The Twentieth Century 329some elements of Jung. His typology was framed within the
statistical factor-analysis approach then common in Britain,
whereby temperamental factors were defined as continua.
Eysenck recognized three major independent continua or
axes. The most basic was extraversion-introversion, in which
extraversion was defined as a balance where inhibitory
activity dominated excitatory processes, and introversion
was the reverse. The position of any individual on this axis
could be determined by various laboratory measures and
questionnaires. The other two axes were psychoticism and
neuroticism, each of which was scaled from low to high. Any
given disorder could be produced by the combination of mag-
nitudes of the three axes. Thus, antisocial personality (the
psychopath) was located in the high extraversion, moderate
psychoticism, and low neuroticism; schizophrenia was
located in the high psychoticism, high introversion, and
moderate neuroticism combination. Most of the laboratory
measures tested sensory and /or motor performance such as
critical flicker fusion, reactive inhibition in motor pursuit
tasks, and the like.
Nervous Diseases—Neurosis and Neurasthenia
The debate about neurological disorders underlying nervous
diseases, in particular hysteria and hypochondria, continued
well into the late nineteenth century. One important event in
the debate was the introduction of the concept of neurasthe-
nia (literally weakness of the nerves) by George Beard
(1880). The term had already found it way into medical lit-
erature (e.g., Kraus, 1831). Charcot’s 1888–1889 modifica-
tion (as cited in Lópes-Piñero, 1983) mentioned two major
neuroses, hysteria and neurasthenia. Both terms passed into
the twentieth century, each carrying the implication of a sep-
arate hereditary biological basis. Many psychopathologists
claimed a gender difference in these two disorders, hysteria
being a female neurosis and neurasthenia a male neurosis.
Organic versus Functional Psychoses
As brain studies of psychotic patients failed to reveal charac-
teristic patterns of neuropathology in most psychoses, re-
searchers began to recognize two kinds of psychosis. One
type, the organic psychosis, arose from demonstrable biolog-
ical origins, such as direct injury, toxic damage, or other
destructive processes acting on the brain; the other type, it
was suggested, arose from intrapsychic conflicts essentially
similar to those that produce the neuroses. By the end of
World War II, psychoanalytic conceptions had begun to dom-
inate psychiatric thinking and practice in the United States.
Although applied mainly to treatment of neuroses, some
practitioners attempted to treat psychotic patients on the as-
sumption that the major psychotic syndromes—schizophrenia,
depression, and manic-depressive psychosis—were the out-
comes of severe intrapsychic conflicts and might therefore
yield to intensive psychoanalytic treatment. Freud had been
pessimistic about the possibility of such treatment, not be-
cause he thought these disorders primarily organic in nature,
but because he judged the patient to have regressed so far to
an infantile level of psychic development that the analyst
could not make the interpersonal contact necessary for psycho-
analytic treatment. Nonetheless many followers of psychoana-
lytic doctrine did attempt to apply psychological treatments.
These included milieu therapy, group therapy, individual psy-
chotherapy, occupational therapy, and recreational therapy
(Shapiro, 1981).
In this context the fundamental distinction between the
“organic” psychoses and the “functional” psychoses arose.
Organic psychoses included paresis, Alzheimer’s disease,
the toxic psychoses, and other psychotic syndromes asso-
ciated with undeniable biological damage. The functional
were those for which no biological basis had been found and
included schizophrenia, manic-depressive psychosis (now
bipolar affective disorder), and psychotic depression. By de-
fault, these were regarded as having intrapsychic origins.
However, techniques to detect brain pathologies in the
living patient were crude. One was electroencephalography
(EEG), another x-ray. By midcentury, Hill and Parr (1950)
concluded that the EEG’s practical value was to enable us to
know something about organic cerebral disorder but little
else. Information also came from cases of patients who had
suffered externally inflicted damage to the brain and where
the locus of the injury could be relatively easily identified.
(German neuropsychiatrist Conrad Rieger employed a bat-
tery of such tests as early as 1888.) It was time-consuming to
administer, consisting of forty different tests (Benton, 1991).
In the aftermath of each of the two world wars much research
into brain-damaged patients provided a knowledge base
about the effects of injuries to specific psychological func-
tions. World War I gave rise to numerous neuropsychological
tests, mostly from German sources. A second major wave oc-
curred after World War II, primarily in the United States.
German psychologist Kurt Goldstein made an impor-
tant contribution to this research. In a seminal monograph,
Goldstein and Scheerer (1941) reported studies of brain-
damaged patients. Their results had led them to formulate the
hypothesis that substantial brain damage produced a loss of
“abstract attitude.” Schizophrenia patients tested with the
same tests used on brain-damaged patients performed in sim-
ilar ways, supporting the view that the functional psychoses
were essentially organic.