J. S. Lawson

Therapeutic advantage of bifrontal electrode placement in ECT

Fifty-nine patients suffering from a major depressive episode, for whom electroconvulsive therapy (ECT) was clinically indicated, were randomly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparison of these groups in terms of number of treatments, duration of treatment, or incidence of treatment failure, showed that the bilateral placements were superior to the unilateral; comparison of Hamilton, Montgomery-Asberg, and visual analogue scale scores showed that the bifrontal placement was superior to both bitemporal and unilateral treatment. Bitemporal treatment showed therapeutic results intermediate between BF and RU. Because BF ECT causes fewer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electrode position in ECT.

Sex Differences in the Cognitive Effects of Unilateral Brain Damage

One hundred subjects (50 men, 50 women), of whom 80 had suffered a unilateral cerebrovascular accident (40 left, 40 right), were tested on the WAIS. In the case of left hemisphere damage the male patients showed lower Verbal than Performance Scale IQ scores; for the right brain damaged men Performance Scale scores were Lower than their scores on the Verbal Scale. Women with unilateral brain damage showed no such reliable discrepancies between their Verbal and Performance Scale scores. This difference in the patterning of WAIS IQs in male and female stroke patients persisted even after the scores of those few patients with any significant degree of expressive aphasia had been excluded from consideration.

Electrode placement in ECT : cognitive effects

Forty patients suffering from a major depressive disorder, for whom electroconvulsive therapy (ECT) was clinically indicated, were assigned to one of three electrode placement groups: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparisons of these groups in terms of cognitive status showed that the BF placement, which avoided both temporal regions, spared both verbal and nonverbal functions. These differential effects, which were independent of the degree of clinical depression, were not, however, evident three months after the last ECT.

Validation of a Learning Disability Index (LDI) Derived from a Principal Components Analysis of the WISC-R

A learning disability index based on a principal components analysis of the WISC-R normative data has been developed to depict verbal or non-verbal deficits on that test. This index was calculated for the individual test performance of a total of 1550 children referred to a school board psychology service because of education difficulties. These children, subdivided by sex, and categorized as learning disabled or mentally retarded, returned mean scores on this index that were reliably different from the expected scores of the normative population; this difference revealed a verbal deficit in the test performance of the referred children. Reliable sex differences on this index appear in both the normal and abnormal groups.

Handedness, sex and intelligence

On the basis of data from a large and representative population (N = 1880), we have now had the opportunity to examine the relationships that have been claimed to exist between handedness, sex, and the patterning of intellectual abilities, as these are reflected in performance on the Wechsler Adult Intelligence Scale--Revised (Wechsler, 1981). Such relationships had previously been studied using rather small samples of men and women. Our analyses show a reliable, if negligible, effect of sex on these test results, but no effect of handedness.

The Psychometric Assessment of Children with Learning Disabilities An Index Derived from a Principal Components Analysis of the WISC-R

A learning disability index (LD1) for the assessment of intellectual deficits on the WISC-R is described. The Factor II score coefficients derived from an unrotated principal components analysis of the WISC-R normative data, in combination with the individuals scaled scores, are used for this purpose. The population parameters of this index then allow for the assessment of the abnormality of the LDI in the individual case, as well as for the evaluation of the statistical significance of any change in the LDI from test to re-test.

Lithium treatment: a comparison of once-and twice-daily dosing

The effects of once‐ and twice‐daily dosing with lithium carbonate were compared in a non‐blind, cross‐over study on 20 consecutive patients with mood disorders. Mental status, side effects and target organ function were examined after a minimum of a 1‐month treatment with each regimen. Eighteen patients completed the study and 2 withdrew because of side effects. There were no significant differences between the 2 groups on the Hamilton Rating Scale for Depression, the Bech‐Rafaelsen Mania Scale, the UKU Side Effects Scale or in serum lithium, electrocardiogram and urine volumes. Most blood tests showed no significant difference between the 2 treatment schedules except for white blood cells, ionized calcium and phosphate concentration. The once‐daily regimen was associated with a higher white cell count, increased serum phosphate and elevated serum ionized calcium. We conclude that patients are able to tolerate once‐daily dosing with lithium carbonate as well as twice‐daily dosing.

Reanalysis of a Meta-Analysis of the Validity of the Wechsler Scales in the Diagnosis of Learning Disability

A meta-analysis of Wechsler scale data on 9,372 LD children failed to distinguish these children from their normal peers on any of the ability patterns that have conventionally been held to characterize LD childrens test performance. However, a reanalysis of their data using a learning disability index (LDI), derived from a principal-components analysis of the WISC-R, was found to discriminate reliably between the two groups of children.

Are the renal effects of lithium modified by frequency of administration

It has been claimed that the unwanted effects and toxicity of lithium can be minimized by changes in the dosing schedules. Twenty consecutive psychiatrically stable patients were investigated in a cross‐over study to determine whether renal function and other biochemical tests change significantly with changes from once to twice or multiple doses per day or vice versa. There were no significant differences between the 3 study conditions on the mood rating scales or a side effect scale (UKU). Urine volume, test of renal function and other biochemical and hematological indices were similar in all study conditions. We thus conclude that dosing strategy does not consistently affect renal function in lithium ‐ treated patients.

Factorially defined verbal and performance IQs derived from the WISC-R: Patterns of cognitive ability in normal and learning disabled children

Abstract The axes of the first two dimensions of a principal components analysis of the normative data of the WISC-R were rotated through 45°. This resulted in two orthogonal continua which were interpreted as describing verbal and nonverbal intelligence respectively. Factor score coefficients were used to calculate Verbal Factorial IQs (VFIQs) and Performance Factorial IQs (PFIQs). In normal children, girls (N=1100) prove to be reliably superior to boys (N=1099) in VFIQ, whereas the reverse is the case for PFIQ. In a large group (N=1050) of learning disabled (LD) children, VFIQ is reliably lower than in normal children, and there is also a reliable decline with age over the years 6–16. The LD boys (N=744) are no different from the LD girls (N=306) in VFIQ. In these LD groups the PFIQ is reliably lower than in the normal group at age 6, but rises to a normal level by age 8. The LD boys, overall, return higher PFIQ scores than the LD girls. These results can be used to evaluate the rival hypotheses of ‘deficit’ vs ‘developmental lag’ as a cause of learning disability.