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Parapsychological J. of South Africa. 1981, 2:2, 35-55
PSI, GENETICS AND THE TEMPORAL LOBE
Vernon M. Neppe MB, BCh, DPM, FFPsych(SA), MMed (Psych),
BA, Ph D (Med)*
Lewis A. Hurst BA, BSc, MB, ChB, Ph D, M D, F R C Psych**
* Senior Lecturer/Senior Psychiatrist Dept of Psychiatry,
University of the Witwatersrand, Johannesburg. President,
SASPR.
** Professor Emeritus, Dept of Psychiatry and Honorary Research
Professorial Fellow, Dept of Genetics, University of the
Witwatersrand, Johannesburg.
Former President, SASPR.
__________________________
Key words : Psi
Epilepsy
Genetics
Temporal lobe
___________________
ABSTRACT
The exact heritability of the faculty of subjective paranormal
experience is unknown. The theoretical role of anomalous
temporal lobe functioning in producing the epiphenomenon
of subjective paranormal experience is delineated. This
kind of anatomical substrate is hypothesized as having certain
specific hereditary predispositions. Further, the genetics
of epilepsy, particularly of the temporal lobe, may give
a clue to genetic faculties in subjective paranormal experients,
although the grounds for such a relationship are tenuous.
1. GENETIC STUDIES IN SUBJECTIVE PARANORMAL EXPERIENTS
The inheritance of a psi faculty is not yet established.
Studies appear to be very limited: Nash and Buzby found
that monozygotic (i. e. identical) twins had significantly
greater similarity in their ESP scoring levels than dizygotic
twins. 1 This work was replicated by Charlesworth. 2 A classic
study is the comparable evocation of alpha rhythm (apparently
by ESP) in monozygotic twins by Duane and Behrendt. 3 An
early description was that of Fluornoy who described a family
with four generations of 'psychics'. 4
Zorab cites numerous cases of 'psychics' who had strong
family histories of ostensible paranormal experiences. 5
The concept of 'psi running in families' does not, of course,
necessarily imply genetic predisposition as learnt environmental
patterns may possibly explain such phenomena.
Finally Owen suggests the possibility of either single gene
or polygenic inheritance of a psi faculty. 6 He stresses
that the former may well imply an essentially biochemical
difference. To replicate this state experimentally a random
psychopharmacological search may be necessary. In contrast,
if psi were polygenic a 'delicate balance of many factors'
may allow experimental treatments in combination. He warns
against avoiding false correlations without causal relationships,
stressing the importance of balanced or factorial designs.
6
2. SUBJECTIVE PARANORMAL EXPERIENCE
If one were dealing with a genetically determined psi faculty,
an anatomico-physiological substrate for such a faculty
would seem logical. Furthermore, because genetic studies
frequently involve studies of several generations, such
a study would, at present, require retrospective analyses.
For preceding generations to prove retrospectively their
genuine psi faculties would frequently be impossible. Because
of this, the use of Neppe's term, subjective paranormal
experience (SPE)7, is convenient. Such a term does not assess
the objective veridicality of claimed psi events. It is,
however, limited to experiences perceived by the subject
as being of paranormal quality. A hierarchy of defined criteria
can be used to differentiate out the quality of each SPE
along a continuum of subjective veridicality, the most advanced
form in this regard being conformity to 'low-score subjective
paranormal experience. '8
ANOMALOUS TEMPORAL LOBE FUNCTIONING AND SUBJECTIVE PARANORMAL
EXPERIENCE
Neppe embraced the concept of subjective paranormal experience
in his controlled research on the temporal lobe. He utilized
two extreme groups, one of whom, the Subjective Paranormal
Experients, had had at least sixteen 'low-score' SPEs of
at least four different kinds (eg waking ESP, veridical
dreams, trance-mediumship, psychokinesis). In contrast,
the Subjective Paranormal Non-Experient had had no SPEs,
even of 'high-score kind'. 9 After excluding temporal lobe
symptoms occurring with SPEs and despite the small numbers
used, he found that his Subjective Paranormal Experients
had significantly more 'possible temporal lobe symptoms'
(average 3. 3) than a control group (who had no 'possible
temporal lobe symptoms' at all). These subjects were also
studied electroencephalographically but trends only were
noted, possibly because of the small sample size. 10 °
Neppe's research follows on the pioneering uncontrolled
electroencephalographic (EEG) study of Nelson who found
that, with one exception, the EEGs of eleven mediums and
one automatic writer had temporal lobe abnormalities. 11
Three factors should be considered prior to interpreting
these results. Firstly, extreme groups were used - trance
mediums by Nelson, 11 and subjects with large numbers of
SPEs by Neppe. 1O This does not imply that people with occasional
SPEs have unusual temporal lobe functioning. Secondly, Owen
warns against equating correlations with causality. 6 In
these instances, an association with the temporal lobe and
SPE may reflect epiphenomena with two entirely different
origins. Finally, SPEs can neither be equated with genuine
veridical psi experience originating outside the brain nor
with non-veridical distortions of temporal lobe origin.
Consequently, the connection of SPEs with the temporal lobe
does not imply endogenous or exogenous origins of such SPEs.
4. ANATOMICAL CORRELATES TO THE CONSIDERATION OF PSI AND
GENETICS
Following on the work of Neppe8'9 and Nelson 11 quoted above
it would be logical to analyse results of genetic studies
on the temporal lobe. These appear to be void. However,
much has been written about the genetics of epilepsy, and
as temporal lobe epilepsy is the major way in which the
temporal lobe manifests dysfunction an understanding of
the genetics of epilepsy may be motivated at a general level.
5. GENETIC STUDIES IN EPILEPSY
Anomalous temporal lobe firing in Subjective Paranormal
Experients does not imply the presence of disintegrative
features such as temporal lobe epilepsy. In fact, this condition
occurred in only one of Neppe's experients. In view of the
rarity of temporal lobe epilepsy, however, (- 0. 2% of the
general population) this result suggests that the genetics
of epilepsy would be a specific motivation to be considered
in any uncontrolled case descriptions of families with SPEs.
Kallman and Sander reviewed convulsive phenomena throughout
the animal kingdom, their graded character in Man, and their
universal elicitability by stimuli such as electro-convulsive
therapy. l2 The clinical studies of Conrad showing dizygotic
and monozygotic twin concordance rates of 4, 3 and 86, 0
percentl3 and of Lennox and Gibbs where the corresponding
figures based on EEG criteria were 25, 0 and 100, 0 percent,
l4 were compatible with the hypothesis of a single autosomal
dominant genetic mechanism fully penetrant at the EEG level.
Alstrom, however, found figures in first degree relatives
of his sample derived from the Serefimer Clinic in Norway,
not significantly different from figures in the general
population (parents 1, 3 percent, siblings 1, 5 percent
and children 3, 0 percent). l5 However, in 1 percent of
his sample he found pedigrees suggesting single autosomal
genetic mechanisms, mainly dominant. Hurst, Reef and Sachs
considered that the large families in Soweto might provide
clinical material to elucidate the conflict of the findings
of Conrad and Lennox and the Gibbses on the one hand, with
their single autosomal genetic hypothesis, and Alstrom on
the other, who found no evidence of a genetic mechanism
in the vast majority of his cases, and the possibility of
a single-gene mechanism in a very small minority. l6 The
severity of the cases necessitating confinement in a mental
hospital does not explain the difference, as both the Lennox
group and Alstrom worked with general hospital cases, l5
and Conrad with mental hospital cases. l4 In Hurst's study
conducted at the Meadowlands Clinic, Soweto, 13 of the 46
families (i. e. 28, 3 percent) showed pedigrees compatible
with single-gene mechanisms, 9 dominant, 1 irregular dominant
and 3 non specified. l6 These findings were in line with
the view of protagonists of the single dominant hypothesis,
rather than those of Alstrom. Metrakos made a magnificent
synthesis of previous findings and his own comprising 211
probands and 112 controls, in which, after excluding symptomatic
epilepsies and retaining only the centrencephalic, he proposed
a single autosomal dominant genetic mechanism, with the
special feature of high penetrance within the age range
65 to 145 with rapid tailing off of the incidence curve
below and above this range. l7 Further details will be found
in Hurst. l8
CRITERIA FOR RESEARCH INTO THIS PROBLEM
The authors believe that an index group of Subjective Paranormal
Experients and a demographically similar control group of
Non-Experients should be utilized. Previous research by
Neppe has illustrated the difficulties of categorizing descriptions
of so-called paranormal experiences by other members of
family into the framework of subjective paranormal experience.
l9 Thus personal interviews are as far as possible necessities.
The criteria for SPE could be those laid down by Neppe.
8'9
An important kind of exclusion would be phenomena that are
interpreted as subjectively paranormal but in fact are possibly
psychotic. Subjects with histories of SPEs plus major psychiatric
illness would best be excluded from this research. Moreover,
the delineation of what West calls the 'sane hallucination'
(i. e. the perceptual impression of the paragnost psychic,
his hallucinatory SPE) from 'insane hallucinations' should
be borne in mind. 20 West emphasized the stereotyped, vague,
repetitive and usual auditory nature of the pathological
hallucination. Neppe stressed that the temporal lobe symptoms
of subjective paranormal experients were invariably of perceptual
hallucinatory kind but regarded as possibly the prime differentiator,
the non-existence or the only rare occurrence of impressions
pertaining to self. 8 Self-reference as ideas of influence,
or overvalued concepts or special symbolic interpretations
pertaining to self are hallmarks of major psychopathology.
Because the study suggested would involve analyses of temporal
lobe symptoms as a prime method of establishing an anatomico-genetic
correlate, it is necessary to outline 'possible temporal
lobe symptoms' all of which should be perceived in the context
of the 'company they keep' and of non-leading questions.
Neppe lists the following based on a comprehensive literature
survey. 21
1. complex visual hallucinations 1inked to other qualities
of perceptions such as voices, emotions or time
Any form of :
2. auditory perceptual abnormality
3. olfactory hallucinations (? antero-medial hippocampus)
4. gustatory hallucinations (probable deep-lying Sylvian)
5. rotation or dysequilibrium feelings linked to other perceptual
qualities (posterior insula)
6. unexplained 'sinking', 'rising' or 'gripping' epigastric
sensations
(posterior insula)
7. epileptic amnesia
8. lapses
9. conscious confusion
10. play-backs
11. illusions of distance, size (micropsia, macropsia),
loudness, tempo,
strangeness, unreality, fear, sorrow
12. epileptic automatisms
13. masticatory-salivatory episodes
14. speech automatisms
15. hallucinations of indescribable modality
16. 'fear which comes of itself' linked to other disorders
(hallucinatory
or unusual autonomic)
17. uncontrolled, unprecipitated, undirected, aggressive
episodes
18. superior quadrantic homonymous hemianopia
19. receptive (Wernicke's) aphasia.
Neppe has devised a special Temporal Lobe Questionnaire
to serve as for research of this kind21 (Appendix A). Questionnaires
pertaining to Subjective Paranormal Experience can be found
elsewhere. 8 (A Brief Paranormal Questionnaire was published
in an earlier issue of this journall9).
7. CONCLUSIONS
The value of an anatomical approach to the genetics of psi
based on the high correlation of SPEs to temporal lobe symptoms
is undetermined. It certainly appears a worthwhile area
to pursue.
REFERENCES
1. Nash, C. B. and Buzby, D. E. 'Extrasensory Perception
of Identical and Fraternal Twins. ' J. Hered. 1965, 56,
53-54.
2. Charlesworth, E. A. 'Psi and the Imaginary Dream. ' Research
in Parapsychology 1974. 1975, 85-89.
3. Duane, T. and Behrendt, T. 'Extrasensory Electroencephalographic
Induction between Identical Twins. ' Science. 1965, l5O,
367.
4. Fluornoy, T. 'Frorn India to the Planet Mars : A Study
of a Case of Somnabulism with Glossolalia. ' New York :
University Books. 1966.
5. Zorab, G. 'Modern Genetics and Psi Phenomena. ' Parapsychology
Review. 1975, 4 : 5, 1-3.
6. Owen, A. R. G. 'Methodological Approaches in Psi Research
: An Overview. ' In Cavanna, R. (ed) Psi Favourable States
of Consciousness. New York : Parapsychology Foundation 1970,
pp 27-35.
7. Neppe, V. M. 'Subjective Paranormal Experience. ' Psi.
1980, 2 : 3, 2-3.
8. Neppe, V. M. 'An Investigation of the Relationship between
Subjective Paranormal Experience and Temporal Lobe Symptomatology.
' M Med (Psych) dissertation, University of the Witwatersrand,
Johannesburg. 1979.
9. Neppe, V. M. 'Subjective Paranormal Experience and Temporal
Lobe Symptomatology. ' PJSA. 1980, 1 : 2, 78-98.
10. Nelson, G. K. and Neppe, V. M. 'The Neurophysiological
Wave Correlates of a Controlled Sample of Subjective Paranormal
Experients - A Preliminary Report. ' PJSA. 1980, 1 : 2,
99-101.
11. Nelson, G. K. 'Preliminary Study of the Electroencephalograms
of Mediums. ' Parapsychologica IV. 1970, 9, 30-45.
12. Kallman, F. J. and Sander, G. The Genetics of Epilepsy.
New York : Grune and Stratton. 1947.
13. Conrad, C. in Guett, A. (ed) Handbuch der Erbkrankheiten.
Leipzig : Thieme. 1940.
14. Lennox, W. G. , Gibbs, E. L. and Gibbs, F. A. 'The Brain-Wave
Pattern : An Hereditary Trait. ' J. of Heredity. 1954, 36,
233-243.
15. Alstrom, C. H. 'A Study of Epilepsy in its Clinical,
Social and Genetic Aspects. ' Acta Psychiat. et Neurol.
Scandinav. 1950, suppl. 63.
16. Hurst, L. A. , Reef, H. and Sachs, S. B. 'Neuropsychiatric
Disorders in the Bantu. I. Convulsive Disorders. ' SA Med.
J. 1961, 35, 750-754.
17. Metrakos, J. D. 'The Centrencephalic EEG in Epilepsy.
' Proceedings of the Second International Conference of
Human Genetics. Rome. 1961, 1792-1795.
18. Hurst, L. A. 'Genetics of Epilepsy. ' SA Med. J. 1974,
48, 603.
19. Neppe, V. M. 'A Study of the Incidence of Subjective
Paranormal Experience. ' P. J. S. A. 1981, 2 : 1, 15-37.
20. West, D. J. Psychical Research Today. Middlesex : Penguin.
1962.
21. Neppe, V. M. 'A Study of Deja Vu Experience. ' Ph D
(Med) thesis,
University of the Witwatersrand, Johannesburg. 1991, vol.
4, p 571.
APPENDIX A - TEMPORAL LOBE QUESTIONNAIRE (TLQ)
(Instructions in brackets are for the interviewer. If the
subject
answers positively all the information in brackets must
be obtained. )
Please answer Yes or No to the following questions.
The answer 'yes' refers to something having occurred at
any time in
your life. Indicate if you are uncertain. If 'yes' is answered,
then
consider how many times this has occurred, and please describe
in more
detail.
(Frequency: 0ccasional = +, Frequent = ++, Immobilizing
or requiring
treatment, or occurring daily
or more frequently = +++).
1. What medicine are you on? (Please list indicating duration
and the
name of the Doctor who prescribed it).
2. Have you ever had an E. E. G. ? (Please give details
when, why, where
and what the result was).
3. Have you ever had any fits? (Please give details when,
for how long, when the last was, the form it takes, who
diagnosed it, the medication taken for it, and any known
cause, plus the doctor involved, any headaches or confusion
or fatigue or weakness afterwards. Describe any feelings
or aura or sensations before the fit)
4. Have you ever lost consciousness (been unconscious) or
been knocked out? (Please give details including dates,
duration, cause, memories before and after the accident
or happening, the doctor involved, duration of hospitalization).
5. Have you ever had meningitis, encephalitis or infection
of the brain? (Please give details including dates, duration,
cause, hospitalization duration, doctor involved, and any
results thereof);
6. Were you a normal: a) pregnancy? b) birth? c) baby?
If not, in each case, please indicate what was wrong.
7. Have you ever been in hospital for physical or mental
causes? (Please list duration, dates, doctors, diagnosis,
results).
8-. a) Have you ever been treated or seen by a psychologist,
psychiatrist or neurologist?
If so;
1. Were you ever hospitalized?
2. With what medication were you treated, for how long and
how many times?
3. Were you treated without medication, or by psychotherapy?
For how long and for how many sessions?
4. What diagnosis or diagnoses were made? (Please list all
treatments, the duration, dates, doctor, diagnosis, results
and medication used).
b) 1. Have you ever had difficulty coping with life, with
your job, with your family, or with other people in general?
(Please describe).
2. Were you ever unemployed? If so, for how long?
9 a) Have you ever had any other illness you have not listed
above?
(Please list)
b) Have you ever had any operations you have not listed
above?
(Please list)
10 a) Have you ever had any blackouts? b) Have you ever
found yourself in a place and not known how you
got there?
c) Have you ever done something and not known afterwards
that
you had done it?
d) Have you ever found that you have a memory blank (amnesia)
or
are unable to remember a certain period of time just after
this
has occurred?
e) Have people ever told you that you were behaving strangely
and you were unaware of it?
f) Have you ever been diagnosed as having epilepsy?
(If so, please deta4. 1 date, occurrence, any alcohol or
drugs, duration, causes, memories before and after (and
durations doctor involved, any hospitalization, headaches/fatigue/confusion/
weakness afterwards. Describe any feelings or aura or sensations
before the happening. Please include any diagnoses made,
and any treatment given. )
11. a) Do you ever lose control of yourself?
b) Do you ever get into an extremely bad temper?
c) Do you ever become extremely angry?
d) Are you ever told that you become violent or very aggressive
and you have no recollection of this?
If "yes" to any of 11a through d, please answer
below:
1. Is there a reason for your behavior or anger?
2. Does this reason deserve so much anger or such a reaction?
3. Is the reason always a culmination (or end-point) of
things (possibly little) which are frustrating?
4. Can you completely control your anger?
5. Do you sometimes find you had no control over what you
did, even for a short while?
6. Do you sometimes not understand your angry behavior?
7. Are you always aware of what you are doing during these
spells?
8. Have you ever hurt yourself during these spells?
9. Do you sometimes hurt others during these spells?
10. Do you hit out at anyone or anything or is your anger
directed towards the people or objects with whom/which you
are angry ?
11. Do you sometimes find that you cannot remember part
or the whole of what happened during these periods?
12. Do these angry spells occur when you take alcohol or
other agents? If so, what?
13. Do these angry spells occur when you have not taken
alcohol or other agents?
14. At what age did this begin? -
15. In your opinion, what caused these angry spells?
16. Do you sometimes become violent during these spells?
17. How do you feel afterwards?
18. Do you feel !better', relieved or guilty
afterwards? Indicate how you feel.
19. Do you afterwards have a headache or feel fatigue, sleepy
confused or weak?
20. Do you ever have any feelings, aura or sensations preceding
this anger?
21. How frequently does this occur?
12. Do you get very tired even when you have had enough
sleep?
If so,
1. To what do you attribute this?
2. Does your medication help to lift the tiredness or does
it make it worse?
3. Is there any specific time of the day it occurs?
4. How much sleep do you get?
5. Do you feel depressed?
6. Do you feel bored at times when you get tired?
7. How frequently does this occur?
13. 1. Please describe how you sleep? (Total sleep time;
initial, terminal, paroxysmal insomnia; dreams)
2. Please describe your appetite? (quantity, desire)
3. Please describe your weight and any recent changes?
All these refer to the past 3 months (extend backwards if
necessary).
14. 1. Do you have difficulty concentrating?
2. Do you have difficulty reading books because of your
thinking ?
3. Are your difficulties continuous? Do they relate to a
specific time of the day? Are you anxious at any stage,
do you just feel at times confused?
1S. a) Do your moods fluctuate within minutes for no reason?
b) Do your feelings change during the day without reason?
OR
c) Do you find that at times you are happy and then for
no reason
sad, or sad and then happy?
If yes, to l5a, l5b or l5c
1. How frequently does this happen?
2. Does this occur at any particular time of the day?
3. Does the change take a few minutes, hours, days or weeks?
16. Do you have frequent or severe or continuous headaches?
(Please describe fully including onset age, duration, frequency,
changes, position, character, precipitators, relief, associated
factors, response to medication, associated nausea, visual
or vestibular features).
17. Do you have a strange feeling in you stomach or upper
abdomen? (Please describe: churning, swelling, discomfort,
any relation to meals, any other associated sensations or
symptoms; any specific periodicity; frequency).
18. a) Do you have visions of any kind?
(Please describe: differentiate from thought or delusion).
b) Do you see dots, spots, or lights in front of your eyes?
(Please describe: associated headache or not; both eyes;
frequency; other symptoms)
c) Have you seen shapes distorted, or things too big or
too small, or things moving when they should be stationary.
(Describe, as above).
19. Do you ever smell something when there is nothing to
smell? (Describe ) Have you ever come across the sme'1 of
any of the following when there is nothing to smell? Steak,
burning, rotten eggs, sweetness, perfume, cake, indescribable.
(Please describe: associated frequency and features).
20. Do you ever encounter tastes in your mouth which you
cannot explain? (Describe: e. g. metallic).
21. Do you ever have very odd sensations in any part of
your body? (Describe: associations, periodicity, frequency,
toxicity).
22. Do you ever feel something which is not there crawling
on you? (Describe: as above). t. ,
23. Do others ever tell you of odd behavior which you are
unaware of?
(Describe: e. g. buttoning - unbuttoning, chewing movements
ask specifically).
24. Do you ever hear any of the following, when there is
no-one there or nothing to cause it?
(Describe including specifically the following qualities:
buzz, sizz, music, whistling, unformed sound, single word,
jumble, full messages including discussing, instructing,
and arguing voices, names; differentiate pseudo-hallucinations
from true hallucinations; frequency and periodicity).
25. Do you ever have episodes of sudden, unexplained dizziness?
(Describe: quality (rotational, syncopal), frequency, periodicity).
26. Do you ever have exactly the same repetitive dream?
(Describe: include nightmares).
27. 1. Do you sometimes experience a warm/cold feeling in
a certain specific part of the body ? OR 2. around you,
which is not experienced by others with you?
28. Do you sometimes feel you are not yourself, or are just
watching yourself, or are not part of yourself? (Describe).
29. Do you ever find familiar surroundings strange or foreign
or different or not recognize them? (Describe).
30. Do you have periods when you find that you feel confused
(i. e. you don't know where you are, or why you are there,
or what time or date it is?) (Explain)
31. Have you found that at times for no apparent reason
you feel you are reliving something in the past, even though
this is not awakened by the present environment? (As if
the past flows like a cinema screen before you?) (Explain).
32. Do you ever find that even though you hear what is being
said, you cannot make sense of it? (You cannot understand
it even though it involves a simple vocabulary in your home
language. ) (Please explain with examples, indicating frequency,
circumstances and associated symptomatology. )
33. Are you ever told that you at times appear to lose contact
(consciousness) and just stare for seconds or a minute or
two? [ Please describe: kind of stare e. g. fixed, clear,
studied, alive stare compared with a blank one; duration
e. g. 30-60 seconds not 15 seconds; age of onset; frequency,
circumstances associated symptomatology) (waking from this)(not
day-dream) (clouded consciousness after the episode)]
34. Do you ever have episodes whereby a memory or vision
of a past experience becomes so vivid, it is as if it is
occurring over again? (Please distinguish from the feeling
that something in the present has happened before or is
being recognized i. e. deja vu).
35. Do you have unexplained, unprecipitated and uncontrollable
attacks of intense fear for no apparent reason? (Please
describe: include associated symptoms, frequency, autonomic
concomitants, duration (Panic attacks) (sweat, palpitations,
pallor, pupils)).
36. Do you ever find that you are slurring your speech?
37. Do you have episodes whereby a particular thought 'forces'
its way into your consciousness i. e. even though you resist
a particular thought it intrudes into your mind (i. e. compulsive
thought). (Please explain).
38. Would you say that you have periods which are out of
character to your normal personality and involve behavior
that is not approved of, or episodes of moodiness, irritability
and anger, for which you have no explanation? (Please describe
with examples, duration, frequency, associated symptomatology).
39. Have you ever had the strong feeling or impression that
you had been in some place or in the same situation before,
even though you had never actually been there before, or
really were experiencing the event for the first time in
real life? (Please indicate frequency and vividness).
40. Have you ever had the strong feeling or impression that
you had never been in a place or situation that you knew
you had been in many times before and in fact, knew well?
(P1ease explain).
41 Do you ever discover that your word order in your home
language is wrong or you are misplacing figures (digits)?
42. Do you easily become irritable over 'nothing'?
43. Do you find there are any specific things which trigger
any
one of the symptoms discussed? (e. g. television, lights
flashing, sudden or special sound,
smell). (Describe).
44. Which of the following symptoms above which you have
said do occur,
have been improved by your medication?
(Please list response).
45. Which of the above symptoms occur very frequently or
solely
after you have had a small amount of alcohol? (less than
two tots).
(Please list responses).
46. Which symptoms began only after your head injury (or
other
trauma mentioned above e. g. encephalitis)?
47. Did you have fits associated with fever Or other illness
as a young child?
48 a Were you a hyperactive child? Did you have learning
problems?
b. Have you ever wet your bed? (Elicit whether this was
enuretic or epileptic
Ask about blood on the pillow or strange sounds or shaking.
)
49. What role has drug abuse played in the development of
your symptoms? C(List drug used (specifically dagga, LSD,
amphetamines, barbiturates, alcohol), duration of use, symptoms
associated with taking or withdrawal, changes after drug
usage
50. Do you keep a diary of the events in your life?
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