVATIONS: l. Quaint. Variability of Induced-Beita—Activityt In the patients receiving convulsive treatment and investigated Mimi Mm , a} 1 M/b/ by the methods outlined, the variability in the Wed-Wotivity is considerable. We have summarized the observations in 1146 patients in Table I0 While the per-cent of records in the high degree category increases with successive treatment given at three tines a week, half the population has Aral“, a; Z:/£ not achieved..:the’ degree of—éelta activit}; in the third week, and in the fourth week. in all subjects. By the fourth week, however, 5% m ‘ y 140%“ is apparent �TABLE I £24 4314/4. Degree of Inducedfisihe Activity With Gonvalsive Therapy gPerfizem of Groug, Name) Treatment Period W ~lHts-Aetjjri’ox Mao—k ## First Rx High Degree Moderate Degree Low None Degree # Week Second Week ‘l‘hird Week Fourth Week 1-3 h-b 7-9 10-12 ‘ 14% 28% he?! 60% 12% 21% 27% 2275 68% h8% 25% 18% 16% 3% 2% 0% HH 3/58 �-72. BA «MM Relation of Pre-Treatment Rorschach to 3.4.3 *4 Variabili ”“2" In the analyses of parable-meat 21:3... Rorschach 7%). the number of responses andAqualitative aspects *ann—Iimaw.._ .. i’movement Mbfiuywa/‘iée' related to the degree of induced tel-ta activity. Wm—uummuw z.»_..mM.m.w.w—m:"g:od Me “mum—.9... h re were significantly fewer cup-us t W EEG and color were WWW ‘nv mu» magnum-u “a...“ m.» .own-ru‘m-v-u-m: ”4/. ML. m mm.mm wulmw‘w.m mm,,. ‘ that With gh "‘ were observed. WW We activity \ manifesting moderate and low degrees of such activity. degrees of Be W 133121911135 m deem-96") in patients with highNRgrees of -.._-----_---_:.§ w on those activity t , 3* - van.” w rv: .-mm—Nw-w,.bv,W M. In patients who were observed) avid; taéeported signii‘'ican significant differences in Mw‘m.mmq_,m.m-.~=m~ failed to report 44». M ”iv! movement WK fly fewer EEG Low reactivity "égher degrees of 7 ”WW’ / , �... -_’.. .ymrw—W‘w~——-- -w'r“"" ~- v-vwam- / W- --»—',.w erw w �W-num z 19*; III ff ; “¢“-'—-h nqh-II-uylL-" '51? A expressed y‘TAIB'I-E ------ similar relationship is noted for color responses. Patients form-color“ in the Rorschach developed lower degrees of delta activity with treatment than those l or a , greater degrees of human movement who W4. expressed color, coior-forxnll . olor responses. Combining both 1W My who & movement and b color) 4“, Wobserved in patients w who gave nor form-color reSponses, than in those patients who neither expressed either or both these responses. Analyses for number of whole responses (W), per-cent of good form responses (F‘s-$5), significanttx 444% populago) and per-cent oi responses, failed to demonstrate Sawwufl—v M relationships 1; the degree of induced an» activity. �II TABLE Relation of Number of Rorschach ReSponses to Induced wide-«4L EEG 9* Mean Activity $.13. Diff. Number High Degree Moderate, am Low Degree 3m 114.2 7.2 20.8 15.0 High Degree Moderate, b... Law Degree h. of Resgonses 6.6 Number 2.9 3J4 5.0 5.]. ’0 2.8 4L SR2 (.01 of Movement Reagonse 2.1 2.3 wE305 gM+Fm+m2 �TABIE Relation of Movement and To A/ Induced III Rorschach Responses golor EEG M» Activity Ht High Degr_ee .— 9* Moderatesz Degree h Sign; . Human Movement (M) 3? 20 (53%) 18 (147%) Other Movement (FM-m) 2f 20 (71%) 8 (29%) I? 16 (814%) 3 (15%) 33 17 (52%) 16 (h8%) x2== 39 (75%) 13 (25%) P 93 11 (148%) 12 (52%) x2= 7.60 25‘ 15 (60%) 10 (140%) p L .05 37 3o (81%) 7 (19%) No - Movement Form Color (FC) Other Color (C, or None Both mm Either M Neither M or FC nor FC CF 0-0) 52‘- X2= p 6.19 4 .05 3.88 4 .05 �.11.. 3. Relation of Pro-Treatment Errors §g§§gglo"1Variabilit In a previous study ( ) related to changes in the degree of on drug: is scored bveo Smx to q errors on the hidden-figures test were EEG ,1, $.4va eel-be activity and positive reaponses the amobarbital test for cerebral dysfunction physiologic responses into a to on Hidden—Figures Test % ). ( Combining the index, a range of changes from zero (Table Did)- The larger the pre-treatment error score, the greater the degree of physiologic change with treatment. The triserial ILL correlation is +0.3h, significant atA .05 level. TABLE IV In a similar analysis of the pre-treatment errors to /\ the difference just fails of significance Relation of Pre-Treatment 1;. Considering the Spectrum made. An initial some EEG Pattern to amongst EEG ( Variability. ) or these and frequency the subjects, an analysis of the of these characteristics and the study variabilityfilm./ (Table Nb). variability in modulation, voltage, in the pro-treatment relation between EEG EEG patients EEG nesponsivity was whose pre—treatment EEG �TABLE IV Relation of Pre-Treatment Errors in Hidden-Figures Test to Physiologic Variabili 132 (a) Combined EEG - Amobarbital Index: Miologic Changes Mean # Errors 6+ (8) 13.3 3+, u+ (19) 11.2 0 (lb) 7.9 5+ ) , 1+, 2+ ~= p +0.31; 4.05 34.» Mark (b) EEG Ma Activity nghflai‘ha No Highifi: 5.13. Diff. 3,2, (31) 11.1; 7,7, (13) 8.2 4.? t p M, ms. �.13... manifested slow wave activity had demonstrated that high degrees of delta activity appeared earlier such activity, As was as per-cent M confirming earlier report} of Kennard and W'illner 1" Jawwnw correlated with the degree of induced dean activity, time/)del-ta- activity.* MIX; / in patients without ( ). 13h; pre—treatment per-cent time alpha one approach to the problem, activity h and were sustained longer than measured In 44 subjects, a correlation of +0.35) ‘05‘ week (10-12 treatment). treatment the observed fourth during level/was DISCUSSION : In these studies, the degreeof induced EEG delta activity during convulsive therapy has beer- related to pre-treatment perceptual and dwwations ure, patterns. “i limited and are scope in \\ 2' / concluszwgarding I these\ and d bservati theor data with clini of s th\consistencz \\ explomtiglng; ,2; 1,7 further warrants constructs "”” ‘"‘ ”” "W“ ‘ EEG [While {a 1m.“ reports the behavioral patterns of euphoria, hypcmania and denial were shown to be consistently inter- preted by the psychiatric observer or family as "improvement," While somatization, ).Improvement "unimproved,"( and in excitement rated were as paranoia panic, convulsive therapy has been related to such lire-treatment variables as high * Previously demonstrated as a correlation of +0.81; with degree of delta activity ( ). �scores on denial personality indices anal-eerie the California F scale )t , ( W M ); absence of ( cam-W color, human movement, form-color responses, low number of responses, or high number of whole and tests good form responses on Rorschach and foreign birth ( most highly esteemed, educational ( ) ). Thus, ( ); and low educational attainment in an environment where verbal therapy is patients least like the therapist in social Mattributes W are referred for somatic (or non-verbal) therapy. Under the conditions of induced altered brain WM function, those subjects with least ability Wm hypomania, '\ WW ‘ " , she I; reapond with non-verbal behavioral mode; of euphoria, denial, displacement and minimization, and are rated as M "W ” "“76"“! while Subjects with greater perceptual and linguistic discrimination respond with the more verbal patterns of paranoid, panic, somatization and anxiety, and are I/ rated unimproved. II In the observations reported here, the pre-treatment perceptual also related to the degree of physiologic response. 4 discrimmtion and verbal discrfiptive ability degree of induced gum» The greater the mode is M“! on the Rorschach, the lower the delta activity; the fewer the Rorschach responses, the less ., �.15discriminating and the less the ability to separate figure from ground, W the greater the physiologic responsivity to induced convulsions. difficult to formulate a causal relationship fer—the—eepeetc—e£ It is clinical behavior,(both pre and post-treatment) perceptual patterns and physiologic response. But M M behaviors it ’L“’Z° is operationally meaningful to interpret these various W of the subject tainteraction with the environment, with each measure of behavior representing an abstract or sample of subjectexaminer relationship. In this framework the problem of the relationdhip between personality and physiologic measures is transformed "whether" to one of "how" and ”under What ccnditions." from one or In these series—afl- subjects, heightened perceptual discrimination appears related to low degrees My» W25 MW Wluf / of alpha activity in routine, suite recording and decreased delta-activity- f06fl””‘$ responssnity to convulsive therapy. In clinical behavior sudn subjects are prone to A tutu: introspection, anxiety and ideastional disturbances; and show poor improvement ratings to convulsive therapy. These observations are and EEG consistent with previous studies relating personality a5pects by Kennard, Ulett and Shagass. Kennard and Schwartzman related resting EEG spectra of low alpha index ( to schizophrenic personality, ) �~16- psychotics , non-mm, while high alpha index to Ulett gt_ a_l_. ( ) psychopaths and young individuals. indicated anxiety prone7ness was flying: correlated with v M poor alpha activity, slow and fast activity in the resting record, and poor response to photic stimulation the sedation threshold amplitude of beta ( ), ), ( activity and with poor in the alpha range. In Shagass' studies of low was responsivity to barbiturate as measured by positively correlated with anxiety clinical response to convulsive therapy ( ' ). and tension Thus, behavioral reaponsivity and interaction, reflected in personalitytheoay ltheenyand psychiatric nosology by EEG may be m related to neurophysiologic reactivity as reflected patterns, within the limits of the sensitivity of our measurements or methods of experimentally altering (activating) both behavior Inherent in neurophysiologic responsivity are all and EG. the aspects of the internal milieu, as reflected in individual differences in biochemistry, and in the pre-treatment continuum as EEG record characteristics; the individual environment reflected in perception, motor patterns, mood’ and verbalization; but also the sociologic aspects of the individual's experience. In the series of patients studied here, an ardysis of educational level with degree of . responsivity demonstrated a I.‘ 24.,q me $45 a: D . 3 EEG V] ( - p< .02) relationvship. Subjects �years of formal education had a lower percentage of high 6&b’tgd7’a" 56w! degree records than subjects with less than eight years or education. \ with nine or m more /CONCLUSI ON: The variability in the degree of induced 5am) mm deb: activity manifest during convulsive therapy has been related to technical factors of the treatment. Yet, when these are held constant, (regs-365%; ' ' y has studies, been patterns. Patients with fewer variability is still manifest. In these related to pretreatment perceptual and EG number of responses, fewer movement responses, and absence of human movement, color and form-color responses on the Rorschach; greater errors on figure-ground discrimination alpha activity 026m) 00'“ ' had higher degrees or induced eel-te- activity. Physiologic reactivity, measured in EEG tasks; and higher per-cent time interpersonabv patterns; behavior, manifest personality measures and d scriptions of clinical or m different verbal behavior aspects of the interaction of subjects If environment. In mks framework, EEG and and personality variables are related within the limits of the sensitivity of the measures used' ��#3:» Mummmammmmtmmmmmmo Mumthanmwmhmwuwuw ). pmmummmtmaflommm( mmthCAMomhi‘flmh'f ( . handmmmnwmu )yaaatomahmmctutountm,mumm,m plau.a£b1rth( ). mtmmmmumotuutmtmt imammnmmmummmmmmwamo and thud:in pmptu-luwyuholoflo prim, Wow 13mm m WWW. m mam... �swam: 3w m mm mm m cumm- ”that: studio‘s. for W110 3210 than” in a Wham patients runs“! in ago I'm 22 mwumandunorwmsaMnr-dhwumfm psychotic: Wain, mhiaophmic and W110 tho mum mtm‘. from mm minim range of uppnod mm sitcom: m baud, m mm (mum-mm:Maamcm(mhmmm «and common Wmmmum. - m: emu), mugmt and first Wm. They are primarily m group. mum- mm m mm: m immfma used. mycimm: Mm voluntarily thwith a ported first (M fa tin. Malina, pm}; M was to in: yum) of paychuuic 11111333. I Him a uni: prior in mutant abject- wm mud Ink mummm WIW m new Wmm mmrmermofmmm mm W crud mamt 2W (Wm), in: nah» mam-(0, m)mdm1uubcr,ormponna(n). Winn 113th (M), ma or color of Winner: Gamma mam mum M, a ( ). the mam» �umuwnmmmmmzmummtw, mmzeammmummmmuummm mnwmmuwngummwommtwm. Vassar-«u. ”WWI mm WWImathath. m obtainca prior to mutant, and at. Pamumwmmt mm mm mm mm «may mm mm rm tn. 1%. “finmtcxinflmdflmmwwmflwwnmrdbymm mmtmanmumanmmammmmcmm. and tho highest. Mind: of claw and {mum wtlviw, m W Wmmnotmuwmiwmmmm. Emu-1mm”, Wmclnuiflqdu'lufimworhuh'WfiwM ”adv, wwmwcmmWWC ). Infim Whimuwmhn,mm1mm¢hishmeidwm amuwm the mud and autumn) m Wind mm of tmhnnt (My mod 1:: the tabulation. 7*? mm Patina who Gov-10nd him �Wdummtmdtadmumrorw sump-nodsmn’ chased in that high m map. m when mm am we damn-mu ‘ an: dm: at activity in “that wok mo alum in tho Manta-la on“. WW1“ tmtmt m mm mm m:- mm that than u m, malt-cum! or animating cam-mt ”mm. Mm: o£ mutants from m to m, mm» mm mm: to tum tram-mt» run an: the pom mm �W Win “that was» mam outlined, ficvarmwm mmtofmnu in th! an nab activity in mu 1:: puma MM WI». We aw ham sum-trim the mucus in m1. 1.- “fiflflflfl “QC“flQ 1mm munch-unto: «and: luau high dame cat-guy umwiflz tho half a at grim wok, pomuazm 8mm m.um m1” MWammmtmtymommmmw-m mama Bythofourtbmk, rm“, 830%”me “raw“. Mm. �Hum mun man Duane Manta Dame Whom. a§§§ EH 3/58 �mmmammmmmmmamw quuuwmmammtwmmmawhmagma mawmum ‘Inpmuummamotm‘Mwmmum mimwrmmn NW and thaw-m farm was (mama). ”HQQQO ”we Mmmum mama“ tom Wotmntreama, Wm of differ-um in m; Many worn ohm-rod. mm dam am saw activity tun obumd maaent than in than with any 1n philant- mmnt, oz- who mud to apart than with 2mm movement. Ofld’“. m3 ammmwumxmcm mm“. WIWrmmWhMdemrmofdalm humanize «thug with tmuut than them who ”puma! color lad confirm only �gmaamAL Ruth» at m my an Be a ' 7.2 nod-nu. Low my“ am 15.0 Mata, Lu Dign- 5.0 5.1 393‘ 6.6 R 2.3 (.01 �mun—movement, (:4) ‘ mm mm (m) lo mm .. 38 mm) 2a 2a 19 16 (ma) a: 17 (m) g 39 £7”) 23 u as 15 {60%) 37 30 (31%) 1.8 (m) (ms) a (293) ' 3 lat-6.19 p g .05 (mg I as. 001°? W” or Hone color (m) m ((3., 0?, mo aim-H or m MW" new 5‘0 ’2’! M) ' as (W) 13 (253) x2 .. 3.31: P < .05 ‘ (hfiii) n (52%) x’ .. 1.6a w (W) p < .05 7 (19) �4h or m mm an to we at damn mar human mt mm clawing were chance! in mr’tmlar magma, and cow. petunia we saw with» than in than put-nu who mm: or both that names. Analyses We: Cm rum-Ia. bofih‘mmt. for (Mi). m:- and of than pm mm” porn-am or good ram (P) man, mud to with m m.- of at pomhr Wane ummm autism (W, am new we 10121718: mamwltudy( immqu-tm mmwwmmmc: MW mm mum m mm the physiologic sun an activity andtopofltiw for uranium We (macro toaixpluammrad Em «swam 3. into a single 1min. a range of (Table In). The chum manhunt 11er .mm,mmmmmfimwcwummam. 1:» W .05 at. the 40.31;, in significant. correlation M. �0») W WW K0 MW (31) not} 702 (13) 3.3 has 3.2 1.5 Fast �DIBOUSBIOII In theee etudiee, the degree of induced EEG delta eetivity during cenvuleive therapy hee been releted to pre-treeteeut pereeptuel end 380 petterne. In eerlier reperte the behevierel patterns at euphoria, hype-enie end deniel were eheen he be ceneietently interpreted by the peyehietrie tenily eheerver e! ee 'ieprevenent', while eenetieetion, penis, pereneie end excite-eat were reted ee Inniepreved( ). leprevenent in eenvuleive therepy hee been releted te each pre-treeteent veriehlee ee high eeeree deniel pereeneiitw indicee (e )3 eheence Beele ( ) end an the Geiiternie r or been: eeveeent, color, toreoeolor whole or anther high nether 1e! e! er reeveneee, reepeneee, end seed for: reepeneee on lerecheeh teete )3 end ( lee edecetienel etteineent end tereign birth ( ). Thus, in en environment where verhel therepy ie eeet highly eetee-ed, petiente 1eeet like the therapist in eoeiel end edncetienel ( ) ettrihutee are referred for eeeetie (er nonuverbel) therepy. Under the aenditiene of induced �altered hrein reaction, thoee eanecte with leeet diearieineo ve tiee ehility reepend with non—verbal hehevierel Iedee o: enphorie, hype-enie, deniel, diepleceeent end linieieetien, end ere reted ee 'eueh improved”, while enhjecte with greeter peroepteel end linguietie dieerininetien reepend with the mere verhel petterne or pereneid, penic, eoeetiee~ tiou end enxiety, end ere reted 'uniepreved.“ In the ebeervetione reparted here, the prentheeteent perceptuel node ie elea releted to the degree of physiologic reeponee. the xreeter the perceptnel diecrieinetion end verhel dieeriptive ehility on the Boreahech, the lower the degree of induced elew were activity, the fever the hereeheeh reepeneee, the ieee dieerieiheting end the 1eee the ehiiity to eeperete figure In: ground, the greeter the phyeielosic reepeueivity te induaed aonvuleiene. It ie difficult to rereelete e eeeeel reletiehehip between clinical hehevior (both pre end peetetre%teent) pereeptuel �pottorno and phyoiologic rooponlo. But it in oporotionolly looningtul to intorprot thou. various tasks to rolotod behaviors of tho oubjoot in hit intorootion with tho onvironnont, with ouch nonsuro or bohovior roprouoating on obstruct or Io-plo or oubaootuoxoninor rolotiouohip. In thio tronowork the problon of tho rolotionship botvoon poroonolity and physiologic noosuroo 1| transfornon tron on. or 'whothor' to can of 'hov' and 'ondor what conditions." In than. Jobs-eta, hoizhtouod porooptuol disoriuinotion dogrooo of alpha oppooro rolotod to low activity in routino, waking rooordo and docroosod amount: of inducod slowing in such bohovior In oonvuloivo clinical to thoropy. coupons. ond idootionol to anxiety introopootiou, oro subject: pron. dioturhouooo: and shot poop inprovolont voting: to oonvnloivo thoropy. an... 1/ oboorvotioao oro conoiotont with proviouo studio: toloting personality and EEG oopooto by Konnord, Ulott and �shagaae. Kannard and subvertaaan EEG ( ) related reating apectra of low alpha index to aehinophrenic pereouality, while high alpha index to non-paycbetice, payebopatha and young indivifluale. Ulett g§_5;, anxiety ereneneea and elow and wee ( indicated ) correlated with peer alpha activity, feet aetivity in the reating record, and poor reapenea to phetie atiaulatien in the alpha range. abaxaae' atadiee at the aedatien threshold ( In ), lav reepenaivity to barbiturate aa aaaaurad by amplitude of beta activity teneien wee peaitively correlated with anxiety and ), ( aonvulaire therapy and and with peer clinical reepenee te ). Thee, behavioral reapenaivity ( interaction, retleeted in personality concepta psychiatric neaolexy nay reactivity ae tetlected be by and in related to neurophysiolocio BEG patterna, within the liaita at the aeneitivity at our aeaaureaente er aethoda at experiaentally altering (activating) both behavior and mac. �Ink-rent in nonrophyliologic rcapensivity uro .11 the tnpccta of tho inturuni lilicu, a: rotlnotod in individual prootrostn§nt and 336 ditterouccu in biochonistry, in tho rtcord entrnotorictiolg the individual onvirounont continuum I! rctloetcd in porccption, notor patterns, need lad varbdiiaation; but also tho oeeiologio 33poctn of th- iudividnal'a .xparionec. In the scrioi at pati¢utc otudiud hnro, an anulyuiu of cduentional lovol with dear-o of rooponuivity danonatratud a aiguiricuut ( - p EEG (.02) relationship. Subjects with nine or sore yunra of tarsal cducttion had a lover parcentago at high degree slow unto oleotronruphie rccords than aabjcct- with yuurn or education. lot. thin eight �- 19 . COICLUSIOII The veriebility in the degree of induced aloe eotivity eeniteet during convuleive therepy to technieel feature at the treeteent. held cenetent, etudiee, BEG fit, were hee been when releted theee ee veriehility is still eeniteet. In theee slowing hee been releted to pretreeteent pereeptuel end EEG petterne. Petieute with fewer number of reepeneee, fever reverent reepeneee, end ebeence of hneen eaveeent, color end Rorecheohg greeter errore for-acoler responses on on the figure-ground diecriniwetiou teeke; end higher percent tine elphe edtivity hed higher decreee e: induced elee were eetivity. Phyeielegio reeetivity, eeeenred in EEG petterne; interpereenel heherier, eeuireet pereenelity eeeeuree end deeoriptiene of clinicel or verhel behevier ere different eepecte er the interectien e: euhjeate end environment. In thie treeeverk, EEO end pereonelity verieblea ere releted within the lieite or the eeaeitivity e! the eeeeuree need. �WWHWCW “WWW } i an: 111*, 11.0., W m. A. 11.9.0 and W L. Kuhn, 31.9.“ �mmwfamuyumwmumo: www.mmwotwmxarmm. mmm.m.m,msaw. mW m MM, In part. by £41380 at tho Kiwi”, rib-2715, Eli-072% and mam. at mm. lit-1th. �WWMmumfimmmmfimua may, WMJmmmuisiu,fwmviml mummmm mmnw* mwam-myammrmammm (a). Mwlwmumivity. W,mmfmqwmy “Wolsmmmidtyvmmgmmin wtmmjm. mmofdowlwtmmmtof alumivitymbmmmmmofflnwbject, fmmdw,mmofmwdm(m, Meal. Wall) (6). Mmofmm. m.m£mmicimtwupmnuummminm mwmuudfityiwmmt. months mmwdm‘mm lid Womb f leak {ism-mam (7, 19). task: (23) mm and sad: “01051031 hector: u in, Mom). 11ml, and (21!), phat of birth (22, 23). on �WWW: W Wupntimtsmhmdfor til-WW. Th- ut‘hocb (3-4 lad-25) Mob stud“ mmr tow m W We thmmmtawjeMMMt-ddth minim in I volmtuy Wm}. atudiod. WI ($.tm1flmmtmpm (HOW). mums-bar “court-39m, (mormmmmunmotmm (R). Thu figure-ma MWG: task was W's Mad-m £13m“. a nutritionist! of �.m-me—v_ wmwvvv.wm-‘_ ....___~mv.m V.- ww..ww— mm—pw'wlr‘ . u...” .m— Wm mwmmmmhmwvitym Mmdudfiodufiou,“ thmlm. mm: "mam" “myimhmadnymmmt. or "my." in this of slow wave activity, WmWn-Wofmpamntfimoffnqmu M7mw¢1m.flnsmtmmmywhimtwlim ofulwmmivity,md1awtamimothumtactivity mmmm. mmuwamdmrwmmummmm Panama-«mammawotsm attractant (8—8.7-Ommthmrun)mchmdin fiahighdogntm. mmmaamtamm Wmotmiutymciflnrmkmwmm mumm. mmmmmaWMfmfimm Maudmckmmamimmwmamt. W W Manhunt-“(21). WdWquWaflfiw“ memmumdmm. mmmmmmwanumfingmt «thud-(6). inorhntatim, oaxfmion. and inmost! mmormuvmmtxwmmm, dmqummtnMMIwmfmun W. W �-7“ _..__,., Mr". v- wwwmw “up...“ -- m wu—w'mWwvr-nmrvw‘ "mm mm V W___. _ ¢.‘WVI—m WWW: 1. vmngamdsmmmwg mmdMBMMMfltyI-nom (1.51.1). mmwwmmmmmgm Wynn-undid: umdwmm.,ha1ffin mummammmmymm www.mm‘mmtmm. 35!me m.m,msmwmawmwin �“wwmww—w—W. .w. .—V .- -mm ——--—-——u——~—v-—-- MI with (Jamal-iv. Baum of mum-mug RX 5 mm Hist: Dam: Dam. Lav Ham gm mus) W MN MW Hm“ Whit-k 1~3 I-G an m m 12‘ 11‘ 27$ w: 1“ nu 25$ 3t 2t 7-3 �mmmmm,mmormmmm muunmwmwmmmmumw tmmammmmmm mum. mu MWatmIMuwmifltyMWsmiflmfiy mmef-mrmmn . WWII). m ”WMMMMRMMWWWOf mm... munituhmmmofnaummivitymmlcubjm Mnmnmdmmmm WMwmmm(m 3). m WWMaW‘mmmip. Purim mwwmmmmwmm nfmumdwdthmmflmmmwm “Woulymfafladmfinmlu'm. Dubbing mmmmm,mwormmmm «mummwmmmmaw m’mmmmmmuw Wmthm «techno-um» ‘ I wamum'mu Mum: “Wot W M.Wafpod rum, mmmnummmwmmmotnmmnn (PM). ’ activity. (P) mm �mm' HEB slaw Hhmu.&at1v1§: M 8.13. Diff. “L “.2” Hunburraf ggggggggg (R) Hodunutu, Law Dacron 13.2 7.2 20.0 15.0 Hu-hlr*o!‘nbwunnnt Egggggggg (Hoggggz Hidh Dusruo 2;! a.» 2.1 Hodumuun Lou Dust-o 5.0 5.1 2.3 «.05 �WimmmAv-Wm—w—w‘mw _——-..—— .3... wmqumm'NWWfi—w W111 Wormwmmmmm m; mug to W £1. M cm m (m M Slow HIV. W ‘Piodnnta 3 Low 20 (53” 18 28 20 (71‘) 19 1.6 33 ow 52 m 23 Hun: (M) No Fan Color (PC) Color ((2, CF, 0-6) m flan ”PC mm or re a new PC H mm mm! ngm I (Wt X1 B (29%) 13¢ .05 (8%) 3. (16‘) 17 (52‘) 16 (um 39 (75‘) .13 (25%) 11 (um 12 (52%) 25 15 (60‘) 10 (“0%) 31 30 (an) 38 ' 7 (19‘) 6.19 . Y . 4, �! "4”"1 map-ammunmuumtmm-umm mnwmmsmmmotmmmmivm mmmtiwmmmmmmwmm Wins. Wmmmmnwmamn W,umo£dmpuhwmmuixplmmm(mfln. thym.mdflfmhfladcflwm miner-th‘mmwmnnmm mamas-«mm. mmmmunttm MmmmmmMmmwm mmwmwmuvanme-m memmmtmmmm mmmvnymmmmhmmatw Mmmivity.mmdupmtmamhmivfly. mmmjm:,.wmonommom mm m mW nook (10-12? mm“). �.._._,f ‘ ‘rflmww‘W‘m-m- " " "‘"' ' ' ' "—"" ' my burial of Pvt—W Ram in Marian—gm ant to muggy» manning (I) W wmvmtmms ' (a) m a» (19) 11.2 - '90.“ a. 10. (1m 7.9 p c .05 555+ to. (b) 2* Mn 0 13.3 ‘ ‘ mama»: Acting: MW Nofli‘fibugncua) (31) 8.9. Diff. ' 11» 7.2 3.2 m 3.2 t w .2... 1.5 ms. �W ofmmmumifltymwmiwme mmdm WWMMW. mutifitymmmndfimsuithmmwm mmWmenymfl-th. m WMMWwfitthn-u‘ww mmwuumamwmmnmmjm. (10-13). 3M1» hymn-gm (3145). (mm). (2523) WWW; mm mm. mm 1211 no) (Mmuthwmgwmmm (as-mm m(a.1nmtmvammmnmamm.. than new». tho mudwor m Inw‘mim or In m.mmmwgmmm.w WWWmWnMMb-mnwwm .Whmdmmwmdcm. «Moan: WWW tint-hm magnum. mewmnmmmmummm Mviwcfflumathinfluudunfmmtflfltyofm Wt.mmmmotthgmmw.uw wmmuhwmmmaotum muwmmmmmmmmarw V " �Wigwam antennas: is a major (30) Welmmmlstudia Mom“). specificity «cf 5: subjoet any rennet 3W cmmmmmwmmumm mm. Witisopomimnymmingmlm immeam wwwmnmjoatinhia Wimwithm mm mdptmiolagioaltamu of th- rolatimship bum Wt)! and phyaiolodml WhmlmfmmafW"tomof”W“md Wmmm.“ MWmmmmflmmwm mumm. Fan-cobrmm, Wormpams.mwnmormu m‘mmm Gazer. 10w (1953m1mmimlmmt Wmhu‘mfiuu WWW mmm mmmm-m, (22, 23). mm infirm-tad sung-sting that 1mm mvimmm: um . �oohwj "V'Ir r—v"-__ .wv _ W. m— .- “muwfimw‘wm a: w ,_ ~13. WCwm—wmn therapy. mmmdwinmin mum. tho subject- with the lust ability Win wuwmmmmmuom, mm. mm. «113th mainimiutian. mm "Mammal“;muflmwbjomwithm mummmmmmmmmmmm mmmofmk.pmic.mtionm wow.mdmntodoo"mmw.“ �€ 1l Wm___.,_‘i 4 i 4 “n... Variability in the dam- of 1mm 01.0w um activity mm‘nwmmmmmmrm offinmt. “MmMMtht.m. Inmpmmswa,mc thsflnmifut. ummmmmmpmmmmpmmm putt-m. Paintswimfmtotalm,fmw mm,mdmefmw,mlorw’w10r mpmmtbm,mmmfimw «Wm..mmmmmmvm hadhifiurdumofiufindslmmmvity. Wamutynmdiufimmm, www.mzyummmmm «memmarzmmdm mummWammmmwm. www.mmpomutym-hmemhm‘dminfiu Mudmmifivityoffiumm. ��v.‘_,-..-...—, .w—~ .ku— __.—_.. 11__V.,~......——mr -- ym—‘W‘Fm__ -WV..-——.7—w...7Ww-.... [ m ,, w __ v—v _ W u "—— v W— ‘v «mm-m mmw.ww V‘mw.)-—_‘—m~ vm‘wm I ! E 17 . W, mwmmmmuapmmmmmmmh. Jana, Mu. J. PAM... W mm m 10. Kim, a. to 19. Canny. K. 1-!"i R. '1‘” 1965. 122: E. and Layla. R. S. _ 3341. L.wfink,fl. J. Wityfminwmimlmpm #548. 1959. l: Wyeth!” W. mmmm. m. chdmofmmaitmin 2u2~2N5. 1: 1960, J. 1 to WV umywm” W; R. 1... PM, H. ad Sisal. N. “mythological upsets of m, in than mammary hospitals. mm. M. mm" Wt m. n. W m W m. W. aid Kuhn. K. 1... Pink H. w clinical (cum), 195$, 18: m, Witll in Wok. Auk. Mamet. 7391M. “013313513, 23-29. E. A. W111} of W m M. ma. n. n. 1... in a wimtuy mm hospital. J. ‘22.. mm”949., 1:! or «harm 1957, W Palm, mini: We! WeWinamem rating mm” diam $95,211:??? 63 2 c. 3 ma diagnosis. Melt. "“0 $ Win W. 2". Man. 3. I... Polladc. souls and Pom. W, ,lmfll. Mo, 28. I‘d Pink, J. H. and m, Gen. Social limit-nan (Cnlifmia F 915.. 1960.. 130: 187-192. flow. 14. H. m. Flam-gum diowinimtim 1‘ "'5 10 ILA. 27. 14. W W. 25. mm. 3.1... 23 Mop-yanlogm aspects of H. and Fink. H. 23. Kuhn. R. L., 'nn 1953, 15: ’5’1150 in paydmologtml diam. r W,H.A.mw.s. mmammmmwm. 1952. 115: “13423. 1. km. Beat. in 9426.. W. Wsmwmmmwmmammummmmm can. dim. WW. ummm" in a. 6mm mm. J. fluid“... malts fm ahehomplulm W. ad 3.. m,inMuwywfia unrammotmmm m, J. mm" We:Mt.«action disarm. far «flaming mien mm W6. W, can. NW”... in Eummpk. patina. We H. A” Mimitdu, 3. ad rimmw. The m at 1mm 1955, 7: 29.38. A. 19%, 30. 1.05: and Winner, A. Significmaa of which shod: “0-35. H. Grass, 3. a... mamas. A. 1968.110: 651-661. 31 . C. ‘1'!» A tho th M. ‘ 195“, 6: 221-233. �32. 33. 3'5. mm. W. Pam“. Win: m. Shun- c. C. Sod-tin: A .W. m. mm Awaits“ W Ammumyamrmammmd 9: mass. can. lawman” A. L. 1!; 750 patient. (3. diam-13:1 11k: 100 0guns - . . , “9 . <2.st but prsyehiatric mm” 1958. ' . WWmlwdvityinmdmic Winn. Melt. madam" 1962, 6: 235432. H. Wmfiatfiuinpoymimc macaw Add. 5:34:12. . Am. 3. v. 3%, mu, m: 3km: 3’ 0 z ham. 1. 1957‘. mmmmamowa Sims,c.mdfldm,d. 37. tool for Wyniolncim M... 1956, 18: #10419. 1988. 121: ‘ 11. may. H. «I. A... - W. Martian. tam. m1 0.. m Vimmlmmm Wm. W m,n.mdm,u. ”MMMW madam: Weird-tic. shag-s H. J. Hmmyem” J. mam... 1962, 3 ' (mid: tbs-58. Uhtt 6.A.andm 3. mmmdwwimmlmwmn thl Many mama we. 1952. 115: urn-sea. 3m, “1. mm. mm York. 1353. Haw s Wihy Sons. Inc... m mm 1mm. . �February 21, 1957 Individual Differences in EEG Responsivity Fink, MJD. to present observations Nbx 1) Problem tonight is in the laboratory of Ex- made perimental Psychiatry at the Hillside Hospital and then try to discuss their significance. we have no the clarification The problem explanation but wish to present this material for it may bring. is to account for the variability in EEG re3ponse to electroshock. The Observations: 1) Repeated EST induces EEG changes. These are of many kinds includ- ing disorganization of frequency; decrease in beta frequency, amplitude; increase in delta % % time and amplitude; delta bursts; spike charges; increased sensitivity to hyperventilation, amobarbital, There 2) is a direct relation in group data of (a) with degree of induced EEG time and dis- - # of treatments changes (b) frequency of treatment (c) type of ' treatment Note (gm or pm). that our analyses are devoted to one aspect of the EEG response - i.e., delta. quantitative measurements The and myself and included were bursts; slowest frequency 3) % and were described here time delta, highest 1955 by Dr. Kahn time delta, duration of highest amplitude of delta. But analysis of our records, so classified as high, middle and demonstrated a definite relation between the ment" % in EEG response and the "improve- in the behavioral\response. Presented at the Metropolitan EEG low Society, February 21, 1957. �In the first 2h table the was obtained: following patients, % High Abnormality 1-3 h—o 7-9 10-12 25 80 91 88 Moderately improved (6) o 16 so ho Unimproved (7) 0 0 O 20 (ll) Much improved first we were struck by this correlation, and, devoted the subsequent year to demonstrating the significance of this relationship. our conclusion - that, improvement You may know of in electroshock therapy requires the induction of a state of altered brain fUnction, of which the EEG-delta index is a cardinal sign. recently, More notes that 3 we at the part of our table which of 2h patients had high records within 1-3 treatments, and that after 10-12 treatments 5 ord! Why Let took a second look patients still had not achieved a single high rec- this difference? me demonstrate some of our records to show the difference in EEG responsivity to electroshock. It is first series all treatments were given in the in the latest by Medcraft - three important to note here that by Reiter instrument; and times a week. That extraneous ulus was eliminated, all factors as threshold or suprathreshold stim- recent treatments have been given at threshold stimulation, achieved by Dr. Green by repeated PM a seizure resulted. 1) . High EEG 2) Moderate 3) Low EEG response. EEG - Lesnick response. - response. Baum - Silverwater in increasing dosage until �To what can we ascribe the difference in response? immediately come to mind, and I will discuss each one A number of factors briefly: (a) .553: is a factor in this varying responsivity, but not the sigIt is true that some younger patients achieve high EEG abnormal- Age nificant one. ity early; as first two patients over 60; but an analysis of the data of our electroshock studies, for which I am indebted to Dr. Green, indicates do some age to play a small role. Analyzing the records of h9 patients, Dr. Green divided the results in- to those above and below hS; above and below 50 - as significant cut-off points. There was a tendency for the older group to have lower EEG ratings in the h-é period; but by the 7-9 period, the differenCe was gone. ' (b) ‘ §_egc_: Clearly not a factor. (c) Clinical diagnosis: is difficult to assess. As you know, clinical diagnoses have no independent reliability. They are approximate descriptions of experience, clinical states and depend largely‘on the examiner's‘bias, setting This factor [of the examination, purpose,etc; also on the patient's age; and only incident- ally on any operationally defined observable pattern in the patient. For these reasons, this analysis is deferred. However, gross more inspection shows that patients with low reactivity have often been called schizophrenic and paranoid, than involutional depress- ives and manic depressive- and that patients with high reactivity have more often been called involutional depressives and manic depressives than schizophrenia-paranora. -_-——-————————-——— of treatment: �-h- significant factors, and since we are describing the results of individuals treated in groups in whom these factors were constant, we are Both are not going to explain this further than to say that stances, to convert a low a high EEG it is possible, in some in- response to three times per week electroshock to response by going from Reiter to Medcraft; or by going from three EEG times per week to five times per week or twice a day. But these factors only amplify further the variation in response. Egg. DeFede We have assumed abnormality We is have looked appear that the development of cerebral changes, of which delta a prototype, for is the logical outcome of repeated electroshock. an explanation, therefore, of the after adequate courses of It may be may reSpond by failure of delta to shock. that not all patients respond to brain trauma by delta, but other changes (as increased beta voltages and frequency; or increased disorganization; or increased responsivity to hyperventilation). Regardless of the construction, a difference in responsivity exists, and is manifested in our series. we have The factors conceptualized the problem as one of "cerebral reactixdty." we have already outlined are important in such reactivity, as have described, but we believe that more is involved. Out studies are we new in the progress along the following lines: 1) 222 Factor of Personality: In the course of our study of factors which bare on the type of behavioral response euphoria, paranoia, withdrawal define personality -), we to electroshock (i.e., denial, undertook a study of personality. To is extremely difficult. But Dr. Kahn in our laboratory has done so by the use of a variety of indices. The Rorschach; an interview with relatives designed to elicit premorbid behavior, eSpecially denial; figure-ground perception; tachistoscopic recognition of words, 32g. �To our surprise, significant correlations between the degree of delta abnormality and two Rorschach factors I score were achieved. 63 and the patients, EEG have listed the table of in the h-6 score reflects a low or middle The IS as well as the denial interview M & C initial in scores our responsivity. The EEG's were done CHART (M & C) EEG and 7-9 treatment period. The negative response; the plus, a high reSponse. THEN REFERRED TO significance of this chart is in the "apparent" diverse phenomena that it purports to relate. If borne out by future observations, it states, that patients who'have no movement responses and either no color or color-form responses have hh% chance of high EEG delta reSponse in the 2nd and 3rd week of treatment; while patients with Form-color reSponses have only a for such a 16% chance result. it be that one's perception of the world is directly related to one's cerebral respOnsivity? Or, do the conditions which permit delta to appear, that is, those that require an ability to withdraw and assume a passive Could ree Ostow described attitude as by for alpha index, also midify the patient's sponse to the Rorschach? we have become increasingly interested in this problem of passive choose to describe attit- it - in the problem of "vigilance" - "alertness.“ In our laboratory, Drs. Pollack and Kahn are engaged in developing psychophysical ude, or, as we measures of such "vigilanceg" while we have become increasingly aware of the influence of the observer's activity on the ongoing 2) A second factor which EEG. interests us with regard to the problem of in- dividual responsivity is the concept of physiologic reactivity. Electroshock �EEG (17) ResRonsivifiz to ECT or R (58) GM 00 2 OM czyc h (33) h (33) 7 M CE/C 3 (30) u (no) M 00 1 (25) 2 (50) OM M m FC 5% level of conf. S (71) 9 (50) h (22) 12 10 �is a way of inducing certain diffuse chemical changes in the nervous system. So is metrazol - barbiturate - activation technics it is show - hyperventilation. significant variation in responsivity. hypoglycemia Each of these For example, that hyperventilation induced delta readily in some patients - eSpecially children - but in others, no such response is noted. Dr. commonly known Green of our laboratory has hypothesized, and is now studying, the possibility that a degree of physiologic responsivity - which is measurable - is an inherent characteristic'of organisms. To this end, he is carrying out pretreatment activation records in all our subjects; as well as measuring their threshold for in EEG depend. electrically induced convulsions. I am confident that there are other "factors" on which responsivity to electroshock - and perhaps to all activation - we the variation may the ones described, namely personality, vigilance, are excited by and physiologic responsivity. tonight, not the common characteristic of the EEG response to activation, but the individual variability and the factors on we have emphasized which this depends. 'We have tried to exemplify our problem by our data of the variation in delta response to electroshock. Further study of each act- ivation technic to relate the role of personality, vigilance and physiologic reactivity to the variation in EEG responsivity. �-3and middle (lower socio-economic upper lower (Jewish)! ' j , ~ first The generation, group. and _ ideation‘ mood , responses. W; in the first hospitalisation, of Psychiatric . psychiatric bellman” «read-tune class), immigrant and were ' patterns we 114' W. They use voluntaflefion‘ar predominantly 1, with a short period (few months to few years) illnesjzlectroconvulsive treatment was administered three «W “M'- _ times a week using 1hr % WM mthods. rfl L3 r . suprathreshold unidirectional or alternating current A“n*”"t ”WA a Jayne/1nd“! 11’ flat man !0 ti 3.: Wig Ml’" {M-dtun flit/“23‘ Within a week prior to treatment subjects were tested with Rorschach and figure-ground discrimination for presence or absence of j ,x’”‘\_, [I 2 responses and total (H + EM+ tasks. The Rorschach human movement protocol was scored responses (M), total m), type and number of color responses (0, movement CF and F0) In the figure-ground discrimination task, a, () modification of Gottschaldt's hidden figures, the subject number of responses (R). L niacin-mam is presented with and below it a page containing two forms a cmnplex figure in which the - a simple geometric figure, simple figure is embedded. The task is to outline the embedded figure in the complex figure. I' ”A4€ "- ad‘ Electroencephalograms were obtained prior to treatment, andweekly“ on a day following a Mamie, treatment. Patients whose pre-treatment records contained �measurable delta activity were excluded from the study. slow wave activity frequencies of and 7 W MW was measured 04, wave actifity, Based on these activity in the record. of induced by determining the per-cent time of and—less three selected in cps, highest amplitude of slow The amount and leads; the slavest frequency / longest duration of burst indices, records were classified as pan/40M "low," "moderate" or "high" degree delta- W previously described of high degreesdeébba ( activity, according to criteria ). In the observations reported here, the activity in the second and third development weeks of treatment treatment intervals) was used in the tabulation. Patients who M. (We, developed high WWactivity during either or both these periods were classed in 3 of delta degree the high degree group. Those whose records did not demonstrate activity in either ,week were classed in the moderate-low class. 7-9 tt%gree or" �watt—baa WI? “H.“HQ mammmuormmmummmwm "mu alum, that «warm ant m1: of “Mom (W m). In Guide“ the “mummy in mum, vellum, m rmwmmwmmmmmtm mm,“ Wsamunugmmwmmmmmumum mflWNudl. MMM3M( )orthmputmtlm mmzmwmnmcmutmwmammwmtw mama in aetifiirapmfi muormdmmmalmthm such with“ «mum mm mmm< mm an «mu- apart at W )., «mapmwmmmmpmmmm ”mtg-lam muey m “rant-d nth tho W W ma of as pass-mm was at such wuvflyw In mum «1' ”3.“, +0.35, " m1: {'“4‘. ..., am “tax”; 44”.. a l1" an activity. tom-rm autism, tho .05, w a WW 2.3.2.1.“ Wmudu‘mumormduummwmu � 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 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 Individual Differences in EEG Responsivity Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context mfp-03-01-002-6-006 Date A point or period of time associated with an event in the lifecycle of the resource 1957 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 Research papers, files, and related correspondence. Drafts, one with Martin A. Green and Robert L. Kahn 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