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Although ECT as the treatment of choice for psychotic depression has been in use for many years, little is known about the neocortical residual of such treatments inferred from behavioral measures. The major portion of the literature has been concerned with inferred or observed changes in affective state. The present study compared pre- and posttreatment performances on the Halstead-Reitan neuropsychological battery of 20 patients who were receiving ECT from two different machines. Most Ss gave indicators of cerebral impairment prior to treatment when performance of one side of the body was contrasted with performance of the other side. After treatment, there was an increased number of Ss who evidenced signs consistent with damage to the right cerebral hemisphere. Some concern was raised that a large number of patients who eventually are subject ot ECT because of depression behave in this way because of an undiagnosed neocortical dysfunction. There is some suggestion that the effect of the procedure is to either create or intensify a right hemisphere focus as inferred from behavioral measures.

Leli and Filskov (1979) reported cross‐validated classification accuracy that equalled 83% for a discriminant funcation derived on two measures of intellectual deterioation. This investigation made a preliminary assessment of the clinical utility of this function through a clinical‐acturial classification paradigm. Wechsler‐Bellevue Intellience Scale From I protocols from 12 nonpsychotic nonimpaired and 12 cerebrally impaired individuals were used by experienced clinicians and predoctoral interns to identify the presence of intellectual deterioration associated with brain damage through their own clinical experience (Clinical Judgment condition) and, then, in conjunction with the discriminant function (Clinical‐Actuarial condition). The classification accuracy from the discriminant function weights (Actuarial condition) and those from clinicians in the Clinical‐Actuarial condition were statistically comparable and significantly above chance levels. These results indicate that the clinician who is assessing for the presence of intellectual deterioration associated with brain damage should rely heavily upon a valid actuarial index.

Assessed the clinical utility of four cross‐validated discriminant functions derived on Wechsler‐Bellevue (W‐B) variables (Leli & Filskov, 1981) through a clinical‐actuarial prediction paradigm. These functions were constructed to be acturial indices of the presence, chronicity extent, and lateralization of brain impairment. From W‐B and demographic data gathered on brainimpaired and nonimpaired individuals, 6 students and 6 clinicians were asked to idetify the presence and describe the nature of brain impairment with (Clinical‐Actuarial condition) and without (Clinical Judgment condition) the four functions. Relative to the Clinical Judgment condition, clinical actuarial predictin was significantly better in indentifying and determining the extent of brain impairment. Actuarial classification was significantly more superior in lateralizing deficts than were the other conditions. In both judgment conditions, students and clinicians did not differ significantly in classification accuracy. These results indicate that with actuarial indices, the adult Wechsler scales can be used accurately to identify and lateralize brain impairment.