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Six audiometric procedures were administered to seventy patients divided into seven groups: normal, eighth nerve, brain stem, temporal lobe, non-auditory CNS, aphasic, and amyotrophic lateral sclerosis (ALS). Pure-tone sensitivity was equated among groups. For the eighth nerve group, performance was consistently poor for all measures. For the brain stem group, performance was consistently depressed for difficult monotic speech tasks. For the temporal lobe group, performance was most severely affected for difficult dichotic speech messages. For the aphasic group, performance was generally poor for both monotic and dichotic speech procedures. For the non-auditory CNS and ALS groups, results were normal. Inter- and intra-group variability were substantial.

Postural scintimyelography is a refinement of scintimyelography, applicable in cases of cervical myelopathy. Differences in radioactivity between ante-and retroflexion of the head indicate, in most cases, intermittent pathological narrowing of the cervical subarachnoid space, endangering the spinal cord. The procedure is simple with no discomfort for the patient. The results of 82 postural scintimyelograms are discussed in relation to the final clinical diagnosis. Our observations suggest that false pathological results can be diminished using Ytterbium-DTPA instead of 131RIHSA.

This study discusses the clinical validity of 101 postural scintimyelograms as a screening method for cervical myelopathy. The RIHSA or Ytterbium isotope-examination are not an extra burden to the patient if the radiopharmacon is introduced into the dural sac following Queckenstedt's test. If there is a normal rise and fall of CSF pressure after bilateral jugular compression and postural scintimyelography is judged normal as well, a cervical subarachnoid obstruction may be excluded. If both examinations yield pathological results an obstructive process in the cervical spinal canal is made certain; and in cases of spondylotic myelopathy a positive contrast myelogrpahy may thus be superfluous. If the results of these two examinations are contradictory then further neuroradiolocal studies are indicated.

(1956). The Clinical Validity of the Bender Gestalt Test with Children: A Developmental Comparison of Children in Need of Psychotherapy and Children Judged Well-adjusted. Journal of Projective Techniques: Vol. 20, No. 2, pp. 127-136.

Using 50 case histories, an attempt is made to clarify the nosographic and clinical validity of fulminating catatonia as an entity amongst the psychoses. Four groups could be established: fulminating catatonia without organic disease; somatic diseases with fulminating catatonia; catatonic excitement states with an intercurrent organic process, and unclassifiable fulminating catatonia. On the basis of this analysis the syndrome cannot be regarded as possessing the characteristics of a special psychosis. Rather it seems more appropriate to regard fulminating catatonia as a nonspecific symptom complex induced by a multilayered causation.

An attempt was made to develop a self-administered test of placebo reactivity that combined the reliability of a test of suggestibility with the clinical validity of reaction to the placebo effect. Response to the Placebo Test was determined by a patient's response to a placebo tablet, which was taken by the patient at home for the ostensible purpose of determining which medicine would be most helpful to him. The Placebo Test and other information were collected after the patient's initial intake evaluation at a psychiatric clinic. A series of independent variables were related to the Placebo Test as dependent variables, and an attempt was made to predict clinical course for patients in psychiatric treatment. Although the Placebo Test had high internal-consistency reliability of measurement, it may have had low validity as a test of placebo-proneness, as evidenced by the difficulty of selecting relevant parameters for measurement of the placebo effect. Depending on the method of measurement, 32 to 36 patients had positive reactions, 36 to 49 had neutral reactions, and 14 to 30 had negative reactions. Thirty-eight patients had side effects from the placebo, and 15 refused to take the test. In general, the results obtained varied with the method of scoring the Placebo Test, except for the major finding that negative placebo reactors were clearly differentiated from positive reactors and nonreactors, who were not significantly different from one another. The conclusion, now supported by two studies, is that analysis of placebo studies requires that positive reactors not be compared to a pooled group of negative reactors and nonreactors. In addition, analysis should include patients who refuse to take the placebo. The relationship between patient improvement and the likability measures is the strongest relationship among variables and improvement, and it warrants further study.

The Keniston Alienation Scale was administered to a group of 47 adolescent psychiatric hospital patients, to a control group of 78 college undergraduates and to the staff ( n = 28) of the psychiatric hospital. Three main factors emerged: interpersonal alienation, self-repudiation, and cultural alienation. The patient group scored much higher on the first two factors, but cultural alienation did not differentiate any of the groups and seems unrelated to pathology. Clinical data showed that patients high on self-repudiation have a greater tendency toward withdrawal and depression, whereas those low on this dimension were characterized by anti-social behavior. The findings are discussed in relation to the clinical validity of the alienation scale, and the dangers of treating alienation as a unitary dimension.

A random sample of 91 first admissions to a Provincial Psychiatric Hospital, were tested with the Hoffer-Osmond Diagnostic Test (HOD) and the Inpatient Multidimensional Psychiatric Scale (IMPS) to permit comparison of the tests' ability to discriminate between various diagnostic groups, and to discriminate patients diagnosed as schizophrenic from all others in the sample. Both tests were found to yield significant discriminations between the diagnostic groupings, the IMPS generally yielding more significant probabilities of difference. Discriminant analyses and a survey of mean score values suggested that the IMPS was tapping a wider variety of distinct sympton-dimensions, than the HOD. Canonical correlation indicated that the two tests appeared to reflect some similarities in dimensions of psychopathology. The results are discussed in terms of the relative values of the two tests for specific research purposes.

Diagnostic models of illness shape the directions of research, treatment, and theory. There are three such models in psychiatry: typological, dimensional, and mixed typological-dimensional. Of these, the typological model is by far the most popular. A review of pertinent studies suggests, however, that this popularity is not based on clinical validity or the nature of psychiatric variables. On the other hand, the mixed diagnostic models appear to be too complex for general use. There is increasing evidence that the dimensional diagnostic model best fits the nature of psychiatric data and might therefore provide the most fruitful basis for progress in psychiatric research and clinical practice.