Communication deviances in parents of schizophrenics

In an attempt to make a multimethod assessment of communication deviance in parents of schizophrenics, a communication conflict situation (CCS) and the TAT were used to obtain qualitative and quantitative measures of communication for a sample of 50 parental couples, 21 of which were parents of schizophrenics, 9 were parents of nonpsychotic psychiatric patients, and 20 were parents of normals. The results were a general confirmation of earlier reports that communication deviance is an outstanding characteristic in families with a schizophrenic offspring. The most important finding, however, was that parents of paranoid and nonparanoid schizophrenics score very differently on a majority of the communication variables. Parents of nonparanoid schizophrenics form one extreme on a continuum of communication deviance, and parents of paranoid schizophrenics and normals the other. Egocentrism, measured by CCS, turned out to be the single qualitative variable with best discriminating power across all groups.     

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.     

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.     

Psychometric detection of schizotypy: perceptual aberration and physical anhedonia in relatives of schizophrenics.

We administered scales of Perceptual Aberration (PERAB) and Physical Anhedonia (PHYSAN), traits that may be related to risk for schizophrenia, to 54 schizophrenics, 146 of their first-degree relatives (evaluated for schizophrenia-related disorders), and 178 normal subjects (screened for psychotic disorders in them or their relatives). For both scales, there was a significant effect of group membership. For the PERAB scale, the schizophrenics had higher scores than the normal subjects, who had higher scores than the relatives. For the PHYSAN scale, schizophrenics had higher scores than their relatives, who had higher scores than the normal subjects. Patterns of familial correlations also suggested that physical anhedonia, but not perceptual aberration, may be familial among schizophrenics and their relatives. The PHYSAN scale, but not the PERAB one, may be a useful indicator of liability for schizophrenia among the relatives of affected probands.     

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.     

Communication deviance in families of schizophrenic and manic patients

Levels of communication deviance (CD) distinguish parents of schizophrenic patients from parents of nonpsychotic patients, but the prevalence of intrafamilial CD in other psychotic disorders has not been examined. Levels of CD were compared across biological parents of schizophrenic (n = 39) and bipolar manic (n = 16) patients and across patients themselves. CD ratings were based on Thematic Apperception Test protocols (parents only) and family interactions (parents and patients). Total levels of CD did not distinguish between groups of parents or patients. However, instances of odd word usage were more frequent among parents of manic patients than among parents of schizophrenic patients on both CD measures. Also, during the interaction task, odd word usage was more frequent among manic patients, whereas schizophrenic patients made more ambiguous references. Results suggest that high levels of intrafamilial CD are not unique to schizophrenia.     

A comparison of metacognitions in patients with hallucinations,delusions, panic disorder,and non-patient controls

This study tested the hypothesis that metacognitions are a general vulnerability factor for psychological disorder. It was predicted that patients with psychosis (hallucinations or delusions), and patients with panic disorder would score higher than non-patients on measures of metacognition. Moreover, it was hypothesised that patients showing most dysregulation of thinking (voice-hearers) would endorse significantly higher metacognition scores than individuals in the other groups. The Meta-Cognitions Questionnaire (MCQ: ) was administered to patients who met DSM-IV criteria for schizophrenia spectrum disorders with auditory hallucinations, patients who met DSM-IV criteria for schizophrenia spectrum disorders with persecutory delusions, patients who met DSM-IV criteria for panic disorder and non-patients. The results showed that psychotic patients who experience auditory hallucinations tended to exhibit higher levels of dysfunctional metacognitive beliefs than other patient groups, scoring significantly higher than at least two of the three control groups on positive beliefs about worry, negative beliefs about uncontrollability and danger, cognitive confidence and negative beliefs including superstition, punishment and responsibility. It was also found that the metacognitive beliefs of patients with persecutory delusions and panic patients were often similar to each other, and elevated in comparison to non-patients, suggesting that such beliefs are generic vulnerability factors. The theoretical and clinical implications of these findings 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.     

Stress-Induced Drinking in Parents of Boys with Attention-Deficit-Hyperactivity Disorder: Heterogeneous Groups in an Experimental Study of Adult-Child Interactions

Research on whether parents of children with externalizing disorders are at elevated risk for alcohol problems is equivocal. To reduce this ambiguity, we examined how individual differences in stress reactivity might moderate the drinking behavior of such parents. Parents (119 mothers, 44 fathers) of ADHD sons interacted with different child confederates during each of two counter-balanced sessions. In one, the confederate portrayed a friendly, cooperative, “normal” boy; in the other, the confederate portrayed a “deviant” boy who exhibited behavior characteristic of externalizing disorders. Following each interaction, parents were given an opportunity for ad lib consumption of alcohol while anticipating a second interaction. Latent class analysis identified three subgroups of parents using distress scores and alcohol consumption: minimal stress reactivity; reacts to child deviance with increased distress, but not increased drinking; marked stress-induced drinking. Decisions about the nature and proper treatment of parents raising children with ADHD may be compromised by failure to attend to individual differences in stress reactivity and inclinations to use drinking to cope.     

Referential communication disturbances in the speech of nonschizophrenic siblings of schizophrenia patients

Several different types of communication disturbances have been identified in the speech of schizophrenia patients. This study assessed 6 types of referential communication disturbances in the speech of 32 stable outpatients, 23 of their nonschizophrenic siblings, and 27 control subjects. The siblings made more frequent reference failures of all types than control subjects and did not differ from the patients on most types of disturbance. Only on the arguably most "schizophrenic" type of disturbance, the missing information reference, did patients show more deviance than siblings. On the vague reference, siblings showed more deviance than patients. These results, which are very similar to those previously reported on parents of patients, support the idea that referential disturbances reflect vulnerability to schizophrenia.     

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.     

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.     

Temperament and character inventory in homicidal, nonaddicted paranoid schizophrenic patients: a preliminary study

This study assessed the personalities of 13 murderer schizophrenics using Cloninger's Temperament and Character Inventory, controlling different factors such as institution, treatment, detention or loss of liberty, and can discriminate between schizophrenic patients involved in homicide, schizophrenics with no past violent behavior, paranoiac murderers, and imprisoned murderers with no psychiatric history. Results show significantly that murderer schizophrenics had significantly higher scores on the subscale, Self-transcendence, than other groups, which suggests that Self-transcendence as measured may be an aggravating factor for schizophrenia and may be found in the personality of schizophrenic subjects who performed homicidal acts. This dimension constitutes a way and an additional element for diagnosis not available with the DSM-IV criteria. It may help understanding and predicting violent behavior among schizophrenic patients.     

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.     

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.     

Primitive drive-dominated thinking: relationship to acute schizophrenia and sociopathy.

To investigate primitive drive-dominated thinking in schizophrenic disorders and sociopathic behavior, responses on the Rorschach and other personality tests of 171 acute psychiatric patients were assessed using Holt's system. Results suggested that: (a) Acute schizophrenics were high on primitive drive content, but this was also characteristic of some nonschizophrenics, and other types of disturbed thinking were even more prominent in schizophrenics. (b) There were no significant differences between process and reactive schizophrenics in expression of primitive drive content. (c) Males showed more drive-dominated thinking than females (p less than .10), although sex was not a powerful variable. (d) Depressives showed less drived-dominated thinking than nondepressive (p less than .05). (e) Patients high on sociopathic or rule-breaking behavior tended to show more primitive drive-dominated thinking (p less than .01).     

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.     

Neuromotor Functioning and Behavior Problems in Children at Risk for Psychopathology

Previous studies have found that early neuromotor deficits may be a precursor of later psychopathology. The present study examined the relationship between neuromotor dysfunction and behavioral deviance in children characterized by a variety of risk factors (parental schizophrenia, parental psychiatric disorder other than schizophrenia, and parental maltreatment). The sample consisted of 108 children (average age 9.75 years) who were assessed twice, approximately 1 year apart. It was found that maltreated children had poorer neuromotor functioning and more behavior problems than children who were not maltreated, regardless of parental psychiatric status. The results also indicated that the relationship between neuromotor functioning and problem behaviors varied as a function of parental psychiatric status. These findings suggest that, although the effects of maltreatment are generalized and pervasive, there are distinctive relationships between neuromotor functioning and behavioral deviance depending on the nature of the risk factors a child has been exposed to.