Study of Association in Insanity | Page 6

individual reactions.
It should be mentioned that occasionally a presumably normal subject
has given a record very similar to those obtained from patients, in
respect to both the number and the nature of the individual reactions. A
few subjects who gave peculiar reactions were known to possess
significant eccentricities, and for this reason we excluded their records
from the thousand records which furnished the basis for the frequency
tables; we excluded also a few peculiar records obtained from subjects
of whom nothing was known, on the ground that such records would
serve only to make the tables more cumbersome, without adding
anything to their practical value. The total number of records thus
excluded was seventeen.
It will be apparent to anyone who examines the frequency tables that
the reactions obtained from one thousand persons fall short of
exhausting the normal associational possibilities of these stimulus
words. The tables, however, have been found to be sufficiently
inclusive for the practical purpose which they were intended to serve.
Common reactions, whether given by a sane or an insane subject, may,
in the vast majority of instances, safely be regarded as normal. As to
individual reactions, they cannot all be regarded as abnormal, but they
include nearly all those reactions which are worthy of special analysis
in view of their possible pathological significance. What can be said
further of individual reactions, whether normal or abnormal, will

appear in the second part of this contribution.

PART II.
ASSOCIATION IN INSANE SUBJECTS.

§ 1. GENERAL SURVEY OF PATHOLOGICAL MATERIAL.
The pathological material which forms the basis of the present part of
our study consists mainly of two hundred and forty-seven test records
obtained for the most part from patients at the Kings Park State
Hospital.
The different groups from which the cases were selected, together with
the number from each group, are shown in Table I.
TABLE I.
Dementia præcox 108 cases. Paranoic conditions 33 " Epilepsy 24 "
General Paresis 32 " Manic-depressive insanity 32 " Involuntary
melancholia 8 " Alcoholic psychoses 6 " Senile dementia 4 "
A comparison of our pathological with our normal material en masse
reveals in the former evidence of a weakening of the normal tendency
to respond by common reactions. This is shown in Table II.
TABLE II.
Common Doubtful Individual reactions. reactions. reactions. 1,000
normal subject 91.7% 1.5% 6.8%
247 insane subjects 70.7% 2.5% 26.8%
It seems evident from this that pathological significance attaches
mainly to individual reactions, so that our study resolves itself largely
into (1) an analysis and classification of individual reactions and (2) an
attempt to determine what relationship, if any, exists between the
different types of reactions and the different clinical forms of mental
disease.

§ 2. CLASSIFICATION OF REACTIONS.
Those who have attempted to use the association test in the study of
insanity have felt the need of a practical classification of reactions, and

have at the same time encountered the difficulty of establishing definite
criteria for distinguishing the different groups from one another. It is a
comparatively simple matter to make these distinctions in a general
way and even to formulate a more or less comprehensive theoretical
classification, but there still remains much difficulty in practice. We
have made repeated attempts to utilize various systems of classification
which involve free play of personal equation in their application.
Although for us the matter is greatly simplified by the elimination of all
the common reactions with the aid of the frequency tables, we have
nevertheless met with no success. The distinctions made by either of us
have on no occasion fully satisfied, at the second reading, either the one
who made them or the other, while a comparison of the distinctions
made by each of us independently has shown a disagreement to the
extent of 20-35 per cent.
We sought, therefore, to formulate a classification in which the various
groups should be so defined as to obviate the interference of personal
equation in the work of applying it, hoping thus to achieve greater
accuracy. In this we can lay claim to only partial success; for, in the
first place, having satisfactorily defined a number of groups, we found
it necessary in the end to provide a special group for unclassified
reactions, into which falls more than one-third of the total number of
individual reactions; and, in the second place, in at least two of our
groups the play of personal equation has not been entirely eliminated,
so that there is still a possibility of error to the extent of five per cent of
individual reactions, which means approximately one per cent of the
total number of reactions. We have found, however, that in spite of
these shortcomings the classification here proposed is more serviceable
than others which, though more comprehensive, are at