BEAPPRAISAL OF THE DIAGNOSIS OF MENTAL DEFICIENCY IN MENTAL HOSPITALS 361

as an additional category, they would not be a substantial influence on the per-

centages shown.
The sample in this study represents most of the patients at Medfield who are
diagnosed or considered to be mentally deficient. The total number of approximately
120 patients represents about 10% of our total patient population and 20% of our
continued treatment population (this excludes admissions and geriatric populations).
CONCLUSIONS
The significance of these findings lies in the high percentage (58%) of chronic
patients who were diagnosed or considered to be mentally deficient yet were able to
display intellectual functioning of at least a borderline level. The limited testing in
this brief screening project suggests that there is more undiscovered potential. More
intensive testing may be advisable in order to assess the patients' ability more com-
pletely. The limited testing in the abbreviated test form appears to be compensated
for by the advantage of testing more patients than could otherwise be done by a
small staff in a limited time period.
More challenging work placements and an increase in work and social per-
formance expectations have already shown positive results among these chronic
"mental defectives". These results suggest that unfavorable diagnoses, low levels of
expectation, and a custodial type of treatment are involved in the continuing chron-
icity of many of our mental patients. Further study of the potentialities of the
chronic mental patient is indicated.
REFERENCES
1. WECHSLER, DAVID. The Measurement of Adult Intelligence. Baltimore: Williams and Wilkins,
1944, p. 227.

PATTERN OF INITIAL CONTACTS WITH A UNIVERSITY

PSYCHOLOGICAL CLINIC AND ITS RELATION TO
ACADEMIC STRESSORS^
ROBERT WILLIAM BAKER
Clark University

As part of an investigation of psychological disturbances in the college popula-

tion, records of a university psychological clinic'^ for six academic years were an-
alyzed to determine the pattern of incidence of appeals for services by, or on behalf
of, undergraduate students through the academic year. The two semesters of the
academic year were divided into sixteen weeks each, and the incidences for com-
parable weeks across the several years were combined, yielding the composite pat-
tern presented in Figure 1.
Visual inspection of Figure 1, borne out by statistical test', indicates that ap-
peals are more numerous in the first semester than the second, especially in the first
half of the first semester. To the extent that the high incidence at the beginning of
the year is comprised disproportionately of freshman students, and there is evidence
that this is the case, it may reflect the difficulties of initial adjustment to the college
'This investigation was supported by a PHS grant (M-5247 A) from the National Institute of
Mental Health, of the National Institute of Health, Public Health Service. A more detailed version
of this report may be obtained from the author.
^his clinic works with personal-social problems of college students; it does not pro%nde educar
tional or vocational counseling.
'Analysis of variance was employed to test for significance of difference between various weeks
and groups of weeks. All statistical comparisons mentioned are significant at the .05 level of con-
fidence or better.
362 ROBERT WILLIAM BAKER

FIG. 1. AVERAGE NUMBER OF STUDENTS MAKING INITIAL CONTACT WITH CUNIC DURING
EACH WEEK OF THE FIRST AND SECOND SEMESTERS OVER SIX ACADEMIC YEARS.

FIRST SEMESTER O EXAMINATION WEEKS

o
o

SECOND SEMESTER

o
UJ
CQ

UJ
O
<

UJ

I I I I \ \ I I I I__J I
I 2 3 4 5 6 7 8 9 10 II 12 13 14 15 16
SEMESTER WEEKS
situation. Coelho, Silber and Hamburg, in their study of adjustment in thefirstyear
of college, describe that year as a "transition period in late adolescent development
(providing) new and stressful situations that challenge the adaptive and problem-
solving potential of entering freshmen" <^' P '"^ This challenge could be expected to
be greatest in the beginning of the academic year, and may in part account for the
large incidence of appeals for psychological services at that time.
Inspection of Figure 1 also suggests an overall correspondence of pattern for the
two semesters. In the analysis of variance the weeks-by-semester interaction is not
statistically significant, indicating that the weeks when initial contacts are high or
low generally correspond for the two semesters. The similarity of pattern implies the
operation of common precipitating factors, and it was reasoned that one such factor
could be the regularly occurring examination periods.
The weeks when major examinations occur are encircled in Figure 1. The fif-
teenth and sixteenth weeks in each semester include the final examination period;
the time of mid-semester examinations is estimated as the two week period prior to
the date by which mid-term grades must be submitted by instructors to the registrar
of the university.
Clearly the effect of examinations is not to increase appeals for services during
the periods that they occur; in fact, the average incidence for the eight examination
weeks is significantly lower than the average for the other twenty-four weeks of the
academic year. However, there are periods of significantly higher incidence im-
mediately following mid-term examinations in both semesters, suggesting that some
students may show delayed response to the stress associated with examinations.
Other periods of significantly higher incidence in comparison with surrounding
weeks are found in the second half of the first semester in the twelfth week (the cor-
 PATTERN OF INITIAL CONTACTS AND ITS RELATION TO ACADEMIC STRE8S0RS 363

responding increase in the twelfth week of the second semester is not statistically
significant) and in the second week of the second semester, in each case three to four
weeks before major examination periods are to occur. One may speculate whether
the students comprising these "bulges", as well as some of the students in the period
of high incidence in the first half of the first semester, may be responding anticipator-
ily to examination-stressors.
These interpretations suggest that the effect of examination-stressors is in part
a function of personality differences among students. Qualitative analysis of diag-
nostic and therapeutic interview data is indicated to determine if there are behavioral
and personality characteristics common to students appealing for services at differ-
ent times in relation to examination periods.
REFERENCES
1. CoELHO, G. V., SiLBER, E. and HAMBURG, D . A. Use of the Student - TAT to assess coping
behavior in hospitalized, normal, and exceptionally competent college freshmen. Percept. Mot.
SkiUs, 1962, 14, 355-365.

A SUMMER EXTERNSHIP IN PSYCHOLOGY FOR MEDICAL STUDENTS

R. V. HECKEL AND M. J. BRENNAN
VA Hospital, Augusta, Georgia

One indication of a maturing profession is seen having an opportunity to observe and participate
in the willingness to open its doors and reveal to in an on-gomg psychology program where both
persons of other disciplines the inner workings, service and research are combined in the thinking
techniques, goals and values which are unique of staff members and where "interdisciplinary"
to it. Such behavior represents a breakdown of when applied to these functions is something
the d^us ex machine^ approach, the stealthy de- more than an acquiescence by those higher in the
positing of information, gospel-like before others status hierarchy.
as the product of some mystical form of insight The staff had two goals in establishing this
permitted only to members of the in-group. This project: (1) To provide a functional picture of
IS not to imply that such concealment is uniquely the interests, capabilities, and functions of the
a phenomenon found in psychology. It shares psychologist for a inedical student, particiJarly
with other professional groups a reluctance to those whose specialties may limit their contacts
expose many of its techniques and efTorts to the with psychologists during their training; and (2)
scrutiny of the public or other professions. Like to enhance communication with the "other" pro-
niany phvsicians and psychoanalysts, psycholo- fession, hoping to break down in at least several
gists appfy the concept of the "gestalt", reason- instances over a period of time the impression
ing that unless an individual has had the proper noted frequently (and often quite realistically)
indoctrination in the form of courses, time in by medical persons that psychologists are "clan-
residence, diplomas, and other symbols of at- nish", impractical and too intellectual.
tainment, he would be unable to understand the The opportunity for instituting such a program
functional unit of the profession and thus derive came about as a result of a smaU budgetary sur-
no benefit from viewing smaller portions of the plus which could be allocated for use as salary for
"big picture" each group attempts to foster. position of student assistant on the Psychology
The necessity for maintaining such a view is, Service. Fortuitously, at the same time, a medi-
of course, open to question. Psychologists may cal student interested in summer employment
actually be able to offer to other professions, made application to the hospital. The student,
particularly medicine, something beyond the while having no previous training nor acquaint-
almost purely ancillary relationship which hsLS ance with psychology other than a required
been its role in the past and is still preserved in under^aduate course in general psychology, had
many medical schools and some clinical settings. no objection to becoming temporarily identified
Believing quite strongly in the work of psy- with the Psychology Service for a penod of three
chology and its potential value to other pro- months.
fessions, a program for a summer extemship in To say that at that time an extensive syllabus
psychology was established for a medical student had been worked out, planning each moment and
on the peycholog]^ service of the Veterans Ad- each activity for a medical student's participa-
ministration Hospital, Augusta, Georgia. It was tion in the activities of the Psychology Service,
felt that a medical student might benefit from would be less than accurate. There was some