The Sedation Threshold

Abstract

The concept of the sedation threshold, recently introduced into the medical literature, has received considerable attention as a tool of value in psychiatric and psychosomatic research. It acquired its significance from the findings that it correlated with two important and fundamental determinants in the psychological and psychoanalytic theory: the degree of anxiety and the degree of impairment of ego functions. It also acquired another value as a relatively constant level for the individual and a relatively enduring biological characteristic of him, as indicated by a high testretest reliability in studies of the sedation thresholds for amobarbital (Amytal) sodium.10 A study has been undertaken to investigate the relationship between various manifestations that have been designated "anxiety" and the amount of central nervous system depressants\p=m-\namely, amobarbital sodium and ethyl alcohol\p=m-\required to produce the levels of the sedation thresholds. The assumption was that the psychological state of the organism determines, to a large extent, his reaction to the drug.The study also investigates the consistency in the effects of the two drugs, which were reported, separately, to produce some rela¬ tively comparable psychological changes. A study of the general effects of the drugs, qualitatively and quantitatively, on patterns of performance has also been attempted at the levels of the sedation thresholds.7 Method of StudyA group of 24 patients presenting varying degrees of "anxiety" were obtained from the psychiatric division of the Kings County Hospital Center.The subjects were selected on the following basis: The present admission was the first to a psychiatric hospital, and they were white males with an age range of 16 to 36 years. These subjects had never received any type of shock therapy and did not show any evidence of encephalopathy on physical, mental, and laboratory examinations. Clinically they presented a picture of predominantly psychoneurotic or character disorder. The group of subjects used was thus a selected one. This selectiv¬ ity was felt desirable to secure-more or lesshomogeneous sociopsychological patterns and to avoid as much as possible the interference of environmental, racial, and sex differences, which are known to be potential handicaps in studies of this nature. Such a group was also thought to reflect any existing differences or trends to a degree that would permit achievement of statistical sig¬ nificance. On each subject included in the study the following data were obtained :1. Basic identifying information, including age, sex, race, degree of education, weight, and height.2. An evaluation of the degree of his anxiety using three measures: clinical judgment,1 the Figure-Drawing test,8 and Taylor's Anxiety Scale." 3. The sedation thresholds for amobarbital sodium and ethyl alcohol.4. The performance on four psychological and psychomotor tests under the effects of amobarbital sodium, ethyl alcohol, and a no-drug condition. These tests are the sentence completion, the twohand ...

VIII: Clinical‐Electroencephalographic investigation

“…The most sceptical about the usefulness of the method have been A c k n e r and Pampiglione who on the one hand regarded the method as ))very tedious)), and on the other, questioned the correlation with anxiety since they had not been able to find any correlation between the ST and other measurements of the peripheral vasolability which in Ackner's (1 956) investigations proved to discriminate between patients with low and high anxiety. On the other hand, other workers seem to have been able to confirm most of Shagass's observations, jarticylarly the occurence of a high ST in patients with marked anxiety and a low ST in patients with psychotic depressions (Boudreau: 1958), Pinelli (1957), Kawi (1958), Seager (1959), N y mguard (1959), Perris et al (1959), Perris & Brattemo (1963). The reliability has been confirmed by Nymgaard.…”