Body Image Disturbance in Schizophrenia: A Study of Arms and Feet

This study investigated the significance of omitting arms/hands and legs/feet on the Draw-A-Person Test (DAP) in 128 hospitalized schizophrenic and 104 normally functioning adult males. The DAP was administered according to Machover's instructions, and the data were analyzed by chi-square tests. It was found that schizophrenics demonstrated significantly more omissions of arms/hands and legs/feet than the normals. These findings were interpreted to indicate body image disturbance in schizophrenia and were related to Schilder's and Federn's theories of the disorder emphasizing an impairment of ego boundaries.     

Emotions as wishes and beliefs

Emotions can be assessed by means of different diagnostic methods, for example, by self-report instruments, ratings of facial expressions, or by projective techniques. This study presents an alternative approach: a computerized investigation of verbally expressed emotions by means of the Affective Dictionary Ulm (ADU; Dahl, H?lzer, & Berry, 1992), which was applied to responses in the Holtzman Inkblot Technique (HIT; Holtzman, 1988; Holtzman, Thorpe, Swartz, & Herron, 1961). A normal group (n = 30), patients with neurotic disorders (n = 30), borderline patients (n = 30), acute schizophrenics (n = 25), and chronic schizophrenics (n = 25) were compared in regard to verbally expressed emotions. According to the results, patients with neurotic disorders did not differ from the normal group in regard to verbally expressed emotions. Borderline patients expressed fear and emotions in general significantly more frequently than all other diagnostic groups. Furthermore, borderline patients differed in regard to specific emotions from patients with neurotic disorders, acute schizophrenics, and chronic schizophrenics. Acute schizophrenics did not differ from the normal group in regard to the expression of emotions, whereas chronic schizophrenics expressed anger, fear, anxiety, and emotions in general significantly less frequently than normals. By a discriminant analysis using verbally expressed emotions as predictors of the diagnosis, hit rates between 87% and 100% could be achieved. Furthermore, hypotheses about correlations between emotions on the one hand and internalized primitive object relations and bizarre-idiosyncratic thinking were tested empirically. Significant correlations could be demonstrated. These results support the validity of assessing emotions through a lexical content analysis of the HIT by use of the ADU.     

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.     

Comparison of adult schizophrenics with matched normal native speakers of English as to “acceptability” of English sentences

This study tried to make some determinations as to whether the distortions observed occasionally in speech in chronic schizophrenics was, at root, a thought disturbance or a problem of comprehension and use of standard English speech. We compared 25 normal college students with 25 educationally matched inpatients at Camarillo State Hospital, Camarillo, California, who had been diagnosed as chronic undifferentiated schizophrenics in the judgment of sentences as being either relatively acceptable or unacceptable. The sentences (from Maher's 1972 study) varied in the degree to which they violated Chomsky's selection restriction rules: animate versus inanimate, human versus animal, and concrete verus abstract. Using Tuley's comparison test, we found no significant difference between normal and schizophrenic subjects in determining sentence acceptability or in the detection of sentence rule violations. The performance of chronic schizophrenics in rating sentences as relatively ungrammatical was not significantly different from that of normals. In addition, schizophrenics did not turn out to be significantly less sensitive to the number and types of selection rule violations in sentences. It seems probable that distortion in thought processes, rather than inability to use the semantic and syntactic rules of English speech, might be the underlying cause of the bizarre speech patterns which occur at times in the language of schizophrenics.     

Personality Trait Characteristics in Relation to Neuropsychological Dysfunction in Schizophrenia and Depression

Knowledge of the personality trait and psychopathology variables that differentiate neuropsychologically impaired and nonimpaired psychiatric patients has been limited relative to the study of higher cortical functions. This study reports findings from the Milton Clinical Multiaxial Inventory (MCMI) developed by Millon (1982) in a sample of hospitalized schizophrenics and depressives who also received the Luria-Nebraska Neuropsychological Battery. The principal findings indicate that neuropsychological dysfunction may be related to substance abuse, including its underlying personality dimensions, in schizophrenia, but only modest support is indicated for the construct of negative symptoms in schizophrenics with neuropsychological dysfunction. Further, the findings do not support the view that psychosis is a characteristic feature of depressives with impaired neuropsychological performance.     

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.     

Psychoanalytic Explorations in Art by Ernst Kris

A review of 43 controlled studies was conducted which evaluated the effectiveness of group therapy for schizophrenics. Group therapy was judged to be an effective modality of treatment for schizophrenics in 67 percent of the inpatient studies. It was especially useful in groups lasting more than three months. Therapy groups were effective for schizophrenics in 80 percent of the outpatient studies. Interaction-oriented approaches were more effective than insight-oriented approaches, which were found to be harmful for some schizophrenics.     

Peer evaluations of the competence of children vulnerable to psychopathology

Peer evaluations of the behavior of 75 children of schizophrenic mothers, 57 children of depressed mothers, and 153 controls were collected using the Pupil Evaluation Inventory. The children, both boys and girls, were in grades 2 through 9. Both male and female children of schizophrenics were viewed more deviantly than controls on Aggression and Unhappiness-Withdrawal factors. Only the female children of schizophrenics were viewed as less likable than controls. In general, children of schizophrenics did not differ from children of depressives. The exception was the older daughters of schizophrenics, who were rated as more deviant than members of both the remaining groups.This research was supported by grant MH 21145 from the National Institute of Mental Health and by funds from the William T. Grant Foundation.     

A comparison of two flash and two click thresholds in schizophrenic and normal subjects

The thresholds of fusion of paired flashes and paired clicks were compared. It was found that schizophrenics tended to show relatively higher click thresholds than normal subjects and in the most deteriorated schizophrenics two click thresholds tended to be higher than two flash thresholds.     

Gender, social competence, and symptomatology in schizophrenia: a longitudinal analysis

The relationship between gender and social skill measured by performance on a role play test was examined in a sample of 57 schizophrenics, 33 affective disorder patients, and 20 nonpatient controls. Female schizophrenics were more skilled than male schizophrenics, but no gender differences were present in the affective patients or the controls. Longitudinal analyses conducted on the schizophrenic group indicated that the superior social skill of women was stable over the year following a symptom exacerbation. Symptoms and social adjustment improved for both men and women over the year, but did not differ according to gender. The implications of the results for gender differences in the long-term outcome of schizophrenia are discussed.     

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.     

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.     

Interjudge Agreement of Draw-A-Person Diagnostic Impressions

Summary

The interjudge agreement of Draw-A-Person (DAP)-based diagnostic impressions was assessed. Twenty-four psychologists were asked to categorize 48 DAP protocols as being the productions of organics, paranoid schizophrenics, non-paranoid schizophrenics or normal controls. The mean between-judges proportion of agreement was only .41 and the mean proportion correct was a mere .28. (A proportion of .25 could be anticipated in each case by chance.) Strength of interjudge agreement did not vary with the extent to which judges utilized the test but did seem dependent upon the subjects' diagnoses. The results indicated that diagnostic impressions based on the DAP alone seem to be neither usefully valid nor impressively consistent across psychologists. It is suggested that the profession is due for a re-evaluation of its DAP training techniques and its use of the test.     

Memory in schizophrenia and affective disorders*

The purpose of the present study was to investigate the stability of memory and information processing in schizophrenics and affectively disturbed patients. Twenty-two schizophrenics, eight affectives and 14 normal controls were tested twice, with an interval of approximately one year. Results showed that normals performed better than schizophrenics and affectively disturbed patients on almost all of the cognitive measures. The differences reached a level of significance on a reaction time test, a vigilance task and a long-term memory task. The only measure where the difference did not reach a level of significance was on a short-term memory test. Groups' performance to some extent changed over time on most of the measures, but the changes were not significantly different for different 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.     

Level of aspiration and performance of chronic psychiatric patients on a simple motor task

The level of aspiration and performance was examined for 25 male psychiatric inpatients whose mean age was 57.4 yr. and mean length of hospitalization was 23.6 yr. For a simple motor task involving flipping a plastic chip over a goal line, each patient expressed the ward and his personal pretask levels of aspiration, performed the task, and expressed his personal posttask aspiration. The expressions of both the ward and pretask levels of aspiration were less than the mean score of a nonhospitalized referent group. Both performance and posttask levels of aspiration were greater than the pretask level. More patients predicted they would perform worse than the other patients on the ward than predicted they would perform better. The patients appropriately shifted their levels of aspiration either up after success or down after failure. The results were discussed according to expectations from classical theory as well as findings with schizophrenics. Implications for further research were discussed.     

The effect of context during word perception in schizophrenic patients

Hospitalized chronic and acute schizophrenics were compared with age- and social-status-matched controls on word perception tests to measure the effect of context on recognition thresholds. In Experiment 1 the method of J. Morton (1964, British Journal of Psychology, 55, 165-180) was adopted to see how related and unrelated contexts influenced word recognition thresholds when both context and stimulus word were presented visually. Experiment 2 was an auditory analog of Experiment 1 and in addition the chronic schizophrenics were selected on the basis of a presence or absence of auditory hallucinations. The influence of context on perceptual thresholds was quite normal in all schizophrenics. However, analysis of the incorrect responses elicited showed that some schizophrenic subjects do produce bizarre or irrelevant responses or perseveration to a greater extent than their controls. These results are explained in terms of automatic and strategic modes of information processing. The automatic processes responsible for the adjustment of perceptual thresholds operate normally in schizophrenics but response production which demands strategic selection and editing of responses is prone to malfunction which results in the observed deviations in the normal use of language.     

Differentiating Psychotic Patients From Nonpsychotic Patients With the MMPI–2 and Rorschach

Rorschach responses of 36 process and 23 reactive schizophrenics have been evaluated for presence of primary and secondary process thinking, and for oral, anal, sex, aggression, and anxiety content. Responses of the process schizophrenics involved more primary process than secondary process thought, whereas the reactive schizophrenics' responses showed more secondary than primary process thinking. A linear trend, parallel for both groups, was noted with regard to frequency of content responses, such that anxiety was greater than aggression, which was greater than oral, which was greater than sex and in turn was greater than anal. In both groups oral content was least invaded by primary process thinking, the remaining categories tended to cluster.