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Three brief excerpts from the autobiographical writings of Mohandas K. Gandhi were analyzed for neuropsychobiological content using the PCAD 2000 computer program. The computer software produces scores on 13 scales such as anxiety, hostility, cognitive impairment, and depression; compares the assigned scores with norms derived from 5-minute speech samples taken from normal, medically and psychiatrically healthy adults and children; and suggests DSM-IV diagnostic categories for consideration. The results demonstrate an objective, repeatable method for achieving insight into the mental states and traits of historic figures based on their writings.

The emotional impact of illness sustained by patients, their families, and friends is increasingly recognized as an important dimension of clinical evaluation and intervention. This study first attempted to extend a computerized technique of measuring the magnitude of mental events from a content analysis of speech initially designed for use on single verbal samples or verbal texts to the analysis of conversational interactions. The study then applied this method of extended measurement to conversations concerning seriously ill surgical patients. The authors' objective was to develop a graphic method that illustrates the neuropsychological interchanges occurring in these conversations. Speech samples were recorded during discussions among nurses, surgeons, intensivists, and family members involved in the care and treatment of seriously ill patients hospitalized in the surgical intensive care unit at Barnes-Jewish Hospitals associated with Washington University School of Medicine, St. Louis, Missouri. These samples then were transcribed into computer-readable text files and divided into utterances: uninterrupted speech by a single individual. The utterances were assigned numeric scores by a computer program on each of 14 validated content analysis scales measuring various neuropsychological dimensions. The scores are presented graphically in chronological sequence to illustrate the emotional interactions in these conversations. The graphic representations depicting sequences of computerized content analysis-derived scores for the mental reactions of the speakers in such conversations provide insights into the psychodynamics occurring in such stressful situations.

The aim of this study was to test the validity of a computer software program previously demonstrated to be capable of making DSM-IV neuropsychiatric diagnoses from the content analysis of speech or verbal texts. In this report, the computer program was applied to three personal writings of Napoleon Bonaparte when he was 12 to 16 years of age. The accuracy of the neuropsychiatric evaluations derived from the computerized content analysis of these writings of Napoleon was independently corroborated by two biographers who have described pertinent details concerning his life situations, moods, and other emotional reactions during this adolescent period of his life. The relevance of this type of computer technology to psychohistorical research and clinical psychiatry is suggested.

Focusing on language and the assessment of its meaning, this volume concentrates on a method of content analysis developed by the author and Goldine Gleser. Applicable to transcripts of speech or verbal texts, this method uses the grammatical clause as its smallest unit of communication, considers whether or not a verb is transitive and involves an object, or is intransitive and describes a state of being. It derives scores on many scales that have been tested for reliability of scoring and for construct validity with concurrently administered measures, such as rating and self-report scales as well as biochemical and pharmacological criteria. Finally, this volume provides detailed descriptions of the clinical and basic research establishing the validity of these scales, so that a reader can locate studies that have pertinence to any special interest area. A major achievement described in this book is the development of computer software that understands grammar and syntax, can parse natural language, knows most of the words in the Merriam-Webster dictionary, has been taught to identify idioms and slang, and is capable of continuing to learn. The program can score all the scales, report whether the scores obtained from a verbal sample are one to three standard deviations from the norms, and suggest APA DSM-IIIR diagnostic classifications the clinician might consider in assessing the patient.

This study aimed to cross-validate the capacity of a computer software program to detect and measure, using a measurement method applied to the content and form analysis of 5-minute speech samples, cognitive impairment and associated comorbid neuropsychiatric psychobiological dimensions in drug-abusing patients. At the University of California-Irvine (UCI) Neuropsychiatric Center, 28 drug-abusing inpatients using illegal drugs were clinically evaluated. Their scores for cognitive impairment derived by the computerized content analysis method were compared with scores derived from selected tests from the Halstead-Reitan Neuropsychological Test Battery, the computerized Automated Neuropsychological Assessment Metric Battery (ANAM), the Alzheimer's Disease Assessment Scale-Cognitive Portion, the Stroop Color and Word Test, the Symbol Digit Modalities Test, and the Controlled Oral Word Association Test. The statistical significance ( P value) of the correlations of scores from these different measures with scores obtained from the computerized content analysis measures was less than .05 to .001. The comparative “hit rate,” detecting cognitive impairment above the norms for each measure administered to these drug-abusing patients, for the computerized content analysis measures and some of the ANAM neuropsychological measures was 75% to 89%, and for the other neuropsychological measures, 25% to 64%. In conclusion, the computerized content analysis methodology applied to 5-minute verbal samples is a valid, rapid, easily administered measurement instrument for assessing the magnitude of cognitive impairment and comorbid neuropsychiatric dimensions.

Twenty-five new psychiatric outpatient were clinically evaluated and were routinely administered a brief psychological screening battery which included measures of symptoms, personality, and cognitive function. Included in this assessment procedure were the Gottschalk-Gleser Content Analysis Scales on which scores were derived from five-minute speech samples by means of an artificial intelligence-based computer program. Intercorrelations of these content analysis measures with scores obtained from the MMPI-2, SCL90, and other measures confirmed previously published construct validation findings. The use of this computerized content analysis procedure for initial, rapid diagnostic neuropsychiatric appraisal is supported by this research.

Positron emission tomography (PET) studies have shown decreased glucose metabolism in brain regions of detoxified alcoholics and cocaine abusers. However, it is not clear whether this decrease is due to chronic drug abuse or a pre-existing condition. Molecular genetic studies have found an association of the D2 dopamine receptor (DRD2) A1 allele with alcoholism and drug abuse. Moreover, reduced central dopaminergic function has been suggested in subjects who carry the A1 allele (A1+) compared with those who do not (A1-). In the present study, using 18F-deoxyglucose, regional glucose metabolism was determined in healthy nonalcohol/nondrug-abusing subjects with the A1+ or A1- allele. The mean relative glucose metabolic rate (GMR) was significantly lower in the A1+ than the A1- group in many brain regions, including the putamen, nucleus accumbens, frontal and temporal gyri and medial prefrontal, occipito-temporal and orbital cortices. Decreased relative GMR in the A1+ group was also found in Broca's area, anterior insula, hippocampus, and substantia nigra. A few brain areas, however, showed increased relative GMR in the A1+ group. Since polymorphism of the DRD2 gene is commonly observed in humans, the importance of differentiating A1+ and A1- alleles subjects in PET studies is suggested.

Over several decades, the senior author, with various colleagues, has developed an objective method of measuring the magnitude of commonly useful and pertinent neuropsychiatric and neuropsychological dimensions from the content and form analysis of verbal behavior and natural language. Extensive reliability and validation studies using this method have been published involving English, German, Spanish and many other languages, and which confirm that these Content Analysis Scales can be reliably scored cross-culturally and have construct validity. The validated measures include the Anxiety Scale (and six subscales), the Hostility Outward Scale (and two subscales), the Hostility In Scale, the Ambivalent Hostility Scale, the Social Alienation-Personal Disorganization Scale, the Cognitive Impairment Scale, the Depression Scale (and seven subscales), and the Hope Scale. Here, the authors report the development of artificial intelligence (LISP based) software that can reliably score these Content Analysis Scales, whose achievement facilitates the application of these measures to biomedical and neuropsychiatric research.

This is a report of the development, validation, and computerized applications of a method of measuring cognitive and intellectual impairment through the content analysis of verbal behavior. The content analysis procedure utilized is based on the method developed by Gottschalk and Gleser for the measurement of the magnitude of many other psychological states and traits, in addition to cognitive dysfunction. Verbal behavior studies are reviewed that examine the cognitive effects of age, certain psychoactive drugs, alcohol, total body irradiation, sensory overload, and dementia. Finally, the availability of a recently developed artificial intelligence software program is reported that will reliably, rapidly, and objectively score speech samples (on Gottschalk-Gleser Scales) transcribed according to specific directions from IBM-compatible computer diskettes.

The influence of the quality of care that patients receive during the course of their illness has been the subject of special scrutiny in the area of mental health. The concept of "expressed emotion" (EE) evolved in an effort to understand the impact of family and social environment on the vulnerability to relapse of schizophrenic patients. A semistructured interview, the Camberwell Family Interview, was developed to assess expressed emotion. This article examines the historical context, generalizability, methodological strengths and limitations of the construct of EE and the Camberwell Family Interview, as well as the nature and effects of treatment intervention programs designed to neutralize adverse effects of patient caretaker attitudes.

OBJECTIVE The cortical-striatal-thalamic circuit modulates cognitive processing and thus may be involved in the cognitive dysfunction in schizophrenia. The imaging of metabolic rate in the structures making up this circuit could reveal the correlates of schizophrenia and its main symptoms. METHOD Seventy male schizophrenic patients underwent [18F]-fluorodeoxyglucose positron emission tomography after a period of at least 4 weeks during which they had not received neuroleptic medication and were compared to 30 age-matched male normal comparison subjects. RESULTS Analyses revealed decreased metabolism in medial frontal cortex, cingulate gyrus, medial temporal lobe, corpus callosum, and ventral caudate and increased metabolism in the left lateral temporal and occipital cortices in the schizophrenic cohort. Consistent with previous studies, the schizophrenic group had lower hypofrontality scores (ratios of lateral frontal to occipital metabolism) than did comparison subjects. The lateral frontal cortical metabolism of schizophrenic patients did not differ from that of comparison subjects, while occipital cortical metabolism was high, suggesting that lateral hypofrontality is due to abnormalities in occipital rather than lateral frontal activity. Hypofrontality was more prominent in medial than lateral frontal cortex. Brief Psychiatric Rating Scale (BPRS) scores, obtained for each schizophrenic patient on the scan day, were correlated with regional brain glucose metabolic rate. Medial frontal cortical and thalamic activity correlated negatively with total BPRS score and with positive and negative symptom scores. Lateral frontal cortical metabolism and hypofrontality scores did not significantly correlate with negative symptoms. Analyses of variance demonstrated a reduced right greater than left asymmetry in the schizophrenic patients for the lateral cortex as a whole, with simple interactions showing this effect specifically in temporal and frontal cortical regions. CONCLUSIONS Low metabolic rates were confirmed in medial frontal cortical regions as well as in the basal ganglia, consistent with the importance of the cortical-striatal-thalamic pathways in schizophrenia. Loss of normal lateralization patterns was also observed on an exploratory basis. Correlations with negative symptoms and group differences were more prominent in medial than lateral frontal cortex, suggesting that medial regions may be more important in schizophrenic pathology.

Hope and hopelessness are useful constructs that have been employed by clinicians in theory making regarding the pathogenesis and course of disease and in the application of various psychological and medical treatments to illness. French (1952) and Frank (1968) viewed hope as a necessary motivating force in influencing an individual to try to overcome inner psychological conflicts and seek to resolve a psychoneurosis. Melges and Bowlby (1969) classified the types of hopelessness in psychopathological processes. Perley et al. (1971), using an objective method for content analysis of small samples of speech (Gottschalk 1974), found that elevated hope scores predicted continuation of psychiatric treatment rather than dropping out. Gottschalk et al. (1967, 1969) found that hope scores derived from verbal samples predicted the duration of survival of patients with terminal cancer receiving irradiation treatment (1969) and predicted relatively favorable outcome in psychotherapy (1967).

This study investigated the relationships between the relatively mild manifestations in verbal behavior of social alienation and disorganized thinking in normal subjects and cerebral glucose metabolic rates measured by positron emission tomography (PET). Three groups of 10 young normal male subjects were injected with d -[ 18 F]deoxyglucose (FDG) during either wakefulness, rapid eye movement (REM), or non-REM (NONREM) sleep, and 32 to 45 minutes later they were asked to report their thoughts, emotions, or dreams and free-associations to these mental events. Nonparametric correlations were obtained between measures of interpersonal social alienation, intrapsychic conflicts, and thought disorder derived from the typescripts of these reports by content analysis—using the Gottschalk-Gleser Social Alienation-Personal Disorganization Scale—and regional cerebral glucose metabolic rates obtained from PET scans. Total social alienation-personal disorganization scores obtained from the reports of wakeful, silent mentations showed significant positive correlations with glucose metabolic rates in the left temporal lobe. The patterns of significant correlations involving these verbal behavior measures derived from the content analysis of verbal reports of dreams or other mental events occurring during REM and non-REM sleep were in different cerebral locations from those found with these variables during silent, waking mentation. Previous observations suggesting that increased left temporal lobe glucose may typify chronic schizophrenia may instead be indicative of a wide range of thought disorder and/or social alienation manifestations occurring, at times transiently and minimally, in normal people.

Ten normal, wakeful, young (average age, 25.3 +/- 6.6 years) male subjects received positron emission tomographic (PET) scans 45 to 120 minutes after an infusion of D-[18 F]deoxyglucose in order to assess localized cerebral glucose metabolic rates during silent visual and other sensory imagery and cognitive mentation. The typescripts of the verbal reports, limited to 5 minutes, of this type of mentation (including free-associations to all the silent mental events), were blindly content-analyzed to provide objective measures of various kinds of anxiety and hostility. Many significant positive and negative correlations were found in medial cortical, lateral cortical, and subcortical gray matter, and white matter areas between the magnitude of the anxiety and hostility aroused in the silent mental processes and localized cerebral glucose metabolic rates. Clearly, energy consumption in the brain, as judged from localized glucose metabolic rates, is highly influenced by the quality and quantity of emotionally tinged private reveries and mental events occurring spontaneously within human subjects. Brain areas involved with the processing of language, sensation, cognition, memory, and emotional reactions appear to be involved especially in these significant correlations. The implications of such findings in the neurosciences and behavioral sciences are discussed.

The 'quality of life' is a construct which many researchers are attempting to measure by means of self-rating procedures and by ratings from external observers. Another method of measuring this construct includes features of both the self-report method and the external observer rating method, and by doing so it minimizes some of the measurement errors inherent in the separate methods; this third method involves the content analysis of verbal behavior. This latter method preserves the reliability and validity of the scales that have been developed and tested for content analysis, while preserving the meanings intended by the subjects who are being assessed on this dimension, which meanings are often obscured or lost through self-report and ratings scales. A group of Content Scales especially applicable to assess the quality of life are reviewed and examples of their applicability are given. A discussion is provided dealing with special problems involving the assessment of this dimension, including cross-cultural issues and other factors that need consideration with respect to generalizability of the findings.

There are long-standing viewpoints that impulsive and violent behavior may stem from brain dysfunction or damage secondary to head injury, disease, or toxic chemical substances. This research has aimed to examine the relationship between potentially toxic metals and aberrant behavior, especially violent activity, through the nonintrusive technique of hair analysis for trace elements. In an initial study, phase I, it was not possible to replicate findings of others who reported high levels of lead, cadmium, and copper in violent offenders. However, high levels of manganese were found in prison versus control groups. In phase II, the possibility of artifactual results arising from prison cooking utensils was controlled for by sampling early after incarceration. Phase III was included to substantiate the initial post hoc findings in an additional jail population. In both latter phases, significantly elevated manganese levels were found in the hair of violent versus nonviolent subjects (P less than .0001). A review of the effects of manganese at deficient and toxic levels does not provide a simple answer as to why manganese levels are elevated in the hair of individuals who have been incarcerated for violent behavior. Our study does not implicate the prison environment or soaps and shampoos used in California prisons. Other factors, such as alcohol, dietary, or psychosocial factors, might influence manganese levels in hair, or any of these factors might function in combination with mild manganese toxicity to contribute to aberrant behavior.

A group of 24 adolescents and young adults were classified according to four measures using Research Diagnostic Criteria on the dimension of the severity of their schizophrenic syndrome. Independent assessments by the Gottschalk-Gleser Social Alienation-Personal Disorganization Scale and the Abrams-Taylor Emotional Blunting Scale corroborated that the definite schizophrenic group (n = 7) was significantly more schizophrenic than the not schizophrenic group (n = 12), but not more so than the probably schizophrenic group (n = 5). The Halstead-Reitan Category Test and Rhythm Test significantly differentiated the definite schizophrenic group from the not schizophrenic group with respect to cognitive impairment. The Gottschalk-Gleser Cognitive Impairment Scale did not indicate a significant difference in cognitive function between these patient groups. The computerized EEG revealed a significantly higher percent of EEG abnormalities among the definite and probably schizophrenic groups than the not schizophrenic group of patients. These findings are analyzed and discussed.

Ten normal male subjects were injected with D-[18F]deoxyglucose during REM sleep, and 32-45 min later they were aroused and reported their dreams as well as free associations to these dreams. Nonparametric correlations between the anxiety scores derived from the typescripts of these verbal reports by the Gottschalk-Gleser content analysis method and localized cerebral glucose metabolic rates obtained from PET scans revealed significant positive correlations in lateral parietal and medial frontal cortex and negative correlations in adjacent white matter.

Twenty Hispanic patients, who sustained a work-related physical injury or emotional stress, were compared with 20 Hispanic control subjects, who had not experienced such a recent injurious event, with regard to their anxiety and hostility scores derived from the content analysis of 5-minute speech samples using the Gottschalk-Gleser scales. The patient group had significantly elevated total anxiety scores compared to the control group. Language: en

We are in an era when the common denominators accounting for the major favorable effects of the different psychotherapies merit further clarification. At the same time, definite progress has been made in determining those specific psychotherapeutic techniques and methods that produce the desired results most efficiently with particular types of patients with specific types of problems. Continuing psychotherapy research will be required, and such research will need to be linked and co-ordinated with the new scientific progress being made in biological psychiatry and the neurosciences.

Platelet MAO activity has been reported by several investigators to differentiate schizophrenia, schizophrenia related depressive disorders, alcoholism, unipolar and bipolar depression from normal controls. Evoked potentials likewise have differentiated schizophrenic and affective patients. However, the precise relationship between MAO activity, evoked potentials (EP), and psychiatric illness has not been clarified. A possible association between psychopathology and high MAO activity/EP reducing and low MAO activity/EP augmenting has been reported. Such a bidirectionality further confounds results. This study was undertaken to determine the association of psychopathological dimensions found in a group of subjects whose platelet MAO activity and evoked responses were obtained two years earlier. Utilizing the Gottschalk-Gleser verbal behavior scales of Anxiety, Depression, Social Alienation-Personal Disorganization and Cognitive Impairment a significant correlation was revealed between low platelet MAO activity and high Total Anxiety scale and Shame Anxiety subscale scores. Additionally, a significant correlation was demonstrated between reducing evoked potentials and elevated Death Anxiety, Somatic Concerns, and Total Death and Mutilation Depression subscales scores, combined and separately. Furthermore, a significant positive correlation was found between augmenting evoked potentials and Overt Hostility Outward scores. No significant correlations were demonstrated between platelet MAO activity or evoked potentials and Social Alienation-Personal Disorganization or Cognitive Impairment scores. These findings lend support to the position that biological markers may predict predispositions to anxiety and depression.

The life expectancy of people living in the United States is increasing. Are very elderly individuals compromised mentally and physically in comparison to much younger persons? The purpose of this study was to test the efficacy of a computerized program applicable to the content analysis of 5-minute speech samples obtained from a group of individuals 90 years of age and older and to compare the results with those previously obtained in younger people with respect to their mental capacities in terms of a set of diverse neuropsychiatric dimensions. After obtaining informed consent from 26 elderly people, recorded verbal samples were elicited from each individual in response to purposely ambiguous instructions to talk for 5 minutes about any interesting or dramatic personal life experiences. The transcripts of their speech samples were digitized on a computer diskette and processed on the computer program. The computer program compared the scores obtained on each verbal sample with norms obtained on 15 previously validated content-analysis scales from individuals ranging in age from 5 to 80. The norms on these content-analysis scales are different for children (aged 5-10) and adults (aged 11-80). The computerized content-analysis scores obtained from this elderly cohort reveal plausible deviations from the norms for younger people.

The Psychiatric Content Analysis and Diagnosis (PCAD) program performs automated content analysis of machine-readable transcriptions of speech samples to measure the magnitude of neuropsychiatric states and traits. Technological advances provided by computerized speech recognition may offer a possible alternative to labor-intensive manual transcription for preparation of samples for PCAD processing. To test this hypothesis, 25 digitally recorded verbal samples were transcribed both manually and by a commercially available speech recognition software package, and the transcriptions scored by PCAD. The inter-correlations between scores derived from the two different methods of transcriptions offer mixed results, with values ranging from a high of 0.920 to a low of -0.119.

This preliminary study aimed to apply a novel computerized measure derived from the content analysis of 5-min speech samples from patients with breast cancer to measure cognitive impairment and other neuropsychiatric dimensions during the course of anticancer chemotherapeutic treatment. Since such patients are often administered other pharmacological agents to alleviate their symptoms in addition to anticancer chemotherapeutic agents, another aim was to try to distinguish the mental effects of the anticancer drugs from the effects of any other drugs administered. Before and during the course of their anticancer chemotherapy, 12 breast cancer patients gave 5-min verbal samples, elicited by purposely ambiguous instructions, to talk about any personal life experiences. The recorded verbal samples were scored by a computer program (PCAD 2000) to measure the magnitude of cognitive impairment and other relevant neuropsychiatric dimensions. All of the pharmacological agents administered to the patients were recorded. The computer program automatically compared the scores derived from each verbal sample to already established norms to determine whether each score was within normal limits or one to three standard deviations from the norms. Significantly elevated Cognitive Impairment Scale scores were found in the verbal samples of 9 of the 12 patients. All patients had instances of elevated Health/Sickness Content Analysis Scale scores as well as frequent significantly elevated scores in shame anxiety and in death anxiety. In the Quality of Life Content Scale, the scores were uniformly low, ranging from +1.64 to -9.11. Further studies are being carried out to determine which patients are especially susceptible to cognitive impairment under these treatment conditions.

The Life Orientation Test (LOT; Scheier & Carver, 1985) is a common measure of optimism. Previous studies of the convergent and discriminant (vis-a-vis neuroticism) validity of the LOT have relied solely on questionnaires. Our Study 1 was a multitrait, multimethod investigation of the LOT incorporating Gottschalk and Gleser's (1969) method of content analysis of speech samples as a nonquestionnaire assessment method. The LOT did not correlate significantly with the Gottschalk Hope Scale (Gottschalk, 1974) derived from speech samples. Study 2 was an initial attempt to determine the nature of the differences between these alternate measures of optimism. In particular, it was hypothesized and found that the LOT was more fakable than the Hope Scale. Participants who received special instructions to "fake good" scored significantly higher on the LOT than did control participants who received no special instructions. Faking instructions did not significantly affect scores on the Hope Scale.

This is a report of a study testing the capacity of a computerized measure of the content analysis of five minute verbal samples to detect and measure cognitive impairment and comorbid neuropsychiatric dimensions in 117 drug-abusing inpatients. The cognitive impairment scores obtained from the computerized procedure correlated significantly with independent scores from the Trails B and Stroop Color and Word test as well as with ANAM (Automated Neuropsychiatric Assessment Metric) neuropsychological tests, including the Matching to Sample Efficiency and Accuracy, the Code Substitution Efficiency, the Continuous Performance Task Efficiency and Accuracy, the Code Substitution Delayed Recall Accuracy, and the Simple Reaction Time Efficiency. When the computerized verbal-content-analysis-derived cognitive impairment scores were combined with scores of selected other ANAM measures, more and higher intercorrelations occurred with Trails A, Trails B, the Stroop Color and Word test, and the Wisconsin Card Sort test. In addition, validated measures of a broad range of associated neuropsychiatric dimensions can be obtained simultaneously from the same five minute verbal samples providing the cognitive impairment scores. No significant effects were found on the cognitive impairment scores of age, education, gender, race, and duration of drug-abuse abstinence.

For many years the author and his colleagues have been involved in studying the roots and processes of the conveyance of semantic messages via spoken language and verbal texts. After establishing that reliable and valid measurements of highly relevant neuropsychiatric categories, such as anxiety, depression, and cognitive impairment, can be made by identifying and counting the occurrence per grammatical clause of language content and form categories typifying specific content-analysis scales, the research focus has turned towards computerizing this process of content analysis. This report summarizes the achievements and applications of the current empirical status of this method of computerized content analysis of natural language to psychotherapy research, and it speculates on possible future applications in the millennium.

A randomized, double-blind, placebo-controlled study was conducted to assess the efficacy of risperidone in the treatment of developmental stuttering in 16 adults. Eight subjects received placebo and eight received risperidone at 0.5 mg once daily at night, increased to a maximum of 2 mg/day. After 6 weeks of treatment, decreases in all measures of stuttering severity were greater in the risperidone group than in the placebo group; the between-treatment difference was significant (p < 0.05) on the most important measure, the percentage of syllables stuttered. In the risperidone group, reductions from baseline in scores for the percentage of syllables stuttered, time stuttering as a percentage of total time speaking, and overall stuttering severity were significant (p < 0.01); changes in scores on the fourth measure of stuttering, duration, were not significant. No significant decreases occurred in the placebo group. Among the eight patients in the risperidone group, five responded best to 0.5 mg/day, with stuttering recurring at higher doses. The remaining three patients responded better with increasing doses of risperidone. Risperidone was generally well tolerated. The results of this small study indicate that risperidone may be effective in the treatment of developmental stuttering. This finding needs to be confirmed in a larger trial.