Electroconvulsive therapy (ECT) is a contro-versial psychiatric treatm

Question

Electroconvulsive therapy (ECT) is a controversial psychiatric treatment involving the induction of a seizure in a patient by passing 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. ECT is extremely effective against severe depression, some acute psychotic states, and mania, though, like many medical procedures, It 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 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 documented In books and movies, such as Ken Kesey's One Flew Over the Cuckoo's Nest, portrayed ECT as punitive, cruel, overused, and violative of patients' legal rights.

Modem ECT is virtually unrecognizable from Its earlier days. The treatment Is modified by the muscle relaxant succinylcholine, which renders muscle contractions practically 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 take several weeks to work effectively. Exactly how ECT exerts its effects is not known, but repeated applications affect several neurotransmitters In the brain, Including serotonin, norepinephrine, and dopamine.

ECT has proven effective, but it Is not without controversy. Though decades old studies showing brain cell death have been refuted in recent research, many patients do report loss of memory for events that occurred in the days, weeks, or months surrounding the ECT. Some 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 that sometimes results from severe depression.  
 1 
 1. According to the passage, why has ECT been viewed negatively by the public?

(A) Though ECT is effective in many cases, the medical community is not certain exactly how it works.
(B) Cultural depictions of ECT implied that the therapy infringed upon the lawful rights of those receiving the treatment.
(C) Effective use of ECT requires exposure to concerning medications, such as muscle relaxants and anesthesia.
(D) ECT does not benefit individuals with anxiety disorders.
(E) ECT cannot be performed without subsequent loss of memory in the patient.

2 
 2. Which of the following can be inferred about the way in which the modern form of ECT works?

(A) Greater amounts of the neurotransmitters serotonin, norepinephrine, and dopamine seem to reduce symptoms of depression.
(B) ECT cannot be used prior to attempting psychotherapy or medication.
(C) Succinylcholine completely immobilizes the patient's body.
(D) ECT generally works faster than antidepressants.
(E) One ECT treatment is often sufficient to reduce symptoms of depression significantly.

3 
 3. The author mentions amnesia as a possible side effect of severe depression in order to

(A) acknowledge one of the possible negative side effects associated with ECT
(B) emphasize the seriousness of severe depression as a debilitating disease
(C) introduce a possible alternative cause for short-term memory loss reported by some patients
(D) draw a connection between brain cell death and short-term memory loss
(E) refute claims that ECT is responsible for any form of amnesia in patients

4 
 4. Each of the following is cited in the passage as a current or historical criticism of electroconvulsive therapy  EXCEPT

(A) ECT may cause the death of brain cells and memory loss
(B) in certain cases, ECT was portrayed as a means to punish individuals
(C) ECT had the potential to be used in inappropriate situations
(D) early forms of ECT did not adequately protect patients from secondary harm brought on by the treatment
(E) repeated applications of ECT affect several neurotransmitters in the brain

5 
 5. The tone of the passage suggests that the author regards ECT with

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

6 
 6. 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) Severe depression can have symptoms unrelated to emotional mood.

Sajjad1994 · Accepted Answer

Official Explanation

1. According to the passage, why has ECT been viewed negatively by the public?

Explanation

(A) Though ECT is effective in many cases, the medical community is not certain exactly how it works. 
The passage states both that ECT can be effective and that the exact mechanism by which it works is unknown. Neither of these, however, is cited by the passage as a reason that the public has viewed ECT negatively.  (True but not right)

(B) Cultural depictions of ECT implied that the therapy infringed upon the lawful rights of those receiving the treatment. 
  CORRECT.   The last sentence of the second paragraph says that examples...documented in books and movies...portrayed ECT as... violative of patient's legal rights.

(C) Effective use of ECT requires exposure to concerning medications, such as muscle relaxants and anesthesia. 
The passage does state that ECT now uses muscle relaxants and anesthesia, but the passage does not call these medications concerning. If anything, the passage considers these positive advances, as the patient is asleep and fully unaware.  (One word off)

(D) ECT does not benefit individuals with anxiety disorders. 
The passage does not mention individuals with anxiety disorders.  (Out of scope)

(E) ECT cannot be performed without subsequent loss of memory in the patient. 
The last paragraph does mention that ECT can result in memory loss, but does not say that this side effect is always present. (Nor does the passage mention public conception with respect to memory loss.)  (Extreme)

2. Which of the following can be inferred about the way in which the modern form of ECT works?

Explanation

(A) Greater amounts of the neurotransmitters serotonin, norepinephrine, and dopamine seem to reduce symptoms of depression. 
The third paragraph does talk about these neurotransmitters. Some people might think this is plausible in the real world, but be careful—you have to find proof in the passage. The third paragraph says only that repeated applications of ECT affect these neurotransmitters. It does not indicate what effect these neurotransmitters have on depression.  (Out of scope)

(B) ECT cannot be used prior to attempting psychotherapy or medication. 
Whenever you see an extreme word, check whether the passage justifies the usage. In this case, the third paragraph does not justify the use of the word cannot; it implies only that those other therapies are tried first at least some of the time.  (Extreme)

(C) Succinylcholine completely immobilizes the patient's body. 
The third paragraph states that succinylcholine renders muscle contractions practically nonexistent. The qualifier practically means the muscle contractions are almost gone, but not entirely. The word completely, then, is too extreme.  (Extreme)

(D) ECT generally works faster than antidepressants. 
  CORRECT.   The third paragraph states that ECT may also be considered when there is an imminent risk of suicide, since antidepressants often take several weeks to work effectively. If ECT is used when there is an imminent, or immediate, risk, because antidepressants take a while to work, then ECT must generally work more quickly than antidepressants.

(E) One ECT treatment is often sufficient to reduce symptoms of depression significantly. 
The passage does not mention the number of treatments necessary to reduce symptoms significantly. At one point, it does mention repeated applications so, if anything, it appears that more than one treatment might be typical.  (Out of scope)

3. The author mentions amnesia as a possible side effect of severe depression in order to

Explanation

(A) acknowledge one of the possible negative side effects associated with ECT 
The passage does talk about many negative side effects associated with ECT, but the reference to amnesia is intended to introduce the idea that certain side effects actually might not be due to ECT.  (Direct contradiction)

(B) emphasize the seriousness of severe depression as a debilitating disease 
This choice sounds very tempting: in the real world, amnesia is a very serious issue and severe depression is a debilitating disease. However, depression is mentioned only as a possible alternative cause; the passage does not state that the amnesia is definitely a result of the depression.  (True but not right)

(C) introduce a possible alternative cause for short-term memory loss reported by some patients 
  CORRECT.   The first half of the sentence brings up patient reports of memory loss due to ECT; the second half indicates that some doctors think this memory loss might actually be due to amnesia from depression.

(D) draw a connection between brain cell death and short-term memory loss 
The fourth paragraph mentions both brain cell death and short-term memory loss. The passage does not connect the two ideas, however. In fact, it says that reports of brain cell death have been refuted, though memory loss is still in evidence.  (Mix-up)

(E) refute claims that ECT is responsible for any form of amnesia in patients 
The sentence does offer a possible alternative cause, but ECT is not definitively ruled out as one possible cause.  (Extreme)

4. Each of the following is cited in the passage as a current or historical criticism of electroconvulsive therapy  EXCEPT

Explanation

(A) ECT may cause the death of brain cells and memory loss.  
 True.  The fourth paragraph mentions that very old research showed brain cell death (even though that research has been refuted today) and that memory loss is an ongoing concern.

(B) In certain cases, ECT was portrayed as a means to punish individuals. 
 True.  A Line indicates that ECT was portrayed as punitive.

(C) ECT had the potential to be used in inappropriate situations. 
 True.  Tricky! Line 26 indicates that ECT was portrayed as overused. If a treatment is overused, then at least some of those uses shouldn't be happening, or are inappropriate.

(D) Early forms of ECT did not adequately protect patients from secondary harm brought on by the treatment.
 True.  Lines indicate that early forms of ECT often led to compression fractures of the spine or damage to the teeth.

(E) Repeated applications of ECT affect several neurotransmitters in the brain.
  CORRECT.      False   . Lines 45–47 do mention that ECT affects neurotransmitters, but this information is not presented as a criticism of ECT. Rather, it is presented as a partial means of understanding how ECT works.

Hope it Helps

tapasgupta · Answer

1. According to the passage, why has ECT been viewed negatively by the public?

(A) Though ECT is effective in many cases, the medical community is not certain exactly how it works.  - Inconsistent
 (B) Cultural depictions of ECT implied that the therapy infringed upon the lawful rights of those receiving the treatment.  - given in 2nd para
 (C) Effective use of ECT requires exposure to concerning medications, such as muscle relaxants and anesthesia.  - opposite
 (D) ECT does not benefit individuals with anxiety disorders.  - opposite
 (E) ECT cannot be performed without subsequent loss of memory in the patient.  - out of scope

2. Which of the following can be inferred about the way in which the modern form of ECT works?

(A) Greater amounts of the neurotransmitters serotonin, norepinephrine, and dopamine seem to reduce symptoms of depression. - cannot conclude, Inconsistent
 (B) ECT cannot be used prior to attempting psychotherapy or medication. - can be used. Inconsistent
 (C) Succinylcholine completely immobilizes the patient's body.  - out of scope
 (D) ECT generally works faster than antidepressants.  - given in 3rd para. can be concluded
 (E) One ECT treatment is often sufficient to reduce symptoms of depression significantly.  . not stated in the passage. cannot conclude

3. The author mentions amnesia as a possible side effect of severe depression in order to

(A) acknowledge one of the possible negative side effects associated with ECT  - author does not acknowledged anything. He is neutral
 (B) emphasize the seriousness of severe depression as a debilitating disease  - out of scope
 (C) introduce a possible alternative cause for short-term memory loss reported by some patients  - can be stated
 (D) draw a connection between brain cell death and short-term memory loss  - out of scope
 (E) refute claims that ECT is responsible for any form of amnesia in patients  - he is neutral. Inconsistent

4. Each of the following is cited in the passage as a current or historical criticism of electroconvulsive therapy EXCEPT

(A) ECT may cause the death of brain cells and memory loss  - stated in last para
 (B) in certain cases, ECT was portrayed as a means to punish individuals  - given in 2nd para
 (C) ECT had the potential to be used in inappropriate situations  - given in 2nd para
 (D) early forms of ECT did not adequately protect patients from secondary harm brought on by the treatment  - given in 2nd para
 (E) repeated applications of ECT affect several neurotransmitters in the brain  - this is not criticism. that is a fact. so is the answer.

Wonderwoman31 · Answer

Hi,

I am not convinced with question 2. Anyone else facing the same problem?

pandeyashwin · Answer

(A) Greater amounts of the neurotransmitters serotonin, norepinephrine, and dopamine seem to reduce symptoms of depression. 
 Not mentioned in the passage. (Read para 3 last line. It says something completely different)

(B) ECT cannot be used prior to attempting psychotherapy or medication.
 "It may also be considered when there Is an imminent risk of suicide, since antidepressants often take several weeks to work effectively. "
Passage says it can be used so it's inconsistent.

(C) Succinylcholine completely immobilizes the patient's body.
 The treatment Is modified by the muscle relaxant succinylcholine, which renders muscle contractions   practically nonexistent. 
Partially doesn't mean completely.

(D) ECT generally works faster than antidepressants.
 You can infer this from :  
"It may also be considered when there Is an imminent risk of suicide, since antidepressants often take several weeks to work effectively. "

(E) One ECT treatment is often sufficient to reduce symptoms of depression significantly.
 Nothing regarding this mentioned in the passage

AnushkaPatel961 · Answer

In 5. why can not it be option C? I am still not convinced with B
In 6. I am confused between option D and E. D cannot be properly inferred because anxiety in not mentioned in the passage, and in option E I am not convinced because of emotional. Please clarify this points.

Posted from my mobile device

bM22 · Answer

Hi  AnushkaPatel961 ,

Let me know if this helps.

5. The tone of the passage suggests that the author regards ECT with

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

Correct Answer : B.
Explanation: Throughout the passage, we can see that the author is not convinced of ECT, being used a method for psychiatric treatment, as he mentions: "ECT is extremely effective against severe depression, some acute psychotic states, and mania, though, like many medical procedures, It has its risks.", and then goes on to explain how ECT affect the brain, and how does the procedure harm the patients.
Option C is incorrect, as author doesn't accept or support the method as a proper one, even mildly, as can be inferred from the lines. He simply states the public opinions,facts from several researches and studies. The view of the author is impartial and objective, implying B.

Thanks.

bM22 · Answer

Official Explanation

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

Explanation

(A) Most severely depressed individuals have suicidal thoughts.

A includes the words severely and depressed, which leads us to the third para of the passage. This para indicates that ECT is considered as a treatment option,  when there is an imminent risk of suicide . However, nothing in the passage, tell us about the percentage(or number) of severely depressed individuals who have suicidal thoughts. The use of word Most is unjustified here, thus answer choice A can be eliminated.

(B) The general public was unaware of the bodily harm caused by unmodified ECT.

B includes keywords mentioned in the first para. This paragraph describes ways in which  public was aware of the bodily harm caused by unmodified ECT . This knowledge influenced the general public's strongly negative conception of the procedure, thus directly contradicting B. Answer choice B can be eliminated.

(C) Research into the side effects of ECT has only recently begun.

C again directly contradicts to what's mentioned in the passage. The second sentence of the final paragraph cites  decades old studies  of ECT's. Thus Answer choice C can be eliminated.

(D) ECT does not benefit individuals with anxiety disorders.

The first paragraph states that ECT is extremely effective against severe depression, some acute psychotic states, and mania. This does NOT necessarily mean that ECT is ineffective for anxiety disorders. With an "according to the passage" question, the correct answer must be provable by the passage text. Thus Answer choice D is not shown by the passage to be true.  .

(E) Severe depression can have symptoms unrelated to emotional mood.
 
  CORRECT.   The final sentence of the passage states that memory malfunction is a possible side-effect of severe depression. A memory malfunction is clearly unrelated to emotional mood. Answer choice E is thus correct.

Target4bschool · Answer

GMATNinja  I am having difficulty to answer Q4 (contenders: options D, E)
Each of the following is cited in the passage as a current or historical criticism of electroconvulsive therapy EXCEPT

(D) early forms of ECT did not adequately protect patients from secondary harm brought on by the treatment 
It brings harm to people. -> is that the basis of being considered as criticism.

(E) repeated applications of ECT affect several neurotransmitters in the brain  
Yes, this is a fact.

Both D & E can be considered as facts. So why did we put D as a criticism and E as a fact.

bM22 · Answer

Hi  Target4bschool ,

Criticism means judging the faults and merits of something. Now here, Option D is the evaluation of the effects of early forms of ECT on patients. E on the other hand is mentioned as fact : "Exactly how ECT exerts its effects is not known, but repeated applications affect several neurotransmitters In the brain, Including serotonin, norepinephrine, and dopamine", its not mentioned as a positive or negative point about ECT. It is simply mentioned as a fact about ECT.

Hope This Helps.
Thanks.

GDT · Answer

SajjadAhmad

Can you pls explain Q5 option B, C, E through negation of unsuitable options.

bM22 · Answer

Hi  GDT ,

Let me know if you still have doubts.

The author is not convinced of ECT, being used a method for psychiatric treatment, as he mentions: "ECT is extremely effective against severe depression, some acute psychotic states, and mania, though, like many medical procedures, It has its risks.", and then goes on to explain how ECT affect the brain, and how does the procedure harm the patients.

Option C is incorrect, as author doesn't accept or support the method as a proper one, even mildly. He simply states the public opinions, facts from several researches and studies. The view of the author is impartial and objective, implying B.

We can eliminate E based on a similar reasoning as C. Author is objectively talking about how ECT is harmful for patients, and the risks it. We have no evidence to infer that author regards ECT with acceptance and that too an increasing one.

Thanks.

VerbalBot · Answer

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Electroconvulsive therapy (ECT) is a contro-versial psychiatric treatm

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Electroconvulsive therapy (ECT) is a contro-versial psychiatric treatm

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