Another series of attempts at the solution of this problem has been made through observations upon deteriorating minds. The question is, Do mental functions deteriorate together or separately in dements? When a person is “losing his mind,” is the impairment general or selective in its progress?
The study of demented persons had been carried on by a few investigators in the hope that the decay of capacities might throw light upon their relationships. The chief obstacle to study from this approach has been that the investigators have never been able to know the original mentality of their subjects. They have always been obliged to make assumptions. It is difficult to see how this factor may be controlled, short of filing careful mental analyses of great sections of the population in youth. The chief conditions in which decay of ability is most probably present, as distinguished from decay of effort and attitude, are senile dementia, dementia paralytica, and alcoholic psychosis; and it cannot be known beforehand which persons are destined to represent these conditions. It cannot be predicted who will live long enough to become senile, who will contract syphilis, eventuating in general paresis, or who will be a chronic alcoholic. It is true that original mental status may be inferred with a moderate amount of accuracy from school status attained. If the dements studied had all been high school graduates, for instance, then we could be certain that the performances shown in the recorded studies really represent deterioration.
Unfortunately, the subjects of study have been, with rare exceptions, persons of elementary education and humble social status. They come from those sections of the education-occupation distributions, where very limited capacity is found. Therefore, we are rather uncertain as to how much deterioration from original status has really taken place. So far as actual figures go, it is not shown that there has been decay of intellect.
However, assuming that these segregated persons had actually deteriorated in their ability to perform tasks, let us inquire what the researches show. Binet and Simon worked with forty adults, classified as senile dements or as victims of dementia paralytica. They conclude that “Every dement has an intellectual level below normal,” as measured by tests of general intelligence. The limitations of dements are, nevertheless, qualitatively different from those of other incompetents (children and the feeble-minded); and the reactions of the senile differ from those with dementia paralytica. Of the victim of dementia paralytica they say, “He has not tumbled down the ladder of development, rung by rung. His is a difficulty of functioning.” “It is characteristic in these losses of functioning that the subject knows how to meet the problem submitted to him; he has the knowledge, but from time to time the power fails him.” This inertia of comprehension is general, and has the effect of lowering the total level of performance, though the particular items of failure and success may vary markedly from occasion to occasion. It is hardly the same thing as actual decay of a structure. Thus one cannot predict the responses of these dements, as one can those of other incompetents, like children and imbeciles, because their errors and failures have a remarkable degree of inconsistency. “In a general way, one can hardly foresee how such a one is going to conduct himself, for special failures and successes are at such variance with the general level.” “General paralytics are hardly able to perform the hundredth part of what they know.”
Senile dements are different, in that they actually no longer know. The structure itself has been demolished, not merely has it been paralyzed as to function. According to the observations of Binet and Simon the abilities of senile dements as a group are by no means equally impaired. They cannot remember events nor learn new things, yet they retain the power of auto-criticism, many complaining that they no longer “know anything.” They may be degraded to the level of early childhood in ability to repeat digits, yet retain use of the vocabulary of a superior adult.
These observations are extremely suggestive, but they lack statistical validity, being limited to narrative descriptions. It is true that one who has worked much among dements in a practical way, recognizes the pictures drawn by Binet, of persons decayed in some functions, yet “surprisingly preserved” in others. Proof of the extent to which this characteristically happens would necessarily be derived from tests of large numbers of cases, treated mathematically, and not by the method of narrative.
Hart and Spearman more recently presented a study of sixty-one insane persons,[[5]] asking the question, “Does an insane person present, as a rule, much greater inequality of performance than a sane one?” Recognizing the error from not knowing the original status of the presumably deteriorated minds, in all the various functions to be tested, the attempt was made to allow for this by testing in the same way thirty-three sane persons, selected presumably to represent what the insane were like before they became alienated. Nineteen mental functions were thus tested, and the results were then treated by the method of correlation, the assumption being that if there were greater inequality among mental functions in the insane (that is to say, among deteriorated minds) than among the sane, this would show itself in diminished coefficients of correlation.
It is interesting to consult the original tables of data, which, however, will not be presented here. The conclusion reached is that “The inequality between the powers of the same person for different kinds of performances does not appear to be appreciably greater in insanity than in health, nor in one of the forms of insanity tested than in another. Thus, in the main, the mental injury appears to be of a perfectly diffuse character, or to constitute a lowering of the whole intellectual level.... Over and above this general impairment, elaborate methods can also detect certain damages characteristic of particular maladies. These are very narrow and specific in kind, but probably may be correspondingly grave in intensity.”
Spearman thus again maintains his “two factor” theory of endowment—the “general factor” conditioning performance as a whole, and “specific factors” conditioning certain mental functions to a much greater extent than others. To determine what these special mental functions are, Spearman leaves to further research.
This careful investigation is nevertheless imperfect for the purpose, which is to learn whether there is selective enfeeblement of abilities. It is really impossible to know that deterioration has occurred, unless there have been measurements made beforehand. Sane persons, selected from the same social stratum, are not entirely reliable as a control, because those who are of the psychic constitution destined for insanity undoubtedly differ originally from those who remain sane, and this difference may involve a difference in mental abilities, either of amount or of relationship. The degree of deterioration calculated by Hart and Spearman may be merely a matter of original differences in central tendency between the two groups.