Psychosomatic Medicine 7:158-168 (1945)
© 1945 American Psychosomatic Society

Psychophysiological Relations in Cases with Head Injuries

¹ Division of Psychiatry of the University of California Medical School

Respiratory functions under basal conditions and during work, muscular tension and heart rate during endurance to pain and fatigue have been correlated with tests of intelligence and personality in five groups of patients. These consisted of 16 cases with brain disease, 29 cases with recent head injuries, 29 cases of post-traumatic syndromes and signs of brain damage, 28 cases of post-traumatic syndromes without signs of brain damage, and 30 cases with psychoneuroses. In addition, 15 normal controls were subjected to some of these tests.

The post-traumatic syndromes without signs of brain damage resembled the psychoneuroses more than the post-traumatic cases with evidence of brain lesions. The cases with recent head injuries were in many respects the most normal of all the patients studied.

Basal ventilation volume and tidal air increased proportionately with rising neurotic scores in the Minnesota Multiphasic Personality Inventory. The higher the basal ventilation volume, the smaller was the subsequent increase during work. Irregularity of breathing was measured by a new scoring method, which revealed that individuals with neurotic tendencies breathe irregularly, especially during work.

Metabolism under basal conditions and during work was higher in cases with signs of brain damage than in cases without evidence of a lesion. The more intelligent subjects were apt to use less oxygen than patients with average or sub average intelligence.

During examination of endurance to strain (work of the hand during complete ischemia), all the cases with head injuries showed a smaller rise in heart rate than either cases with brain disease, psychoneuroses, or normal controls. Return of the heart rate to the initial level following exercise was delayed in the acute head injuries. Muscular tension was greatest in cases with brain disease and smallest in the normal controls. Endurance to strain was smallest in the psychoneuroses.

In conclusion, it can be said that there exists an antagonism between presence of brain damage and psychoneuroses. The more marked one component, the less obvious the other becomes. Cases with posttraumatic syndromes usually show presence of both components but with marked prevalence of the neurotic aspects.