Comparison of Beck Depression Inventories-IA and-II in Psychiatric Outpatients

The study of mental representations on projective tests such as the Rorschach has made substantial contributions to our understanding of psychopathology. It is not clear, however, whether the representations of paranoid schizophrenics can be differentiated from those of normals and whether the Rorschach is the best test for such comparison. Object representations on the Rorschach and a role-playing (Johnson & Quinlan, 1980, 1985) test were studied in groups of normal (n = 31) and schizophrenic subjects (divided into paranoid [n = 16], intermediate [n = 11], and nonparanoid groups [n = 16]). Developmental levels of representation on both tests were measured with the widely used system of Blatt, Brenneis, Schimek, and Glick (1976), derived from Werner's concepts of differentiation, articulation, and integration. Generally the groups were not differentiated on these measures on the Rorschach. The role-playing test showed greater discriminatory power than the Rorschach, possibly due to its explicit demand to produce representations of humans in interaction. Results of the role-playing test showed differentiation and integration scores were negatively correlated with measures of psychotic symptoms. Nonparanoids differed from the other three groups on differentiation measures, and paranoid and normal groups scored higher on integration measures than did the intermediate and nonparanoid groups. Paranoid subjects scored higher than nonparanoids on functional articulation and higher than intermediates on perceptual articulation; however, paranoid subjects were not differentiated from normals on any developmental measure. Differences between the schizophrenic sample and normals were explained entirely by the nonparanoid subgroup, supporting the paranoid-nonparanoid distinction and raising questions regarding the nature of the deficit in paranoid schizophrenia.     

Response-selection processes in paranoid and nonparanoid schizophrenia

Previous research (Marshall, 1973) has shown that the most pronounced component of deficit on a choice reaction time task among a mixed schizophrenic sample involved response-selection processes. Other evidence has indicated that paranoids may be more deficient in this respect than nonparanoids. Hence, it was hypothesized that the former subgroup of schizophrenics would display response-selection deficit while the latter subgroup would display either less or no deficit. Response-selection processes were re-examined using the CRT paradigm with comparisons carried out among paranoid and nonparanoid schizophrenics and a group of nonschizophrenic controls. Results indicated that only the paranoid schizophrenics displayed abnormally retarded response-selection operations, the nonparanoid schizophrenics being nonsignificantly discriminable from the controls. It was suggested that past evidence of CRT response-selection deficit among mixed schizophrenics might have been attributable primarily to the performance of the paranoids, whose performance appears to be adversely affected by an increase in the number of dimensions relevant to response selection.     

The role of perceptual laws in the Rorschach test

The purpose of this study is twofold: to ascertain the perceptual deficits in schizophrenic subjects and to test the assumption that the Rorschach is mainly a perceptual task. Forty-eight subjects participated in the study, distributed in six groups of eight subjects each: normals, affective disorders, and four groups of schizophrenics (chronic paranoid, chronic nonparanoid, acute paranoid, and acute nonparanoid). They were given a perceptual test developed by Fernández-Trespalacios, Bermudez, and Luna (1979). Contrary to previous findings, no differences in the perceptual test were found among the groups. In the second part of the study, a group of schizophrenic subjects was given the Rorschach and the perceptual test in a balanced order. Subsequently, subjects in the experimental group were trained in the perceptual laws they had failed. Comparison of the Rorschach protocols obtained before and after this training failed to show any significant differences in the expected direction, thus questioning the perceptual nature of this test. Interestingly, an increase in negative categories of the Rorschach subsequent to the perceptual training was observed.     

Symposium: Research In Projective Techniques

Psychotic and nonpsychotic psychiatric inpatients were tested on the Rorschach. "Reality-testing" was measured by four form-level scoring systems designed by Beck, Mayman, Becket, and Wilensky, The psychotic subjects were dichotomized on three diagnostic dimensions: schizophrenia, paranoia, and premorbid social adjustment. No significant differences were found for the Beck system. With the other systems, psychotics showed significantly poorer reality testing than nonpsychotics. No differenced were found for the schizophrenic and paranoid dimensions. The Phillips premorbid adjustment score was negatively correlated with all four measures of "reality-testing." The conclusion drawn was that Rorschach measures of "reality-testing" are associated with psychotic and poor premorbid functioning, but do not differentiate schizophrenic from nonschizophrenic psychotics or paranoid schizophrenics from nonparanoid schizophrenics.     

A comparison of Rorschach developmental level and form-level systems as indicators of psychosis.

Psychotic and nonpsychotic psychiatric inpatients were tested on the Rorschach. "Reality-testing" was measured by four form-level scoring systems designed by Beck, Mayman, Becker, and Wilensky. The psychotic subjects were dichotomized on three diagnostic dimensions: schizophrenia, paranoia, and premorbid social adjustment. No significant differences were found for the Beck system. With the other systems, psychotics showed significantly poorer reality testing than nonpsychotics. No differences were found for the schizophrenic and paranoid dimensions. The Phillips premorbid adjustment score was negatively correlated with all four measures of "reality-testing." The conclusion drawn was that Rorschach measures of "reality testing" are associated with psychotic and poor premorbid functioning, but do not differentiate schizophrenic from nonschizophrenic psychotics or paranoid schizophrenics from nonparanoid schizophrenics.     

Parental communication deviance and schizophrenia: a cross-cultural comparison of Mexican- and Anglo-Americans

Levels of parental communication deviance (CD), as measured on the Thematic Apperception Test (TAT), were compared among families of schizophrenic patients in two culturally distinct groups. Spanish-speaking Mexican-American parents of schizophrenics completed the TAT in their native language, and CD was coded from their stories by a Spanish-speaking rater. Mexican-American parents had levels of CD that were nearly identical to those of a carefully matched sample of English-speaking Anglo-American parents. Factor scores that measure distinct subtypes of CD also did not differ across groups. The data suggest that levels of CD, despite discriminating between parents of schizophrenics and nonschizophrenics, do not vary across different languages and cultures.     

Patterns of transactional style deviance in the TAT's of parents of schizophrenics

Parents of schizophrenics show more transactional style deviance in diverse situations than do other parents. In a sample of families of nonschizophrenic outpatient adolescents, a manual for scoring such deviance on stories told for seven TAT cards was developed. This scoring system was shown to be composed of six meaningful factors. When this system was applied to the TAT's of parents of offspring with a variety of psychiatric diagnoses, a total deviance score did not discriminate among the parents. High scores on two particular factors were found only in parents of hospitalized schizophrenics, but four factors were nondiscriminating. Parents of young adults with schizophrenia spectrum disorders were more likely to show high scores on at least one of these six factors than other parents. Considering the scores of mothers and fathers together yielded the best discrimination of parents of schizophrenia spectrum disorders from other parents.     

Disconfirmatory feedback in families of schizophrenics

A new approach to the study of family communication and psychopathology, in particular schizophrenia, using Saugstad's theory about use of language as its point of departure is presented. Conflicts between family members were observed and measured using a new unrevealed difference technique, the Colour Conflict Method (CCM). Communication was analysed in terms of continuous feedback processes, using the new computerized method, Confirmation-Disconfirmation Coding System (CONDIS). Feedback mechanisms in the internal communication of families of schizophrenics, normals, and non-schizophrenic pathological controls (n = 21) are described. The findings show that families of schizophrenics lack the ability to adapt their communication to changing situational requirements. When conflicts were introduced, families of schizophrenics-in contrast to non-schizophrenics within the extended schizophrenia spectrum and normals-increased their frequency of disconfirmatory feedback reactions instead of expressing disagreements openly. This was due to active disqualifications occurring between the parents and from the parents towards their schizophrenic offspring, who reacted with incomprehensible egocentric communication acts.     

Speech competence of children vulnerable to psychopathology

Verbal productivity and cohesion and reference patterns of children of schizophrenics (N=23), unipolars (N=43), bipolars (N=38), and normals (N=53) were assessed using the Rochester and Martin (1979) evaluation system. Children of all offspring groups could be discriminated from one another, with children of schizophrenics showing the most deviant speech performance across all dependent measures. Children of schizophrenics were less verbally productive and had poorer patterns of cohesion between ideas than children of normals. In addition, they produced more unclear and ambiguous references to previously mentioned ideas than did children of normals. The consistency of deviance and performance on specific dependent variables in these children at risk for schizophrenia was similar to the speech performance of thought-disordered schizophrenics. Possible explanations for these similarities were discussed and evaluated.This research was supported by grant number MH21145 from the National Institute of Mental Health and by funds from the William T. Grant Foundation. The authors would like to thank Lina Jandorf for her invaluable assistance in data collection and scoring.     

Phenylthiocarbamide (PTC) tasting in paranoid and nonparanoid schizophrenic patients.

The present study reports on the association between Phenylthiocarbamide tasting for paranoid and nonparanoid schizophrenic patients. The incidence of PTC tasting is highly variable, and tasters and nontasters are frequently associated with some pathological states. 25 paranoid and 25 nonparanoid schizophrenic patients were examined for their PTC taste sensitivity. Frequency of paranoid tasters resembles the distribution of the normal population, whereas the nonparanoid patients are significantly different in their taste thresholds, with a higher incidence of nontasters. The members of this latter group have twice the incidence of psychiatric illness in their family histories as those of the former group. The significance of these findings is discussed as related to vulnerability for schizophrenia.     

Two-flash threshold, sensitivity and β in normal subjects and schizophrenics

Two-flash threshold, response criterion, and sensitivity (defined by the slope of the psychophysical ogive), were examined in schizophrenics and in normals under three conditions--a base-line condition, and during and after continuous white noise. Schizophrenics were subdivided into four groups on the basis of whether or not they exhibited paranoid symptomatology and electrodermal orienting responses. In general schizophrenics had more lenient two-flash response criteria than normal subjects. In the base-line condition schizophrenics with orienting responses had lower two-flash thresholds than those without orienting responses. Paranoid schizophrenics had more lenient criteria than non-paranoid schizophrenics and lower sensitivity than the non-paranoid group with orienting responses. Differential group effects were obtained during and after noise, especially with regard to sensitivity.     

ABSTRACTS

This is one of a series of research studies comparing parents and siblings of 30 schizophrenics with 30 neurotics. The parents of schizophrenics had a greater incidence of schizophrenia, personality disorders, and borderline disorders than did the normals. The siblings of the schizophrenics showed more varied disturbance than the parents. Of 30 schizophrenic families, 14 were "schizmatic" and 7 were "skewed"; 10 families were chaotic, 11 were rigid, 6 showed both patterns, and three were atypical. The families from which schizophrenics come are usually disturbed both genetically and environmentally.     

Affect in early memories of borderline patients

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.     

Qualitative and Quantitative Szondi Diagnosis

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.     

Communication deviances: a comparison between parents of learning-disabled and normally achieving students

This study explored the relationship between parents' communication deviances and children's placement in a learning disability class. Participants were the parents of 30 learning-disabled students and 30 average students attending junior high school. Samples of communication were taken from parents' participation in an experimental task. Using a "blind" sorting procedure, raters were able to identify 87% of the learning-disabled students' parents by their high communication deviance scores and 77% of the average students' parents by their low communication deviance scores on the experimental communication task (p less than or equal to .0001). Implications for future research on the etiology and remediation of learning disabilities are discussed.     

Symbiosis and Confirmation Between the Parents of the Schizophrenic

Parents of schizophrenics (N = 17 ) were compared with parents of nonschizophrenic hospitalized patients (N = 14 ) and parents of normals (N = 15 ) on the degree of symbiotic enmeshment and confirmation of individuality in the parental relationship. Symbiosis was divided into six component variables: undifferentiation, dependency, intervention, disapproval of other relationships, separation difficulty, and injunctions. Confirmation was bifurcated into acknowledgment and accommodation. Projective tests (TAT and Make-A-Picture-Story) and interviews were used to measure both variables. The results suggest that mothers of schizophrenics tend to be symbiotically attached to their husbands and view their husbands as forming the same type of attachment to them. Fathers of schizophrenics do not tend to be symbiotically involved with their wives but fail to confirm them. The implications of the results for the family system of the schizophrenic are discussed.     

Parental Communication Deviance as a Predictor of Competence in Children at Risk for Adult Psychiatric Disorder

Measures of communication deviance derived from three different Rorschach situations were obtained from parents of 62 children vulnerable to future psychiatric disturbance. The families were maritally intact, with one parent having a history of previous psychiatric hospitalization and a male index child, 7 or 10 years of age. Amount of parental communication deviance in one situation was not significantly related to amount of communication deviance observed in another setting. However, mothers who exhibited high levels of communication deviance in both the Individual and Family Consensus situations tended to have offspring who were judged as low functioning in multiple settings, based on teacher ratings, peer ratings, and parental report. Conversely, children judged as high functioning in multiple settings had mothers who were free of high levels of communication deviance in both Rorschach situations.     

Lack of acknowledgment in the family Rorschachs of families with a child at risk for schizophrenia.

Lack of acknowledgment, a characteristic of the direct interactions of families of schizophrenics, was found also to characterize the Family Rorschach interactions of families whose disturbed, non-psychotic adolescents were assessed at high risk for schizophrenia on the basis of parental communication deviance. The same high-risk families had unbalanced interaction patterns as reflected in three measures of family structure.     

Mueller-Lyer illusion and size estimation performance in schizophrenics compared to normal controls

A size estimation (SE) paradigm and the Mueller-Lyer (ML) illusion were used to examine perceptual disturbances in schizophrenics. 35 reliably diagnosed (DSM III-R) schizophrenics were compared to 20 subjects with no history of psychiatric illness. Perceptual distortions found in previous studies of schizophrenics were only to a certain extent confirmed in the present results. More overestimators were found among the schizophrenics than among the normals on the SE task. The schizophrenics, first of all the chronic patients, also proved to be more prone to the Mueller-Lyer illusion. A reason why the very clear differences between schizophrenics and normals found in previous examinations were not confirmed in the present study, might be that a reliable diagnostic instrument was for the first time used in this kind of study.     

Parental focus of attention in a videotape feedback task as a function of hypothesized risk for offspring schizophrenia

The families of 29 disturbed but nonpsychotic adolescents were observed in a structured task in which they discussed their reactions to viewing themselves interacting on videotape. Measures derived from the Singer-Wynne concenpt of transactional style deviance were applied to the parental behaviors and related to prior assessments of parental communication disorder based on individual parental TAT protocols. The results confirm the Singer-Wynne hypothesis of the cross-situational stability of transactional style deviance. The most striking finding, however, is that an index of positive focusing behavior differentiates more strongly parents of adolescents hypothesized to be at varying leves of risk for schizophrenia than does the measure of transactional style deviance.