Archives of General Psychiatry

MASON, JOHN W.;SACHAR, EDWARD J.;FISHMAN, JACOB R.;HAMBURG, DAVID A.;HANDLON, JOSEPH H.

doi: 10.1001/archpsyc.1965.01730010003001pmid: 14303983

Abstract WITHIN recent years it has been observed repeatedly that animals6,10,11 and humans14,16 may show marked emotional reactions to novel environmental changes as reflected in substantial plasma and urinary 17-hydroxycorticosteroid (17-OHCS) elevations. The general consistency of these findings has suggested that transfer to new and unfamiliar environments might be a useful experimental measure for predictably eliciting emotional arousal in human subjects in psychophysiological or psychosomatic studies. The present investigation is concerned with measurement of the 17-OHCS responses in several groups of normal young adults to hospital admission under relatively standardized conditions. A primary objective is to evaluate the practicability of using hospital admission as an experimental means for eliciting emotional or psychoendocrine disturbance, with an interest not only in the magnitudé of mean 17-OHCS response, but also in the extent of group and individual differences. If substantial psychoendocrine responses do occur when normal References 1. Fishman, J. R., et al: Emotional and Adrenal Cortical Responses to New Experience , Arch Gen Psychiat 6:271-278, 1962.Crossref 2. Fox, H. M., et al: Adrenal Steroid Excretion Patterns in 18 Healthy Subjects and Tentative Correlations With Personality Structure , Psychosom Med 23:33-40, 1961.Crossref 3. Friedman, S. B.; Mason, J. W.; and Hamburg, D. A.; Urinary 17-Hydroxycorticosteroid Levels in Parents of Children With Neoplastic Disease , Psychosom Med 25:364-376, 1963.Crossref 4. Glenn, E., and Nelson, D.: Chemical Method for Determination of 17-Hydroxycorticosteroids and 17-Ketosteroids in Urine Following Hydrolysis With B-Glucuronidase , J Clin Endocr 13:911-921, 1953.Crossref 5. Harwood, C. T., and Mason, J. W.: Systematic Evaluation of Nelson-Samuels Plasma 17-Hydroxycorticosteroid Method , J Clin Endocr 16:790-800, 1956.Crossref 6. Holcombe, R. B.: Investigations on Urinary Excretion of "Reducing Corticoids" in Cattle and Sheep , Acta Endocr 34( (suppl) ):1-100, 1957. 7. Mason, J. W.: " Psychological Influences on Pituitary-Adrenal Cortical System ," in Pincus, G., ed.: Recent Progress in Hormone Research , New York: Academic Press, 1959, pp 345-389. 8. Mason, J. W.: Visceral Functions of Nervous System , Ann Rev Physiol 21:353-380, 1959.Crossref 9. Mason, J. W., and Brady, J. V.: " Sensitivity of Psychoendocrine Systems to Social and Physical Environment ," in Symposium on Psychobiological Approaches to Social Behavior , Palo Alto, Calif: Stanford University Press, 1964, pp 4-23. 10. Mason, J. W.; Brady, J. V.; and Sidman, M.: Plasma 17-Hydroxycorticosteroid Levels and Conditioned Behavior in Rhesus Monkey , Endocrinology 60:741-752, 1957.Crossref 11. Mason, J. W.; Harwood, C. T.; and Rosenthal, N. R.: Influence of Some Environmental Factors on Plasma and Urinary 17-Hydroxycorticosteroid Levels in Rhesus Monkey , Amer J Physiol 190:429-433, 1957. 12. Mason, J. W., et al: Concurrent Plasma Epinephrine, Norepinephrine and 17-Hydroxycorticosteroid Levels During Conditioned Emotional Disturbances in Monkeys , Psychosom Med 23:344-353, 1961.Crossref 13. Nelson, D. H., and Samuels, L. T.: Method for Determinations of 17-Hydroxycorticosteroids in Blood: 17-Hydroxycorticosterone in Peripheral Circulation , J Clin Endocr 12:519-526, 1952.Crossref 14. Price, D. B.; Thaler, M.; and Mason, J. W.: Preoperative Emotional States and Adrenal Cortical Activity: Studies on Cardiac and Pulmonary Surgery Patients , Arch Neurol Psychiat 77:646-656, 1957.Crossref 15. Rosenthal, N. R., and Mason, J. W.: Urinary 17-Hydroxycorticosteroid Excretion in Normal Rhesus Monkey , J Lab Clin Med 53:720-728, 1959. 16. Sabshin, M., et al: Significance of Pre-Experimental Studies in Psychosomatic Laboratory , Arch Neurol Psychiat 78:207-219, 1957.Crossref 17. Sachar, E. J., et al: Corticosteroid Excretion in Normal Young Adults Living Under "Basal" Conditions, to be published. 18. Sachar, E. J., et al: Psychoendocrine Aspects of Acute Schizophrenic Reactions , Psychosom Med 25:510-537, 1963.Crossref 19. Wadeson, R. W., et al: Plasma and Urinary 17-OHCS Responses to Motion Pictures , Arch Gen Psychiat 9:146-156, 1963.Crossref 20. Wolff, C. T., et al: Relationship Between Psychological Defenses and Mean Urinary 17-Hydroxycorticosteroid Excretion Rates: I. Predictive Study of Parents of Fatally Ill Children , Psychosom Med 26:576-591, 1964.Crossref 21. Wolff, C. T.; Hofer, M. A.; and Mason, J. W.: Relationship Between Psychological Defenses and Mean Urinary 17-Hydroxycorticosteroid Excretion Rates: II. Methodological and Theoretical Considerations , Psychosom Med 26:592-609, 1964.Crossref

TRUNNELL, LT THOMAS L.

doi: 10.1001/archpsyc.1965.01730010011002pmid: 14303991

Abstract BLEULER2 focused attention on thought disorder making it one of the primary symptoms in his conceptualization of the syndrome schizophrenia. There have been recent attempts to understand thinking disturbance in schizophrenia from the context of intrafamilial relationships. Bateson et al1 proposed the classic double-bind hypothesis in 1956 delineating peculiarities in the communication between parents and schizophrenic offspring. Wynne et al41 and Lidz et al15 focused attention on the possibility that thought disturbance in schizophrenia reflected the intrafamilial organization and relationships of the family-schizophrenic offspring in 1958. This thesis has been elaborated,42,43 and in 1963 Singer and Wynne demonstrated schizophrenic features, especially thought disorder, in the Rorschachs of parents of young adult schizophrenics in 95% (38 of 40) of the parents studied.36 Wynne and Singer summarized the conceptual and clinical basis for the hypothesis that specific links exist be References 1. Bateson, G., et al: Toward a Theory of Schizophrenia , Behav Sci 1:251, 1956.Crossref 2. Bleuler, E.: Group of Schizophrenics, 1911 , (trans.) J. Zinkin, New York: International Universities Press, 1950. 3. Flavell, J.: Developmental Psychology of Jean Piaget , Princeton, NJ: D. Von Nostrand, Co., Inc., 1963. 4. Goodnow, J.: Test of Milieu Effects With Some of Piaget's Tasks , Psychol Monogr , vol 76, No. (36) , 1962. 5. Jackson, D.: Question of Family Homeostasis , Psychiat Quart 31( (suppl) ):79-90, 1957. 6. Jackson, D.; Riskin, J.; and Satir, Y.: Method of Analysis of a Family Interview , Arch Gen Psychiat 5:321-339, 1961.Crossref 7. Kesson, W., and Kuhlman, C. (ed.): Developmental Psychology of Jean Piaget , Monogr Soc Res Child Develop , 1962, vol 27. 8. Laurendeau, M., and Pinard, A.: Causal Thinking in Child , New York: International Universities Press, 1962. 9. Lidz, R., and Lidz, T.: Family Environment of Schizophrenic Patients , Amer J Psychiat 106:332-345, 1949. 10. Lidz, T., et al: Role of Father in Family Environment of Schizophrenic Patient , Amer J Psychiat 113:126-132, 1956. 11. Lidz, T., et al: Family Environment of Schizophrenic Patient: II. Marital Schism and Schew , Amer J Psychiat 114:241, 1957. 12. Lidz, T., et al: Intrafamilial Environment of the Schizophrenic Patient: I. Father , Psychiatry 20:329-342, 1957. 13. Lidz, T.: Schizophrenia and Family , Psychiatry 21:21-27, 1958. 14. Lidz, T., et al: Intrafamilial Environment of Schizophrenic Patient: IV. Parental Personalities and Family Interaction , Amer J Orthopsychiat 28:764-776, 1958.Crossref 15. Lidz, T., et al: Intrafamilial Environment of Schizophrenic Patient: VI. Transmission or Irrationality , Arch Neurol Psychiat 79:305-316, 1958.Crossref 16. Piaget, J.: Language and Thought of Child , New York: Harcourt, Brace & Co., 1926. 17. Piaget, J.: Judgement and Reasoning in Child , New York: Harcourt, Brace & Co., 1928. 18. Piaget, J.: Child's Conception of World , New York: Harcourt, Brace & Co., 1929. 19. Piaget, J.: Child's Conception of Physical Causality , New York: Harcourt, Brace & Co., 1932. 20. Piaget, J.: Moral Judgment of Child , London: Kegan Paul, Trench, Truebner & Co., 1932. 21. Piaget, J.: Principle Factors Determining Intellectual Evolution From Childhood to Adult Life , in Factors Determining Human Behavior , Cambridge: Harvard University Press, 1937. 22. Piaget, J.: Psychology of Intelligence , New York: W. W. Norton & Co., 1950. 23. Piaget, J.: Play, Dreams, and Imitation in Childhood , New York: W. W. Norton & Co., 1951. 24. Piaget, J., and Inhelder, B.: La genese de l'idee de hasard chez l'enfant , Paris: Presses Universitaires de France, 1951. 25. Piaget, J.: Origins of Intelligence in Children , New York: International Universities Press, 1952. 26. Piaget, J.: Construction of Reality in Child , New York: W. W. Norton & Co., Inc., 1956. 27. Piaget, J., and Inhelder, B.: Child's Conception of Space , New York: W. W. Norton & Co., Inc., 1956. 28. Piaget, J.: Logic and Psychology , New York: Basic Books Inc., Pub, 1957. 29. Piaget, J., and Inhelder, B.: Growth of Logical Thinking From Childhood to Adolescence , New York: Basic Books, Inc., Pub, 1958. 30. Piaget, J.; Inhelder, B.; and Szeminska, A.: Child's Conception of Geometry , New York: Basic Books, Inc., Pub, 1960. 31. Piaget, J.: Comments on Vigostkey's Critical Remarks Concerning Language and Thought of Child and Judgement and Reasoning in Child , Cambridge, Mass: M.I.T. Press, 1962. 32. Piaget, J., and Inhelder, B.: Early Growth of Logic in Child , Classification and Seriation, London: Routledge and Kegan, 1964. 33. Scheerer, M.: " Cognitive Theory ," in Lindzey, G.(ed.): Handbook of Social Psychology , Cambridge, Mass: Addison-Wesley Co., 1954, vol 1, pp 91-137. 34. Sherman, M.: Brief Objective Test for Measurement of Mental Impairment , J Genet Psychol 52:285-296, 1955.Crossref 35. Siegel, S.: Nonparametric Statistics , New York: McGraw-Hill Book Co., Inc., 1956. 36. Singer, M., and Wynne, L.: Differentiating Characteristics of Parents of Childhood Schizophrenics, Childhood Neurotics, and Young Adult Schizophrenics Amer J Psychiat 120:234-243, 1963. 37. Trunnell, T.: Thought Disturbance in Schizophrenia , Arch Gen Psychiat 11:126-136, 1964.Crossref 38. Waelder, R.: Psychoanalytic Theory of Play , Psychoanal Quart 2:208-224, 1933. 39. Werner, H.: Comparative Psychology of Mental Development , New York: International Universities Press, 1957. 40. Wolff, P.: Developmental Psychologies of Jean Piaget and Psychoanalysis , Psychol Issues Monogr No. (5) , 1960. 41. Wynne, L., et al: Pseudo-Mutuality in Family Relations of Schizophrenics , Psychiatry 21:205-220, 1958. 42. Ryckoff, I.; Day, J.; and Wynne, L.: Maintenance of Stereotyped Roles on Families of Schizophrenics , Arch Gen Psych 1:93-98, 1959.Crossref 43. Wynne, L., and Singer, M. Thought Disorder and Family Relations of Schizophrenics: I. Research Strategy , Arch Gen Psychiat 9:191-220, 1963.Crossref 44. Wynne, L., and Singer, M.: Thought Disorder and Family Relations of Schizophrenics: II. Classification of Forms of Thinking , Arch Gen Psychiat 9:207, 1963.Crossref

SLOANE, R. BRUCE;DAVIDSON, PARK O.;PAYNE, ROBERT W.

doi: 10.1001/archpsyc.1965.01730010021003pmid: 14303982

Abstract Introduction ONE approach to the problem of neurosis is to regard it as a form of abnormal learned behavior. There are a number of theories which purport to explain why this learning process takes place. Common to many of these is the concept of anxiety whether it be expressed as a "wish conflict" or as a "drive state."Most of the controversies related to the learning of neurotic behavior center around the relationship between learning and anxiety and biological needs for food, warmth, and love. Spence and Taylor1 have suggested that all drives summate to increase and improve simple learning. However, much of their work is based on applications of their Manifest Anxiety Scale. This questionnaire deals with hypochondriacal and anxious complaints, and its general validity is open to question. Eysenck2 has advanced a theory of anxiety which borrows from both Pavlov3 and Hull.4 He has References 1. Whether the autonomic phenomenon observed was one of lack of habituation and thus more properly "pseudo-conditioning" than true conditioning could not be decided on the data available. It is likely that habituation and the orienting reflex described by Pavlov 8 depend upon physiological mechanisms of arousal similar to those involved in classical conditioning, although this remains to be explored. 2. Spence, K. W., and Taylor, J. A.: Anxiety and Strength of UCS as Determiners of Amount of Eyelid Conditioning , J Exp Psychol 42:183-188, 1951.Crossref 3. Eysenck, H. J.: Dynamics of Anxiety and Hysteria , London: Routledge & Kegan Paul, 1957. 4. Pavlov, I. P.: Conditioned Reflexes , G. V. Anrep (trans.), London: Oxford University Press, 1927. 5. Hull, D. L.: Principles of Behaviour , New York: Appleton-Century-Crofts, 1943. 6. Franks, C. M.: Personality Factors and Rate of Conditioning , Brit J Psychol 48:119-126, 1957.Crossref 7. Mowrer, O. H.: Learning Theory and Behaviour , New York: John Wiley & Sons, Inc., 1960. 8. Malmo, R. B., and Davis, J. F.: Monopolar Method of Measuring Palmar Conductance , Amer J Psychol 74:106-113, 1961.Crossref 9. Davidson, P. O.; Payne, R. W.; and Sloane, R. B.: Introversion, Neuroticism and Conditioning , J Abnorm Soc Psychol 68:136-143, 1964.Crossref 10. Taylor, J. A.: Personality Scale of Manifest Anxiety , J Abnorm Soc Psychol 48:285-290, 1953.Crossref 11. Eysenck, H. J.: Maudsley Personality Inventory , London: University of London Press, 1959. 12. Claridge, G. S., and Herrington, R. N.: Sedation Threshold, Personality and Theory of Neurosis , J Ment Sci 106:1568-1583, 1960. 13. Mowrer, O. H.: Learning Theory and Personality Dynamics , New York: Ronald Press, 1950. 14. Das, J. P.: Experimental Investigation of Relation Between Hypnosis, Conditioning, and Reactive Inhibition, unpublished Doctoral Dissertation, University of London, London, 1957. 15. Willett, R. A.: " Measures of Learning and Conditioning ," in Eysenck, H. J., (ed.): Experiments in Personality , Vol 2. London: Routledge & Kegan Paul, 1960, pp 157-192. 16. Farber, I. E.; Bechtoldt, H. P.; and Spence, K. W.: Emotionality, Introversion-Extraversion and Conditioning, paper read before Midwestern Psychological Association, Chicago, May, 1957. 17. Martin, I.: Skin Resistance and Relationship to GSR Conditioning , J Ment Sci 106:281-287, 1960. 18. Becker, W. C.: Cortical Inhibition and Extra-version-introversion , J Abnorm Soc Psychol 61:52-66, 1960.Crossref 19. Bronzaft, A., et al: Relationship Between PGR and Measures of Extraversion, Ascendance and Neuroticism , J Psychol 50:193-195, 1960.Crossref 20. Becker, W. C., and Matteson, H. H.: GSR Conditioning, Anxiety and Extraversion , J Abnorm Soc Psychol 62:427-430, 1961.Crossref 21. Jenkins, J. J., and Lykken, D. T.: Individual Differences , Ann Rev Psychol 8:79-112, 1957.Crossref 22. Jensen, A.: Personality , Ann Rev Psychol 9:295-322, 1958.Crossref

RAPOPORT, JUDITH L.

doi: 10.1001/archpsyc.1965.01730010026004pmid: 14306530

Abstract Introduction FEW exceptions exist to the laws which declare abortion illegal in the United States. In 31 states abortion may be performed to save the life of the mother and in seven of these (Alabama, Colorado, District of Columbia, Maryland, Massachusetts, New Mexico, and Oregon), to preserve the health of the mother. In Colorado and New Mexico exceptions include bodily injury but not mental illness. The high incidence of illegal abortions15,36 and dubious legal interpretations4,29 suggest, however, that unwanted pregnancy still causes important social, economic, and medical problems in the United States.Although extensive studies have been made on women seeking abortion in other countries,5,14,23,26 the severe laws in the United States have restricted collection of data. Some accounts have been published,6,15,33,36 but these have been retrospective statistical accounts, or limited to patients seeking abortion on drastic medical or psychiatric grounds. References 1. Bernstein, I.: Investigation into Etiology of Nausea and Vomiting of Pregnancy , Minnesota Med 35:34-37, 1952. 2. Bibring, G.: Some Considerations of Psychological Processes in Pregnancy , Psychoanal Stud Child 14:113-121, 1959. 3. Black, J. D.: " MMPI Results for 15 Groups of Female College Students ," in Basic Readings on MMPI in Psychology and Medicine , W. G. Dahlstrom and G. S. Welsh (eds.), Minneapolis: University of Minnesota Press, 1960, chap 62. 4. Bolter, S.: Psychiatrist's Role in Therapeutic Abortion: Unwitting Accomplice , Amer J Psychiat 119:312-316, 1962. 5. Buser-Wildi, R.: über die uneheliche Schwangerschaft und deren Unterbrechung aus psychiatrischer Indikation, Inaug.-Diss., Zurich, 1948;. 6. Calderone, M. S. (ed.): Abortion in United States , New York: Hoeber-Harper, 1958. 7. Chertok, L.; Mondzain, M. L.; and Bonnaud, M.: Vomiting and Wish to Have a Child , Psychosom Med 25:13-18, 1963.Crossref 8. Clifford, E.: Expressed Attitudes in Pregnancy of Unwed Women and Married Primigravida , Child Dev 33:945-951, 1962. 9. Clothier, F.: Psychological Implications of Unmarried Parenthood , Amer J Orthopsychiat 13:531-549, 1943.Crossref 10. Coppen, A. J.: Vomiting of Early Pregnancy , Lancet 2:172-3, 1959.Crossref 11. Dahlstrom, W. G., and Welsh, G. S.: MMPI Handbook , Minneapolis: University of Minnesota Press, 1960, chap 9. 12. Deutsch, H.: Psychology of Women , New York: Grune & Stratton, Inc., 1945, vol 2, P 179. 13. Edwards, A. L.: Social Desirability Variable in Personality Assessment and Research , New York: Dryden Press, 1957. 14. Ekblad, M.: Induced Abortion on Psychiatric Grounds , Acta Psychiat Neurol Scand , (suppl 99) , pp 1-238, 1955. 15. Gehbard, P. H., et al: Pregnancy , Birth and Abortion in United States , New York: Harper & Row Pub, Inc., 1958. 16. Goodstein, L. D.: Regional Differences in MMPI Responses Among Male College Students , J Consult Psychol 18:437-441, 1954.Crossref 17. Gough, H. G.: " F-K Dissimulation Index for MMPI ," in Basic Readings on MMPI in Psychology and Medicine , W. G. Dahlstrom and G. S. Welsh (eds.), Minneapolis: University of Minnesota Press, 1960, chap 35. 18. Greenberg, N. H.; Loesch, J.; and Lakin, M.: Life Situations Associated With Onset of Pregnancy , Psychosom Med 21:296-310, 1959.Crossref 19. Grimm, E.: Psychological Investigations of Habitual Abortion , Psychosom Med 24:369-378, 1962.Crossref 20. Hathaway, S., and Briggs, P. F.: Some Normative Data on New MMPI Scales , J Clin Psychol 13:364-368, 1957.Crossref 21. Hathaway, S. R., and Mckinley, J. C.: Multiphasic Personality Schedule , J psychol 10:249-254, 1940.Crossref 22. Heiman, M., and Levitt, E.: Role of Separation and Depression in Out of Wedlock Pregnancy , Amer J Orthopsychiat 30:166-174, 1960.Crossref 23. HööK, K.: Refused Abortion , Acta Psychiat Scand , 39( (supp1 168) ):1-156, 1963. 24. Kasanin, J., and Handschin, S.: Psychodynamic Factors in Illegitimacy , Amer J Orthopsychiat 11:66-84, 1941.Crossref 25. Klein, H.; Potter, H.; and Dyk, R.: Anxiety in Pregnancy and Childbirth , New York: Hoeber-Harper, 1950. 26. Koya, Y.: Study of Induced Abortion in Japan and Its Significance , Milbank Mem Fund Quart 32:282-293, 1954.Crossref 27. Kummer, J. M.: Post-Abortion Psychiatric Illness—Myth? Amer J Psychiat 119:980-983, 1963. 28. Mann, E. C.: Psychiatric Investigation of Habitual Abortion , Amer J Obstet Gynce 7:589-601, 1956. 29. McGraw, R. B.: Legal Aspects of Termination of Pregnancy on Psychiatric Grounds , New York J Med 56:1605-1610, 1956. 30. Menninger, K. A.: Emotional Factors in Pregnancy , Bull Menninger Clinic 7:15-24, 1943. 31. Mumford, R. S.: Interdisciplinary Study of Four Wives who Had Induced Abortions , Amer J Obstet Gynec 87:865-876, 1963. 32. Robertson, G. G.: Nausea and Vomiting of Pregnancy , Lancet 2:336-341, 1946.Crossref 33. Rosen, H. (ed.): Therapeutic Abortion , New York: Julian Press, 1954. 34. Schaefer, E., and Manheimer, H.: Dimensions of Perinatal Adjustment, paper read before the EPA meeting, New York, April, 1960. 35. Squier, R., and Dunbar, F.: Emotional Factors in Course of Pregnancy , Psychosom Med 8:161-175, 1946.Crossref 36. Taussig, F.: Abortion , Spontaneous and Induced , St. Louis: C. V. Mosby Co., 1936. 37. Taylor, J. A.: Personality Study of Manifest Anxiety , J Abnorm Soc Psychol 48:285-290, 1953.Crossref 38. Abortion and the Law, Medicine , Time 80:30 ( (Aug 3) ) 1962. 39. Warner, W. L.; Meeker, M.; and Eells, K.: Social Class in America , Chicago: Science Research Association, 1947. 40. Welsh, G. S.: " Factor Dimensions A and R ," in Basic Readings on MMPI in Psychology and Medicine , W. G. Dahlstrom, and G. S. Welsh (eds.), Minneapolis: University of Minnesota Press, 1960, chap 29. 41. Young, L.: Out of Wedlock , New York: McGraw-Hill Book Co., Inc., 1954.

BIRNBAUM, MORTON

doi: 10.1001/archpsyc.1965.01730010036005pmid: 14306531

Abstract THE purpose of this paper is to advocate before a medical audience the recognition and enforcement of the legal right of a mentally ill inmate of a state mental institution to adequate care and treatment for his mental illness. For convenience, this right has been referred to as the right to treatment.1 At present, our law has not recognized this legal right,2,3 although our society undoubtedly recognizes a moral right to treatment. If the legal right to treatment were to be recognized and enforced, it will be shown that the standards of care and treatment probably will be raised for the more than 500,000 Americans who are now inmates of state mental institutions4 and who now usually receive inadequate care and treatment; however, before discussing, in detail, the scope and probable effects of the right to treatment, it will undoubtedly be worthwhile to discuss References 1. Birnhaum, M.: Right to Treatment , Amer Bar Assoc J 46:499, 1960. 2. People ex rel Anonymous vs La Burt, 27 Misc 2d 584, 211 NYS2d 963 (1960) 3. 9 NY2d 794, 175 NE2d 165 4. 14 AD2d 560, 218 NYS2d 738 5. 10 NY2d 708 6. 369 US 428 7. Stephens vs La Burt, writ of habeas corpus denied, no reported decision, USDC, EDNY, July 25, 1962 8. CCA 2d, Nov 20, 1962 9. 373 US 928 10. Donaldson, 364 US 808. 11. US Department Health, Education and Welfare, Public Health Service: Patients in Mental Institutions, 1961, Public Health Service Publication No. 1091, 1963. 12. Administrator of Veterans Affairs: Annual Report, 1960, US Government Printing Office, 1961. 13. Joint Information Service of American Psychiatric Association and National Association for Mental Health : Fifteen Indices: Aid in Reviewing State Local Mental Health and Hospital Programs , Washington, DC: Joint Information Service, 1964. 14. Kramer, M.; Pollack, E. S.; and Redick, R. W.: "Studies of Incidence and Prevalence of Hospitalized Mental Disorders in United States: Current Status and Future Goals," in Hoch, P. H. and Zubin, J. (eds.): Comparative Epidemiology of Mental Disorders: Proceedings of the 49th Annual Meeting of American Psychopathological Association, New York, Feb, 1959, New York: Grune & Stratton, Inc., 1961, p 56. 15. Kittrie, N. N.: Compulsory Mental Treatment and Requirements of "Due Process," Ohio State Law J 21:28, 1960. 16. Lindman, F. T., and McIntyre, D. M., Jr. (eds.): Mentally Disabled and The Law: The Report of American Bar Foundation on Rights of Mentally Ill , Chicago: University of Chicago Press, 1961. 17. Royal Commission: Report of Royal Commission on Law Relating to Mental Illness and Mental Deficiency, 1954-1957 , London: Her Majesty's Stationery Office, 1957. 18. World Health Organization: Hospitalization of Mental Patients, Survey of Existing Legislation, Geneva: World Health Organization, 1955. 19. Special Committee to Study Commitment Procedures of Association of Bar of City of New York : Mental Illness and Due Process: Report and Recommendations on Admission to Mental Hospitals under New York Law , Ithaca, NY: Cornell University Press, 1962. 20. Group for Advancement of Psychiatry: Commitment procedures, Report No. 4, April, 1948. 21. Federal Security Agency, Public Health Service: Draft Act Governing Hospitalization of Mentally Ill, Public Health Service Publication No. 51, US Government Printing Office, revised, 1952. 22. Joint Information Service of American Psychiatric Association and National Association for Mental Health: Psychiatric Points of View Regarding Laws and Procedures Governing Mental Treatment of Mentally Ill, Special Information Bulletin, No. 1, September, 1962. 23. Zubin, J. (ed.): "Field Studies in Mental Disorders," in Proceedings of Work Conference on Problems in Field Studies in Mental Disorders, Feb 15-19, 1959, under the auspices of American Psychopathological Association, New York: Grune & Stratton Inc., 1961. 24. Hoch, P. H., and Zubin, J. (eds.): "Comparative Epidemiology of Mental Disorders," in Proceedings of 49th Annual Meeting of American Psychopathological Association, New York: Grune & Stratton, Inc., 1961. 25. Plunkett, R. J., and Gordon, J. E.: Epidemiology and Mental Illness , Monograph Series No. 6 of Joint Commission on Mental Health and Illness, New York: Basic Books Inc., Pub, 1960. 26. Pugh, T. F., and MacMahon, B.: Epidemiologic Findings in United States Mental Hosptial Data , Boston: Little, Brown & Co., 1962. 27. Causes of Mental Disorder: "Review of Epidemiological Knowledge, 1959," in Proceedings of Round Table Conference Held at Arden House, Harriman, NY, New York: Milbank Memorial Fund, 1961. 28. Pasamanick, B. (ed.): Epidemiology of Mental Disorder: Symposium, Publication No. 60, Washington, DC: American Association for Advancement of Science, 1959. 29. Hoch, P. H.: "Discussion," in Pasamanick, B. (ed.): Epidemiology of Mental Disorders: Symposium Publication No. 60, Washington, DC: American Association for Advancement of Science, 1959, P 92. 30. Birnbaum, M.: Social Class and Mental Illness: Community Study of Hollingshead , A. B. and Redlich, F. C., book review, Amer Bar Assoc J 47:81, 1961. 31. Clausen, J. A.: "Discussion," in Pasamanick, B. (ed.): Epidemiology of Mental Disorder: Symposium, Publication No. 60, Washington, DC: American Association for Advancement of Science, 1959, p 93. 32. Sheeley, W. F.: Protecting State Hospital Function , Ment Hosp 10:28, 1959. 33. Birnbaum, M.: Eugenic Sterilization , JAMA 175:951, 1961.Crossref 34. Committee of American Neurological Association for Investigation of Eugenical Sterilization: Eugenical Sterilization , Reorientation of Problem , New York: Macmillan Co., 1936, at 26. 35. Department of Mental Hygiene, New York: Seventy-Second Annual Report of Department of Mental Hygiene of State New York for Year Ending March 31, 1960, Legislative Document No. 113 (1961), Albany, NY, 1963. 36. Committee on State Institutions: Final Report of General Findings of Committee on Institutions Relating to Conditions at Florida State Hospital Alleged Mistreatment of Patients, May 1, 1961, mimeographed material and published by the Committee on State Institutions as a Report to the Florida Legislative Council. 37. Solomon, H.: American Psychiatric Association in Relation to American Psychiatry , Amer J Psychiat 115:1, 1958. 38. American Psychiatric Association: Standards for Hospitals and Clinics (1956 ed; 1958 revised), Washington, DC: American Psychiatric Association, 1958. 39. Belknap, I.: Human Problems of State Hospital , New York: Blakiston, Division of McGraw-Hill Book Co., Inc., 1956. 40. Program Evaluation and Reports Branch, Division Hospital and Medical l Public Health Service, US Department of Health, Education and Welfare: Hill-Burton State Plan Data for Hospitals and Related Medical Facilities: National Summary as of January 1, 1963, Public Health Service Publication No. 930-F-2 (revised 1963), US Government Printing Office, 1963. 41. Fein, R.: Economics of Mental Illness , Monograph Series No. 2 of the Joint Commission on Mental Illness and Health, New York: Basic Books, Inc., 1958. 42. Kadish, S.: Methodology and Criteria in Due Process Adjudication—Survey and Criticism , Yale Law J 66:319, 1957.Crossref 43. Solesbee vs Blakcom, 339 US 9, 16 (dissenting opinion). 44. Federal Bureau of Investigation: Uniform Crime Reports for United States—1961, Washington: Federal Bureau of Investigation, 1962. 45. Public Health Service, US Department of Health, Education and Welfare: Vital Statistics of United States, 1962: Vol II. Mortality, Part A, 1-21 and 1-25, US Government Printing Office, 1964. 46. Douglas, W. O.: Stare Decisis , Columbia Law Rev 49:735, 1949.Crossref 47. Powell, T. R.: Compulsory Vaccination and Sterilization: Constitutional Aspects , N Carolina Law Rev 21:253, 1943. 48. Ann Intern Med 18:637, 1943.Crossref 49. Division of Hospital and Medical Facilities, Public Health Service, US Department of Health, Education and Welfare: State and Local Surveys of Nursing Homes and Related Facilities, Annotations of Selected Studies, Public Health Service Publication No. 930-G-1, US Government Printing Office, June 1962. 50. Joint Information Service of American Psychiatric Association and National Association for Mental Health: Staffing of Institutions for Mental Defectives, Fact Sheet No. 7, September 1958. 51. A New Right: Editorial , Amer Bar Assoc J 46:516, 1960. 52. Duval, A. M.: "Statement to Subcommittee on Constitutional Rights of Committee on Judiciary, US Senate," in Constitutional Rights of Mentally Ill, Hearings before Subcommittee on Constitutional Rights of Committee on Judiciary, United States Senate, 87th Congress First Session, March 28-30, 1961, Part I. Civil Aspects, US Government Printing Office, 1961, p 13.

ODENHEIMER, JOHN F.

doi: 10.1001/archpsyc.1965.01730010048006pmid: 14303984

Abstract I. Background of Study IN January of 1963 the psychiatric day hospital and the psychiatric inpatient service, both facilities of the San Mateo County Mental Health Services, began a project which gave the day hospital staff the opportunity to screen patients who had been accepted for hospitalization for alternate treatment in the day hospital. These facilities—day hospital as well as psychiatric ward—are located at the San Mateo County General Hospital in San Mateo on different floors. The psychiatric ward is a 30-bed unit for emergency admission and treatment with an "open door" policy and "therapeutic community" orientation dating back to 1956. The day hospital was established in January of 1961 in its present location on the ground floor of the hospital.The project was set up to answer the following questions:1. What percent of patients considered in need of full-time hospitalization on a References 1. Ackerman, N. W.: Psychodynamics of Family Life , New York: Basic Books, Inc., 1958. 2. Delman, A.: Emotional First Aid , Today's Health 40:30-31, 65-69, 1962. 3. Grad, J., and Sainsbury, P.: Mental Illness and Family , Lancet 1:544-547, 1963.Crossref 4. Lystad, M. H.: Day Hospital Care and Family Attitudes , J Nerv Ment Dis 127:145-152, 1958.Crossref 5. Maisel, A. Q.: How We Can Eliminate Our Overcrowded State Mental Hospitals , Reader's Dig 83:59-63, 1963. 6. Peck, H. B.: Role of Psychiatric Day Hospital in Community Mental Health Setting , Amer J Orthopsychiat 33:482-493, 1963.Crossref 7. Steinman, L. A., and Hunt, R. C.: " Day Hospital Treatment of Acute Psychiatric Illness ," in Current Psychiatric Therapies , J. H. Masserman (ed.), New York: Grune & Stratton, Inc., 1962. 8. Zwerling, I., and Wilder, J. F.: " Day Hospital Treatment for Psychotic Patients ," in Current Psychiatric Therapies , edited by J. H. Masserman (ed.), New York: Grune & Stratton, Inc., 1962.

WOOD, EDWIN C.;RAKUSIN, JOHN M.;MORSE, EMANUEL

doi: 10.1001/archpsyc.1965.01730010056007pmid: 14303985

Abstract IN most psychiatric residency programs, the resident has some opportunity to admit emotionally disturbed people to a hospital. This experience can be very important in his training. At the same time, he is in the position to affect patients he sees in very major ways since he is often their first contact with a psychiatrist and psychiatric treatment. His attitudes and behavior carry strong messages to the patient, messages which persist long after the usually brief meeting. To this meeting, the young psychiatrist brings his growing knowledge about psychiatric disturbances as well as his preconceptions, misconceptions, and prejudices. His job is to decide whether or not to admit patients. Often, he finds himself in conflict about this. In this article, we summarize and interpret the views about psychiatric hospital admission expressed by a group of residents toward the end of their first year of psychiatric References 1. Wood, E. C., et al: Interpersonal Aspects of Psychiatric Hospitalization: III. Follow-Up Survey , Arch Gen Psychiat 6:46-55 ( (Jan) ) 1962.Crossref 2. Wood, E. C.; Rakusin, J.; and Morse, E.: Interpersonal Aspects of Psychiatric Hospitalization: I. Admission , Arch Gen Psychiat 3:632-641 ( (Dec) ) 1960.Crossref 3. Wood, E. C.; Rakusin, J.; and Morse, E.: Interpersonal Aspects of Psychiatric Hospitalization: II. Some Correlations Between Admission Circumstances and Hospital Treatment Experience , Arch Gen Psychiat 6:39-45 ( (Jan) ) 1962.Crossref

BIEBER, TOBY B.;BIEBER, IRVING

doi: 10.1001/archpsyc.1965.01730010064008pmid: 14303986

Abstract IN the more recent history of psychiatry, a major trend has been its increasing participation in meeting the mental health needs of the community and in expanding into more broadly social areas. A testament to this development was the First International Congress of Social Psychiatry held in London, August 1964. As far back as 1922 Freud1 stated: The contrast between Individual Psychology and Social or Group Psychology which at first glance may seem to be full of significance, loses a great deal of its sharpness when it is examined more closely. It is true that Individual Psychology is concerned with the individual man . . . but only rarely and under certain exceptional conditions is Individual Psychology in a position to disregard the relations of this individual to others. In the individual's mental life someone else is invariably involved, as a model, as an object, as a helper, as an opponent, References 1. Freud, S.: Group Psychology and Analysis of Ego , New York; Boni and Liveright, 1922. 2. Bieber, T.: Individual and Group , Amer Psychother 13:635-650 ( (July) ) 1959. 3. Blank, H.: " Community Psychiatry and Psychiatrist in Private Practice ," in Handbook of Community Psychiatry and Community Mental Health , L. Bellak (ed.), New York: Grune & Stratton Inc., 1964. 4. Bieber, I., et al: Homosexuality, Psychoanalytic Study of Male Homosexuals , New York: Basic Books Inc., Pub, 1962.

LEHMANN, H. E.;BAN, T. A.;DONALD, M.

doi: 10.1001/archpsyc.1965.01730010069009pmid: 14303987

Abstract Introduction IN psychiatric clinical research, the description and evaluation of behavior is very often based on judgements made by human observers. Of the various psychometric methods employing human judgement, the rating scale is perhaps the most widely used because it is easy to administer and usually yields quantifiable data. The apparent simplicity of the method, however, is deceiving, for the rating scale is subject to error and considerable care must be taken to ensure the validity and consistency of the observers' judgements. To establish such consistency of judgements, the usual method is to systematically train all those who are expected to use a certain rating scale. This is done within the setting where the study will be undertaken and prior to its beginning. It results mostly in a high interrater reliability.However, there are certain reasons why it might be desirable to know how closely different References 1. Campbell, D. T.; Lewis, N. A.; and Hunt, W. A.: Context Effects With Judgmental Language That Is Absolute, Extensive, and Extra-Experimentally Anchored , J Exp Psychol 55:220-228, 1958.Crossref 2. Goldstein, R. H., and Salzman, L. F.: Correlates of Clinical Judgment in Psychiatry , J Med Educ 37:1101-1104, 1962. 3. Hunt, W. A.: " Actuarial Approach to Clinical Judgment ," in Bass , B., and Berg, I. A. (eds.): Objective Approaches to Personality Assessment, New York: D. Von Nostrand Co., Inc., 1959. 4. Hunt, W. A., and Jones, N. F.: Clinical Judgment of Some Aspects of Schizophrenic Thinking , J Clin Psychol 14:235-239, 1958.Crossref 5. Hunt, W. A.; Jones, N. F.; and Hunt, E. B.: Reliability of Clinical Judgment as Function of Clinical Experience , J Clin Psychol 13:377-378, 1957.Crossref 6. Johnson, D. M.: Psychology of Thought and Judgment , New York: Harper and Brothers, 1955. 7. Jones, N. F.: Validity of Clinical Judgments of Schizophrenic Pathology Bases on Verbal Responses to Intelligence Test Items , J Clin Psychol 15:396-400, 1959.Crossref 8. King, G. F.; Ehrmann, J. C.; and Johnson, D. M.: Experimental Analysis of Reliability of Observations of Social Behavior , J Soc Psychol 35:151-160, 1952.Crossref 9. Kreitman, N., et al: Reliability of Psychiatric Assessment: Analysis , J Ment Sci 107:887-908, 1961. 10. Lehmann, H. E.: " Place and Purpose of Objective Methods in Psychopharmacology ," in Drugs and Behavior , L. M. Uhr and J. G. Miller (eds.), New York, John Wiley & Sons, Inc., 1960, pp 107-127. 11. Postman, L., and Page, R.: Retroactive Inhibition and Psychophysical Judgment , Amer J Psychol 60:367-377, 1947.Crossref 12. Taft, R.: Ability to Judge People , Psychol Bull 52:1-23, 1955.Crossref 13. Ward, C. H., et al: Psychiatric Nomenclature , Arch Gen Psychiat 7:198-205, 1962.Crossref 14. Wittenborn, J. R.; Plante, M.; and Burgess, F.: Comparison of Physicians' and Nurses' Symptom Ratings , J Nerv Ment Dis 133:514-518, 1961.Crossref

SPITZER, ROBERT L.

doi: 10.1001/archpsyc.1965.01730010078010pmid: 14303988

Abstract DESPITE the obvious importance of an accurate and systematic record of the results of a mental status examination of the psychiatric patient, the usual record in hospitals and outpatient clinics is far from satisfactory. First of all, there is great variability among different examiners in the areas of psychopathology explored and little systematization in the manner in which the results are recorded. Thus, in reading the usual record, it is impossible to know whether the failure to note an area of psychopathology is because (1) the patient was examined in this area but no psychopathology was observed, (2) psychopathology was present but deemed not significant enough to mention, or (3) the area was not explored. For these reasons, the usual record of the mental status examination has proved to be totally inadequate for subsequent research studies. In addition, usually there is a References 1. The patient is first asked some identifying information and how long it has been since he came to the hospital or clinic. Questions are then directed at the following areas or topics in this order: original complaint, present problems, mood, worries, fears, anxiety, restlessness, depression, crying, self-appraisal, response to criticism, interpersonal relations, irritability, anger, ideation, physical complaints, body image, rituals, sex, fatigue, psychomotor retardation, appetite, olfactory hallucinations, sleep, thinking, memory, imagination, perceptual distortions, bodily sensations, plans and outlook for the future, humor, enjoyment and interest, feelings of punishment, death, suicidal trends, decision-making, referential thinking, dreams, auditory and visual hallucinations, delusional ideation, antisocial attitudes or actions, conception of illness, attitude towards treatment, recognition of need to change, remote and recent memory, orientation and immediate recall. The patient is then asked to wait while the interviewer marks a group of 76 items which describe behaviors that could have occurred at any point in the interview and which are not associated with specific questions. This group of items covers the following areas: grooming, attention, quantity, quality and rate of speech, emotion, and spontaneous physical behavior. The interview concludes when the interviewer asks the patient, "How do you feel answering these questions?" and then marks four more items which relate to the patient's attitude toward the interview. 2. The duplicate score sheet can later be sent to a central office for data processing. 3. Spitzer, R. L., et al: Mental Status Schedule: Rationale, Reliability and Validity , Comp Psychiat 5:384, 1964.Crossref 4. Spitzer, R. L., et al: Mental Status Schedule in Comparing Samples of Rural Kentucky and Urban New York Schizophrenics , Arch Gen Psychiat 12:448, 1965.Crossref 5. Fleiss, J. L.; Spitzer, R. L.; and Burdock, E. I.: Estimating Accuracy of Judgment Using Recorded Interviews , Arch Gen Psychiat 12:562 ( (June) ) 1965.Crossref 6. Spitzer, R. L.: Mental Status Schedule: Potential Use as Criterion Measure of Change in Psychotherapy Research, Amer J Psychother, to be published.