Grace Helen Kent

“ To leave the matter of preference in grouping: to be decided in each case according to the best judgment of the experimenter would mean introducing again the play of personal equation, and would thus court failure of all our efforts to accomplish a standardization of the association test. Therefore, the necessity of establishing a proper order of preference for guidance in the application of the classification became to us quite apparent. ”

“ Although the occurrence of incoherent reactions is hardly subject to doubt, yet in no instance is it possible to establish with certainty that a given reaction is of this type, for in no instance can a remote, or an imagined, or a merely symbolic relationship between stimulus and reaction be positively excluded. Some, indeed, would assert that some such relationship must necessarily exist in every instance, at least in the domain of the subconscious. This circumstance necessitates the placing of this type of reactions in the unclassified group. ”

“ In this group are placed words which are so widely applicable as to serve as more or less appropriate reactions to almost any of our stimulus words. That such reactions are in value inferior to the remaining group of common reactions, which we have termed, in contradistinction, specific reactions, is perhaps sufficiently obvious; we shall speak later, however, of their occurrence in both normal and insane cases.
It is not always easy to judge whether or not a given reaction should be classed as non-specific. ”

“ CO-OPERATION OF THE SUBJECT. In our work with insane subjects we encountered many cases in which we were unable to obtain satisfactory test records owing to lack of proper co-operation. Some subjects seemed to be either too confused or too demented to be capable of understanding and following the instructions given them. Others were for one reason or another unwilling to co-operate. It is important to distinguish inability from unwillingness to co-operate, since the former indicates in itself an abnormal state of the mind, while the latter is quite often shown by normal persons. ”

“ In general the associational capacity of an adult person may be taken to be from 80 per cent to 90 per cent. Should the number sink below 70 per cent the suspicion of a pathological condition must then arise; and the higher the subject's degree of education the stronger is this suspicion. In the case of an associational capacity of 60 per cent or less no doubt of its pathological significance can remain any longer. ”

“ EXPLANATION OF GROUPS AND METHODS OF APPLICATION. *Normal Reactions.*—Inasmuch as the frequency tables do not exhaust all normal possibilities of reaction, a certain number of reactions which are essentially normal are to be found among the individual reactions. In order to separate these from the pathological reactions, we have compiled an appendix to the frequency tables, consisting mainly of specific definitions of groups of words to be included under each stimulus word in our list. ”

“ Logical distinctions do not bring out clearly the differences between the reactions of normal subjects and those of insane subjects; logically, the reaction bath—ink, which was given by a patient, might be placed in the class with the reaction bath—water, although there is an obvious difference between the two reactions. (3) Many of the reactions given by insane subjects possess no obvious logical value whatever; but since any combination of ideas may represent a relationship, either real or imagined, it would be arbitrary to characterize such a reaction as incoherent. ”

“ In the arrangement of the order of preference we were guided mainly by two principles, namely: (i) as between two groups of unequal definition, the one which is more clearly defined and which, therefore, leaves less play for personal equation is to be preferred; (2) as between two groups of equal definition, the one which possesses the greater pathological significance is to be preferred. In accordance with these principles we have adopted the order of preference shown in Table III., placing every reaction under the highest heading on the list under which it may be properly classed. ”

“ ALCOHOLIC DEMENTIA; SENILE DEMENTIA. There are so few cases of these psychoses in our series that we can say but little concerning their associational disorders.
In Table V. we show all the types of reactions given by each subject.
We have not observed in our cases of involutional melancholia any undue tendency to give individual reactions. The records are either perfectly normal or slightly abnormal in that they show an increase of the non-specific (common) reactions. In this respect they resemble strongly the records obtained from some cases of manic-depressive insanity. ”

“ The total number of different sounds used in language articulation is, of course, small, so that any two words are liable to present considerable chance similarity. Some time ago we estimated the average degree of sound similarity between stimulus words and reaction words in a series of one hundred test records obtained from normal persons; we found that on the average 14.53 per cent of the sounds of the stimulus words were reproduced, in the same order, in the reaction word. ”

“ 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. ”

“ It would seem that the importance and magnitude of the problem of association time are such as to demand not merely a crude measurement of the gross reaction time in a large number of cases, but rather a special investigation by such exact methods as have been used by Cattell [1] and others in the analysis of the complex reaction. It would be impracticable for us to employ such methods in a study so extensive as this. ”

“ EPILEPSY. Most of the cases of epilepsy in our collection show advanced dementia and in some the clinical history would indicate also original mental inferiority, that is to say, imbecility or feeble-mindedness.
In these cases the dominant characteristic, so far as shown in the test records, seems to be a narrowing of the mental horizon manifested firstly by a tendency to repeat many times one or another word, and secondly by an abnormally pronounced tendency to make use of non-specific reactions or particles of speech. ”

“ THE NORMAL STANDARD. In order to establish a standard which should fairly represent at least all the common types of association and which should show the extent of such variation as might be due to differences in sex, temperament, education, and environment, we have applied the test to over one thousand normal subjects. ”

“ By the application of the association test, according to the method here proposed, no sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states.
In dementia præcox, some paranoic conditions, manic-depressive insanity, general paresis, and epileptic dementia the test reveals some characteristic, though not pathognomonic, associational tendencies. ”

“ There is, in fact, no type of pathological reactions which a normal person may not be able to produce more or less readily at will, though in the case of incoherent reactions considerable mental effort may be required, and the end may be attained only by regularly rejecting the first and some subsequent words which are suggested by the stimulus. ”

“ Our failure to utilize this system of classification is assigned to the following considerations: (1) Distinctions between associations according to logical relations are extremely difficult to define; in many cases there is room for difference of opinion as to the proper place for an association, and thus the application of a logical scheme depends largely upon the personal equation of the observer; that even experienced observers cannot, in all cases, agree in placing an association is shown by Aschaffenburg's criticisms of the opinions of other observers on this point. ”

“ It must be noted that not infrequently cases of dementia præcox give test records that cannot be distinguished from normal. It seems that the pathological associational tendencies constitute merely a special group of symptoms, some of which may be expected to be manifest in cases which have reached a state of advanced mental deterioration, but may not necessarily be present in the early stages of the disease. ”

“ As examples of such reactions may be mentioned: eating—eatables, short—shortness, sweet—sweetened, quiet—quietness.
*Partial Dissociation.*—We have employed the term dissociation to indicate a rupture of that bond—whatever be its nature-which may be supposed to exist normally between stimulus and reaction and which causes normal persons to respond in the majority of instances by common reactions. ”

“ An attempt to place them in a separate group could be made only with the aid of explanations from the subjects; such aid in the case of insane subjects is generally unreliable. Moreover, to class these reactions as strictly normal would perhaps be going too far, since their general value is obviously inferior to that of the common reactions; and in any case in which they are given in unusually large numbers they must be regarded as manifestation of a tendency to depart from the normal to the extent to which they displace common reactions. ”

“ In such cases as this personal equation must necessarily come into play; comparative uniformity of judgment may, however, be attained by systematically excluding any reaction the relationship of which to the preceding reaction is subject to any considerable doubt and by placing any such reaction in the unclassified group.
*Repetition of Previous Stimulus.*—Here we place any reaction which is a repetition of any previous stimulus from amongst the ten next preceding, at the same time placing *repetition of preceding stimulus* under a separate heading. ”

“ In this investigation no account is taken of the reaction time. The reasons for this will be explained later.
The general plan has been first to apply the test to normal persons, so as to derive empirically a normal standard and to determine, if possible, the nature and limits of normal variation; and then to apply it to cases of various forms of insanity and to compare the results with the normal standard, with a view to determining the nature of pathological variation. ”

“ The normal groups have been studied for the purpose of determining the frequency and manner of occurrence among normal subjects of the various of abnormal reactions. It seemed best for this purpose to consider separately the records of those subjects who gave an unusually large number of individual reactions. Fifty-three records containing fifteen or more individual reactions were found after a fairly diligent search among our normal test records. ”

“ Many patients have given more than 50 per cent of 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 ”