2 BEHAVIORAL SYNDORMES IN YOUNG ADULTS RELATED TO POSSIBLE MINIMAL BRAIN DYSFUNCTION

One hundred and five adolescent and young adult voluntary psychiatric patients were studied to elucidate the significance of soft behavioral organic signs. These patients could be divided by the presence of soft signs and clinical psychiatric history into four groups: (1) no soft signs; (2) borderline; (3) impulsive-destructive; and (4) socially awkward, withdrawn. These groups exhibited significant relationships to abnormal EEG, IQ, psychologists' judgment of organicity, diagnosis, and current behavior. A developmental chart abstract revealed significant relationships between childhood behavior deviancy and present psychiatric status for the soft sign groups. Socially awkward, withdrawn patients exhibited significantly more evidence of 'Life Pattern of Cognitive, Social Defect and Psychomotor Disorganization', 'Evidence of Congenital Abnormality, CNS Trauma and Infection', 'Organic Indicators on Mental Status' and 'Childhood Asociality'. 'Impulsive-destructive' patients exhibited significantly more 'Life Pattern of Hyperactive Impulsivity', and childhood hyperactive impulsive disorder. The childhood patterns were predictive of specific adolescent and adult psychiatric syndromes. This finding is inconsistent with additive augmentation, post-childhood reciprocal interaction and final common pathway models of constitution-environment interaction. It can be argued that the significant constitution-environment interactions occurred in infancy. Alternatively, we hypothesize that the two syndromes described reflect different brain dysfunctions and believe that for these patients the pathoplastic role of environment has been over-emphasized. However, it is questionable whether the lesions underlying 'soft signs' are a sufficient cause for psychiatric disorder and community survey and case finding techniques are indicated to investigate this area. Treatment implications are discussed. © 1969.