DIFFERENTIATING CLINICAL GROUPS BY MEANS OF THE MINNESOTA PERCEPTO-DIAGNOSTIC TEST

JANE GEORQE

West Central Mental Health Center, Willmar, Minn.

PROBLEM Rotation of designs on the Bender-Gestalt among clinical groups often has been

I), but it was left to Fuller and Laird(', 2. 3 ) , Uyeno") and Kreitman(6) to differentiate among diagnostic groups on the basis of rotation alone. Fuller and Laird") based the Minnesota Percepto-Diagnostic Test (MPD) for diagnostic purposes on two main factors: (a) the perceiver, and (b) the perceived, which can influence distortion in perception. They believed that the greater the personality disturbance, the greater the perceptual disturbance and vice versa. Thus, Fuller and Laird") used the MPD to measure the perceptual stability related to the intactness of a person's personality organization. Fuller and Laird hold that perceptual dis- turbance, as measured by rotation, lies on a continuum that ranges from normal perception to the gross perceptual distortions among those with cerebral damage; the former rotates only a few degrees and the latter many.

This study investigated whether normal, anxiety reaction, depressive reaction, conversion reaction, reactive-process schizophrenia, Parkinsonism, epilepsy and expanding lesions of the brain could be differentiated by MPD rotation scores. Hypothetically, the degree of perceptual distortions should be least for the normal, intermediate for the neurotic groups, more for Parkinsonism and epilepsy, much more for schizophrenic groups, and most for the group with expanding lesions of the brain.

METHOD Subjects. A total of 270 adult patients who ranged in age from 22 to 45 (except

Parkinsonians, for whom the upper limit was 55 years) were tested with the MPD. The patients were selected over a period of 5 years from the All-India Institute of Mental Health, Bangalore. The control group consisted of 30 normals with no evidence of psychiatric or neurological disorder. The eight clinical groups consisted of 30 Ss each, selected on the basis of a hospital diagnosis that fitted one of the eight categories. Means for age and education, as well as other details, are presented in Table 1.

TABLE 1. MEAN AND SD OF AQE, EDUCATION AND DEGREES OF ROTATION

Age Education Rotation Mean SD Mean Mean SD SE

~

Normal Anxiety Depression

Conversion

Reactive Schizo. Process Schizo. Parkinsonism

Epilepsy Expanding Leaiona

25.8 3.8

26.2 2 .1

29.3 2.2

25.9 2.3

24.2 1.8

25.3 3.6

50.2 6 .2

28.6 3.5

36.8 5.2

14.2 23.6

13.8 37.7

12.3 34.7

14.4 25.8

11.7 37.0

12.4 69.9

10.5 46.3

13.3 46.7

10.2 78.5

14.6

18.4

21.1

19.7

14.9

22.5

23.6

20.0

32.4

2.2

3.3

3 .4

3 .2

2.9

4.3

4.4

3.7

6 .0

DIFFERENTIATING CLINICAL GROUPS 211

Procedure. The MPD was administered and scored for degrees of rotation as specified by Fuller and Laird (*) . Analysis of variance and Tukey tests were used to estimate the levels of statistical significance.

RESULTS AND DISCUSSION The means, standard deviations and standard errors of rotation scores of the

normals and the eight clinical groups are given in Table 1. Analysis of variance of the rotation scores yielded an F value of 2.91, which

for 8 and 261 degrees of freedom is significant beyond the .01 level. Since the F ratio was significant, the data were analyzed further by Tukey tests to find the differ- ences between means of psired comparisons. The means, the differences between means of each pair of groups, and the comparison of these values with Tukey’s values are given in Table 2. The Tukey value for statistical significance is 14.23. The significant differences between two group means also are represented in the same table.

TABLE 2. DIFFERENCES BETWEEN PAIRS OF MEANS -

Exp. Group Nor. Am. Depr. C o w . Rea. Proc. Park. Epi. Les.

Mean 23.6 37.7 34.7 25.8 37.0 69.9 46.3 46.7 78.5

1 23.6 .14.1 11.1 2.3 13.5 46.3** 22.7** 23.0** 54.9**

2 37.7 3 .0 11.9 0 .7 32.2** 8.6 9.0 40.8**

3 34.5 8 . 8 2.4 35.2** 11.6 12.1 43.8**

4 25.8 11.2 44.1** 20.4** 20.9** 42.6**

5 37.0 32.9** 9.2 9.7 41.4*?

6 69.9

7 46.3

8 46.7

9 78.5

23.6** 23.2** 8.6

0.5 32.2**

31 .?*

* p < .01; **p < .05.

Perceptual disturbance seems to lie along a continuum. When the mean rota- tion scores obtained by clinical groups are arranged along a continuum, they fall in the following order: normal, conversion reaction, depressive redtion, reactive schizophrenia and anxiety reaction, epilepsy, Parkinsonism, process schizophrenia and expanding lesions of the brain. However, out of the 36 pairs of comparisons of groups means, only 18 pairs were statistically significant. The values of differences between means of normals vs. anxiety reactions and normals vs. reactive schizo- phrenia almost reach the Tukey value. If the sample sizes were increased, the means would reach significant values. In any case, the mean values of the neurotic groups fall between the means of the normals and the process schizophrenics.

SUMMARY This study investigated whether normals, anxiety reactions, depressive re-

actions, conversion reactions, process schizophrenics, Parkinsonians, epileptics, and expanding lesions of the brain could be differentiated on the basis of a progressive index of rotation on the Minnesota Percepto-Diagnostic Test. There were 30 Ss in each group. Eighteen pairs of comparisons of means out of 36 were statistically significant. The results showed that there is a direct relationship between personality

212 JANE GEORGE

organization and stability of perception and that the greater the personality dis- turbance or body image disturbance, the greater the perceptual disturbance and vice versa.

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2 . FULLER, G. B. Perceptual conslderations in children wlth a reading disability. Psychol. in

3 . FULLER, G. B. ' The objective measurement of perception in determining personality disorgan-

4. GRIFFITH. It. M. and TAYLOR. V. M. Incidence of Bender-Gestalt Figure rotations. J . consult.

Monograph Supplement, 1963, No. 16. Revised as illomgraph No. 28, 1969.

Schools, 1964, 1, 314-317.

ization among children. J . clin. Psychol., 1965, 21, 305-307.

Psychol., 1960, 24, 189-190.

Grune & Stratton, 1960.

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5 .

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HUTT, M. L. and BRISKIN, G. T. The Clinical Use of the Revised Bender-Gestalt Test. New York:

KREITMAN. L. A note on the use of the Minnesota Percepto-Diagnostic Test. J . d in . Psychol., 1966, 22, 196:

7. UYENO, E. Test. J . consult. Psychol., 1963, 27, 462.

8.

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Differentiating psychotics from organics on the Minnesota Percepto-Diagnostic

WITKIN, H. A., et al. Psychological Diferatiation. New York: Wiley, 1962.

THE HOOPER VISUAL ORGANIZATION TEST AND THE TRAIL MAKING TESTS AS DISCRIMINANTS OF BRAIN INJURY*

DAVID M. STERNE

V A Hospital, Vancouoer, Washington

PROBLEM The Hooper Visual Organization Test (VOT) and the Trail Making Tests

have been employed to assess the presence of brain damage because in addition to the diagnostic information that they may provide they are brief, convenient, and simple to administer and score. With these features in mind, they were added to an existing test battery evaluated earlier('), and their contributions as discriminants of brain injury were examined.

METHOD Seventy-five male patients in a VA general hospital were administered the

WAIS, the Benton Visual Retention Test, the Porteus Mazes, and the VOT and Trail Making Tests. Of the Ss, 25 were classified as organic brain injury, 25 as normal, and 25 as of indeterminate status. Four criteria of organicity were em- ployed: Positive neurological signs, a positive EEG, an organic picture in psycho- logical testing, and current, objective evidence of organic brain damage such as the residuals of a cerebrovascular accident. For our purposes, a S was classified as organic when two or more of the criteria were fulfilled, while those patients to whom only a single criterion applied were labelled as indeterminate. The patients ranged in age from 20 to 72 (M = 43.3, SD 13.0) and in I& from 62 to 134 (M = 101.7, SD 14.7). A regression analysis with groups as the criterion and the other variables as predictors was performed, with analyses of variance between groups and inter- correlations for all variables also calculated.

*Thanks are due Jane A. Hartley, Statistician, and the Western Research Support Center a t V.4H Sepulveda, California for their assistance with the design and statistical treatment of the data.