Electroconvulsive therapy (ECT) is a controversial psychiatric treatment involving the induction of a seizure in a patient via the passage of electricity through the brain. While beneficial effects of electrically induced seizures are evident and predictable in most patients, a unified mechanism of action has not yet been established and remains the subject of numerous investigations. According to most, though not all, published studies, ECT has been shown to be effective against several conditions, such as severe depression, mania, and some acute psychotic states, that are resistant to other treatments. However, like many other medical procedures, ECT has its risks.

Since the inception of ECT in 1938, the public has held a strongly negative conception of the procedure. Initially, doctors employed unmodified ECT. Patients were rendered instantly unconscious by the electrical current, but the strength of the muscle contractions from induced, uncontrolled motor seizures often led to compression fractures of the spine or damage to the teeth. In addition to the effect this physical trauma had on public sentiment, graphic examples of abuse were documented in nonfiction or loosely fictional books and movies, such as Ken Kesey’s One Flew Over the Cuckoo’s Nest, which portrayed ECT as punitive, cruel, overused, and violative of patients’ legal rights. Indeed, the alternative term electroshock has a negative connotation, tainted by these depictions in the media.

In comparison with its earlier incarnation, modern ECT is virtually unrecognizable. The treatment is modified by the muscle relaxant succinylcholine, which renders muscle contractions virtually nonexistent. Additionally, patients are given a general anesthetic. Thus, the patient is asleep and fully unaware during the procedure, and the only outward sign of a seizure may be the rhythmic movement of the patient’s hand or foot. ECT is generally used in severely depressed patients for whom psychotherapy and medication prove ineffective. It may also be considered when there is an imminent risk of suicide, since antidepressants often require several weeks to show results. Exactly how ECT exerts its influence on behavior is not known, but repeated applications affect several important neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine.

The consensus view of the scientific and medical community is that ECT has been proven effective, but the procedure remains controversial. Though decades-old studies showing brain cell death have been refuted in recent research, many patients do report retrograde amnesia (of events prior to treatment) and/or anterograde amnesia (of events during or shortly after treatment). Patients have also reported that their short-term memories continue to be affected for months after ECT, though some doctors argue that this memory malfunction may reflect the type of amnesia sometimes associated with severe depression. A recent neuropsychological study at Duke University documents a significant decline in performance on memory tests, ironically accompanied at times by self-reports of improved memory function; however, the researchers recommended only that these potential detriments be weighed against the potential benefits of ECT in any particular case.

1. The passage is primarily concerned with

(A) recommending a provocative medical practice
(B) explaining a controversial medical treatment
(C) arguing for further testing of a certain medical approach
(D) summarizing recent research concerning a particular medical procedure
(E) relating the public concern toward a particular medical therapy


2. Which of the following is NOT cited in the passage as a current or historical criticism of ECT?

(A) ECT causes the death of brain cells.
(B) ECT has been used to punish certain individuals.
(C) Seizures during ECT can cause bodily harm.
(D) Short-term memory loss results from ECT.
(E) Repeated applications of ECT affect several neurotransmitters in the brain.


3. The passage suggests that the author regards ECT with

(A) conditional support
(B) academic objectivity
(C) mild advocacy
(D) unreserved criticism
(E) increasing acceptance


4. Which of the following statements can be inferred from the third paragraph?

(A) Greater amounts of the neurotransmitters serotonin, norepinephrine, and dopamine seem to reduce symptoms of depression.
(B) ECT is never used prior to attempting psychotherapy or medication.
(C) Succinylcholine completely immobilizes the patient’s body.
(D) ECT often works faster than antidepressants.
(E) One ECT treatment is often sufficient to reduce symptoms of depression significantly.


5. According to the passage, which of the following statements is true?

(A) Most severely depressed individuals have suicidal thoughts.
(B) The general public was unaware of the bodily harm caused by unmodified ECT.
(C) Research into the side effects of ECT has only recently begun.
(D) ECT does not benefit individuals with anxiety disorders.
(E) Patients undergoing ECT today are unconscious throughout the procedure.


6. According to the passage, which of the following is true of the general population’s opinion of ECT? Indicate all that apply.

(A) It has improved in the years since the treatment was first introduced.
(B) It has been affected by artistic representations of the treatment.
(C) It has likely had an effect on the terminology that proponents of ECT might use to describe the treatment.