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It should be noted that at no time did the Army accept illiterates or educationally deficient men for limited service.
Table 10 presents induction station rejection rates for educational deficiency, mental dificiency, and the two combined during November 1942 through May 1943. It can be seen that the rejection rates for educational deficiency increased steadily, more than doubling for Negro registrants. The rates for mental deficiency remained substantially the same for whites and decreased slightly for Negroes. The rejection rate for both defects combined was 4.3 per 100 registrants examined; the corresponding rates for white and Negro registrants were 2.6 and 15.4.
TABLE 10.-Induction station rejection rates for educational and mental deficiency
during selected months, continental United States
In table 11 is shown the percent of registrants examined at induction stations with educational or mental deficiency as the principal defect who were inducted during November 1942-May 1943. Assuming that the small percentage of mentally deficient registrants who were inducted were really educationally deficient, it is apparent that 10.1 percent of the registrants reported as having these two defects were inducted. Corresponding figures for white registrants were 14.2 percent and for Negroes 4.9 percent. The proportion of these registrants inducted increased from November and December 1942 through February 1943 and dropped sharply thereafter. There was less difference between the proportion of whites and Negroes inducted who were mentally deficient than between those recorded as educationally deficient.
TABLE 11.—Percent of registrants examined at induction station with educational
or mental deficiency as principal defect who were inducted, November 1942– May 1943
Registrants having educational
or mental deficiency as princi-
November 1942 to May 1943.
9.6 12.8 15. 7 11.1 6. 5
14. 2 11. 6 17.2 23.3 17.7 8.9
4.9 6.8 7.6 5.9 3.7 3.4
TABLE 11.-Percent of registrants examined at induction station with educational
or mental deficiency as principal defect who were inducted, November 1942– May 1943—Continued
MAY 15, 1941, TO JULY 31, 1942 Effective May 15, 1941, the Army specified that any registrant inducted through the Selective Service System must be able to read and write the English language as well as a person who has satisfactorily completed the fourth grade in an American grammar school.
The local board or the local board examining physician made the determination as to each registrant's educational qualifications. In October 1941 6 objective tests, known as minimum literacy tests, were transmitted to the local boards for use as an aid in determining the educational qualifications of registrants. After January 1, 1942, the ability to meet educational standards was decided by examiners at the induction stations.
During the period May 15, 1941, through September 15, 1941, the accumulative illiteracy reports, DSS Forms 207, received from the various State headquarters showed that 143,467 registrants had been rejected for lack of educational qualifications at local boards and induction stations. Of these, 60,001 were white and 83,466 were Negroes. 8
NOVEMBER 1940 TO MAY 14, 1941 Until Nay 15, 1941, Army regulations governing the acceptance of registrants stated that registrants were acceptable "who appear to have normal understanding, whose speech can be understood, who have no definite signs of organic disease of the brain, spinal cord, or peripheral nerves, and who are otherwise physically and mentally fit.” During this period illiteracy was mentioned in the records of 3.6 registrants per 100 examined. 10 Of approximately 1,000,000 registrants who were found to be not qualified for general military service during November 1940 through May 31, 1941, about 100,000 were so classified for lack of educational qualifications.
7 Local Board Release No.94, February 9, 1942, directed attention to the fact that Selective Service regulations no longer provided
for educational determination at the local board level. & Selective Service in Peacetime: First Annual Report of the Director of Selective Service. Pages 174 and 175. The number and percentage of these deferred registrants is shown, by State, in appendix 29, p.
MR 1-9, August 31, 1940. 10 Medical Statistical Bulletin No. 1, November 10, 1941,
[From Journal of the American Medical Association, August 11, 1945) MENTAL AND PERSONALITY DISORDERS IN SELECTIVE SERVICE REGISTRANTS 1
(Col. Leonard G. Rowntree, Medical Reserve Corps, U. S. Army; Kenneth H.
McGill, and Louis P. Hellman, Washington, D. C.) The diagnosis of mental and personality disorders or serious potentialities for their development has resulted in the rejection of more selective-service registrants than has any other defect. It must be understood that by mental and personality disorders is meant any variation in the emotional capacity of the individual to adjust to his situation which results in symptoms indicating, in this instance, the possibility of maladjustment to military life. Among white registrants no other defects approach mental and personality disorders in importance as a cause for rejection, while for Negroes they are exceeded only by mental deficiency and syphilis. In addition, mental and personality disorders have accounted for more disability discharges from the armed forces than any other defects.
TABLE 1.—Estimated number of registrants aged 18–87 in rejected classes because of
mental and personality disorders, Jan. 1, 1945 1
Rejected for mental and personality disorders
4, 493, 000
17.8 19. 6
1 Includes those in class IV-F and also those transferred from class IV-F to the occupationally deferred classes, II-A (F), II-B (F) and II-C (F).
2 Includes all races other than Negro.
The standards for the rejection or acceptance of men for military service have been the responsibility of the armed forces. Most of the rejections for mental and personality disorders have been made by psychiatrists at the armed forces' induction stations. However, the more serious cases such as those which have necessitated institutionalization have nearly always been rejected by selective service local board physicians; and during peacetime many of those with less serious mental and personality disorders were also rejected at local boards in accordance with the armed forces' physical standards.
NUMBER CURRENTLY REJECTED
On January 1, 1945, an estimated 801,700, or 17.8 percent of the 4,493,000 registrants aged 18-37 in the rejected classes, were so classified because of mental and personality disorders (table 1). This figure does not include the thousands of registrants rejected for such disorders at one time or another but who were • later reexamined and either inducted into the armed forces or rejected for some reason other than mental and personality disorders. These defects accounted for a greater proportion of white registrants rejected than of Negroes.
More than 8 out of every 10 rejections for mental and personality disorders were due to psychoneurotic disorders or psychopathic personality. While most
1 From the Medical Division and the Division of Research and Statistics, National Headquarters, Selective Service System.
This report is based on sample studies of the results of examination recorded on DSS Forms 200, Reports of Physical Examination, for selective-service registrants physically examined at local boards in peacetime, and DSS Forms 221, Reports of Physical Examination and Induction, for registrants examined at local boards and induction stations during wartime. Coverage of the sample studies varies from 10 to 25 percent of the examinations.
2 Mental and educational deficiency are not included in this report. The major subdivisions of mental and personality disorders as used in this report were determined to a large extent by Medical Circular No. 1 revised by the Selective Service System, May 19, 1941, which divided mental and personality disorders into five categories. They are (1) grave mental and personality disorders, such as schizophrenia (dementia praecox), paranoia, and their various manifestations, (2) major abnormalities of mood, such as abnormal fluctuations in mood and constant states of depression and elation; (3) psychopathic personality, including constitutional psychopathic inferiority characterized by the record of certain types of recurrent social, sexual, or legal difficulties; (4) psychoneurosis, including hysteria, morbid anxiety, hypochondriasis, and the socalled psychosomatic disorders such as gastrointestinal and cardiovascular disorders due primarily to mental and personality difficulties; and (5) alcoholism and drug addiction, including psychoses due to these states. 3 Additional data on rejection rates and the prevalence of mental and personality disorders are to be found in the following bulletins published by the Selective Service System: Medical Statistics Bulletin No. 1, November 10, 1944; Medical Statistics, Bulletin No. 2, August 1, 1943; and Medical Statistics Bulletin No.3, November 1, 1944.
of the registrants rejected for these defects are not sufficiently inacpacitated to prevent their following a useful vocation in civilian life, it was determined by Army and Navy medical examiners that military life would probably aggravate their condition. The remaining registrants who were rejected for mental and personality disorders had the more serious disorders or history of such conditions. It is estimated that approximately 30,000 of these had been rejected by local board physicians because of an obviously disqualifying mental or personality disorder. The basis for this disqualification was authentic information that the registrant had been under treatment or in an institution at one time or another.
REJECTION RATES FOR MENTAL AND PERSONALITY DISORDERS
Rejection rates for mental and personality disorders have increased with each successive year of selective-service operations. During 1940 and 1941 approximately 22 of every thousand registrants examined were rejected for this defect (table 2). In 1942 the rate increased to 50, in 1943 to 74, and in 1944 to 120 per thousand examined.
TABLE 2.-Estimated rejection rates for mental and personality disorders by rate,
From November 1940 on, no appreciable changes have been made in the armed forces' actual standards for acceptance of men with mental and personality disorders as prescribed in Mobilization Regulations 1-9. However, with the gradual increase of psychiatrists on the staffs of armed forces' examining stations during wartime there was a stricter interpretation and application of the standards, which resulted in increased rejections for mental and personality disorders. In addition, three factors have operated to increase the rejection rate for mental and personality disorders. They are (1) changes in physical examination procedure, (2) lowering of standards in other defect categories, and (3) actual increased nervous tension among the examined registrants as a result of the entry of the United States into the war and as the war progressed. These factors make it difficult to determine the effect of the changes in the ages of the examined registrants during each of the 4 years on the rejection rate for mental and personality disorders. 4
The first two factors, which produced apparent but not real increases, were partially responsible for the increase in the rate from 1940-41 to 1942. During peacetime most of the registrants who were rejected were examined only by the general practitioner giving the local board examination, and comparatively few rejections were made for mental and personality disorders. Beginning in 1942 the local board physician gave only a screening examination, and most of the rejections were made after the induction station examination, which included an interview with a psychiatrist. The result was that the psychiatrist diagnosed many cases of mental and personality disorders which probably would have been missed by the general practitioner.
The second factor, the lowering of standards in other defect categories, operated with the first to produce an apparent increase in rejections for mental and personality disorders. Thus, during peacetime, tooth and eye standards were very high and tooth and eye defects were the leading causes for rejection. With the lowering of tooth and eye standards in 1942 the probability of being rejected for mental and personality disorders increased, since many registrants who would have been rejected for the more obvious tooth or eye defects also had mental and personality disorders of a disqualifying nature.
• During 1940 and 1941 the majority of examined registrants were in the age group 21-35; in 1942 the age group was enlarged to 20-44; in 1943 and 1944 only registrants aged 18-37 were examined. During 1944, however, the average age of the examined registrants was lower than in 1943.
The third factor, increased nervous tension of registrants after the entry of the United States into the war, was partially responsible for the pronounced rise in the rejection rate for mental and personality disorders from 1942 through 1944. How much of the rise is due to this third factor is difficult to evaluate because of the changes in physical standards in other defect categories and the variations in the application and interpretation of the standards for mental and personality disorders. As the war progressed there was also the possibility that within the extremely limited time allotted for the psychiatric interview and the increasing efforts of the armed forces to maintain at a minimum discharges for psychiatric reasons, some psychiatrists may have been overcautious in excluding border-line cases from the armed forces.
For both races, rejection rates for mental and personality disorders increased with each succeeding year; the rate for Negroes increased more rapidly than for white registrants. In 1940–41 and 1942 the Negro rates were 40 percent and 60 percent as great as the white rates. In 1943 and 1944 the rates for the two races were approximately equal. This greater increase for Negroes is mainly attributable to the fact that beginning in 1943 a greater proportion of Negroes were examined by psychiatrists than in 1942, as a result of the relaxed venereal standards.5
MAJOR SUBGROUPS OF MENTAL AND PERSONALITY DISORDERS
This section deals with the occurrence of the major subgroups of mental and personality disorders among all examined registrants, whether or not they were rejected and as causes for rejection among rejected registrants only. The prevalence data afford a more nearly complete picture of the disorders than data on causes for rejection, since (1) in some cases registrants with mild mental or personality disorders such as transient psychoneurosis because of anxiety over the outcome of the examination were found acceptable for service if otherwise physically fit and (2) some registrants with both physical defects and mental and personality disorders were rejected primarily for physical defects and hence would not be counted in the rejections.
During 1940 and 1941 approximately 26 out of every 1,000 white registrants examined were recorded as having some form of mental or personality disorder, while for Negroes the defect was found one-third as often"(table 3). Psychoneurotic disorders were the most frequent type of disorder recorded for both races—the bases for more than half of these diagnoses were functional disorders of expressive movements (tics, stammering, stuttering) and neurocirculatory asthenia. The prevalence rate for this defect among white registrants was more than four times that for Negroes. Psychopathic personality was next in order ofi mportance, but the white rate was only twice the Negro rate.
TABLE 3.-Prevalence of mental and personality disorders and percentage distribution
of rejections for these defects among registrants physically examined at local boards, 1940-41 1
Grave mental or personality disorders.
1 Corresponding data for induction stations are not available for the period 1940-41. 2 Includes all races other than Negro.
6 In 1942 syphilis was the leading cause for rejection among Negroes, and the great majority of these rejections were based on local board screening examinations. During 1943 registrants with venereal diseases were inductible into the armed forces, so that registrants with these defects were forwarded to induction stations, where they received a psychiatric examination as part of the induction-station routine.
6 Methods used in selecting the principal cause for rejection are explained in Edwards, T. I., and Hellman L. P.: Methods Used in Processing Data from the Physical Examination Reports of the Selective Service System, J. A. Statistical A. 39: 165-182 (June) 1944.