Over the past five years several studies have suggested that flooding and its analogues reduce fear in animals and in man. The literature on analogues of flooding in animals was surveyed by Baum (1970), who himself demonstrated that prevention of a conditioned avoidance response in rats extinguishes the response (Baum, 1966). The longer the duration of response prevention, the quicker the extinction of the avoidance response (Baum, 1969a). The greater the shock trauma involved in the original learning of the response, the longer the response prevention had to be before the avoidance response was extinguished (Baum, 1969b, 1970). In phobic human volunteers controlled studies showed that flooding in imagination reduced avoidance responses to rats (Hogan and Kirchner, 1967, 1968; Kirchner and Hogan, 1966), and that the technique worked more quickly than desensitization (Barrett, 1969) in improving snake phobias. An analogue of flooding—exposure in real life with response prevention—was also shown to be more effective than desensitization for the reduction of snake phobias (Strahley, 1965). Two studies found, however, that desensitization was superior to flooding for the reduction of snake phobias (Mealiea, 1967) and mouse phobias (Willis and Edwards, 1969), while in a further two reports flooding was not significantly different in effectiveness from desensitization for the reduction of snake phobias (de Moor, 1970) or stage fright (Calef and Maclean, 1970).

The initial aim of this study was to determine the relationship between penile volume responses to female and male film sequences and sexual orientation in heterosexual and homosexual males. The second aim was to examine the relationship between aversive and appetitive conditioned responses in heterosexual males.

The Middlesex Hospital Questionnaire (M.H.Q.) is a brief self-rating inventory that is intended to cover the full clinical range of neurotic illness (Crown and Crisp, 1966). It usually takes about 7–10 minutes to complete, and a few minutes to score. Although many questionnaires attempt to measure general neurotic ill-health, the only other short test that purports to rate patients comprehensively in terms of clinical categories (e.g. anxiety state, neurotic depression, obsessional neurosis, hysteria) is Fould's Symptom-Sign Inventory, which requires verbal administration by the examiner and does not cover psychosomatic and phobic syndromes.

The Middlesex Hospital Questionnaire (M.H.Q.) is a self-rating scale designed to provide rapid quantification of common symptoms and traits relevant to the conventional clinical categories of psychoneurotic illness. The inventory comprises 48 brief questions for each of which two or three simple alternative answers are provided. By use of a standard key, the following six subtest scores are easily calculated: free-floating anxiety (FFA), phobic anxiety (PHO), somatic concomitants of anxiety (SOM), obsessional traits and symptoms (OBS), depression (DEP), and hysterical personality traits (HYS). In that the questionnaire provides an approximation to what would be expected at a clinical level from a diagnostic psychiatric interview, it has advantages over other questionnaires which incorporate essentially non-clinical constructs of personality functioning.

During the last twenty years countless attempts have been made to refine, replace or validate our intuitive clinical classifications of mental illness by the statistical analysis of symptom ratings. By and large these attempts have been unsuccessful. In spite of all the elegant and complex manipulations to which innumerable sets of data have been subjected, the classifications used by psychiatrists remain much as they were before the computer was invented. The reasons for this failure—for as such it must be seen at least by clinicians—are complex, but we would attribute it mainly to two factors: a failure to appreciate how unreliable and open to bias are the clinical ratings on which most analyses have been based, and too exclusive a reliance on factor analysis at the expense of other forms of multivariate analysis.

A Glossary of Mental Disorders was published in 1968, prepared by the Registrar-General's Advisory Committee on Medical Nomenclature and Statistics. The document used as a basis the Eighth Edition of the World Health Organization's International Classification of Diseases (I.C.D.), Section V, which deals with mental disorders and mental subnormality. For the first time in this country the meaning of the categories listed in the I.D.C. are described, and the new Glossary stands beside the Second Edition of the American Diagnostic and Statistical Manual (D.S.M. II) which was also published in 1968. The psychiatrists working on the United States-United Kingdom Diagnostic Project at the Institute of Psychiatry, Maudsley Hospital, London, and the Psychiatric Institute, New York, made diagnoses according to the new Glossary descriptions on 820 hospital in-patients drawn from both sides of the Atlantic and interviewed using a standardized interview. The comments contained in this article are based on their experience.

In a well-known, very influential and frequently quoted paper, ‘On the Characteristics of Total Institutions,’ Goffman (1961) calls attention to ideological disputes which are centred on total institutions. As he puts it: ‘It is widely appreciated that total institutions typically fall considerably short of their official aims. It is less well appreciated that each of these official goals or charters seems admirably suited to provide a key of meaning—a language of explanation that the staff, and sometimes the inmates, can bring to every crevice of action in the institution. Thus, a medical frame of reference is not merely a perspective through which a decision concerning dosage can be determined and made meaningful; it is a perspective ready to account for all manner of decisions, such as the hours when hospital meals are served or the manner in which hospital linen is folded…. Paradoxically, then, while total institutions seem the least intellectual of places, it is nevertheless here, at least recently, that concern about words and verbalized perspectives has come to play a central and often feverish role.’ (pp. 83–84.)

The Public Enquiry into William Frederick Windham's ‘alleged lunacy’ is well documented and the evidence of 140 witnesses provides a uniquely full history. The case is of interest as a diagnostic problem, a study in mid-nineteenth century psychiatric thinking and methodology, and in the then prevailing attitudes to mental illness. It was a significant event in psychiatric history, as the scale and expense of the trial brought the method of public enquiry into bad repute. Thus the case represented one of the steps away from legal management in psychiatric illness and towards medical management.

A previous double-blind controlled evaluation of lithium and chlorpromazine in both manic and schizo-affective individuals carried out in this unit (Johnson et al., 1968) indicated that 85 per cent of the schizo-affectives showed a worsening of thought disorder when treated with lithium carbonate, the majority developing symptoms of an acute brain syndrome. The possibility of experimental design accounting for such treatment outcome must be considered.

The aetiology of those movement disorders characterized by localized, involuntary intermittent, and repetitive muscular spasm remains obscure. They include spasmodic torticollis, writer's and other occupational cramps, and facial spasms. The obscurity is reflected in psychiatric and neurological classification. Some, or all, are frequently regarded as conversion symptoms, although they differ profoundly from those typical of that group, particularly in terms of prognosis. Secondly, some, or all, have been regarded as variants of dystonia musculorum deformans. Otherwise, they occupy an indeterminate or ‘miscellaneous' place in classification. If it could be shown that a substantial number of clinical characteristics are shared by those who exhibit localized spasmodic conditions, they could justifiably be regarded as a distinct nosological entity. This might reasonably be regarded as a step towards clarifying their aetiology.

Doubt about one's sexual identity and ideas of changing sex have been shown to be typical of sufferers from schizophrenia (Gittleson and Levine, 1966; Gittleson and Dawson-Butterworth, 1967).

The purpose of the present paper is to draw attention to a remarkable similarity in the age-incidence curves of schizophrenia and neurosis when the sexes are combined. Hare and Price (1969), in a study on the season of birth of schizophrenic patients, found that the age-distribution of cases of schizophrenia (I.C.D. 7th Revision nos. 300, 303) seen for the first time at the Bethlem-Maudsley Hospital during the years 1951–1963 was very similar to that of the cases of neurosis (I.C.D. nos. 310–18) seen there during the same period. However, these cases included out-patients as well as in-patients, were not necessarily first-ever attendances at a psychiatric clinic, and, because they had been referred to a teaching hospital which did not serve a particular geographical area, may have been a somewhat unrepresentative series. For these reasons, their findings (illustrated in Fig. 1 of their paper) might have been no more than a coincidence.