Journal of Personality

Transcription

1 T5r 19c2,4-J uytie& çln 0 Journl of Personlity EDTORAL BOARD GORDON W. ALLPORT Hrvrd University MERTON GLL Austen Riggs Foundtion JOHN GLLN University of North Crolin DONALD. HEBB McGill University DAVD KRECH University of Cliforni GEORGE F. J. University of Cliforni t Los Angeles KAu ZENER, EDTOR Duke University HELGE LUNDHOLM Duke University DONALD W. MACKNNON University of Cliforni LEO POSTMAN Hrvrd University ROBERT R. Ss ow Child Welfre Reserch Sttion DAVD SAKOW College of Medicine Univity of llinois LEHNER JOSEPH ZUBN New York Psychitric nstitute Columbi University VOLUME XV SEPTEMBER, 1948-JUNE, 1949 Published by DUKE UNVERSTY PRESS DURHAM, NORTH CAROLNA

2 RUSSELL erformnce of lbino `sycl:ol., 1947, 40, rts subjected to hock convulsions on nd retez.. iculty of the tsk. Tolerning be publjshcj, TONE, C. P. Effect of electroconvulsive rts..1. Psycho!. 1946, 22, hock convulsions on the!, cquisifio of cmp. Psycho!, 1943, 3.6, the rt fter electroshock convulsions. V. MEMORY LOSS FOLLOWNG ELECTRC CONVULSVE TREATMENTS RVNG L. JANS Yle University :. The reorienttion mze behvior roshock convulsions nd J. cosup. Psycho!. ioning d rections nd their clinicl implic.. on the recovery of inhibited condifioned 1945, 54, , ov, H. nfluence of metrzol, insulin convulsions OR re-estblishment of in exp. Plo!. Med., 1942, 50, Tects of electriclly nd :es. Amer..1. Psych4zt., chemiclly in 1943, 99, 687e effects of electroshock e white rt. J. erp. convlsions On Psychot, 1945, vers! by electroslock in the rt. J. co;np. shll present brief report on some of the findings derived from reserch study designed to determine psychologicl chnges following n entire series of electroconvulsive tretments ECT.' One of the min problems investigted ws memory loss. t hs been generlly observed tht extensive mnesis occur mong men tl ptients during the period when electroshock tretments re being dministered, but mny uthorities clim tht such ninesis cler up within the first two to three weeks fter the termintion of tretment, during which period the confusion, the temporry ntel lectul impirment, nd other trnsient "orgnic" effects of ECT undergo rpid recovery. Do the mnesis cler up completely dur ing the usul recovery period? After the "orgnic" syndrome dis ppers, is the ptient left with ny residul impirment of recll functions? n order to investigte this problem systemticlly, intensive interviews were conducted before nd fter the series of electroshock tretments. There were nineteen ptients in the electroshock group, representing cross-section of ptients who received ECT in the two psychitric hospitls where the study ws crried out. An equted control group of 11 ptients in the sme hospitls ws lso included in the study. Ech group contined severl neurotics md fir number of borderline schizophrenics s well s some nifestly psychotic ptients. The ptients in the electroshock group received minimum of eight convulsive tretments spced three times week. Shortly before the first electroshock tretment stndrdized interview ws given in which wide rnge of personl memories ws elicited, covering school experiences, job history, fmily prob-v lems, detils bout the onset nd development of the mentl disorder, A full report on the reserch study will pper in the ner future in series of three rticles in the Journl of Nervous nd Mentl Diseses.

3 30 RVNG L. JAN15 nd so on. A posttretment interview ws dministered pproxi. mtely four weeks fter the termintion of ECT nd ws designed to test the bility of the ptient to recll the mteril he hd been ble to recll prior to tretment. Generl questions were sked t first, nd, if these filed to elicit recll, more nd more specific ones contining memory cues were given. As lst resort, the ptient ws given recognition test with the permission of the psychitrist in chrge of the cse. This usully consisted of reding to the ptient fir portion of his former response to see if he could then remember the experience nd recll the dditionl detils bout it t ws found tht every one of the 19 ptients in the electrq. shock group displyed definite, retroctive mnesis, s of pproxi rntely four weeks fter the termintion of ECT. For ech cse it ws possible to verify mny of the forgotten events s ctul occur. rences, on the bsis of independent sources of informtion in the ptient's cse history records. Mny of the ptients were unble to recll from 10 to 20 life experiences which hd been vilble to recll prior to electroshock tretments. n contrst, the ptients in the control group were ble to recll prcticlly every detil bout their pst experiences which hd been elicited in the erlier interview. The control ptients hd been given exctly the sme kind of interviews s the pre- nd post-tretment interviews of the ECT ptients, with pproximtely the sme time intervl between, but hd received no form of shock tretment dur ing the intervening period. The results show, therefore, tht electric convulsive tretmenis4 s dministered in stndrd psychitric prctice, produce mnesi which do not cler up within four weeks fter the termintion of tretments. One of the importnt chrcteristics of the mnesis tht they re circumscribed merhory gps. Often the ptients ble to remember things tht hppetie immeditely before nd imi ditely fter the forgotten event. Sometimes ptient will deny given event or series of events hs occurred, nd he will fill in mnesic gp, s in the following exmple. The ptient, 3?old borderline schizophrenic, reported in the pretretment inter tht he hd been unble to work for severl months before to the hospitl, during which period he would spend his time

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5 32 RVNG L. JAN15 in the follow-up study, there were one or two instnces of prtil or complete recovery of mnesic mteril. This evidence, s well s other observtions, implies tht the memory loss is not n irreversible one. The diffuse mnesis of the tretment period pprently cler up rpidly but the ptient is left with mnesic gps which pper to be due to subtle motivtionl fctors rther thn to permnent retention loss. At this point should like to mention some of the observtions mde in the course of concurrent investigtion which tie in with the findings on posttretment mnesis. As prt of the reserch study on psychologicl effects of ECT, chnges in emotionl or ffective disturbnces were investigted by mens of self-rting scles dministered in personl interview. n number of cses it ppered tht there ws very close reltionship between the reduction of disturbing ffect produced by ECT nd the occurrence of the post-ect mnesis. For exmple, one ptient no longer felt disturbed nd hopeless bout his physicl condition fter ECT; but, in ddition, he could not remember hving hd the queer nd sometimes pinful somtic senstions bout which he hd complined so bitterly in responding to the pretretment questionnire. Another ptient who displyed the typicl decrese in self-ggressive ffective ttitudes following ECT hd become mnesic for vrious sexul experiences which, in the pretretment session, she hd frequently referred to s mjor source of her intense guilt feelings. Observtions of this sort strongly suggest tht there my be cusl connection between the post-ect mnesis nd the ffective chnges produced by the tretments. This point rises the possibility tht the posttretment mnesis my invofire repression mechnism which plys t lest secondry role in niâixtining whtever clin icl improvement is chieved by the orgnic chnges produced by electric convulsive tretments. r T 5., b h g 0 0 h C C