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Adolescent depression and interpersonal behavior Furnell, Margery D. 1973

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ADOLESCENT DEPRESSION AND INTERPERSONAL BEHAVIOR by MARGERY D. FURNELL B.S.N. University of Alberta, 1967  A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE MASTER OF SCIENCE IN NURSING i n the School of Nursing  We accept t h i s thesis as conforming to the required standard  THE UNIVERSITY OF BRITISH COLUMBIA JULY, 1973  In presenting  this thesis i n p a r t i a l fulfilment of the requirements for  an advanced degree at the University of B r i t i s h Columbia, I agree that the Library s h a l l make i t freely available for reference  and study.  I further agree that permission for extensive copying of t h i s thesis for scholarly purposes may by his representatives.  be granted by the Head of my Department or  It i s understood that copying or publication  of t h i s thesis for f i n a n c i a l gain s h a l l not be allowed without my written permission.  Department of  /Yl^  The University of B r i t i s h Columbia Vancouver 8, Canada  ii ABSTRACT ADOLESCENT DEPRESSION AND INTERPERSONAL BEHAVIOR i  Margery D. Furnell Adolescents may be p a r t i c u l a r l y vulnerable to depression.  Yet  Public health nurses working with large groups of adolescents are often unable to recognize depressed youths due to the lack of simple, r e l i a b l e screening t o o l s .  This exploratory study was undertaken i n order to gain  information that could be used to develop such a t o o l .  S p e c i f i c a l l y , the  following question was posed: 'Are there modes of r e l a t i n g interpersonally that can be used to d i s t i n g u i s h the highly and moderately adolescent from the non-depressed adolescent?'  depressed  The answer was  sought  from information obtained from adolescent s e l f - r e p o r t s on Beck's Depression Inventory and an adapted and pre-tested form of McNair and Lorr's Interpersonal Behavior Inventory. /These inventories were administered to twenty-five adolescents who attended a treatment centre f o r adolescents with emotional problems and seventy seven randomly selected adolescents who attended four Catholic high schools in Greater Vancouver. Adolescents were c l a s s i f i e d as non-depressed, moderately  depressed  and highly depressed on the basis of t h e i r scores on Beck's Depression Inventory. An analysis of variance was c a r r i e d out to discover i f there was a s i g n i f i c a n t d i f f e r e n c e in interpersonal behavior scores of  non-depressed,  moderately depressed and highly depressed adolescents. A simple regression analysis and a multiple step-wise regression analysis was done to see i f there was a s i g n i f i c a n t c o r r e l a t i o n between any interpersonal behavior categories  that could d i s t i n g u i s h between the non-depressed, moderately depressed, and highly depressed adolescent. The f i n d i n g s supported the overall conclusion: adolescents who exhibit mistrust, competition and detachment most of the time or a l l of the time and exhibit dominance only some of the time or not a l l a l l , may be moderately or highly depressed adolescents. The findings did not support the generally held thesis that suppressed h o s t i l i t y i s an important factor i n the depressed person.  (Thesis Chairman)  iv  TABLE OF CONTENTS CHAPTER  PAGE  I  INTRODUCTION The Problem Purpose of the Study Hypothesis Assumptions Limitations Definitions  1 1 4 4 5 5 7  II  REVIEW OF THE LITERATURE Introduction Adolescence Depression Cause of Depression Adolescence: A Time o f Loss I d e n t i f i c a t i o n of the Depressed Person Interpersonal Behaviors Studies of Adolescent Interpersonal Behavior Studies of Patient's Interpersonal Behavior A Study of Depressed Women's Interpersonal Behavior Summary  9 9 9 16 18 20 21 23 26 26 27 27  III METHODOLOGY Study Population Selection of Population from the Treatment Centre Selection of Population from the High Schools Instruments Beck's Depression Inventory McNair and Lorr's Interpersonal Behavior Inventory Pre-tests by the Researcher Adapted Interpersonal Behavior Inventory (AIBI) Administration o f the Inventories  29 29 29 30 33 33 35 36 37 37  IV ANALYSES OF DATA I d e n t i f i c a t i o n of Non-Depressed, Moderately Depressed, and Highly Depressed Adolescents Using a Depression Inventory Interpersonal Behavior Correlates of Depression Simple Regression Analysis Multiple Step-Wise Regression Analysis Interpersonal Behavior Categories that D i s t i n g u i s h Between Non-Depressed, Moderately Depressed, and Highly Depressed Adolescents  39 39 44 44 47 50  V  CHAPTER  PAGE  IV ANALYSES OF DATA cont'd Discussion Mistrust Competition Dominance Succorance Inhibition and Aggression  39 57 57 58 59 61 63  V  SUMMARY, CONCLUSION, IMPLICATIONS, AND RECOMMENDATIONS Summary Conclusions Implications and Recommendations  64 64 67 69  VI  SOURCES CONSULTED  71  VII APPENDIX A. Philosophy of B r i t i s h Columbia Youth Development Centre B. Consent Letter C. Materials Pertaining to Beck's Depression Inventory Pre-tests Value of Statements on Beck's Depression Inventory Beck's Depression Inventory Inventory Analyses Tables D. Materials Pertaining to the Interpersonal Behavior Inventory Pre-tests Behavior Categories and Corresponding Questions Adapted Interpersonal Behavior Inventory Inventory Analyses  78 79 85 87 88 89 91 98 103 104 107 108 117  vi  LIST OF TABLES TABLE  PAGE  1. Methods o f Delineating Disease Entries Under the C l a s s i f i c a t i o n of Depression  17  2.  Number of Adolescents C l a s s i f i e d as Non-Depressed, Moderately Depressed, Highly Depressed  40  3.  Scores of Non-Depressed, Moderately Depressed and Highly Depressed Adolescents on 15 Interpersonal Behavior Categories  41  4. Analysis of Variance: Interpersonal Behavior Categories of Non-Depressed, Moderately Depressed and Highly Depressed Adolescents  43  5.  Simple Regression Analysis: S i g n i f i c a n t Predictors  45  6. Simple Regression Analysis: Non-Significant Predictors  46  7. Multiple Regression Analysis: C o r r e l a t i o n Between Interpersonal Behavior Categories  48  8. Multiple Stepwise Regression Analysis: S i g n i f i c a n t Predictors  49  9. Multiple Stepwise Regression Analysis: Non-Significant Predictors  51  10.  Discriminant Analysis: Variables to Include as Discriminants  52  11.  Discriminant Analysis: Variables to Exclude as Discriminators  54  12.  Discriminant Analysis: Stepwise Selection o f Variables to be Entered  55  13.  Discriminant Analysis: Goodness of C l a s s i f i c a t i o n into NonDepressed, Moderately Depressed and Highly Depressed Groups  56  14.  Value of Statements on Beck's Depression Inventory  89  15.  Beck's Depression Inventory: Descriptive Data  94  16.  Beck's Depression Inventory: Goodness of F i t of Depression Scores  96  17.  Beck's Depression Inventory: Sources of Variance  97  18.  Item Analysis of Depression Scores  98  V l l  TABLE  PAGE  19.  Interpersonal Behavior Inventory, Behavior Categories and Corresponding Questions  107  20.  Sources of Variation of AIBI Scores  117  21.  Sources of Variation of Dominance Scores  118  22.  Sources of Variation of Competition Scores  119  23.  Sources of Variation of Aggression Scores  120  24.  Sources of Variation of Mistrust Scores  121  25.  Sources of Variation of Detachment Scores  122  26.  Sources of Variation of Inhibition Scores  123  27.  Sources of Variation of Submissiveness Scores  124  28.  Sources of Variation of Succorance Scores  125  29.  Sources of Variation of Abasement Scores  126  30.  Sources of Variation of Deference Scores  127  31.  Sources of Variation of Agreeableness Scores  128  32.  Sources of Variation of Nurturance Scores  129  33.  Sources of Variation of Affection Scores  130  34.  Sources of Variation of S o c i a b i l i t y Scores  131  35.  Sources of Variation of Exhibition Scores  132  36.  Item Analysis of Dominance Questions  148  37.  Item Analysis of Competition Questions  150  38.  Item Analysis of Aggression Questions  152  39.  Item Analysis of Mistrust Questions  154  40.  Item Analysis of Detachment Questions  156  41.  Item Analysis of Inhibition Questions  158  42.  Item Analysis of Submissiveness Questions  160  43.  Item Analysis of Succorance Questions  162  44.  Item Analysis of Abasement Questions  164  45.  Item Analysis of Deference Questions  166  TABLE 46.  Item Analysis of Agreeableness Questions  47.  Item Analysis of Nurturance Questions  48.  Item Analysis of A f f e c t i o n Questions  49.  Item Analysis of S o c i a b i l i t y Questions  50.  Item Analysis of Exhibition Questions  ix  LIST OF FIGURES FIGURE  PAGE  1. Selection of the Population from the Treatment Centre November 14, 1972 to February 1, 1973  31  2. Selection of the Population from Randomly Selected Catholic School Students January 15, 1973 to March 14, 1973  32  3. Frequency Distribution of Depression Scores  95  4. Frequency D i s t r i b u t i o n of Dominance Scores  133  5. Frequency D i s t r i b u t i o n of Competition Scores  134  6. Frequency D i s t r i b u t i o n of Aggression Scores  135  7. Frequency D i s t r i b u t i o n of Mistrust Scores  136  8. Frequency D i s t r i b u t i o n of Detachment Scores  137  9. Frequency D i s t r i b u t i o n of Inhibition Scores  138  10.  Frequency D i s t r i b u t i o n of Submissiveness Scores  139  11.  Frequency D i s t r i b u t i o n of Succorance Scores  140  12.  Frequency D i s t r i b u t i o n of Abasement Scores  141  13.  Frequency D i s t r i b u t i o n of Deference Scores  142  14. Frequency Distribution o f Agreeableness Scores  143  15.  Frequency D i s t r i b u t i o n of Nurturance Scores  144  16.  Frequency D i s t r i b u t i o n of Affection Scores  145  17.  Frequency D i s t r i b u t i o n of S o c i a b i l i t y Scores  146  18.  Frequency Distribution of Exhibition Scores  147  X  ACKNOWLEDGEMENT The writer wishes to extend sincere thanks to the many people who made t h i s study possible: to the administrators of the Vancouver Catholic high schools and the Maples, Youth Development Centre f o r t h e i r support of t h i s research on t h e i r schools; to the s t a f f of these schools who helped with the organization o f the research periods; to the youths for t h e i r w i l l i n g participation i n the pre-tests and research project; to R. Conry f o r his help i n the analysis of the data; to J. Horrocks for her advise; and especially to A. Baumgart and Dr. L. Walters f o r t h e i r guidance.  Although each investigator cannot consider a l l aspects of a problem, we can overcome t h i s l i m i t a t i o n by complementarity of investigators and theorists - that i s invest i g a t i o n o f many facets of a problem by many individuals and pooling t h e i r r e s u l t s . G. A l l port  CHAPTER I INTRODUCTION The Problem Theory and recent reports on the incidence of mental i l l n e s s suggest that adolescents may be p a r t i c u l a r l y vulnerable to depression. Yet adults working with adolescents have had great d i f f i c u l t y in recognizing the youth suffering from this emotional  disorder.  S p e c i f i c numbers of adolescents who are depressed cannot be ascertained from national or provincial v i t a l s t a t i s t i c s .  However, there  are studies which suggest that t h e i r numbers may be large and on the i n crease.  The Celdic Report, undertaken in Canada in 1970, studied c h i l d -  ren under the age of twenty and consulted with professional people  who  worked with them, as well as with parents of these children. The report estimated that a minimum of a m i l l i o n children in Canada suffered from an emotional or learning disorder.^  The American report Action f o r Mental  Health, written in 1960, reported that t h e i r c h i l d population with emotional 2  problems numbered in the m i l l i o n s .  Other research revealed that there  has been a rapid gain in total number of patients with depression  admitted  to state h o s p i t a l s , and that much of that increase could be accounted f o r by an increase in the admission of depressed adolescents and young people  The Commission on Emotional and Learning Disorders in Children, The Celdic Report (Toronto: Leonard Crawnford publisher, 1970), p. 5. The Joint Commission on Mental Illness and Health, Action f o r Mental Health (New York: John Wiley and Sons, Inc., 1961), p. 114.  2 in t h e i r twenties. ' ' '  Dunlop wrote that depression was second only  to schizophrenia as the cause f o r f i r s t and second admissions to mental hospitals in the United States and that the prevalence of depression outside of hospital was approximately f i v e times greater than schizophrenia.^  Beck stated: Depression ranks as one of the major health problems of today. M i l l i o n s of patients suffering from some form of this disorder crowd the p s y c h i a t r i c and general hosp i t a l s , the out-patient c l i n i c s , and the o f f i c e s of private p r a c t i t i o n e r s . Depression may appear as a primary disorder or i t may accompany a variety of other psychiatric or medical disorders. Not only i s depression a prominent cause of human misery but i t s byproduct, s u i c i d e , i s a leading cause of death in certain age groups. 8  In Canada, in 1970, the number of completed suicides for the q  age group of ten to nineteen was 2.83 per 100,000.  In B r i t i s h Columbia,  Saul Rosenthal, "Changes in a Population of Hospitalized Patients with A f f e c t i v e Disorders", American Journal of Psychiatry, 123: 671-675, 1966. J. Oltman and S. Friedman, "Trends in Admissions to a State Hospital, 1942-1964", Archives of General Psychiatry, 13: 549, 1965. W.J. Turner, F. O'Neil, and S. M e r l i s , "The Treatment of Depression in Hospitalized Patients Before and Since the Introduction of A n t i Depressant Drugs", American Journal of Psychiatry, 119: 421, 1962. A.P. Bay, "Discussion of the Treatment of Depression in Hospitalized Patients Before and Since the Introduction of Anti-Depressant Drugs", American Journal of Psychiatry, 119: 425, 1962. E. Dunlop, "The Use of Antidepressants and Stimulants", Modern Treatments, 2: 543-568, 1965. A. Beck, Depression (New York: Harper and Row, 1967), p. x i i i . Dominion of Canada, Bureau of S t a t i s t i c s , Causes of Death (Ottawa: S t a t i s t i c s Canada, 1970), p. 135.  3 in 1970, i t was 5.3 per 100,000 - the third leading cause of death f o r this age groupJ° Some authorities believe that the actual rate of suicide i s three to four times as great as the o f f i c i a l rate, and the number of attempted suicides i s believed to be seven or eight times the number of successful s u i c i d e s . ^ The Celdic Report states that " i n any other f i e l d , a problem of this magnitude would be heralded as an acute epidemic or national disaster and major resources would be poured into the search for a 1p solution". Prevention through early i d e n t i f i c a t i o n of problems, and mobilization of help must become a high p r i o r i t y f o r people working with 13 children.  Public health nurses are in a p a r t i c u l a r l y advantageous  position to contribute to preventative programs. They work with children of a l l ages in c l i n i c s and schools; they have ready access to families in t h e i r homes; they have professional contacts. The Public health nurse i s , however, hampered in carrying out e f f e c t i v e prevention of emotional disorders in c h i l d r e n , by a variety of factors.  S p e c i f i c a l l y , she is hampered in a s s i s t i n g in the prevention of  severe depression in adolescents by the paucity of reference material Province of B r i t i s h Columbia, Department of Health Services and Hospital Insurance, Vital S t a t i s t i c s ( B r i t i s h Columbia: K.M. McDonald p r i n t e r , 1970), p. 50. ^ E. Stengel, "Recent Research into Suicide and Attempted Suicide", American Journal of Psychiatry, 118: 725, 1962. 2 The Commission on Emotional and Learning Disorders in Children, The Celdic Report (Toronto: Leonard Crainford publisher, 1970), p. 393. Ibid., pp. 9-10. 3  4  available f o r understanding the phenomena and by the lack of diagnostic tools suitable to i d e n t i f y a depressed adolescent in need of help, i n a large student population. Purpose The purpose of this study was to answer the question, 'Are there modes of r e l a t i n g interpersonally that can be used to distinguish the moderately depressed and high depressed adolescent, from the nondepressed adolescent?' The answer to t h i s question was sought by comparing the interpersonal behaviors of non-depressed, moderately depressed and highly depressed adolescents. The levels of depression were measured by Beck's Depression Inventory and the modes of interpersonal behavior were ascertained from an adapted form of McNair and Lorr's Interpersonal Behavior Inventory. Hypotheses The hypotheses guiding t h i s study were: 1. there i s no s i g n i f i c a n t difference i n the interpersonal behavior categories of non-depressed, moderately depressed and highly depressed adolescents; 2. there are no interpersonal behavior categories that s i g n i f i c a n t l y correlate with depression; 3. there are no interpersonal behavior categories that can distinguish between non-depressed, moderately depressed, and highly depressed adolescents.  5  Assumption A s p e c i f i c assumption basic to this study was that each adolescent p a r t i c i p a t i n g i n the study was aware of his own feelings and charact e r i s t i c interpersonal behaviors, such that he was able to choose from a l i s t of d e s c r i p t i v e statements the one that most accurately described his f e e l i n g s or behavior.  Elaboration on this i s contained i n Chapter  III under 'Instruments'. Limitations 1. The population was l i m i t e d i n the following way: a) 102 subjects were drawn from one treatment centre and four Catholic high schools i n Metropolitan Vancouver; b) the population from the treatment centre consisted of only those adolescents who chose to p a r t i c i p a t e i n the study between November fourteen, 1972 and February one, 1973; c) the population from the Catholic high schools consisted of those randomly selected students who chose to p a r t i c i p a t e i n the study and who had a guardian's written consent on the day the inventories were administered i n t h e i r high school. Care must therefore be taken in generalizing the findings of this group of adolescents to a d i f f e r e n t or larger group. 2. Information gathered f o r this research was l i m i t e d to how adolescents reported they f e l t and interacted with others, on the day the research took place. Considering the l i m i t a t i o n s of this type of report as discussed in Chapter II under 'Interpersonal Behavior' and i n Chapter III under 1  Instruments ' " the findings of this study are not s u f f i c i e n t to l a y the  6  sole groundwork f o r a tool to i d e n t i f y the depressed adolescent.  Further  research using the 'other person' as the rater of behavior should be completed to discover i f enough similar overt behavior i s commonly perceived by both adolescent and 'other' to warrant the use of this behavior i n a screening t o o l .  7  D e f i n i t i o n of Terms Used in the Study Adolescent Non-depressed Moderately depressed  Highly" depressed  Any male or female youth between the age of thirteen and seventeen, i n c l u s i v e . Any adolescent whose score was equal to or less than t h i r t e e n , on the Beck Depression Inventory. Any adolescent whose score was equal to or less than fourteen to twenty-four, on the Beck Depression Inventory. Any adolescent whose score was equal to or greater than twenty-five on the Beck Depression Inventory.  Interpersonal behavior Any audible or observable interaction between two or more persons, that indicated how one individual thought and f e l t about another person; how he perceived him and what he did to him; what he expected him to do or think, and how he reacted to the actions of the other; the other may or may not be p h y s i c a l l y present. Interpersonal behavior category A mode of r e l a t i n g interpersonally. The modes used i n this study were: Dominance - the tendency to lead, d i r e c t , influence and control others. Competition - the tendency to seek recognition and status. Aggression - the tendency to c r i t i c i z e , r i d i c u l e or be punitive toward others. Mistrust - the tendency to doubt or support the a t t i t u d e s , feelings and intentions of others. Detachment - the tendency to be a l o o f , withdrawn, and seculsive. Inhibition - the tendency to by shy and to withdraw from the attention of others. Abasement - the tendency to take blame, b e l i t t l e oneself, and apologize.  Submissiveness  - the tendency to be passive, d o c i l e , and comply to the directions of others.  Succorance - the tendency to seek help, support, sympathy, and guidance. Deference - the tendency to be involved i n the support and service of a leader or superior. Agreeableness - the tendency to be co-operative, helpful and considerate. Nurturance - the tendency to o f f e r help, support, sympathy and counsel to others. A f f e c t i o n - the tendency to express l i k i n g , warmth, and f r i e n d liness towards others. S o c i a b i l i t y - the tendency to j o i n groups, to be included with others, and to be gregarious. Exhibition - the tendency to act in attention-seeking, and s e l f dramatizing ways.  CHAPTER 2 REVIEW OF THE LITERATURE The paucity of s p e c i f i c relevant l i t e r a t u r e pertaining to both the concept of depression and the area of interpersonal r e l a t i o n s in adolescence has been lamented by several authors.  Coleman has  remarked that: The f i e l d of adolescent development contains a number of areas which have so far remained largely in the area of speculation. . . .No where i s this-,more true than in the area of interpersonal r e l a t i o n s . Krakowski has written that the concept of depression in childhood including adolescence i s unpopular and i n s u f f i c i e n t l y understood. Recourse has thus been made to the general f i e l d s of Adolescence, Depression, and Interpersonal Behavior.  This background of theory and  research has been used for the following purposes: 1) defining the developmental stage of adolescence and identifying i t s unique c h a r a c t e r i s t i c s ; 2) d e f i n i n g depression, identifying possible causes of depression and methods of detection; 3) hypothesising that adolescence i s a period vulnerable to depression; 4) d e f i n i n g interpersonal behavior and d e l i n e a t i n g the ways that i t has been studied. Adolescence The philosophical question of whether man develops in stages, each with i t s unique c h a r a c t e r i s t i c s , has both gained and lost support  A. Krakowski, "Depressive Reactions of Children and Adolescents", Psychosomatics, 11: 431, 1970. J.C. Coleman, "The Perception of Interpersonal r e l a t i o n s h i p s During Adolescence", B r i t i s h Journal of Educational Psychology, 40: 253, 1970.  through those years. H i s t o r i c a l l y , A r i s t o t l e may have been the f i r s t to have d e l i n eated adolescence as a stage of development.  He defined i t as a period  beginning with puberty and ending at age twenty-one. He believed that a b i l i t y to make independent choices was the unique task for youth to achieve during this stage. The c h a r a c t e r i s t i c behaviors of youth were: indiscriminant s a t i s f a c t i o n of strong f e e l i n g s ; changeable, f i c k l e 4  behavior; afront a t being s l i g h t e d . During the Middle Ages, the church repudiated the b e l i e f that man developed i n unique stages. Man was viewed as having instantaneous c r e a t i o n , thus he came into the world as a miniature adult, d i f f e r e n t 5  only i n quantity not q u a l i t y . Rousseau challenged these teachings. He stated that adolescence could be delineated into two age groups: the other from age fourteen to twenty.  one from age twelve to f i f t e e n , The former period represented  the time when youth had to develop his s e l f consciousness, his rational functions, and his c u r i o s i t y . The l a t t e r period required the youth to develop an interest i n other people and a need for a f f e c t i o n . R.E. Muus, Theories of Adolescence (New York: p. 10. 4  A r i s t o t l e , The Work of A r i s t o t l e Translated to English, XI, trans. Rhys Roberts (Oxford: Clarendon Press, 1959), p. 1389a.  5  R.E. Muus, op, c i t . , pp. 18-21. 6  Random House, 1968)  Ibid., pp. 21-31.  In the nineteenth century, Stanley Hall gave the period of adolescence considerable emphasis.  He saw adolescence as a turbulent  t r a n s i t i o n a l state similar to a period i n time when society was i n a chaotic t r a n s i t i o n between primitive times and cultured times. This comparison of man's l i f e cycle to a r e c a p i t u l a t i o n of s o c i e t i e s ' growth was based on Darwin's theory of e v o l u t i o n / Current theorists i n the f i e l d of human development have continued to support the b e l i e f that man passes through a d i s t i n c t period called adolescence during his growth to old age. They vary, however, i what they believe constitutes the uniqueness of that period. Erikson  has viewed adolescence as a time during which youth  has to establish his independence and i d e n t i t y .  Adulthood cannot be  o  reached u n t i l these tasks have been met. Havinghurst defined adolescence as a time when s p e c i f i c b i o l o g i c a l l y and c u l t u r a l l y defined tasks must be mastered.  The  b i o l o g i c a l l y based tasks are: 1) 2) 3) 4) 5) 6)  acceptance of physique and appropriate sex role a c q u i s i t i o n of f r i e n d s of both sexes preparation f o r marriage and family attainment of independence from parents and other adults selection and preparation for an occupation development of i n t e l l e c t u a l s k i l l s and formulation of concepts to contribute to society Ibid, pp.  31-35.  E. Erikson , Identity Youth and Crises (New York, W.W. Norton and Co. Inc., 1968)., pp. 128-135.  12  The c u l t u r a l l y based tasks for the North American youth are: 1) attainment of economic independence 2) achievement of s o c i a l l y responsible behavior 9 3) formulation of values that are in harmony with the s c i e n t i f i c world. Like Erikson and Havinghurst, Strom has recognized the need for adolescents to gain independence but he has given an added  emphasis  to youth's need to build peer r e l a t i o n s . ^ Piaget's writings have d i f f e r e d from these writers primarily in their emphasis on the function of the maturation of the nervous system, interaction with the physical world, and influences from the social invironment as the causative forces in producing this unique stage. He described the adolescent as a person who i s capable of abstract thinking, that i s , at the beginning of t h i s period the youth can make only cumbersome approaches to formal operations but by the end of the period he can make laws and generalizations and support them with p r o o f s . ^ The idea of adolescence as a s p e c i f i c period in mans' l i f e cycle has a l s o been supported by social theorists l i k e Lewin, Sebald, and Ausubel. Lewin wrote that the c h i l d belonged to a s p e c i f i c group and the adult to another but the adolescent was a person who held a social position between and overlapping the adult and c h i l d groups.  Because of this lack  of 'belongingness' the adolescent was similar to a marginal member of an R.J. Havinghurst, Developmental Tasks and Education (New York: Green, 1951, pp. 30-35.  Longmans  M. Strom, Needs of Adolescent Youth (Danville, I l l i n o i s : Interstate Printers and Publishers, Inc., 1963), pp. 77-140. I. Inhelder and J . Piaget, The Growth of Logical Thinking (New York: Basic Books, 1952), p. 334-350.  13 u n d e r p r i v i l e g e d m i n o r i t y g r o u p and d e m o n s t r a t e d s i m i l a r b e h a v i o r s emotional  of  i n s t a b i l i t y and s e n s i t i v i t y . L e w i n a l s o b e l i e v e d t h a t when an  i n d i v i d u a l moved f r o m an o l d r e g i o n t o a new one, t h a t i s , f r o m one g r o u p to another  u n f a m i l i a r one, he c o u l d be e x p e c t e d  to denonstrate  indeci-  s i v e and o f t e n c o n t r a d i c t o r y b e h a v i o r u n t i l he became f a m i l i a r w i t h b e h a v i o r w h i c h would b e s t meet h i s needs i n t h a t new s e t t i n g .  He  the believed  12 t h a t t h e a d o l e s c e n t was  i n such a t r a n s i t i o n a l p o s i t i o n .  L i k e P i a g e t , A u s u b e l has w r i t t e n t h a t a d o l e s c e n c e tional period.  is a transi-  He has s t a t e d t h a t i n N o r t h A m e r i c a , t h i s t r a n s i t i o n a l  period i s prolonged  t o the p o i n t where we have d e v e l o p e d  a n x i o u s a d o l e s c e n t s who  a group of  have l o s t both t h e i r s t a t u s and t h e s e l f 13  esteem t h a t goes w i t h i t . Hans S e b a l d has c o n t e n d e d t h a t i n N o r t h A m e r i c a t h e r e i s a w i d e gap between t h e a d o l e s c e n t and h i s p a r e n t . from:  T h i s gap has r e s u l t e d  a r a p i d l y c h a n g i n g s o c i e t y where v a l u e s h e l d by many p a r e n t s  are  not t h o s e h e l d by s o c i e t y and a r e t h e r e f o r e i n a p p r o p r i a t e t o p a s s on to t h e i r c h i l d r e n ; a t e c h n i c a l l y advancing  s o c i e t y where work e t h i c s a r e  no  l o n g e r r e l e v a n t from one g e n e r a t i o n to t h e n e x t ; an u p w a r d l y m o b i l e s o c i e t y where lower c l a s s p a r e n t a l mores may 14 mobile c h i l d r e n .  not be a p p r o p r i a t e f o r t h e upward  K. L e w i n , F i e l d T h e o r y i n S o c i a l S c i e n c e ( L o n d o n : L t d . , 1 9 5 2 ) , pp. 135-145.  Tavistock  D.A. A u s u b e l , T h e o r i e s and P r o b l e m s o f Adolescent B e h a v i o r Grune and S t r a t t o n , 1 9 5 4 ) , pp. 57-67. H. S e b a l d , A d o l e s c e n c e : C e n t u r y C r o f t s , 1968).  A S o c i o l o g i c a l A n a l y s i s (New  York:  Publications  (New  York:  Appleton-  14  Kenniston has argued that youth finds i t most d i f f i c u l t to adapt to a changing society. They have outlived the social d e f i n i t i o n of childhood and not yet f u l l y located in the World of commitments and are most immediately,torn between the p u l l s of the past and the future. Research by Coleman and the Sherifs has tended to support the theory that adolescents are d i s t i n c t i v e l y d i f f e r e n t from adults in terms of their.value system.  J . Coleman studied the values of adolescents  across the United States and found that adolescents valued the star athlete while their parents valued the scholar.  The Sherifs observed  that adolescent groups formulated rules and value systems d i f f e r e n t from adult standards.  It was to these group norms that the adolescent was  committed.^ In contrast, in a Canadian study by El kin and Westley and in an American study by Hollingshead l i t t l e d i f f e r e n c e was found between the value system of adolescents and their parents. These researchers have, therefore, questioned i f in f a c t adolescence does represent a unique period. ' 1 8  1 9  15  K. Kenniston, "Social Change and Youth in America", Youth: Change and Challenge, ed. E. Erikson (Mew York: Basic Books Inc., 1968), p. 169. ^ J.C. Coleman, "The Adolescent Subculture and Academic Achievement", American Journal of Sociology, 65: 337-347, 1960.  ^ M. Sherif and C. S h e r i f , Reference Groups: Exploration into Conformity and Deviation of Adolescents (New York: Harper and Row publishers, 1961) 18  F. El kin and W. Westley, Myth of1955. Adolescent Culture", American Sociological Review, 20: "The 680-684, 19  A. Holl Hollingshead, Elmtown's Youth (New York: p. 443.  John Wiley and Sons, 1949),  15  Clay B r i t t a i n ' s study c l a r i f i e d  t h i s d i l e m m a , t o some d e g r e e .  He f o u n d t h a t a d o l e s c e n t s s o u g h t t h e i r p a r e n t s ' v a l u e s when t h e y f a c e d a d i f f i c u l t c h o i c e o r one t h a t p e r t a i n e d t o t h e i r f u t u r e . conformed  Adolescents  more t o t h e i r p e e r s ' v a l u e s when t h e c h o i c e i n v o l v e d s o c i a l  mores t h a t were i n c u l t u r a l t r a n s i t i o n s , and when immediate  consequences  were a n t i c i p a t e d . I f , however, t h e r e were c r o s s p r e s s u r e s , a d o l e s c e n t s 20 t r i e d to a v o i d h o l d i n g n o t i c e a b l y d i f f e r e n t views from t h e i r peers. Some doubt has a l s o been c a s t on t h e t h e o r y t h a t a d o l e s c e n c e i s a p e r i o d o f t u r m o i l and a t i m e f o r a p a i n f u l b r e a k i n g away from a d u l t s to g a i n i n d e p e n d e n c e .  E l k i n and W e s t l e y f o u n d t h a t t h e i r y o u t h p o p u l a t i o n 21 had c l o s e and open r e l a t i o n s h i p s w i t h t h e i r p a r e n t s . O f f e r , Marcus, and O f f e r showed t h a t a d o l e s c e n t s f e l t a s a t i s f a c t i o n w i t h both t h e m s e l v e s and t h e i r p a r e n t s , i n d e p e n d e n c e was a c h i e v e d g r a d u a l l y and w i t h l i t t l e 22 or no d i s r u p t i o n . Bandura and W a l k e r showed t h a t none o f t h e i r d a t a 23 s u p p o r t e d t h e t h e o r y t h a t a d o l e s c e n c e v/as a t i m e o f 'storm and s t r e s s ' . E i s e n b u r g w r o t e a b o u t t h e a d o l e s c e n t i n t h e f o l l o w i n g way: In h i s e f f o r t he examines h i s p a r e n t s f r o m a more c r i t i c a l p e r s p e c t i v e and l e a n s more t o peer g r o u p s for h i s sense of belonging. I f h i s r e l a t i o n s with h i s p a r e n t s have been s o u n d l y c o n s t r u c t e d d u r i n g e a r l i e r y e a r s , and i f t h e y meet h i s d o u b t and c r i t i c i s m with sympathetic understanding, t h i s t e m p o r a r y u n s e t t l i n g o f h i s p r i o r r o l e as a c h i l d l e a d s t o a r e - s y n t h e s i s o f h i s r e l a t i o n s with.them  C. B r i t t a i n , " A d o l e s c e n t C h o i c e s and P a r e n t - P e e r C r o s s P r e s s u r e s " , A m e r i c a n S o c i o l o g i c a l R e v i e w , 28: 385-391, 1963. F. E l k i n and W. W e s t l e y , op, c i t . D. O f f e r , D. M a r c u s and J . O f f e r . "A L o n g i t u d i n a l S t u d y o f Normal A d o l e s c e n t B o y s " , A m e r i c a n J o u r n a l o f P s y c h i a t r y , 126: 921-924, 1970. A. B a n d u r a , "The Stormy Decade: S c h o o l s , 1: 224, 1964.  Fact or F i c t i o n ? " , Psychology i n the  on a firm and lasting basis. . . .Where the parent c h i l d r e l a t i o n s h i p has been one of excessive h o s t i l i t y , the turmoil of adolescence may be prolonged and lead to f a i l u r e of emancipation, r e j e c t i o n or i s o l a t i o n . Depression Descriptions of the c l i n i c a l symptoms of depression have been 25 used since the time of Hyppocrates, i n the fourth century B.C. In the second century A.D., Plutarch described the depressed patient i n the following manner: He looks on himself as a man whom the Gods hate and pursue with their anger. A f a r worse l o t i s before him; he dares not employ any means of averting or of remedying the e v i l , l e s t he be found f i g h t i n g against the Gods. The physicians, the consoling friend are driven away. In the nineteenth century Pine! offered the following description: The symptoms generally comprehended by the term melancholia are t a c i t u r n i t y , a thoughtful pensive a i r , gloomy suspicions, and a love of solitude. Those t r a i t s , indeed, appear to d i s t i n g u i s h the characters of some men otherwise i n good health and frequently i n prosperous circumstances. Nothing, however, can be more hideous than the melancholic brooding over his imaginary misfortunes.^ Much more r e c e n t l y , Beck portrayed the depressed person as having the following a t t r i b u t e s : 24  L. Eisenburg, "A Developmental Approach", Children, 12: 135, 1965. A. Beck, Depression (New York: Harper and Row, 1967), pp. 3-4. I. Z i l b o o r g , A History of Medical Psychology (New York: Co. Inc., 1941), p. 67. 27 A. Beck, op. c i t . , p. 5.  Norton and  17  1) A s p e c i f i c a l t e r a t i o n of mood: sadness, loneliness, apathy. 2) A negative self-concept associated with s e l f reproaches and self-blame. 3) Regressive and s e l f - p u n i t i v e wishes: desires to escape, hide or d i e . 4) Vegetative changes anorexia, insomnia, loss of libedo. 5) Changes in a c t i v i t y l e v e l : r e t a r d a t i o n or agitation.28 The use of the term depression has d i f f e r e d amongst authors. Some have used i t to encompass a f e e l i n g state that the average person experiences at some stage in his l i f e , a symptom of a disease, a disease 29  i t s e l f , or a c l a s s i f i c a t i o n for disease e n t i t i e s . When the term depression has been used as a c l a s s i f i c a t i o n heading f o r other diseases no consensus has been reached as to what 30 31 diseases should be placed under the term. ' TABLE I METHODS OF DELINEATING DISEASE ENTITIES UNDER THE CLASSIFICATION OF DEPRESSION 3 2  DELINEATING FACTORS 1. internal or external cause 2. r e a c t i o n or lack of reaction to external events 3. predominant a c t i v i t y level 4. r e a l i t y o r i e n t a t i o n or lack  28  I b i d , p. 6.  29  "  Ibid, p. 7.  30  I b i d , p. 8.  31  I b i d , p. 63. Ibid.  32  DISEASE ENTITIES 1. a) b) 2. a) b) 3. a) b) 4. a) b)  exogenous depression endogenous depression r e a c t i v e depression autonomous depression agitated depression retarded depression neurotic depression psychotic depression  18  Some authors have viewed depression as a single c l i n i c a l disorder. They have seen i t as a continuum where a f e e l i n g state common to most people l i e s at the one end of the continuum and an incapacitating disease stage l i e s at the other end.  With this viewpoint i t becomes legitimate to talk  of the momentary f e e l i n g of sadness as depression as well as the  prolonged  period of g r i e f that prevents the individual from meeting his needs, or leads to his s u i c i d a l act.  Persons supporting t h i s theory have said  that the difference in the depression i s the degree to which i t a f f e c t s the indivual thus the cause can be the same for a l l l e v e l s .  Intervention  i s not required until the individual draws close to the end of the 33 continuum. Causes of Depression According to e x i s t e n t i a l i s t s the depressed person i s born with a pre-morbid personality that gives him the potential to develop depression.  The pre-morbid personality values o r d e r l i n e s s , and t r i e s  to meet his obligations in an exacting manner but i s also very s e n s i t i v e to g u i l t .  Depression r e s u l t s when he f e e l s he has f a l l e n behind in; 34  his obligations or a s p i r a t i o n s . Other t h e o r i s t s believe that family environment predisposes the individual to become manic-depressive.  If the mother i s the head  of the family and the father i s weak or i s made to look so, and i f the c h i l d is made responsible for gaining family presitge, the s i t u a t i o n is r i p e for that c h i l d to develop depression.  These theorists have said  that the interpersonal behavior of such a person i s structured by the 33  3  Ibid  ^ H. Tallenbach, Melancholia (West B e r l i n : Springer, 1961) c i t e d by A Beck, Depression (New York: Harper and Row, 1967), pp. 251-252.  19  b e l i e f that other people are either good or bad; no middle ground exists.  ^ Numerous studies have been carried out to i d e n t i f y a biological  substrate of depression.  Few of their findings have been r e p l i c a t e d .  Positive findings have, however, been c o n s i s t e n t l y associated with sodium retention, changes in sleep electroencephalograms, and excessive l e v e l s of stearoids. The l a t t e r has, however, been shown to be non-specific 36 to depression. Further biochemical studies have shown that a depletion in active norepinephrine at central adrenergic receptor s i t e s r e s u l t s 37 in depressed states of animals. For psychoanalytic theorists,depression i s a reaction to loss of a real or perceived loved object - a person, a possession, a highly valued expectation, a previous state of s e l f , r o l e , or status. The loss i s considered to deprive the ego, therefore, h o s t i l i t y towards the l o s t object r e s u l t s .  If this h o s t i l i t y i s not recognized and worked 38 39 40 through i t turns inward on the s e l f and depression r e s u l t s . ' ' 35 M.B. Cohen, G. Baker, R.A. Cohen, F. Fromm-Reichman, and E.V. Weigert, "An Intensive Study of Twelve Cases of Manic-Depressive Psychosis", Psychiatry, 17: 103, 1954. ^ A. Beck, op, c i t . , pp. 125-153. 37 J. Schildkraut, "The Catecholamine Hypothesis of A f f e c t i v e Disorders: A Review of Supporting Evidence", American Journal of Psychiatry, 122: 509-522, 1965. 38 G.L. Engel, Psychological Development on Health and Disease (Philadelphia Saunders, I960), p. 274. 39 J . Bowl by, "Grief and Mourning in Infancy and Early Childhood", Psychoa n a l y t i c a l Study of the C h i l d , XV (New York: International U n i v e r s i t i e s Press, 1960), p. 9. 40 S. Freud, "Mourning and Melancholia", Collected Papers, XIV Standard Edition (Longon: Hogarth, 1949), pp. 152-173.  20  Adolescence, a Time of Loss Some authors have used the concept o f loss to describe what happens to the adolescent and explain why he i s vulnerable to depression. Anna Freud has written that during adolescence, youth has to detach himself from his parents and h i s i n f a n t i l e objects, and d i s p l a c e these feelings to other persons and i n t e r e s t s . loss and requires the work of mourning.  This represents object  I f the youth does not work through  the mourning, i f he does not overtly express his f e e l i n g s , i f he turns his h o s t i l e feelings toward the l o s t object i n on himself then depression 41 may ensue. Kenniston has also accorded an important place to the idea of loss i n adolescence. He sees the adolescent losing the warmth, love, spontaneity and imagination o f childhood and being unable to replace these benefits or to forsee their replacements with any equal benefits i n 42 adolescence or adulthood. Mitchell has described the dilemma i n a similar manner. Adulthood i s a time when i t i s d i f f i c u l t to find work, or i f work i s a v a i l a b l e , i t i s not a r e f l e c t i o n of the individual's c r e a t i v i t y or motivation. The adolescent can therefore keenly experience the loss of childhood and see l i t t l e replacement value f o r i t s joys and 43 p r i v i l e g e s , i n adulthood. A. Freud, "Adolescence", The Psychoanalytical Study o f the Child, XIII (New York: International U n i v e r s i t i e s Press, 1958), p. 255. K. Kenniston, "Social Change and Youth i n America", Youth: Change and Challenge, ed. E. Erickson (New York: Basic Books, Inc., 1968), p. 176. J . M i t c h e l l , Adolescence: Some C r i t i c a l Issues (Toronto: Rinehart and Winston of Canada, 1971), pp. 45-74.  21  Lindemann wrote that loss always leads to g r i e f but does not of necessity lead to depression. g r i e f , no pathology r e s u l t s .  If the individual works through his  If s i g n i f i c a n t others help the individual  face the r e a l i t y of the loss and supports him as he works through a r e a l i s t i c acceptance of the loss, his work i s less d i f f i c u l t .  I f , however,  the individual avoids or i s unable to a t t a i n i n t e r a c t i o n with others, his a b i l i t y to work through his g r i e f i s more d i f f i c u l t and depression 44 can r e s u l t .  Therefore, i t may be said that an individual must have  adequate s k i l l s in interpersonal r e l a t i o n s to a t t a i n support during a time of loss. I d e n t i f i c a t i o n of the Depressed  Person  Observation has usually been the f i r s t step in the diagnostic process.  Although i t may be considered the simplest and quickest method  of screening a large group of people, o b j e c t i v i t y and v a l i d i t y have been problematic.  The question has been asked whether the observing and thus  evaluating person has known what behavior to watch f o r , that i s , what 45 behavior was s i g n i f i c a n t , and what behavior could be overlooked.  In  trying to d i s t i n g u i s h the depressed adolescent, people have usually looked f o r c l i n i c a l signs and symptoms of depression but as Dr. Krakowski has warned, the depressed adolescent makes i t d i f f i c u l t for others to observe his depression by masking the usual signs with a facade of jocularity E. Lindemann, "Symptomatology and Management of Acute G r i e f " , American Journal of Psychiatry, 101: 141-144, 1944. W.A. Mehrens and I.J. Lehmann, Measurement and Evaluation in Educational Psychology, (New York: Holt, Rinehardt and Winston, Inc., 1973) p. 519. A. Krakowski, "Depressive Reactions of Children and Adolescents", Psychosomatics, 11: 431, 1970.  22  In t h e p a s t i f a p e r s o n ' s b e h a v i o r s u g g e s t e d t h a t he was m a l a d j u s t e d , a t r a i n e d p r o f e s s i o n a l u s u a l l y i n t e r v i e w e d him and/or gave him p s y c h o l o g i c a l t e s t s .  I n t e r v i e w s , however, have been n o t o r i o u s l y  d e p e n d e n t on t h e t h e o r e t i c a l background o r p e r s o n a l b e l i e f s o f t h e i n t e r v i e w e r . 47 '48 '49 If p r o j e c t i v e t e s t s such as t h e Rorschach o r Thermatic  Apper-  c e p t i o n T e s t were u s e d , h i g h l y q u a l i f i e d p r o f e s s i o n a l s were needed t o b o t h a d m i n i s t e r and i n t e r p r e t t h e t e s t s ; even t h e n t h e r e l i a b i l i t y o f s u c h t e s t s has been q u e s t i o n e d .  C e r t a i n l y t h e c o s t o f t i m e t o both t h e 50 51  t e s t o r and t h e t e s t e e has been r e c o g n i z e d .  '  The M i n n e s o t a M u l t i - P h a s i c I n v e n t o r y ' s D S c a l e has a l s o been used t o i d e n t i f y t h e d e p r e s s e d p e r s o n .  Although the subject rates h i s  own b e h a v i o r , t h e f o r m a t o f t h e t e s t i s such t h a t a q u a l i f i e d p e r s o n i s needed t o a d m i n i s t e r and s c o r e i t .  To b e n e f i t f r o m t h e r e p o r t e d r e l i a b i l -  i t y o f t h e t e s t , t h e c o m p l e t e MMPI has t o be a d m i n i s t e r e d .  Researchers  have f o u n d t h i s cumbersome.  E v a l u a t o r s o f t h e MMPI have a l s o s u g g e s t e d 52 that i t i s s e n s i t i v e t o response sets. 4 7  48  4 9  A. Beck, o p , c i t . , pp. 173-175 W.A. Mehrens and I . J . Lehman, Measurement and E v a l u a t i o n i n E d u c a t i o n a l P s y c h o l o g y (New Y o r k : H o l t , R i n e h a r d t and W i n s t o n , I n c . , 1973), p . 519. O.K. Buro (Ed.) T h e S e v e n t h M e n t a l Measurement's Y e a r b o o k , V o l . 1 ( H i g h l a n d P a r k , New J e r s e y : T h e Gryphen P r e s s , 1972).  5 0  I b i d , pp. 422-449.  5 1  I b i d , pp. 452-462.  5 2  I b i d . , pp. 223-266.  23  L e s s t i m e has been r e q u i r e d t o a d m i n i s t e r , c o m p l e t e and s c o r e structural self-rating inventories of depression.  Less s k i l l e d  persons  have been used t o a d m i n i s t e r them b u t , t h e r e l i a b i l i t y and v a l i d i t y o f t h e s e t e s t s has v a r i e d .  Examples o f t h e s e t y p e s o f t e s t s a r e a s  follows:  Jung's S e l f - R a t i n g Depression S c a l e , Depression A d j e c t i v e 53 54 55 Check L i s t , Beck's I n v e n t o r y o f D e p r e s s i o n . ' ' Interpersonal  Behavior  F r i t z H e i d e r has d e s c r i b e d i n t e r p e r s o n a l b e h a v i o r a s c o n s i s t i n g o f how man f e e l s o r t h i n k s about a n o t h e r p e r s o n , how he p e r c e i v e s t h e o t h e r p e r s o n and what he does t o him, what he e x p e c t s t h e o t h e r p e r s o n 56 t o do o r t h i n k , and how he r e a c t s t o t h e a c t i o n s o f t h e o t h e r p e r s o n . L e a r y has d e f i n e d i t as b e h a v i o r t h a t i s r e l a t e d o v e r t l y , e t h i c a l l y , o r s y m b o l i c a l l y t o a n o t h e r human b e i n g , r e a l , c o l l e c t i v e , o r i m a g i n a r y . 57 He f e l t t h a t i n t e r p e r s o n a l b e h a v i o r was t h e u n i q u e human a s p e c t o f man. S t u d i e s o f man's i n t e r p e r s o n a l b e h a v i o r have been done s i n c e e a r l y times a c c o r d i n g t o Heider.  He w r o t e t h a t myth, f o l k - l o r e ,  CO  A. Beck, D e p r e s s i o n (New Y o r k : pp. 188-190.  H a r p e r and Row, p u b l i s h e r , 1967),  ^  O.K. Buro (ec ( e d . ) T h e S e v e n t h M e n t a l Measurement's Y e a r b o o k , V o l . 1 ( H i g h l a n d P a r k , New J e r s e y : The Gryphen P r e s s , 1972), pp. 320-321.  5 5  I b i d . , pp. 132-134.  5 6  I b i d . , pp. 15-19.  ^  F. L e a r y , I n t e r p e r s o n a l D i a g n o s i s o f P e r s o n a l i t y (New Y o r k : Ronald P r e s s Co., 1967), p. 4.  The  24 novels, poans and plays have been some of the best recordings of man's 58 interpersonal behavior to date.  He also stated that there i s a need  to study man's interaction more s c i e n t i f i c a l l y and that to do this in a comprehensive manner the following areas need to be analyzed: 1. a person's l i f e space, 2. his perception of his environment and the other person in i t , 3. his a b i l i t y to cause change, 4. his actual attempt to cause change, 5. his wish to cause change, 6. his sufferings from the effect of environmental change, 7. his f e e l i n g s towards the other person, 8. the e f f e c t of the other person's a l l e g i a n c e to other person's or things, 9. his f e e l i n g s of ought or should. 5g  Leary has asserted that the functional core of human behavior is interpersonal and that personality concepts have to be defined along g an adjustment continuum which includes both normal and abnormal reactions. To understand interpersonal behavior attention must be given to four areas: 1. perceived behavior, 2. reaction of other people to the i n d i v i d u a l ' s behavior, 3. behavior of the individual over time, 4. c u l t u r a l and environmental influences on the i n d i v i d u a l ' s behavior. Leary has explained that perceived behavior should be studied at f i v e l e v e l s . The basic level i s that of public communication  which  consists of the interpersonal impact of the subject's overt behavior on others, as rated by others. The second l e v e l , conscious description, i s how the subject chooses to present himself and his views of the world; F. Heider, The Psychology of Interpersonal Behavior (New York: and Sons, Inc., 1958), pp. 2-3. Ibid., pp. 15-19. Ibid., p. 56.  John Wiley  25 because i t i s his interpretation of his behavior, concensual accuracy has no bearing on the r a t i n g ; information on the third l e v e l , private symbolization, can be sought from projective tests and indirect fantasy materials; the unexpressed unconscious i s the next level and i t cons i s t s of the significantly-avoided patterns of behavior of the subject. The f i f t h level called values, i s defined by the subject's choice of 61  interpersonal t r a i t s that he holds to be good, proper and r i g h t . Leary maintained that a l l interpersonal behavior involves more than one person, thus the second area of study should include (a) the reflex way people t a i l o r their responses to others, (b) the automatic ways CO  they force others to react to them.  He has also suggested that there  are inconsistencies i n the same level of behavior over a period of time, interpersonal behavior should thus be measured over a period of time to CO  gain a more accurate analysis of the behavior.  The fourth area of  study Leary has been concerned with i s the e f f e c t of cultural and environmental factors on a person's interpersonal behaviors, thus research should i d e n t i f y the environment i n which the subjects a c t and the person with whom the subject i s i n t e r a c t i n g , as this can a l t e r 64 interpersonal behavior. 61  Ibid, pp. 76-81  62  Ibid., p. 83.  63  Ibid, p. 243.  64 Ibid,  the subject's  26 Studies of Adolescent Interpersonal  Behavior  A number of studies of the interpersonal behavior of adolescents have been done recently.  In 1965 Meisner used the d i r e c t  question method to gain data on the interaction of adolescents with 65 their parents.  In the following year, also using d i r e c t questioning,  Douvan and Adelson studied the interpersonal behavior of adolescent g i r l s and concluded that g i r l s ' development in the interpersonal sphere cc  was the basis for their adolescent behavior.  In 1970 Coleman studied  the development of interpersonal behavior in adolescents using the r e s u l t of projective t e s t s . He found that there were changes in behavior at fi7  d i f f e r e n t ages within the adolescent period. Studies of Patient's Interpersonal  Behavior  Early in the history of psychiatry, H.S. S u l l i v a n used the interview method to study the interpersonal behavior of emotionally ill patients. He concentrated on discovering what the unique i n t e r personal behavior patterns of patients s u f f e r i n g from a v a r i e t y of personality disorders were. He believed that s c i e n t i f i c study had to CO  be the study of interpersonal behavior. 65  W.W. Meisner, "Parental Interaction of the Adolescent Boy", Journal of Genetic Psychology, 107: 225, 1965. E. Douvan and J . Adelson, Thi The Adolescent Experience (New York: John Wiley and Sons, Inc., 1966~JT  ^ J.C. Coleman, "The Perceptioi Perception of Interpersonal Relationships During Adolescence", B r i t i s h Journal of Educational Psychology, 40: 253, 1970. CO  H.S. S u l l i v a n , "Tensions Interpersonal and International: A Psychiat r i s t ' s View", in Tensions that Cause Woe, ed., H. Cantril (Urbana, I l l i n o i s : University of I l l i n o i s Press, 1950), p. 92,  27 In 1967 a d i s c i p l e of S u l l i v a n ' s , P. Mullahy wrote that anxiety was the central cause of various kinds or categories of mental i l l n e s s , and that anxiety originated and operated only i n the i n t e r personal context, i t "could not occur i n the absence of inadequate 69 interpersonal r e l a t i o n s " . He believed, therefore, that psychiatry was circumscribed by the processes which involve or go on between p e o p l e . ^ A Study of Depressed Women's Interpersonal Behavior In 1970 Paykel et al were looking for a r e l i a b l e means of identifying improvement i n the depressed state of women patients.  Using  a semi-structured interview based on a developed rating scale they found that f i v e dimensions of social adjustment could i d e n t i f y improvement i n their patients. One dimension measured the work performance of the patient, the other four dimensions measured various aspects of their interpersonal r e l a t i o n s - interpersonal f r i c t i o n , i n h i b i t e d communication, submissive dependency and family attachments. Summary The l i t e r a t u r e has suggested that adolescents may be p a r t i c u l a r l y vulnerable to depression.  Adolescence has been represented as a period  during which youth has l o s t his status and p r i v i l e g e s of childhood.  This  loss r e s u l t s i n g r i e f , and g r i e f unless worked through to a r e a l i s t i c  P. Mullahy, A Study of Interpersonal Relations (New York: Science House, 1967), p. xx. 7 0  Ibid.  28  a c c e p t a n c e becomes d e p r e s s i o n .  T h e a d o l e s c e n t c o u l d work t h r o u g h h i s  g r i e f with the help of f r i e n d s or f a m i l y ; the person without t h i s help, however, would f i n d i t more d i f f i c u l t t o do s o . The a d o l e s c e n t who f i n d s i t d i f f i c u l t t o r e l a t e w i t h o t h e r s may be more p r o n e t o d e p r e s s i o n . Y e t , i n t e r p e r s o n a l b e h a v i o r p a t t e r n s have n o t been used as a means o f detecting depression i n adolescents.  CHAPTER 3 METHODOLOGY Study Population The study population consisted of one hundred and two adolescents drawn from a residential centre and four Catholic high schools in Greater Vancouver. Adolescents at the treatment centre represented an available population of adolescents with emotional problems.  It was postulated that  among t h i s group there would be a high potential f o r some adolescents to be depressed. The remaining adolescent population was made up of randomly selected youths in four Catholic high schools.. Data were c o l l e c t e d i n these high schools as t h e i r administrators were amenable to having t h i s type of research done i n t h e i r schools. Four schools out of a possible eight were sampled to gain a total population of over one hundred.  On  suggestion of the school administration, high schools i n Burnaby, North Vancouver, East Vancouver and Point Grey were used i n order that most socioeconomic groups would be represented.  It was recognized that the very  poor c h i l d had less l i k e l i h o o d of attending a Catholic school i n B r i t i s h Columbia as t u i t i o n fees are required. Selection of Population from the Treatment  Centre  Thirty-nine adolescents attended the treatment centre during the period of November fourteen, 1972 to February one, 1973 when the research took place; of those, twenty-five participated i n the study.  Written  consent had been obtained from the acting administrator of the treatment centre to ask each of the 39 students to be part of the research project.  30  Thirty seven were approached to participate in the project. Two were ruled out on the grounds that they had previously p a r t i c i p a t e d i n the pre-test.  Nine adolescents chose not to take part i n the study.  Three  adolescents were unable to complete the inventories as they were unable to concentrate f o r the required period of time. See Appendix A f o r information on the philosophy of the Treatment Centre. Selection of the Population from the High Schools A total o f ninety-two adolescents were randomly selected from the alphabetical school l i s t s of four high schools and asked to p a r t i c i pate i n the study; of those seventy-five took part i n the f i n a l study. Written consent had been obtained from the Catholic School administration to approach the principals of the Catholic high schools i n Greater Vancouver to ask i f t h e i r students might p a r t i c i p a t e i n the study.  Four principals  were v i s i t e d and the research was explained to them. Although one p r i n c i pal asked that his students not p a r t i c i p a t e , another principal whose school was i n the same area consented.  The randomly selected students were  approached about p a r t i c i p a t i n g .  One student refused. Parental or guardian  consent was sought f o r the ninety-one students, who indicated a willingness to p a r t i c i p a t e i n the study.  (A copy of the consent l e t t e r i s found i n  Appendix B). Nine consent l e t t e r s were not returned by the day the invent o r i e s were scheduled to be answered.Five adolescents who had written consent were absent on the day the research took place i n t h e i r high school.  FIGURE 1 SELECTION OF THE POPULATION FROM THE TREATMENT CENTRE NOVEMBER 14, 1972 - FEBRUARY 1, 1973  32  FIGURE 2 SELECTION OF THE POPULATION FROM RANDOMLY SELECTED CATHOLIC HIGH SCHOOL STUDENTS JANUARY 15, 1973 to MARCH 14, 1973  Instruments In t h i s study s e l f report inventories were used to obtain i n formation on adolescents f e e l i n g s and interpersonal behaviors.  The  instruments used were Becks Depression Inventory and McNair and Lorr's Interpersonal Behavior Inventory, adapted by the researcher f o r an adolescent population.  These tools were selected on the grounds that  they seemed well suited to the purpose of the study; they offered a means of c o l l e c t i n g data i n a standardized way; and they could be administered by someone less q u a l i f i e d than a c l i n i c a l p s y c h i a t r i s t or psychologist. Scoring could be done and normative values might be a v a i l a b l e with which to make v a l i d comparisons between the subjects of t h i s research and those of others.  Moreover, information could be quickly obtained from a large  number of  respondents.  Beck's Depression  Inventory  This inventory consists of items drawn from systematic  observa-  tions and recordings of attitudes and symptoms of depressed patients that are consistent with descriptions of depression found i n the l i t e r a t u r e . It was designed to i d e n t i f y the depressed person.  Normative scores were  established to d i s t i n g u i s h between low, moderate and high l e v e l s of depression.  These were 0-13, 14-25, and 25 and over, respectively.  In the inventory c h a r a c t e r i s t i c attitudes and symptoms were grouped into twenty-one categories: sadness, pessimism, sense of f a i l u r e , d i s s a t i s f a c t i o n , g u i l t , expectation of punishment, s e l f - d i s l i k e , s e l f accusation, s u i c i d a l ideas, crying, i r r i t a b i l i t y , s o c i a l withdrawal, i n decisiveness, body image change, work retardation, insomnia, f a t i g a b i l i t y ,  34  anorexia, weight l o s s , somatic pre-occupation, loss of l i b i d o .  These  categories became questions one through to twenty-one, r e s p e c t i v e l y . Each question then consisted of a graded series of four to f i v e s e l f evaluative statements.  Numerical values from zero to three were assigned  to each statement to indicate the level of s e v e r i t y of the symptom.  In  many questions there were two a l t e r n a t i v e statements of equal value presented.  Details of the inventory can be found in Appendix C, In developing the test Beck subjected i t to various s t a t i s t i c a l  checks.  An item analysis of 606 cases showed that the categories of  depression correlated p o s i t i v e l y with the total depression score (range .31.68). These were a l l s i g n i f i c a n t at the .001 l e v e l .  Pearson's r between  the odd and even categories was computed and yielded a r e l i a b i l i t y coeff i c i e n t of .86; with a Spearman Brown Correction, t h i s c o e f f i c i e n t rose to .93. times.  The test was administered to t h i r t y - e i g h t patients at two d i f f e r e n t Each time a c l i n i c a l estimate of the depth of depression was made  by a p s y c h i a t r i s t .  The change i n the scores on the inventory p a r a l l e l l e d  the changes i n c l i n i c a l ratings of the depth of depression. The KraskalWallis One-way Analysis of Variance by Ranks was used to evaluate the stati s t i c a l s i g n i f i c a n c e of the differences between the mean scores of each level of depression. The p-value of these differences was < 0.001J Similar r e s u l t s were found when the inventory was used i n England by Metcalfe and Goldman. Correlations between scores on the Depression Inventory and c l i n i c a l judgments concerning depth of depression was s i g n i f i c a n t at the 0.001 level i n studies done by Beck and r e p l i c a t e d by Metcalfe. A ^ A. Beck, Depression (New York: Harper and Row, 1967), pp. 193-200.  35 higher c o r r e l a t i o n existed between the Depression Inventory score and c l i n i c a l ratings of depression, than existed between the c l i n i c a l ratings and scores on the D scale of the MMPI. When the Depression Inventory scores were correlated with other tests f o r depression the following correlations were found: 1. Depression Inventory with MMPI D Scale r = .75 2. 3.  "  "  with Hamilton Rating Scale r = .75  "  with Lubins Depression Adjective Check L i s t  r = .66.  McNair and Lorr's Interpersonal Behavior Inventory The f i n a l revised edition of this inventory consists of 140 statements covering f i f t e e n behavior categories that were selected from the l i t e r a t u r e : dominance, competition, aggression, mistrust, detachment, i n h i b i t i o n , submissiveness, succorance, abasement, deference, agreeableness, nurturance, a f f e c t i o n , s o c i a b i l i t y ,  e x h i b i t i o n . Each statement i s rated  according to the frequency that i t ' s behavior i s exhibited; not at a l l , occasionally, usually, and very often. Three experiments were designed and multiple f a c t o r analysis was done to test i f these behavior categories existed.  In the f i r s t experiment 163 psychologists and p s y c h i a t r i s t s i n  private and public p r a c t i c e used the inventory to describe a total of 346 patients as well as 86 normal i n d i v i d u a l s .  It was then used by 254  seniors and graduates i n psychology to describe 290 normal men and women. F i n a l l y , a group of therapists employed the inventory to rate the behavior  2  Ibid.  36. of sixty neurotic patients. The hypotheses was supported. ' ' Pre-tests by the Researcher The purpose of the pre-tests was two-fold: 1. to determine whether adolescents aged t h i r t e e n to seventeen could use the inventories to rate t h e i r own feelings and behavior, 2. to gain expertise i n administering the inventories. It was discovered that no changes were required i n Beck's Depression Inventory but modifications were needed i n the wording of McNair and Lorr's Interpersonal Behavior Inventory and the grouping of questions. Adaptations to the inventory were made and pre-tested until the inventory could be understood and used by the youngest adolescent i n the study. Details o f these pre-tests are i n Appendix C and D. A s p l i t h a l f , odd-even check f o r r e l i a b i l i t y using Pearson's Product C o e f f i c i e n t of C o r r e l a t i o n , was used to discover the r e l i a b i l i t y of the f i n a l l y adapted interpersonal behavior inventory.  I t revealed a c o r r e l a -  tion of .96. This adapted form o f McNair and Lorr's Interpersonal Inventory was then sent to Dr. Lorr.  Behavior  He wrote:  Your revisions seem very plausible and reasonable. The major questions one might have i s whether your subjects w i l l tend to answer i n a s o c i a l l y desireable d i r e c t i o n , otherwise you have converted the statements i n a commendable way. 6  M. Lorr and D. McNair, "An Interpersonal Behavior C i r c l e " , Journal o f Abnormal and Social Psychology, 67: 68-75, 1963. M. Lorr and D. McNair, "Expansion of the Interpersonal Behavior C i r c l e " , Journal of Personality and Social Psychology, 2: 823-883, 1965. M. Lorr and A. S u z i e d e l i s , "The Interpersonal Behavior Inventory", B r i t i s h Journal o f Social and C l i n i c a l Psychology, 8: 124: 132, 1969. Based on personal correspondence between Dr. CM. Lorr, Professor, Department o f Psychology, Catholic University and the writer.  37  It was decided that f o r the purpose of this study the p o s s i b i l i t y of biased answers due to s e l f - r e p o r t would be a l i m i t a t i o n of the study. Adapted Interpersonal Behavior Inventory A1B1 The A1B1 resulted from changes made i n McNair and Lorr's Interpersonal Behavior Inventory. C.  The A1B1 contains three sections: A, B, and  Sections A and B contain f i f t y statements; Section C contains f o r t y .  Each statement can be rated as: not a l l a l l , occasionally, u s u a l l y , a l l the time.  The values f o r these r e p l i e s are one to four r e s p e c t i v e l y .  Details of the A1B1 can be found i n Appendix D. Administration of the Inventories Two-hour periods were scheduled f o r the researcher to administer the inventories to groups of adolescents i n both the treatment centre and the high schools. Data were c o l l e c t e d from the treatment centre during f i v e twohour periods. Four periods were a l l o t e d f o r completion of the inventories by students in each of the four residences in the treatment centre; a f i f t h period was established to allow l a t e r admissions to the centre, the opportunity to p a r t i c i p a t e i n the research. Data from the high schools were c o l l e c t e d in one two-hour period spent in each of the four high schools. It was explained to each group that during the next two hours there were two inventories to be answered; one concerning how they f e l t and one about how they thought they usually acted towards other people.  They  were told that the answers to these questions might be useful in helping i n the early treatment of teenagers with problems.  They were reminded that  38  t h e i r answers were c o n f i d e n t i a l and that they were free to withdraw from the study at any time.  I n a b i l i t y to complete the questionnaires would not be  reported to the teachers; i t would simply mean that t h e i r set of incomplete answers would not be used f o r the study.  A set of four coded o.m.fl. com-  puter cards and a medium soft pencil with eraser were d i s t r i b u t e d to each student.  Instructions on how to use the cards were given and t h i s was  then demonstrated.  The researcher was aviTable to a s s i s t with problems  using these cards, as they arose. F i r s t the Beck's Depression Inventory was d i s t r i b u t e d to each student.  Directions were given on how to answer the inventory and  demonstrated.  When i t was completed the Adapted Interpersonal Behavior Inventory was handed out and the same procedure of explanation and demonstration followed.  To  minimize the p o s s i b i l i t y that subjects would answer i n a s o c i a l l y desirable way, they were ensured that t h e i r answers were anonymous. To further motivate the subjects to answer t r u t h f u l l y , they were told that l i t t l e had been written about how adolescents viewed t h e i r own f e e l i n g s , and i n t e r a c t i o n s with others and that i t was hoped that by f i n d i n g out t h i s information, nurses could help other teenagers with problems i n these areas. Exactly the same procedure was followed in the high school groups as was used with the treatment centre groups. The researcher was the only person who gave the d i r e c t i o n s and answered questions i n a l l the groups.  CHAPTER 4 DATA ANALYSIS AND RESULTS Data was analyzed t o : categorize adolescents into three groups; determine differences i n interpersonal behavior group mean scores; discover interpersonal behavioral correlates of depression; i d e n t i f y interpersonal behavior categories that can d i s t i n g u i s h the highly depressed, depressed and non-depressed  moderately  adolescent.  I d e n t i f i c a t i o n of Non-Depressed, Moderately Depressed and Highly Depressed Adolescents Using a Depression Inventory The f i r s t step i n the treatment of the data was to categorize adolescents into three groups on the basis of t h e i r depression inventory scores: non-depressed, moderately depressed, high depressed.  A value f o r  each reply on the Depression Inventory was obtained by using a s p e c i f i c a l l y designed computer program SCALER (See Appendix C f o r values). These values were aggregated to obtain a score f o r each subject. Those with scores i n the range of 0.-3 were c a l l e d non-depressed, those in the range of 14-24 were c a l l e d moderately depressed and those who gained 25 or above were i d e n t i f i e d as highly depressed (Table 2). Differences i n Interpersonal Behavior Scores of Non-Depressed, Moderately Depressed, Highly Depressed  Adolescents  A value f o r each reply on the A1B1 was obtained using an extension of the SCALER program (see Appendix D f o r values). A score was then computed f o r each subject, f o r each of the f i f t e e n behavior categories i n the AlBl.  Next, the UBC program ANALYSIS OF VARIANCE was used to c a l c u l a t e  mean scores and standard deviations (Table 3). Analysis of variance was  TABLE 2 NUMBER OF ADOLESCENTS CLASSIFIED AS NON-DEPRESSED, MODERATELY DEPRESSED, HIGHLY DEPRESSED  NON-DEPRESSED 0-13 n total =  48 102  MODERATELY DEPRESSED 14-24 38  HIGHLY DEPRESSED 25 -> 16  TABLE 3 SCORES OF NON DEPRESSED, MODERATELY DEPRESSED AND HIGHLY DEPRESSED GROUPS ON 15 INTERPERSONAL BEHAVIOR CATEGORIES INTERPERSONAL BEHAVIORS Dominance Competition Aggression Mistrust Detachment Inhibition Submission Succorance Abasement Deference Agreeableness Nurturance Affection Sociability Exhibition N = 102 df = 101  NON-DEPRESSED Mean Score STRD Dev. 18.250 19.812 17.979 17.625 20.625 15.208 20.375 19.917 17.021 24.979 24.375 26.813 19.583 24.833 15.167  2.7637 4.0720 3.5639 3.6532 3.6063 3.3260 3.2917 3.5719 3.3294 3.6987 3.2592 4.0668 3.7634 4.6646 3.8278  MODERATELY DEPRESSED Mean Score STRD Dev. 18.947 22.158 19.684 20.816 21.395 16.105 21.026 22.263 18.237 23.553 23.132 25.974 18.211 26.184 17.263  3.2378 4.0305 3.9600 3.8484 4.2141 3.9235 3.6279 4.1374 4.2199 3.6517 2.5698 4.0100 2.5697 4.5432 3.5082  HIGHLY DEPRESSED STRD. Dev. Mean Score 16.375 22.250 22.437 24.375 28.313 21.062 24.312 23.688 21.062 23.000 21.750 26.312 17.313 22.00 14.812  2.9637 4.7539 5.6800 4.2249 6.7796 5.9830 5.4738 2.1515 4.2185 7.1461 3.8210 4.6147 4.3162 5.0200 3.2087  42 then carried out to discover i f there was a d i f f e r e n c e i n the interpersonal behavior category mean scores of non-depressed, moderately depressed and highly depressed adolescents that was greater than chance. It was found that non-depressed, moderately depressed, and highly depressed adolescents had s i g n i f i c a n t l y d i f f e r e n t mean scores i n thirteen out o f f i f t e e n interpersonal behavior categories, namely: dominance aggression mistrust competition detachment inhibition submission  succorance abasement agreeableness affection sociability exhibition  In a l l thirteen cases the F r a t i o was greater than 3.09 which was the c r i t ical value o f F a t .05 with two degrees of freedom f o r the greater mean square and one hundred degrees of freedom f o r the lesser mean square. The F r a t i o was highly s i g n i f i c a n t f o r : mistrust, detachment, i n h i b i t i o n . The chance probability of obtaining the observed F value f o r the thirteen interpersonal behavior categories was less than .05. Non-depressed, moderately depressed and highly depressed adolescents d i d not have s i g n i f i c a n t l y d i f f e r e n t mean scores on: deference, nurturance.  For these categories the F r a t i o was less than 3.09 and the F  p r o b a b i l i t y was greater than .05 (Table 4 ) . This analysis rejects the null hypothes number one and shows that there i s a s i g n i f i c a n t d i f f e r e n c e between the interpersonal behavior scores of non-depressed, moderately depressed and highly depressed adolescents. This suggests that non-depressed, moderately depressed, and highly depressed adolescents may interact d i f f e r e n t l y with others i n thirteen areas: dominance, competition, mistrust, aggression, detachment, i n h i b i t i o n , submission, succorance, abasement, agreeableness, a f f e c t i o n , s o c i a b i l i t y , exhibition.  TABLE 4 ANALYSIS OF VARIANCE INTERPERSONAL BEHAVIOR CATEGORIES OF NON, MODERATELY DEPRESSED AND HIGHLY DEPRESSED ADOLESCENTS  BEHAVIOR CATEGORIES Dominance Competition Aggression Mistrust Detachment Inhibition Submission Succorance Abasement Deference Agreeableness Nurturance Affection Sociability Exhibition  F RATIO c D.F = 2/99  CHANCE PROBABILITY OF F  4.2033 4.1213 7.3554 20.6336 18.7309 12.7495 6.4609 8.2705 6.7411 1.7616 4.6748 0.4432 3.2184 4.5154 4.3970  N = 102 df = 2,99 C r i t i c a l value of F at .05 level = 3.09  .0175 .0188 .0012 .0000 .0000 .0000 .0025 .0006 .0020 .1750 .0115 .6488 .0431 .0132 .0147  44  Interpersonal Behavior Correlates of Depression To d i s c o v e r . i f there were interpersonal behavior categories that s i g n i f i c a n t l y correlated with depression (Hypothesis II) simple regression analysis and multiple stepwise regression analysis was c a r r i e d out using UBC computer program TRIP, subroutines INMSDC, SIMREG and STPREG. Simple Regression Analysis This was computed to discover i f there was a zero c o r r e l a t i o n between depression scores and each of the interpersonal behavior category scores.  If a zero c o r r e l a t i o n existed between the two variables i t  was interpreted to mean that no systematic r e l a t i o n to each other existed. It was found that a c o r r e l a t i o n s i g n i f i c a n t l y d i f f e r e n t from 0 existed between depression scores and scores on ten d i f f e r e n t interpersonal behavior categories. The F p r o b a b i l i t y was l e s s than .05 f o r a l l ten cases. High scores on the Depression Inventory s i g n i f i c a n t l y correlated with high scores on the following interpersonal behavior categories: 1. competition 2. aggression 3. mistrust 4. detachment 5. i n h i b i t i o n 6. submission 7. succorance 8. abasement (Table 5) High scores on the depression inventory correlated with low scores on the interpersonal behavior categories: 9. agreeableness 10. a f f e c t i o n A c o r r e l a t i o n between depression scores and scores on f i v e d i f f e r e n t interpersonal behavior categories was not s i g n i f i c a n t l y d i f f e r e n t from 0. These were:  1. e x h i b i t i o n 2. dominance 3. s o c i a b i l i t y 4. e x h i b i t i o n 5. nurturance  (Table 6)  45  TABLE 5 SIMPLE REGRESSION ANALYSIS, SIGNIFICANT PREDICTORS  CRITERION VARIABLE Depression  PREDICTORS Mistrust  CORRELATION COEFFICIENT 1.212  F RATIO  F PROBABILITY  64.49  .0000  Detachment  .8560  34.90  .0000  Inhibition  .8790  26.07  .0000  Succorance  .9913  24.29  .0000  Submissiveness  .9310  22.76  .0000  Aggression  .7997  19.00  .0001  Abasement  .7991  15.02  .0003  Competition  .5692  8.573  .0043  Agreeableness  - .7208  7.714  .0065  Affection  - .5835  5.980  .0155  46 TABLE 6 SIMPLE REGRESSION ANALYSIS, NON SIGNIFICANT PREDICTORS CRITERION VARIABLE Depression  PREDICTORS  CORRELATION COEFFICIENT  F RATIO  F PROBABILITY  Dominance  - .3835  1.869  .1711  Sociability  - .2221  1.597  .2139  Deference  - .2344  1.437  .2316  Exhibition  .1906  .6762  .4180  Nurturance  - .1333  .3984  .5367  47 This analysis rejects the null hypothesis and shows that there is a s i g n i f i c a n t c o r r e l a t i o n between depression scores and interpersonal behavior category scores on competition, aggression, mistrust, detachment, i n h i b i t i o n , submission, succorance, abasement, agreeableness and a f f e c t i o n . This i s a p o s i t i v e c o r r e l a t i o n f o r the f i r s t eight categories and a negative c o r r e l a t i o n f o r the remaining two. The findings of the regression a n a l y s i s , therefore predict that an adolescent who shows frequent interpersonal behaviors c l a s s i f i e d under competition, agression, mistrust, detachment, i n h i b i t i o n , submission, succorance and abasement and rare interpersonal behavior c l a s s i f i e d under agreeableness and a f f e c t i o n , may be depressed. Multiple Regression Analysis Given that the simple regression analysis indicated that there were interpersonal behavior categories s i g n i f i c a n t l y correlated with depression, the more sophisticated multiple step-wise regression analysis was c a r r i e d out. This was computed to discover which predictors (interpersonal behavior categories) had a s i g n i f i c a n t l y d i f f e r e n t c o r r e l a t i o n than 0, with depression, when i n t e r c o r r e l a t i o n of the interpersonal behavior categories were considered (Table 7). This analysis showed that there was a c o r r e l a t i o n s i g n i f i c a n t l y d i f f e r e n t from 0, between depression scores and four interpersonal behavior categories.  There was a p o s i t i v e c o r r e l a t i o n between high scores in depres-  sion and high scores i n : mistrust, competition, succorance.  There was a  negative c o r r e l a t i o n between high scores in depression and high scores i n dominance. The F p r o b a b i l i t y f o r these observations was less than .05 (Table 8).  TABLE 7 MULTIPLE REGRESSION ANALYSIS CORRELATION BETWEEN INTERPERSONAL BEHAVIOR CATEGORIES o  o  o-a o  ZZ  Dominance Competition Aggression Mistrust Detachment Inhibition Submission Succorance Abasement Deference Agreeableness Nurturance Affection Sociability Exhibition  1.00 + .592 + .424 + .137 -.807 -.273 -.212 + .319 -.900 .144 -.406 .208 .279 .205 .520  1.00 .432 .168 .938 -.184 .552 .346 .180 .331 .347 -.966 .998 .248 .607  2  o m  OO  CO  oo \—i zz  o  1.00 .366 .240 -.225 -.965 .258 -.106 -.148 -.396 -.226 -.223 .464 .409  •—1  —1 ZO cz oo —1  1.00 .487 .366 .304 .366 .262 -.825 -.116 .382 -.204 -.119 .141  o m —t 3= o rr. 2 m zz —I  1.00 .583 .410 .871 .184 .235 -.320 -.344 -.296 r.425 -.189  o  zz o  zz —\  o m -n rn zo m zz m  1.00 .251 .507 .448 .156 .225 .178 -.561 -.324  1.00 -.368 .110 -.411 -.148 .119 .301 .448  1.00 .447 .321 .432 .309 .144 .138  1.00 .501 .280 .345 .192 .130  i—i zz nr  oo cr. co  CO  *—*  i—t  t—t —1 I—1 o zz.  1.00 .461 .674 .340 .762 -.664 .198 -.123 -.436 -.311  OO 00 K-1  oo cr o o zo  o  m  3=>  co OO  m 2  m  o  O zo m m y>  zz cz zo —1 cr zo  m  ZZ o  3a  CO  1.00 .523 .555 .359 .599  3=-  m  3>  -n -n m o —1 i—i  o  zz  oo o  <-> I—1  3» CO 1—1  f— t—t  TY  m —1 i —1 »—»  3>  NESS  2 * ZZ J» O m  o  1.00 .567 1.00 .414 .545 1.00 -.414 .249 .411 1.  TABLE 8 MULTIPLE STEP-WISE REGRESSION ANALYSIS SIGNIFICANT PREDICATORS INDEPENDENT VARIABLES  CORRELATION COEFFICIENT  F RATIO  F PROB  Mistrust  .9210  32.2510  .0000  Dominance  -.9519  15.0191  .0003  Competition  .5233  7.8903  .0060  Succorance  .4209  4.5941  .0322  50 The addition of the other eleven interpersonal behavior  category  scores did not s i g n i f i c a n t l y improve the prediction of the depression  scores.  That i s , when the correlations between mistrust, competition, succorance, dominance and the eleven remaining interpersonal behavior categories was eliminated, the F p r o b a b i l i t y was greater than .05 (Table 9). This analysis rejects the null hypothesis number two and shows that there is a s i g n i f i c a n t c o r r e l a t i o n between depression and four i n t e r personal behavior categories.  It suggests that we may be able to predict  that an adolescent i s depressed i f he portrays frequent interpersonal  behavior  c l a s s i f i e d as mistrust, competition, succorance, and rare interpersonal behavior c l a s s i f i e d as dominance. Interpersonal Behavior Categories that Distinguish Between Non-Depressed, Moderately Depressed and Highly Depressed  Adolescents  To discover and i s o l a t e the interpersonal behavior  categories  which best d i s t i n g u i s h between whether an adolescent i s non-depressed, moderately depressed or highly depressed, the UBC computer program STEPWISE DISCRIMINANT ANALYSIS was used. This program performs a multiple discriminant analysis in a stepwise manner. At each step, one variable i s entered into the set of discriminating variables. The variable entered i s selected because i t holds the least F p r o b a b i l i t y value.  Only variables with an F p r o b a b i l i t y less  than .05 are entered as discriminators. Four variables ( i e . four interpersonal behavior categories) were selected that could c l a s s i f y adolescents as non-depressed, moderately depressed and highly depressed. They were: mistrust, detachment, dominance, comp e t i t i o n (Table 10).  51  TABLE 9 MULTIPLE STEP-WISE REGRESSION ANALYSIS NON-SIGNIFICANT PREDICATORS INDEPENDENT VARIABLES  PARTIAL CORRELATION WITH SIGNIFICANT PREDICATORS  UNEXPLAINED VARIANCE  F PROB  Detachment  .1799  .6123  .0727  Aggression  .1604  .6274  .1104  Inhibition  .1595  .6293  .1125  Agreeabl eness  .1412  .9322  .1616  Affection  .1325  .8749  .1900  Submission  .0972  .6836  .3436  Deference  .0964  .8705  .3475  Exhibition  .08 6 6  .5223  .4011  Nurturance  .0267  .9759  .7830  Sociability  .0180  .8707  .8373  Abasement  .0122  .7147  .8723  TABLE 10 DISCRIMINANT ANALYSIS VARIABLES TO INCLUDE AS DISCRIMINATORS  VARIABLES Mistrust  F PROB -  .0006  Detachment  .0043  Competition  .0281  Dominance  .0052  53 The other eleven categories of interpersonal behavior did not s i g n i f i c a n t l y increase the likelihood of c l a s s i f y i n g the adolescents c o r r e c t l y (Table 11).  Once mistrust, detachment, dominance  and competition had been selected, their F p r o b a b i l i t y was greater than .05 (Table 12). When only the four behavior categories were used, 58.8% of the adolescents could be c o r r e c t l y c l a s s i f i e d as  non-depressed,  moderately depressed or highly depressed (Table 13). This analysis rejected the null hypotheses and showed that mistrust, detachment, dominance and competition can be used to d i s tinguish i f an adolescent i s non-depressed, moderately depressed or highly depressed.  D i f f i c u l t y arose in the d i s t i n c t i o n of adolescents  whos Depression Inventory or AIBI scores neared the cut o f f score between groups.  Two factors may explain t h i s . A standard error of  measurement existed f o r both the Depression Inventory scores and each of the Interpersonal Behavior Category scores as shown in Appendix C and D.  The other explanation complementary to this was that the  scores tended to flow on a continuum thus scores close to any cut o f f point were n a t u r a l l y d i f f i c u l t to d i f f e r e n t i a t e from one another.  These  f i n d i n g s , therefore, tend to support the theoretical assumption that depression f a l l s along a continuum.  TABLE 11 DISCRIMINANT ANALYSIS VARIABLES TO EXCLUDE AS DISCRIMINATORS VARIABLES  F PROB  Aggression  .2210  Inhibition  .7273  Submission  . .8953  Succorance  .2432  Abasement  .6670  Deference  .0732  Agreeableness  .1490  Nurturance  .6942  Affection  .3017  Sociability  .6825  Exhibition  .5946  TABLE 12  o UJ CC —1 o Ul u. oo UJ  Ul  co Ul oo  Donimance Competition Aggression Mistrust Detachment Inhi b i t i o n Submission Succorance Abasement Deference Agreeableness Nurturance Affection Sociability Exhibition  i— i— o Ul CH _ J Ul  teg;  Ul  M  UJ  ca co O «=C cc I-I Q- CC  _i ca ca O < CC i—i Q- CC  u.  u.  Ul _ l  VARIABLE  <:>  =t  >  .0175 .0078 .0188 .1904 .0012 .3834 .0000 .0000 .0007 .0000 .0120 .0025 .1587 .0006 .2505 .0020 .1827 .1755 .5006 .0115 .1540 .6480 .6076 .0431 .5538 .0132 .0268+ .0147 .0157  CVJ  o  TED  TED  TED  ED  TED  DISCRIMINANT ANALYSIS STEP-WISE SELECTION OF VARIABLES TO BE ENTERED o  CJ  Ul _J CC UJ UJ oo 1—  CO  u_ oo <C u i _i co ca oCC i—i o_ cc  u_ oo e t Ul  U. Ct  o CC  O CC  <c  U.  et  >  .0329 .1918 .5415  UJ  1—  Ul _J UJ  •^t UJ _l CC Ul Ul oo  oo  h-  00 Ul _J CO CO  _J CO CO Cu  u.  <  HH  CC  Q.  et  >  u.  .0281 .0909  <  i—i  CC  <>  .2210 •  .4983 .8069 .2193 .3111 .1894 .1526 .5753 .4324 .3829 .1535  .8997 .9863 .0854 .3811 .3637 .1715 .5760 .4160 .4685 .2009  .7273 .8953 .2432 .6670 .0732 .1490 .6942 .3017 .6825 .5946  VARIABLES ELIGIBLE FOR ENTRY WHEN F PROB < .05  56  TABLE 13 DISCRIMINANT ANALYSIS GOODNESS OF CLASSIFICATION INTO NON-DEPRESSED, MODERATELY DEPRESSED AND HIGHLY DEPRESSED GROUPS DEPRESSION INVENTORY GROUPS  N  Non-Depressed  48  30  16  2  Moderately Depressed  38  13  19  6  16 102  1  4  11  Highly Depressed  DISCRIMINANT FUNCTION GROUPS Non-Depressed Mod, Depressed Highly Depressed  Discussion The behavioral factors which emerged as s i g n i f i c a n t in this study of depression in adolescents were: mistrust, competition, dominance, detachment, succurance. These same factors have been singled out as important in the more recent l i t e r a t u r e concerning depression.  However, the  suppressed h o s t i l i t y so frequently mentioned by the schools of psychoanalytic thought, was not supported. Mistrust The most s i g n i f i c a n t factor in d i s t i n g u i s h i n g between the non-depressed, moderately depressed, and highly depressed adolescent was mistrust. Analyses showed that as depression increased, so did the frequency of this type of behavior. E. Erikson has written that adults who withdraw into habitual states of depression have a weakness in basic trust.  They  have therefore, f a i l e d to master the f i r s t task of childhood; they have not learned to r e l y on a c e r t a i n continuity of care from others, nor on their own sensations or b e l i e f s / Cohen et al wrote that the depressed person manipulates others  for his ov/n benefit. The depressed person also sees his own  behavior as fraudulent because he knows he tends to undersell himself. This s p l i t between portrayed behavior and actual a b i l i t y must lead the depressed person to be suspicious of the feedback others give him regarding his overt behavior.  E. Erikson, Childhood and Society (New York: 1963) pp. 247-251.  W.W.  Norton and Co.,  M. Cohen, G. Baker, R.A. Cohen, F. Fromm-Reichman, and E. Weigert, "An Intensive Study of Twelve Cases of Manic-Depressive Psychosis", Psychiatry, 17: 121, 1954.  Questions on the AIBI that were concerned with mistrust were: 1. When people are kind to me, I look to see i f they are doing i t so they can get something from me. 2. I mistrust or question indications of a f f e c t i o n from others. 3. When I do something, people think I am doing i t for a d i f f e r e n t reason than why I am r e a l l y doing i t . 4. I am not given the c r e d i t due me for my accomplishments. 5. People c r i t i c i z e or blame me u n j u s t l y . 6. I f e e l others are pulling jokes on me or don't r e a l l y mean what they are saying. 7. I show reluctance to trust or confide in others. 8. I express my suspicion when someone i s e s p e c i a l l y nice to me. 3 9. I accuse others of prying into my a f f a i r s . 10. I misinterpret minor comments by others as unfavourable towards myself. Competition This interpersonal behavior category was the second most s i g n i f i c a n t factor in i d e n t i f y i n g the depressed adolescent. As with mistrust, analysis showed that this behavior was exhibited more frequently the more depressed the adolescent was. Cohen et al wrote that the depressed person i s extremely sensitive to envy and competition. He often grows up in a minority group family who sees a need to maintain and r a i s e the prestige of the family before an adverse world. This p a r t i c u l a r c h i l d i s often singled out to take the r e s p o n s i b i l i t y of obtaining t h i s prestige for the family.  4  Item a n a l y s i s shows that this question does not contribute well to the d i s t i n c t i o n between non-depressed, moderately depressed and highly depressed adolescents. Appendix D. 4  I b i d . , pp. 118-119.  59 Questions pertinent to this behavior category were: 1. I compete and t r y to do better than other kids. 2. I avoid sharing c r e d i t f o r achievement with others. 3. I volunteer f o r jobs that gain me the attention of others. 4. I l i k e to win games even at p a r t i e s . 5. I would rather do well myself than work f o r a team to do w e l l . 6. I set goals f o r myself and t r y to achieve them. 7. I d i r e c t the attention of others toward my  accomplishments.  8. I work f o r things that give me status and s u p e r i o r i t y to others. 9. I contrast unfavourably the accomplishments of others with my  own.  10. I seek membership i n clubs and associations which have high prestige, reputation. Dominance Dominance was a s i g n i f i c a n t interpersonal behavior category in i d e n t i f y i n g the depressed adolescent. Depressed adolescents reported that they exhibited l i t t l e of t h i s behavior. This i s congruent with Cohen et a l ' s a r t i c l e that said that the depressed person tends to undersell his own a b i l i t i e s in order to promote other persons and t h e i r a b i l i t i e s .  Cohen et al believed that he  did t h i s in order to avoid f e e l i n g s of envy. They believed that the depressed person had become s e n s i t i z e d to envy as a c h i l d when he was expected to improve the families' status, but then had to contend with the accompanying envy of others as well as his s i b l i n g s and even 5  his parents. 5  Ibid., p. 119.  60 AIBI questions that referred to t h i s interpersonal behavior category were: 1. I make decisions l i k e what to do or where to go when I'm with another f r i e n d . 2. I dominate conversations, i n t e r r u p t , "talk others down". 3. I boss my friends and associates around. 4. I use someone who isn't as smart as I am to make me look good or get me something I want. 5. I volunteer advice and information when people have decisions to make. 6. I talk my f r i e n d s into doing what I would l i k e . 7. I take opportunities to instruct or explain things to others. 8. I take charge of things when I'm with people. 9. I d i r e c t the a c t i v i t i e s of one or more clubs or associations to which I belong.6 Detachment This behavior category helped to d i s t i n g u i s h between the nondepressed, moderately depressed, and highly depressed adolescent. Highly depressed adolescents were found to e x h i b i t t h i s type of behavior most of the time or a l l of the time.  Moderately depressed adolescents exhibited  i t only some of the time and non-depressed adolescents never exhibited i t . This finding was similar to that of Paykel e t al i n t h e i r research with depressed women. They found that depressed women rated highly on diminished contacts with f r i e n d s , diminished social i n t e r a c t i o n , diminished dating, withdraw!, lack of involvement, inhibited and family attachment.  communication  7  Item analysis shows that t h i s question does not contribute well to the d i s t i n c t i o n between highly depressed adolescents, and moderately and non-depressed adolescents. Appendix D. E. Paykel, M. Weissman, B. Prusoff, and C. Tonks, "Dimensions of Social Adjustment i n Depressed Women", Journal of Nervous and Mental Diseases, 152: 163, 1971.  61 Questions on the AIBI that were related to this behavior category were: 1. I avoid people who t r y to become close or personal with me. o  2. I do things on my own and amuse myself. 3. I act business-like and impersonal with fellow classmates. 4. I turn down i n v i t a t i o n s to social events. 5. I f i n d i t d i f f i c u l t to mix with others. 6. I avoid discussion of my personal a f f a i r s with friends or fellow students. 7. I keep aloof or apart from my neighbours. 8. I stay away from social a f f a i r s where I w i l l have to meet new people. 9. I act cool and distant towards others. 10..I avoid involvement or p a r t i c i p a t i n g in group e f f o r t s . g  11. I spend my free evenings at home with a hobby, book or T.V. program. Succorance The analysis of variance, and regression a n a l y s i s showed that adolescents who were highly depressed reported that they exhibited succorance behavior most of the time or a l l of the time; moderately depressed adolescents said that they exhibited i t less o f t e n , and nondepressed adolescents s t i l l l e s s . Item analysis shows that these questions help d i s t i n g u i s h the nondepressed and moderately depressed adolescent from the highly depressed, but not the non-depressed from the moderately depressed. Appendix D. Op. c i t .  It was interesting to note that Cohen et a l wrote that the depressed person i s exceptionally helpful to s i b l i n g s and o t h e r s . ^ The results from this research suggest that the reverse i s true, the depressed adolescent expects this type of behavior from others f o r himself. This i s more i n keeping with Cohen et a l ' s other b e l i e f t h a t the depressed person has one or a very few very dependent relationships in which he i s very demanding toward the person -- demanding o f his attention, love, service and possessions.^ Beck wrote that the depressed person sees himself i n negative terms — inept, inadequate and undesirable. He tends to overestimate the problems i n normal l i v i n g and expects everything to turn out badly. He therefore, yearns f o r some strong person to take 12 care of him and help him with his problems.  This study suggests that  depressed adolescents overtly seek this out. AIBI questions pertinent to succorance were: 1. 2.  I t r y to get others to make decisions for me. I avoid or refuse to take the lead even when I should. 13  3. 4. 5. 6. 7. 8. 9. 10.  I go to others f o r help and reassurance when i n d i f f i c u l t y . I seek out people who show concern and sympathy f o r me. I borrow money and things o f value from friends. I dump my troubles and problems on others. I ask for help on jobs I could handle myself. I ask others to look a f t e r my i n t e r e s t s . I seek favours from friends even when I can't return them. I seek to have others choose or select for me clothes, food, and even r e c r e a t i o n .  ^ Cohen, op. c i t . , p. 119. 11  12  Ibid.  A. Beck, Depression, (New York: Harper and Row, 1967) p. 265. 13 Item analysis shows that t h i s question contributes very l i t t l e towards the d i s t i n c t i o n between groups. Appendix D.  Inhibition and  Aggression  Considering the emphasis psychoanalytical theorists have given the phenomena of suppressed h o s t i l i t y , i t was s u r p r i s i n g to discover that i t did not appear s i g n i f i c a n t in- i d e n t i f y i n g the depressed adolescent from the non-depressed adolescent.  In r e f l e c t i n g  on the other reasons for t h i s f i n d i n g , three p o s s i b i l i t i e s can be suggested.  The inventory has only two categories, i n h i b i t i o n and  aggression that might r e f l e c t suppressed h o s t i l i t y .  In step-wise  regression analysis and discriminant analysis these factors may get l o s t d u e t o t h e i r c o r r e l a t i o n with other f a c t o r s . The t h i r d p o s s i b i l i t y is that suppressed h o s t i l i t y may not be as important a factor as i t has generally been acknowledged. Support f o r this p o s s i b i l i t y i s given by Cohen et a l who wrote that h o s t i l i t y in the depressed person 14 has been over-stressed. A s t i l l d i f f e r e n t finding was reported by Paykel et a l . Suppressed h o s t i l i t y was not found to be the norm but 15 overt h o s t i l i t y was in t h e i r population of depressed patients.  Cohen op. c i t . p. 121. Paytel op c i t . , pp. 163-168.  CHAPTER 5 SUMMARY, CONCLUSIONS, IMPLICATIONS AND RECOMMENDATIONS Summary Adolescents may be p a r t i c u l a r l y vulnerable to depression.  Yet  public health nurses working with large groups of adolescents are often unable to recognize depressed adolescents due to the lack of simple, i  r e l i a b l e screening tools.  This exploratory study was undertaken in order  to gain information that could be used to develop such a t o o l .  The s p e c i f i c  purpose of the study was to answer the question, 'Are there modes of r e l a t i n g i n t e r p e r s o n a l l y that can be used to d i s t i n g u i s h the highly depressed and moderately depressed adolescent from the non-depressed  adolescent?'  In order to answer t h i s question three null hypothesis were posed: 1. There i s no s i g n i f i c a n t difference between the interpersonal behavior scores of non-depressed, moderately depressed and highly depressed adolescents. 2. There i s no s i g n i f i c a n t c o r r e l a t i o n s between any interpersonal behavior category and depression. 3. There are no interpersonal behavior categories that can d i s t i n g u i s h between the non-depressed, moderately depressed and highly depressed adolescent. One hundred and two adolescents between the age of t h i r t e e n to seventeen l i v i n g i n Greater Vancouver were studied. Twenty-five of those adolescents were from a treatment centre f o r adolescents with emotional problems; the remaining seventy-seven adolescents were randomly selected students from four Catholic high schools. Each adolescent was given two s e l f - r a t i n g inventories to complete, Beck's Depression Inventory and an adapted form of McNair and Lorr's Interpersonal Behavior Inventory. On the basis of t h e i r scores on the depression inventory sixteen adolescents were found to be highly depressed, t h i r t y - e i g h t moderately  65 depressed and f o r t y - e i g h t non-depressed. An analysis of variance was used to discover i f there was a difference i n the interpersonal behavior scores of these three groups of adolescents.  It was found that non-depressed, moderately depressed, and  highly depressed adolescents had d i f f e r e n t scores i n t h i r t e e n interpersonal behavior categories. These were: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.  dominance aggression mistrust competition detachment inhibition submissiveness succorance abasement agreeableness affection sociability  13. e x h i b i t i o n A simple regression analysis was done and i t showed that there was a s i g n i f i cant p o s i t i v e c o r r e l a t i o n between high depression scores and high scores on the following interpersonal behavior categories: 1. 2. 3. 4. 5. 6. 7. 8.  competition aggression mistrust detachment inhibition submissiveness succorance abasement  There was a negative c o r r e l a t i o n between high depression scores and high scores on the following interpersonal behavior categories: 1. agreeableness 2. a f f e c t i o n A multiple step-wise regression analysis was c a r r i e d out and i t showed that mistrust, competition and succorance were s i g n i f i c a n t and p o s i t i v e l y  correlated with high depression scores while high dominance scores were negatively correlated with the high depression scores. Stepwise discriminant was also carried out; mistrust, detachment, competition, dominance were selected as the interpersonal behavior categories that 58.6% of the time c o r r e c t l y distinguished non-depressed adolescents from moderately depressed and highly depressed adolescents. Therefore, the null hypotheses were rejected.  67  Conclusions On the basis of the findings of this study the following conclusions were made: 1. there are modes of r e l a t i n g interpersonally that d i s t i n g u i s h the highly depressed and moderately depressed adolescent from the non-depressed adolescent. Those who exhibit mistrust, competition and detachment most or a l l of the time and dominance only some of the time or not a a l l , may be highly or moderately depressed adolescents. 2. depression i n adolescents appears to occur on a continuum with youths experiencing graduated degrees of i t .  When adolescents in t h i s study were  grouped as non-depressed, moderately depressed and highly depressed, i t was d i f f i c u l t to d i s t i n g u i s h between the adolescents whose depression scores f e l l near the cut o f f points between high depression and moderate depression, and between moderate depression and  non-depression.  3. adolescence i s a developmental stage vulnerable to depression.  Fifty-  four out of 102 adolescents i n the study population showed that they were moderately or highly depressed. 4. adolescents experiencing high levels of depression can be found within the student population of high schools. Eight of the sixteen highly depressed youths were students from the high schools. 5. suppressed h o s t i l i t y i s not as an important f a c t o r i n depression as i t has generally been believed. The two categories in which this phenomena might have been expressed i n t h i s study, were not s i g n i f i c a n t . On the basis of the item analysis of the questions the following conclusion was made: given the assurance of anonymity, adolescents have both the s e n s i t i v i t y and the willingness to accurately describe their own f e e l i n g s and behavior via s e l f - r e p o r t inventories. Analysis of t h e i r answers showed  68  that they did not give t h e i r answers i n a s o c i a l l y desirably manner nor in a manner that suggested guessing. On the basis of administering the inventory, the following conclusions were made: 1. depression does not prevent the individual from undertaking and achieving a demanding task.  Even the highly depressed adolescents were able to  answer a total o f 161 questions on computer cards. 2. willingness to a s s i s t and c u r i o s i t y i n research was the adolescent norm. Most adolescents i n the treatment centre and the high schools were enthusi a s t i c p a r t i c i p a n t s i n the research and asked many questions concerning i t s implementation and purpose.  69  Implications and Recommendations The findings of t h i s study imply that the majority o f depressed adolescents can be i d e n t i f i e d through t h e i r modes of interpersonal behavior. Public health nurses and other persons working with adolescents  should  therefore be alerted to watch f o r the adolescent who frequently exhibits behavior that shows mistrust, competition and detachment, and r a r e l y portrays behavior that i s dominating. The s i g n i f i c a n t findings of t h i s study suggest that further r e search be c a r r i e d out to discover the following: 1. w i l l the same interpersonal behavior categories d i s t i n g u i s h the depressed adolescent i f depression i s defined by a d i f f e r e n t means than Beck's Depression Inventory, eg. by c l i n i c a l psychiatric interviews, Rorachach, Thermatic Apperception Tests, or the D-Scale o f the MMPI. 2. do the s i g n i f i c a n t interpersonal behavior categories d i s t i n g u i s h only the depressed adolescents or do they d i s t i n g u i s h any adolescent who has emotional problems, eg. h y s t e r i a , schizophrenia, personality disorder. 3. do the s i g n i f i c a n t interpersonal behavior categories d i s t i n g u i s h only the depressed adolescent or do they d i s t i n g u i s h depressed adults as well. 4. i f another person rated the adolescents' behavior would the findings be s i m i l a r to when the adolescent rates h i s own behavior. If further research supports the findings of t h i s study a screening tool f o r publich health nurses could be developed.  Mistrust, com-  p e t i t i o n , dominance and detachment could be used as the gross behavior areas to observe, while a c h e c k - l i s t of more s p e c i f i c behaviors could be developed from the seven to eleven statements that are used i n the inventory to describe the behavior categories; only those statements that proved useful i n  70  the item analysis would be used. Once such a tool i s developed i t i s recommended that an experimental study be carried out to discover i f public health nurses using the screening tool recognize more depressed adolescents than public health nurses who use their usual method of i d e n t i f i c a t i o n . The f i n d i n g s of t h i s study suggest that there i s a s i g n i f i c a n t c o r r e l a t i o n between depression and mistrust, competition, dominance and succorance. The findings do not show which f a c t o r ( s ) i s the cause and which the r e s u l t .  It i s therefore recommended that an experimental study  be undertaken to dsicover i f the level of depression in adolescents can be s i g n i f i c a n t l y decreased i f they receive therapy concerned with changing t h e i r mode of r e l a t i n g interpersonally in the areas of mistrust, competition, cominance, succorance. of therapy.  Behavior modification may be an appropriate means  7'  SOURCES CONSULTED Books A r i e t i , S. (ed.) American Handbook of Psychiatry. New York: Basic Book I, 1959. A r i s t o t l e . The Work o f A r i s t o t l e Translated to English. XI, trans. Rhys Roberts, Oxford: Clarendon Press, 1959. Ausubel, D. Theories and Problems of Adolescent Development. New York: Grune and Stratton, 1954. Beck, A. Depression. New York: Harper and Row, 1967. Buro, O.K. (ed.) The Seventh Mental Measurement's Yearbook. 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New York: The Ronald Press Co., 1957. Lewin. Field Theory i n Social Science. London: Tavistock Publications Ltd. 1952. McCandless, B. Adolescents Behavior and Development. Hinsdale, I l l i n o i s : The Dryden Press Inc., 1970. Mehrens, William A. and Irvin J. Lehmann. Measurement and Evaluation i n Educational Psychology. New York: Holt, Rinehart and Winston, Inc., 1973. Meyer, W.J.. Readings i n the Psychology of Childhood and Adolescence, Toronto: B l a i s d e l l Publishing Co., 1967. M i t c h e l l , J . J . Adolescence: Some C r i t i c a l Issues. Toronto: Holt, Rinehart and Winston of Canada, L t d . , 1971. M i t c h e l l , P.H. 1973.  Concepts Basic to Nursing. New York: McGraw-Hill Inc.,  Mullahy, P. A Study of Interpersonal Relations. New York: Science House, 1967.  Muus, R.E.  Theories of Adolescence. New York: Random House Inc., 1968.  Sebald, H. Adolescence: A Sociological A n a l y s i s . New York: Appleton Century-Crofts, 1968. Senn, M.J. and A.J. S o l n i t . Problems in Child Behavior and Development. Philadelphia: Lea and Febiger, 1968. Sherif, M. and C. Sherif. Reference Groups: Exploration Into Conformity and Deviation of Adolescents. New York: Harper and Row, 1961. Stein, R.F. Disturbed Youth and Ethnic Family Patterns. Albany: State University of New York Press, 1971. Straus, M. (ed.). Family Analysis. Chicago: Rand McNally and Co., Ltd., 1969. Strom, M.T. Needs of Adolescent Youth. Danville, I l l i n o i s : The Interstate Printers and Publishers, Inc., 1963. S u l l i v a n , H.S. The Interpersonal Theory of Psychiatry, New York: W.W. Norton and Co., Inc., 1953. Tatsuoka, M.M. Selected Topics in Advanced S t a t i s t i c s : Discriminant Analysis . Champaign, I l l i n o i s : Institute f o r Personality and A b i l i t y Testing, 1970. Thorndike, E., and I. Lorge, The Teachers' Word Book of 30,000 Words. New York: Teachers College, Columbia University, 1952. Walker, H.M., and J . Lev, Elementary S t a t i s t i c a l Methods. New York: Holt, Rinehardt and Winston, Inc., 1969. Wolforth, J.R. Residential Location and Place of Work. Vancouver: Tantalus Research Lmt., 1968. Zachny, C.B. Emotion and Conduct in Adolescence. New York: D. AppletonCentry Co. Inc., 1940. Zilboorg, G. Ltd., 1941.  A History of Medical Psychology. New York: Norton and Co.  74 Periodicals Abdellah, F. "Overview of Nursing Research 1955-1968, Part I", Nursing Research, 19: 6, 1970. A l l port, G. "The Open System i n Personality Theory", Journal of Abnormal and Social Psychology, 1961: 301, 1960. Bandura, A. "The Stormy Decade: Fact or F i c t i o n ? " , Psychology of the School, 1: 224, 1964. Bay, A.P. "Discussion of the Treatment of Depression i n Hospitalized Patients Before and Since the Introduction of Anti-Depressant Drugs", American Journal of Psychiatry, 119: 425, 1962. Bowlby, J. " G r i e f and Mourning in Infancy and Childhood", Psychoanalytic Study of the C h i l d , 15: 9, 1960. B r i t t a i n , C. "Adolescent Choices and Parent-Peer Cross-Pressures", American Sociological Review, 28: 385, 1963. Cohen, M.B., G. Baker, R.A. Cohen, F. Fromm-Reichman, and E. Weigert, "An Intensive Study of Twelve Cases of Manic-Depressive Psychosis," Psychiatry, 17: 103, 1954. Coleman, J . . "The Adolescent Subculture and Academic Achievement", Journal of Sociology, 65: 337, 1960.  American  Coleman, J. "The Perception of Interpersonal Relationships During Adolescence", B r i t i s h Journal of Educational Psychology, 40: 253, 1970. Crumb, F. "A Behavioral Pattern of Depressed Patients", Perspectives in P s y c h i a t r i c Care, Vol. 4, No. 3, 1966. Dunlop, E. . "The Use of Antidepressants and Stimulants", Modern Treatments, 2: 543, 1965. Eisenberg, L. "A Developmental Approach", Children, 12: 131, 1965. E l k i n , F. and W.A. Westley, "The Myth of Adolescent Culture", American Sociological Review, 20: 680, 1955. Freud, A. "Adolescence", The Psychoanalytic Study of the C h i l d, XII, New York: International Press, 1958. Gronlund, N., and L. Anderson. "Personality Characteristics of S o c i a l l y Accepted, S o c i a l l y Neglected, and S o c i a l l y Rejected Junior High School Pupils", Educational Administration and Supervision, 43: 329, 1957. Krakowski, A. "Depressive Reactions of Children and Adolescents", P. Psychosomatics, 11: 429, 1970.  Kuhlen, R., and B.J. Lee. "Personality C h a r a c t e r i s t i c s and Social Accepta b i l i t y in Adolescence", Journal of Educational Psychology, 34: 321, 1943 Lewin, K. " F i e l d Theory and Experiment in Social Psychology", American Journal of Psychology, 44: 868, 1939. Lindemann, E. "Symtomatology and Management of Acute G r i e f " , American Journal of Psychiatry, 101: 141, 1944. Lorr, M., and D. McNair. "An Interpersonal Behavior C i r c l e " , Journal of Abnormal and Social Psychology, 67: 68, 1963. Lorr, M., and D. McNair, "Expansion of the Interpersonal Behavior C i r c l e " Journal of Personality and Social Psychology, 2: 823, 1965. Lorr, M., and A. S u z i e d e l i s , "Modes of Interpersonal Behavior", B r i t i s h Journal of C l i n i c a l Psychology, 8: 124, 1969. Meissner, W.W. "Some Implications of Sources of Anxiety in Adolescent Boys", Journal of Genetic Psychology, 99: 323, 1961. Meisner, W.. "Parental Interaction of the Adolescent Boy", Journal of Genetic Psychology, 107: 225, 1965. Offer, D. "Normal Adolescents", Archives of General Psychiatry, 17: 285, 1967. Offer, D., D. Marcus, and J . O f f e r , "A Longitudinal Study of Normal Adolescent Boys", American Journal of Psychiatry, 126: 917, 1970. Oltman, J . , and S. Friedman. "Trends in Admissions to State Hospitals 1942-1964", Archives of General Psychiatry, 13: 544, 1965. Paykel, E.S. " C l a s s i f i c a t i o n of Depressed Patients: A Cluster A n a l y s i s " , The B r i t i s h Journal of Psychiatry, 118: 283, 1971. Paykel, E.S.. M. Weissman, B.A. Prusoff, and CM. Tonks. "Dimensions of Social Adjustment in Depressed Women", Journal of Nervous and Mental Disease, 152: 158, 1971. Rosenthal, S. "Changes in a Population of Hospitalized Patients with A f f e c t i v e Disorders 1945-1965", American Journal of Psychiatry, 123: 671 , 1966. Schildkraut, J . "The Catecholamine Hypothesis of A f f e c t i v e Disorders: A Review of Supporting Evidence", American Journal of Psychiatry, 122: 509, 1965. Schonfeld, W.A. "Adolescent Turmoil: Socioeconomic Affluence as a Factor New York State Journal of Medicine, 67: 1981, 1967.  Stengel, E. "Recent Research into Suicide and Attempted Suicide", American Journal of Psychiatry, 118: 725, 1962. Turner, W.J., F.J. O'Neil and S. Merlis, "The Treatment of Depression i n Hospitalized Patients Before and Since the Introduction of Anti-Depressant Drugs", American Journal of Psychiatry, 119: 421, 1962. Weissman, M., E. Paykel, R. Siegal and G. Klerman. "The Social Role Performance of Depressed Women: Comparison with a Normal Group", American Journal of Orthopsychiatry, 41: 390, 1971. Wolff, I. "Referral - A Process and S k i l l " , Nursing Outlook, 10: 253, 1962.  Government Publications Dominion of Canada, Bureau of S t a t i s t i c s . Causes of Death. Ottawa: S t a t i s t i c s Canada, 1970. Province of B r i t i s h Columbia, Department of Health Services and Hospital Insurance. Vital S t a t i s t i c s . V i c t o r i a : K.M. McDonald p r i n t e r , 1970.  Other Catholic University of Washington, Department of Psychology, Personal Correspondence between Dr. M. Lorr, Professor, and the writer n.d.  APPENDIX A PHILOSOPHY OF BRITISH COLUMBIA YOUTH DEVELOPMENT CENTRE  79 B r i t i s h Columbia Youth Development Centre This Centre, called "The Maples" f o r convenience, was set up in 1968 by the Mental Health Branch of the Provincial Government of B r i t i s h Columbia to meet the treatment needs of emotionally disturbed children and adolescents. A.  The Family and Children's C l i n i c which was developed about 1956,  Dr. Alan A. Cashmore has been the d i r e c t o r since then, and has developed a m u l t i - d i s c i p i i n a r y team approach, providing out-patient services to c h i l d r e n , adolescents and f a m i l i e s . B. The Psychological Education C l i n i c was developed by the D i r e c t o r , Dr. Denis C. Shalman, C l i n i c a l Psychologist, combining the psychology department with the school on the complex. C.  The Residential Unit i s the l a t e s t addition to the complex and has  been i n operation since September, 1969.  It consists of three cottages,  each contain f i f t e e n beds, and an Arts and Crafts Centre.  Other f a c i l i t i e s  shared by a l l three c l i n i c s include swimming pool, gymnasium, outdoor play and sports areas. At present two cottages are being used f o r residential treatment, the t h i r d functions as a Day C l i n i c .  Adolescent  boys and g i r l s from 13-17 years of age l i v e together i n a therapeutic community. Although the child's total need i s c a r e f u l l y considered, preference i s given to kids who are motivated to undertake a psychotherapeutic contract to help themselves, despite the suffering that personality change e n t a i l s , are admitted. The treatment philosophy i s based upon: giving the kids acceptance f o r what they are now; giving a warm atmosphere where r e l a t i o n s h i p s are offered without a demand that they reciprocate; where communication i s  80  very open and encouraged to be two-way; where feelings are f r e e l y shown and accepted; where physical contact i s encouraged; though the group may set l i m i t s to the expression of aggression.  The kids learn that they  are worth-while, are important to us as people, that we l i s t e n , and care about t h e i r needs, and that t h e i r personal desires are v a l i d . As they r e a l i z e t h i s , t h e i r self-esteem r i s e s , and i s reinforced by the s a t i s f a c tion and achievement they experience in p a r t i c i p a t i n g with the counsellors in learning and enjoying new s k i l l s i n sports, arts and c r a f t s , etc., and in human r e l a t i o n s h i p s . There i s a large measure of freedom given in the internal running of the cottages, although there are the r e a l i t y - l i m i t a t i o n s of being an i n s t i t u t i o n , under the C i v i l Service. The kids accept that freedom in the community must involve r e s p o n s i b i l i t y to that community so they accept the rules v o l u n t a r i l y and are involved in a democratic of r e l a t i v e self-government.  process  A community meeting i s held d a i l y in which  young people and s t a f f p a r t i c i p a t e f r e e l y , with confrontations, appreciat i o n s , information g i v i n g , s e n s i t i v i t y techniques, e t c . , a l l intermingled. Freedom of choice, with r e s p o n s i b i l i t y f o r accepting the consequences of t h i s , enable the kids to learn decision making and as t h e i r self-esteem and self-confidence grow, the kids i n i t i a t i v e to help himself, and to f u l f i l l his own personal needs, increases. By v o l u n t a r i l y accepting personal r e s p o n s i b i l i t y for the r e s u l t s of his choice, the youngster begins to develop s e l f - c o n t r o l and to r e a l i z e that s e l f - c o n t r o l serves a protective function, and should be reduced by the group, s e l f - c o n t r o l and personal r e s p o n s i b i l i t y increase.  81  In addition to the community meetings, there are regular Gestalt Therapy Groups a v a i l a b l e to the kids. A s t a f f member may also use these opportunities to work out a problem when feelings have come up strongly in the course o f work. There i s another group f o r s t a f f each week. There are also talking groups, one a d i r e c t encounter-confrontation  type, the  other a non-directive, very relaxed informal group i n which s e n s i t i v i t y techniques are f r e e l y used. The P s y c h i a t r i s t w i l l see any youngster or counsellor on request, but he does not see them by rota. The i n i t i a t i v e must be t h e i r s , they come when t h e i r need i s high, and usually "work" well i n the interview, which i s usually Gestalt Therapy. Program often centers around the turn-on center, an educational project enriched by arts and c r a f t s . One of our keywords i s " p a r t i c i p a t i o n " . Counsellors enjoy "doing t h e i r thing" with the kids. Pottery, weaving, k n i t t i n g , etc., t i e dye and batik, photography, music, cooking, sewing, woodworking, sports, trampoline, s a i l i n g , s k i i n g , camping and many other a c t i v i t i e s are warmly shared.  These a c t i v i t i e s usually provide opportun-  i t i e s f o r greater contact and increased intimacy, and also f o r the working out of aggression.  There i s , of course, frequent wrestling and also  f i s t f i g h t i n g , using boxing gloves when the occasion demands. The educational program aims at "turning on" kids who have experienced f a i l u r e and disillusionment at school.  School curriculum i s  completed eschewed, and instead the kids f r e e l y follow t h e i r own general i n t e r e s t s , usually i n bursts of enthusiasm l a s t i n g from a couple of hours to a couple of days. Gradually we focus on special i n t e r e s t s , extended over a longer period and when c u r i o s i t y and s a t i s f a c t i o n i n learning are  restored, then kids may elect to do correspondence courses, or have specif remedial teaching.  The counsellors are expected to have a basic bachelor'  degree, so are drawn from many d i f f e r e n t d i s c i p l i n e s , including teachers, social workers, psychologists, etc., and so provide a r i c h and varied resource pose. They carry on a l l programs, whether educational or recreational or treatment under the Director's d i r e c t i o n . The various  resource  persons who come i n on a sessional basis are used to t r a i n counsellors, wh have the real r e s p o n s i b i l i t y of caring f o r and helping the kid to grow. An in-service t r a i n i n g program i s conducted to a s s i s t with counsellors' personal and professional development. The schedule and s p e c i f i c content of t h i s changes from time to time, i n keeping with the needs o f the s t a f f i n r e l a t i o n to the Unit.  Staff members attend  t r a i n i n g sessions on alternate weeks. Included i n the t r a i n i n g a r e : (1) Attendance at a kid's case conference held i n the cottage with a l l kids and Unit and "outside" social workers.  (The conference report i s  prepared by the kid and a counsellor gives an evaluation o f his progress. The report i s retained i n the f i l e s and a copy sent to the r e f e r r i n g Social Agency or P s y c h i a t r i s t . ) (2) S k i l l t r a i n i n g i n arts and c r a f t s , a t h l e t i c s , water safety, e t c . (3) Personal growth through Gestalt Therapy, S e n s i t i v i t y and Encounter Groups, and theory and practice in conducting various types of groups. (4) Sessions with f u l l s t a f f o f each cottage only to deal with p o l i c y , administrative matters, treatment questions with regard to s p e c i f i c kids, and s t a f f interpersonal r e l a t i o n s h i p s .  Referrals A l l manner o f social psychological and learning problems can be referred as long as the i d e n t i f i e d patient has not reached his seventeenth birthday.  A centralized intake service w i l l screen r e f e r r a l s and  selection of patients w i l l be made on the basis of t r e a t a b i l i t y .  It i s  worth emphasizing that the Residential Unit i s an a c t i v e , intensive, comprehensive treatment unit and not a holding or emergency unit. Referrals are made through the d i s t r i c t o f f i c e s of the Department o f Rehabilitation and Social Improvement who forward the request through Special Placements or through the Children's A i d Society, the Catholic Children's Aid or the V i c t o r i a Family and Children's C l i n i c .  (Miss) M. Eileen Campbell, B.N. Acting Director Residential Treatment Unit Peter Campbell , M.D. Psychiatrist  APPENDIX B CONSENT LETTER  QUESTIONNAIRE 1: Choose which statement best describes how you feel  today:  I t r y to put o f f making decisions. I have great d i f f i c u l t y making decisions. I can't make any decisions any more. I make decisions about as well as ever.  QUESTIONNAIRE 11: Rate the behavior that i s most typical of you: I do things on my own and amuse myself. 1. Not at a l l . 2. Occasionally. 3.  Usually.  4. A l l the time. I do favours f o r others without being asked. 1. Not at a l l . 2.  Occasionally.  3.  Usually.  4. A l l the time.  PLEASE REMEMBER THAT AT NO TIME WILL YOUR SON OR DAUGHTER PLACE HIS OR HER NAME ON ANY ANSWER SHEET.  APPENDIX C MATERIALS PERTAINING TO BECK'S DEPRESSION INVENTORY Pre-tests Table 14 Value of Statements on Beck's Depression Inventory Beck's Depression Inventory I Inventory Analysis  88  Pre-tests The purpose of t h i s pre-test was to answer the following: could thirteen year old youths and p o t e n t i a l l y depressed adolescents comprehend Beck's Depression Inventory; would they have d i f f i c u l t y following the instructions f o r the questionnaire; could they use the computer cards; how long did this population require to answer t h i s inventory? A copy of Beck's Depression Inventory was given to each of f i v e thirteen year old boys.  The researcher read aloud  the f i r s t page of  instructions and the f i r s t f i v e statements grouped under question one, and demonstrated how to mark on the computer card the statement that they f e l t best explained how they f e l t at that moment. They were then asked to read c a r e f u l l y the remaining questions, f o r themselves, and use the computer cards to answer on.  They were encouraged to ask the researcher whenever  they were unsure of how to answer on the computer card or the meaning of a word or phrase used on the questionnaire. This same procedure was followed with a group of eighteen adolescents in a treatment centre. No adolescents asked questions concerning methodology or comprehension. Adolescents requested erasers to change answers on t h e i r computer cards, otherwise they had no d i f f i c u l t y using them to answer on. The longest time required to complete the inventory was one half hour.  TABLE 14 VALUES OF STATEMENTS ON BECK'S DEPRESSION INVENTORY  QUESTION 1  STATEMENTS 2 3  4  5  1  3  2  2  0  1  2  2  0  3  2  1  3  1  0  2  2  3  4  3  2  0  1  1  5  3  0  2  2  1  6  1  3  0  3  2  7  1  3  0  3  2  8  1  2  3  0  9  1  3  2  2  10  0  1  2  3  11  1  2  0  3  12  0  3  2  1  13  1  3  0  2  14  0  2  3  1  15  1  2  3  16  3  2  0  1  17  3  0  2  1  18  0  3  1  2  19  3  1  2  0  20  3  2  1  0  21  0  1  2  3  0  INVENTORY I  On the questionnaire there are groups of statements.  Pick out the ONE statement i n that group which best describes the way you feel today, that i s RIGHT NOW.  91  1  1. 2. 3. 4. 5.  am so sad or unhappy that I can't stand i t . am so sad or unhappy that i t i s quite painful. am blue or sad a l l the time and I can't snap out of i t . do not feel sad. feel blue or sad.  2  1. 2. 3. 4. 5.  feel that I won't ever get over my troubles, am not p a r t i c u l a r l y p e s s i m i s t i c or discouraged about the future. feel that the future i s hopeless and that things can't improve. feel that I have nothing to look forward to. feel discouraged about the future.  3  1. 2. 3.  4  1. 2. 3. 4. 5.  am d i s s a t i s f i e d with everything, don't get s a t i s f a c t i o n out of anything anymore, am not p a r t i c u l a r l y d i s s a t i s f i e d , feel bored most of the time, don't enjoy things the way I used to.  5  1. 2. 3. 4. 5.  feel as though I am very bad or worthless, don't feel p a r t i c u l a r l y g u i l t y , feel quite g u i l t y . feel bad or unworthy p r a c t i c a l l y a l l the time now. feel bad or unworthy a good part of the time.  6  1. 2. 3. 4. 5.  have a feeling that something bad may happen to me. want to be punished, don't feel I am being punished, feel I deserve to be punished, feel I am being punished or w i l l be punished.  feel that I have f a i l e d more than the average person, do not feel l i k e a f a i l u r e . feel I have accomplished very l i t t l e that i s worthwhile or that means anything. 4. As I look back on my l i f e a l l I can see i s a l o t of f a i l u r e s , 5. feel that I'm a complete f a i l u r e as a person.  1. 2. 3. 4. ' 5.  am disgusted with myself, am disappointed in myself, don't feel disappointed in myself, don't l i k e myself, hate myself.  8  am c r i t i c a l of myself f o r my weaknesses or mistakes, blame myself f o r my f a u l t s , blame myself f o r everything bad that happens, don't feel I am any worse than anybody else.  7  1. 2. 3. 4.  92 9  1.1 2. I 3. I 4. I 5. I  have thoughts of harming myself but I would never carry them out. have definite plans about committing suicide. feel I would be better o f f dead. feel my family would be better o f f i f I were dead. don't have any thoughts of harming myself.  10  1. 2. 3. 4.  I don't cry any more than usual. I cry more now than I used to. I cry a l l the time now. I can't stop i t . I used to be able to cry but now I can't cry at a l l even though I want to.  11  1. 2. 3. 4.  I I I I  12  1. I have not l o s t interest i n people. 2. I have l o s t a l l my interest in other people and don't care about them. 3. I have l o s t most of my interest in other people and have l i t t l e feeling f o r them. 4. I am less interested in other people now than I used to be.  13  1. 2. 3. 4.  14  1. I don't feel I look any worse than I used to. 2. I feel that there are permanent changes in my appearance and they make me look unattractive. 3. I feel that I am ugly or repulsive looking. 4. I am worried that I am looking old or u n a t t r a c t i v e .  15  1. 2. 3. 4.  16  1. I wake up early every day and can't get more than f i v e hours sleep. 2. I wake up one to two hours e a r l i e r than usual and find i t hard to get back to sleep. 3. I can sleep as well as usual. 4. I wake up more t i r e d in the morning than I used to.  17  1. 2. 3. 4.  I I I I  I I I I  I I I I  get annoyed or i r r i t a t e d more e a s i l y than I used to. feel i r r i t a t e d a l l the time. am no more i r r i t a t e d now than I ever am. don't get i r r i t a t e d at a l l at the things that used to i r r i t a t e me.  t r y to put o f f making decisions. can't make any decisions at a l l anymore. make decisions about as well as ever. have great d i f f i c u l t y in making decisions.  don't work as well as I used to. have to push myself very hard to do anything. can't do any work at a l l . can work about as well as ever.  get too t i r e d to do anything. don't get anymore t i r e d than usual, get t i r e d from doing anything. get t i r e d more e a s i l y than I used to.  93  18 1. 2. 3. 4.  My appetite i s no worse than usual. I have no appetite at a l l anymore. My appetite i s not as good as i t used to be. My appetite i s much worse now.  19 1. 2. 3. 4.  I I I I  have lost more than 15 pounds. have l o s t more than 5 pounds. have l o s t more than 10 pounds. haven't l o s t much weight, i f any, l a t e l y .  20 1. I am completely absorbed in what I feel l i k e . 2. I am so concerned with how I feel or what I feel i t ' s hard to think of much else. 3. I am concerned about aches and pains or upset stomach or constipation. 4. I am not more concerned about my health than usual. 21  1. 2. 3. 4.  I I I I  have not noticed any recent change in my i n t e r e s t i n sex. am less interested in sex than I used to be. am much less interested i n sex now. have l o s t i n t e r e s t in sex completely.  TABLE 15 DESCRIPTIVE DATA FOR SCORES ON BECK'S DEPRESSION INVENTORY  NUMBER OF INDIVIDUALS 102  HIGH SCORE  38  NUMBER OF ITEMS  LOW SCORE  0  21  MEAN 14.8592 STANDARD DEVIATION  8.69891  FREQUENCY 11 10 9 8 7 6 5 4 3 2 1 0 CLASS  1  2  3  4  5  9  10  LOW SCORE  0  2  4  6  8 10 12 14 16  18  HIGH SCORE  2  4  6  8 10 12 14 16 18  20  6  7  8  :  11  12  13  14  15  16  17  18  19  20  20  22  24  26  28  30  32  34  36  38  22  24  26  28  30  32  34  36  38  40  FIGURE 3 DISTRIBUTION OF DEPRESSION INVENTORY SCORES  vO  TABLE 16 GOODNESS OF FIT DISTRIBUTION OF DEPRESSION SCORES  CLASS 0-2 2-4 4-6 6-8 8-10 10-12 12-14 14-16 16-18 18-20 20-22 22-24 24-26 26-28 28-30 30-32 32-34 34-36 36-38 38-40  MIDPOINT 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39  DEGREES OF FREEDOM CH 1 SQUARE CH 1 PROBABILITY CRITICA VALUE @ .05  FREQUENCY 4 6 4 8 10 8 8 11 4 10 7 3 6 4 2 3 2 1 0 1 7 5.25193 .62925 14.07  97 TABLE 17 SOURCES OF VARIATION, BECK'S DEPRESSION INVENTORY DEGREES OF FREEDOM INDIVIDUALS  SUM OF SQUARED SCORES  SQUARE OF MEAN SCORES  101  360.51  3.57  20  217.01  10.85  RESIDUAL  2020  1458.42  0.72  TOTAL  2141  2035.94  0.95  ITEMS  INTERNAL CONSISTENCY COEFFICIENT .80 STANDARD ERROR OF MEASUREMENT  3.89  TABLE 18 ITEM ANALYSIS OF BECK'S DEPRESSION INVENTORY QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PER CENT WHO CHOSE ITEM  Bl SERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4 5  3 2 2 0 1  2 2 4 78 16  2.0 2.0 3.9 76.5 15.7  0.34 ' 0.29 0.50 -0.68 0.37  28.00 26.00 29.25 12.26 20.50  2  1 2 3 4 5  2 0 3 2 1  7 64 '4 8 19  6.9 62.7 3.9 7.8 18.6  0.2 -0.67 0.24 0.23 0.48  19.29 11.28 21.75 19.62 21.47  3  1 2 3 4 5  1 0 2 2 3  9 67 13 12 1  8.8 65.7 12.7 11.8 1.0  0.36 -0.79 0.36 0.52 0.14  22.11 10.88 20.92 23.92 22.00  4  1 2 3 4 5  3 2 0 1 1  0 1 60 16 25  0 1.0 58.8 15.7 24.5  0 0.34 -0.77 0.55 0.38  0.0 32.00 10.40 23.25 19.24  ITEM ANALYSIS CON'T STATEMENT  VALUE  NO. WHO CHOSE ITEM  PER CENT WHO CHOSE ITEM  5  1 2 3 4 5  3 0 2 .2 1  3 63 12 4 20  2.9 61.8 11.8 3.9 19.6  0.39 -0.81 0.27 0.49 0.46  27.67 10.41 19.58 29.00 20.95  6  1 2 3 4 5  1 3 0 3 2  17 0 59 7 19  16.7 0.0 57.8 6.9 18.6  0.14 0.0 -0.55 0.27 0.43  16.88 0.0 11.56 20.86 20.74  7  1 2 3 4 5  1 3 0 3 2  3 33 52 12 2  2.9 32.4 51.0 11.8 2.0  0.27 0.47 -0.90 0.53 0.33  23.67 19.39 8.71 24.17 27.50  8  1 2 3 4  1  20 22 10 50  19.6 21.6 9.8 49.0  .31 .05 .64 - .63  18.95 15.45 27.10 10.38  QUESTION  2 3 0  BI SERIAL CORRELATION COEFFICIENT  MEAN SCORE  ITEM ANALYSIS CON'T QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PER CENT WHO CHOSE ITEM  9  1 2 3 4 5  1 3 2 2 0  24 2 7 4 65  23.5 2.0 6.9 3.9 63.7  .33 .32 .54 .15 - .67  18.83 27.00 27.00 19.25 11.34  10  1 2 3 4  0 1 2 3  49 21 5 27  48.0 20.6 4.9 26.5  - .55 .32 .22 .24  10.86 19.05 20.60 17.56  11  1 2 3 4  1 2 0 3  40 .4 27 31  39.2 3.9 26.5 30.4  .16 .30 - .25 - :04  16.17 23.50 11.93 14.39  12  1 2 3 4  0 3 2 1  84 3 3 12  82.4 2.9 2.9 11.8  - .38 .10 .22 .32  13.62 18.00 22.00 20.42  13  1 2 3 4 5  1 3 0 2 0  19 2 50 30 1  18.6 2.0 49.0 29.4 1.0  .22 .33 - .77 .51 .00  17.84 27.50 9.90 20.17 15.00  BI SERIAL CORRELATION COEFFICIENT  MEAN SCORE  ITEM ANALYSIS CON'T QUESTION  STATEMENT  VALUE  Bl SERIAL CORRELATION COEFFICIENT  MEAN SCORE  14  1 2 3 4  0 2 3 1  66 13 9 14  64.7 12.7 8.8 13.7  - .62 .15 .34 .49  11.65 17.38 21.67 22.79  15  1 2 3 4  1 2 3 0  21 30 2 49  20.6 29.4 2.0 48.0  .01 .65 .32 - .66  14.90 21.60 27.00 10.08  16  1 2 3 4  3 2 0 1  •3 7 33 59  2.9 6.9 32.4 57.8  .31 - .12 - .48 .42  25.00 12.00 10.06 17.25  17  1 2 3 4  3 0 2 1  10 40 7 45  9.8 39.2 6.9 44.1  .34 - .59 .34 .24  21.30 9.77 22.43 16.62  18  1 .2 3 4  0 3 1 2  57 7 25 13  55.9 . 6.9 24.5 12.7  - .56 .40 .13 1.42  11.35 23.86 16.36 22.00  NO. WHO CHOSE ITEM  PER CENT WHO CHOSE ITEM  ITEM ANALYSIS CON'T QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PER CENT WHO CHOSE ITEM  BI SERIAL CORRELATION COEFFICIENT  MEAN SCORE  19  1 2 3 4  3 1 2 0  2 12 5 83  2.0 11.8 4.9 81.4  .23 .04 .31 - .25  23..50 15..50 23..00 13..99  20  1 2 3 4 5  3 2 1 0 0  12 11 17 61 1  11.8 10.8 16.7 59.8 1.0  .31 .36 .17 - .53 - .04  20..33 21..45 17..09 11..84 13..00  21  1 2 3 4  0 1 2 3  86 11 4 1  84.3 10.8 3.9 1.0  - .20 .01 .25 .23  14..05 15.,00 25..25 35.,00  APPENDIX D  Materials Pertaining to the Interpersonal Behavior Inventory Pretests Table 19, Behavior Categories and Corresponding Questions Adapted Interpersonal Behavior Inventory (AlBl) Inventory Analyses  104 Pre-tests The pre-test was undertaken to discover what form the inventory should take, in order that t h i r t e e n year old youths and p o t e n t i a l l y depressed adolescents could comprehend the questions on the inventory and follow the d i r e c t i o n s in answering i t .  It was also hoped to discover i f adolescents  could accurately answer the questions on OMR computer cards and to f i n d the length of time adolescents required to complete the questionnaire. A second aspect of the pre-test was to see i f adults working c l o s e l y with adolescents could complete the inventory on a youth that they f e l t they knew w e l l . The level of comprehension f o r each word used in the questionnaire was compared with the level of words Thorndike and Lorge suggested understandable at the thirteen year old l e v e l .  was  Professors in Education  and Nursing were consulted in order to change sophisticated and out-dated phrases to ones that might be more r e a d i l y understood by today's adolescent. This interpersonal behavior inventory was given to each of two thirteen year old boys.  The f i r s t page of i n s t r u c t i o n and the f i r s t ques-  tion was read to them, as well as the four possible answers to i t . Verbal d i r e c t i o n s with demonstration were given on how to mark on a computer card the one answer to the question that best explained how the adolescent usually acted. The boys were asked to read each of the following questions caref u l l y and choose the appropriate answers from the four statements at the top of the page. They were given three computer cards to answer 140 questions on.  They were encouraged to ask v e r b a l l y and immediately when they were  unsure of the meaning of a word, an idea, or the method of answering.  It  105  was emphasized that they could best help by finding questions that they or other youths might ask. A new questionnaire was made, changing those words the boys had had d i f f i c u l t y understanding.  As no other questions had arisen this ques-  tionnaire was given to twenty-eight thirteen year old g i r l s using the same procedure. Some of the g i r l s had d i f f i c u l t y understanding words on the questionnaire and some had d i f f i c u l t y answering the f i r s t f i f t y questions on the f i r s t computer card, the next f i f t y questions on the next card and the remaining questions on the l a s t card. An adapted questionnaire was designed changing each word that any of the g i r l s had asked the meaning of. The questionnaire was subdivided into three sections: part A, B and C.  Part A contained f i f t y ques-  tions that could a l l be answered on a computer card that was coded number two, part B contained f i f t y questions that could be answered on a computer card coded number three, and part C consisted of f o r t y questions to be answered on the f i r s t f o r t y spaces of computer card four. The newly adapted questionnaire was then given to f i v e thirteen year old boys. The original procedure was used but the new format of the questionnaire was explained. They had no d i f f i c u l t i e s answering the questionnaire.  It took the  slowest of the thirteen year old boys f o r t y - f i v e minutes to complete. When the adapted questionnaire was given to two adolescents in the treatment centre who the c h i l d care counsellors thought were depressed, no questions were asked although they had been encouraged. This boy and g i r l  106 were timed.  It took the slowest one hour and twenty minutes to complete.  A s p l i t - h a l f , odd-even check f o r r e l i a b i l i t y was calculated on the f i v e adolescent boys and two depressed adolescent scores, using Pearson's Product Moment C o e f f i c i e n t .  A c o r r e l a t i o n of .96 was obtained.  F i n a l l y this adapted inventory was given to eighteen adolescents in a treatment centre as well as to t h e i r c h i l d care c o u n c i l l o r s . The adolescents answered the inventory while the researcher was present. A c h i l d care counsellor was to answer the inventory on an adolescent who had p a r t i c i p a t e d i n the study, and who the counsellor knew w e l l ; they were to complete the inventory that day. There was a minimal return o f the questionnaires l e f t f o r the counsellors to complete; those that attempted to answer the inventory reported that they had d i f f i c u l t y knowing the youth well enough to adequately complete i t .  For these reasons, i t was decided that this level of  data would not be sought.  The level of data would be l i m i t e d to that  reported by the adolescents themselves.  TABLE 19 ADAPTED INTERPERSONAL BEHAVIOR INVENTORY BEHAVIOR CATEGORIES AND CORRESPONDING QUESTIONS BEHAVIOR CATEGORY  CORRESPONDING QUESTIONS SECTION A SECTION B SECTION C  Dominance  1 16 31 46  11 26 41  6 19  Competition  2 17 32 47  12 27 42  7 20 30  Aggression  3 18 33 48  13 28 43  8 21 31  Mistrust  4 19 34 49  14 29 44  9 22 32  Detachment  5 20 35 50  15 30 45  Inhibition  6 21 36  1 16 31 46  Submission  7 22 37  2 17 32 47  11 24 34  Succorance  8 23 38  3 18 33 48  13 26  Abasement  9 24 39  4 19 34 49  13 26  Deference  10 25 40  5 20 35 50  14 27 36  Agreeableness  11 26 41  6 21 36  1 15  Nurturance  12 27 42  7 22 37  2 16 28 37  Affection  13 28 43  8 23 38  3  Sociability  14 29 44  9 24 39  4 17 29 38  Exhibition  15 30 45  10 25 40  10 23 33 39  5 18  i 0 V  Al Bl  Base your ratings on the behavior you believe you show. Rate the behavior that i s most typical of you. Don't t r y to answer questions the same way.  People often show, f o r  good reasons, behavior:that seem opposite. Rate quickly by drawing a straight l i n e through the appropriate number with a p e n c i l . Rate every statement. your best guess.  If you feel uncertain about a judgment, record  109  1. Not At A l l  3. Usually  2. Occasionally  4. A l l Of The Time  1. I make decisions l i k e what to do or where to go when I'm with another friend. 2. I compete and t r y to do better than other kids. 3. I r i d i c u l e or run down others. 4. When people are kind to me, I look to see i f they are doing i t so they can get something from me. 5. I avoid people who t r y to become close or personal with me. 6. I show discomfort and nervousness when people watch me at work or play. 7. I l e t others take charge of things even though the r e s p o n s i b i l i t y i s mine. 8. I t r y to get others to make my decisions f o r me. 9. I apologize when c r i t i c i z e d or blamed regardless of who's f a u l t i t i s . 10. I show respect for persons in authority by a t t i t u d e and manner. 11. I contribute favourably as a member of a team or group. 12. I l i s t e n sympathetically to others t a l k about t h e i r troubles. 13. I e x h i b i t an open t r u s t and f a i t h in others. 14. I go out of my way to be with people. 15. I draw attention to myself i n a group by t e l l i n g jokes and s t o r i e s . 16. I dominate conversations, i n t e r r u p t , "talk others down". 17. I avoid sharing c r e d i t for achievement with others. 18. I act as i f I'm the underdog; as i f I'm being picked on. 19. I mistrust or question indications of a f f e c t i o n from others. 20. I do things on my own and amuse myself.  1. Not At A l l  3. Usually  2. Occasionally  4. A l l Of The Time  21. I show signs of self-consciousness with strangers. 22. I give way when someone i n s i s t s on a point. 23. I avoid or refuse to take the lead even when I should. 24. I blame myself when disagreements occur with others. 25. I speak favourably of persons i n charge or i n authority over me. 26. I feel comfortable with other kids and they l i k e me. 27. I give help or advice to people who are having d i f f i c u l t y . 28. I show a f f e c t i o n and closeness to members of my family. 29. I take the f i r s t step such as saying hello f i r s t , when making new friends. 30. I take over conversations by talking about myself ( i l l n e s s , experiences, t r a v e l ) . 31. I boss my friends and associates around. 32. I volunteer f o r jobs that gain me the attention of others. 33. I put down or c r i t i c i z e the successes and strengths of others. 34. When I do something, people think I do i t f o r a d i f f e r e n t reason than why I am r e a l l y doing i t . 35. I a c t business-like and impersonal with fellow classmates. 36. I keep s i l e n t when i n a group. 37. Even when I have a good reason, I don't show other people I am i r r i t a b l e or angry with them. 38. I go to others f o r help and reassurance when i n d i f f i c u l t y . 39. I apologize f o r not having done better when I complete a task. 40. I make myself useful to persons I admire or respect.  111  •1. Not At AH  3. Usually  2. Occasionally  4. All. Of The Time  41. I relate to and treat people as equals. 42. I reassure and comfort others when they are f e e l i n g low. 43. I say something favourable about nearly everyone I mention. 44. I avoid a c t i v i t i e s i n which I might be alone. 45. When I'm t e l l i n g friends about what I've done on the weekend, I make i t sound extra e x c i t i n g . 46. I use someone who i s n ' t as smart as I am to make me look good or to get me something I want. 47. I l i k e to win games even a t parties. 48. I c r i t i c i z e or defy persons i n authority. 49. I am not given the c r e d i t due me f o r my accomplishments. 50. I turn down i n v i t a t i o n s to social a f f a i r s .  1.  3. Usually  Not At Al1  2. Occasionally  4. A l l of the Time  1. I avoid actions in public which might make people notice me a l o t . 2. I go out of my way to avoid an argument. 3. I seek out people who show concern and sympathy for me. 4. I accept or take blame when things go wrong. 5. I carry out orders of my superiors with  eagerness.  6. I carry out my share of common tasks or assignments. 7. I lend things I value to my f r i e n d s . 8. I show a real l i k i n g and a f f e c t i o n for people. 9. I work hard at being popular and accepted. 10. I make s t a r t l i n g remarks that a t t r a c t attention. 11. I volunteer advice and information when people have decisions to make. 12. I would rather do well myself than work for a team to do well. 13. I show impatience and don't t o l e r a t e others' mistakes or weaknesses. 14. People c r i t i c i z e or blame me unjustly. 15. I f i n d i t d i f f i c u l t to mix with others. 16. I show signs of discomfort or self-consciousness in the presence of authority f i g u r e s . 17. I am agreeable and t r y to reach agreement when differences a r i s e . 18. I get opinions from others for even minor decisions. 19. I make a l o t of apologies f o r my appearance or conduct. 20. I choose friends who have greater popularity or greater prestige. 21. I l i k e to work with others on a project that we a l l want to do.  113  22. I put aside my own work or pleasure i f someone asks f o r help. 23. I find i t easy to l i k e people on short acquaintance. 24. I encourage friends to drop in informally at my home. 25. I speak up at meetings whether I have anything to say or not. 26. I t a l k my friends into doing what I would l i k e . 27. I set d i f f i c u l t goals f o r myself and t r y to achieve them. 28. I show anger or i r r i t a b i l i t y in my dealing with others. 29. I feel others are pulling jokes on me or don't r e a l l y mean what they are saying. 30. I avoid discussion of my personal a f f a i r s with friends or fellow students. 31. I keep shyly in the background in a social gathering. 32. I y i e l d to the wishes and plans of others. 33. I borrow money and things of value from f r i e n d s . 34. I t a l k at length about my f a u l t s and f a i l u r e s even in a group. 35. I copy the behavior of admired or successful persons. 36. I express my ideas so that they won't hurt other people's f e e l i n g s . 37. I am o b l i g i n g and cooperative when asked to perform l i t t l e services or favours. 38. I act close and personal with people. 39. I i n v i t e friends and acquaintances to my home. 40. I turn conversations in the d i r e c t i o n of my ideas, misfortunes.  accomplishments,  41. I take opportunities to i n s t r u c t or explain things to others. 42. I d i r e c t the attention of others toward my  accomplishments.  43. I feel I'm above other kids my age. 44. I show reluctance to trust or confide i n others. 45. I keep aloof or apart from my neighbours.  1.  Not At A l l  2. Occasionally  3. Usually 4. A l l of the Time  46. I feel uncomfortable i n close face-to-face individual contacts. 47. I give i n rather than f i g h t f o r my rights in a c o n f l i c t . 48. I dump my troubles and problems on others. 49. I t e l l others I feel i n f e r i o r to them. 50. I r e a d i l y accept advice of superiors.  1. Not At A l l  3. Usually  2. Occasionally  4. A l l of the Time  1. I consider the feelings and needs of others before speaking or a c t i n g . 2. I do favours f o r others without being asked. 3. I express a f f e c t i o n openly and d i r e c t l y through words, gestures and contact. 4. I mix widely at a social gathering. 5. I act the clown or amuse others at a party. 6. I take charge of things when I'm with people. 7. I work f o r things that give me status and s u p e r i o r i t y to others. 8. I t e l l people " o f f " when they annoy me. 9. I express suspicion when someone i s e s p e c i a l l y nice to me. 10. I stay away from social a f f a i r s where I w i l l have to meet new people. 11. I y i e l d without objection when my opinions are questioned or challenged. 12. I ask f o r help on jobs I could handle myself. 13. When I compare my s k i l l s and accomplishments with those of my f r i e n d s , mine seem small and of l i t t l e c r e d i t . 14. I t r y to obey and please people who are more powerful and s k i l l e d than I am. 15. I t r y to " f i t i n " and do what i s expected. 16. I show a genuine i n t e r e s t i n the problems of others. 17. I drop i n to v i s i t f r i e n d s j u s t to talk. 18. I openly describe my personal a f f a i r s even to casual acquaintances. 19. I d i r e c t the a c t i v i t i e s of one or more clubs or associations to which I belong. 20. I contrast unfavourably the accomplishments of others with my own. 21. I make unfavourable or h o s t i l e remarks about my equals.  1. Not At A l l  3. Usually  2. Occasionally  4. A l l of the Time  22. I accuse others of prying into my a f f a i r s . 23. I act cool and distant towards others. 24. I compromise to avoid  unpleasantness.  25. I ask others to look a f t e r my i n t e r e s t s . 26. I express a great deal of gratitude f o r help or favours. 27. I t r y to be helpful and agree with the teacher and other people who are i n authority over me. 28. I respond to others' f a u l t s in a h e l p f u l , accepting manner. 29. I attend or help organize p a r t i e s , dances, celebrations and reunions. 30. I seek membership in clubs and associations which have high prestige, reputation. 31. I use a s a r c a s t i c or b i t i n g type of humor. 32. I misinterpret minor comments by others as unfavourable towards myself. 33. I avoid involvement or p a r t i c i p a t i n g i n group e f f o r t s . 34. I l e t my friends push me around. 35. I seek favours from friends even when I can't return them. 36. I submit to the judgment of older i n d i v i d u a l s i n making decisions. 37. I exhaust my energies being helpful to others. 38. I t r y to be included i n most of my friends' a c t i v i t i e s . 39. I spend my free evenings at home with a hobby, book or T.V. program. 40. I seek to have others choose or s e l e c t for me clothes, food, and even recreation.  117 TABLE 20 SOURCES OF VARIATION A1B1 SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  320.21  3.17  34  491.61  14.46  RESIDUAL  3434  2262.80  .66  TOTAL  3569  3074.62  .86  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .79 4.80  118 TABLE 21 SOURCES OF VARIATION DOMINANCE SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  105.92  1.05  8  140.89  17.61  RESIDUAL  808  360.67  0.45  TOTAL  917  607.48  .66  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .57 2.00  119 TABLE 22 SOURCE OF VARIATION COMPETITION SCORES  INDIVIDUAL ITEMS RESIDUAL TOTAL  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  186.25  1.84  9  129.38  14.38  909  561.72  .62  1019  877.36  .86  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .66 2.2/9  TABLE 23 SOURCE OF VARIATION AGGRESSION SCORES  INDIVIDUAL ITEMS RESIDUAL TOTAL  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  190.88  1.89  9  41.35  4.59  909  451.05  0.50  1019  683.20  0.67  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .24 2.23  121 TABLE 24 SOURCE OF VARIATION MISTRUST SCORES  INDIVIDUAL ITEMS RESIDUAL TOTALS  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  204.13  2.02  9  25.45  2.83  909  457.25  .50  1019  686.84  .67  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .75 2.24  TABLE 25 SOURCE OF VARIATION DETACHMENT SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  101  245.65  2.43  10  116.66  11.67  RESIDUAL  1010  646.44  .64  TOTALS  1121  1008.75  .90  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  SUM OF MEAN SCORES  .24 2.65  TABLE 26 SOURCE OF VARIATION INHIBITION SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  250.51  2.48  6  28.16  4.69  RESIDUAL  606  368.99  .61  TOTALS  713  647.66  .91  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .75 2.06  124 TABLE 27 SOURCE OF VARIATION SUBMISSIVENESS SCORES  INDIVIDUAL ITEMS RESIDUAL TOTAL  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  164.68  1.63  9  157.21  17.47  909  510.30  .56  1019  832.18  .82  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .66 2.37  TABLE 28 SOURCE OF VARIATION SUCCORANCE SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  138.19  1.37  10  76.69  7.67  RESIDUAL  1010  548.59  .54  TOTAL  1121  763.46  .68  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .60 2.44  TABLE 29 SOURCE OF VARIANCE ABASEMENT SCORES  SUM OF MEAN SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  101  183.18  1.81  8  143.10  17.89  RESIDUAL  808  445.57  0.55  TOTALS  917  771.84  0.84  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .70 2.23  127 TABLE 30 SOURCE OF VARIANCE DEFERENCE SCORES  INDIVIDUAL ITEMS RESIDUAL TOTAL  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  197.01  1.95  9  122.37  13.60  909  500.04  .55  1019  819.41  .80  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .72 2.35  128 TABLE 31 SOURCE OF VARIANCE AGREEABLENESS  DEGREE OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  131.69  1.30  7  12.86  1.84  RESIDUAL  707  435.26  .62  TOTAL  815  579.82  .71  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .53 2.22  TABLE 32 SOURCE OF VARIANCE NURTURANCE SCORES  INDIVIDUALS ITEMS RESIDUAL TOTAL  DEGREE OF FREEDOM  SUM OF SQUARED SCORES  101  170.69  1.69  9  97.44  10.83  909  410.27  .45  1019  678.39  .67  INTERNAL CONSISTENCY COEFFICIENT STANDARD MEASUREMENT OF ERROR  SUM OF MEAN SCORES  .73 2.12  TABLE 33 SOURCE OF VARIATION AFFECTION SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  180.96  1.79  6  28.31  4.72  RESIDUAL  606  311.70  .51  TOTAL  713  520.97  .73  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .71 1.90  131 TABLE 34 SOURCE.OF VARIATION SOCIABILITY SCORES  INDIVIDUAL ITEMS RESIDUAL TOTAL  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SUM OF MEAN SCORES  101  236.18  2.34  9  24.30  2.70  909  646.40  .71  1019  906.89  .89  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .70 ' 2.67  132 TABLE 35 SOURCE OF VARIATION EXHIBITION SCORES  DEGREES OF FREEDOM  SUM OF SQUARED SCORES  SQUARE OF MEAN SCORES  101  176.73  1.75  7  50.92  7.27  RESIDUAL  707  389.20  .55  TOTAL  815  616.85  .76  INDIVIDUAL ITEMS  INTERNAL CONSISTENCY COEFFICIENT STANDARD ERROR OF MEASUREMENT  .69 2.10  FREQUENCY 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 1 2 0 2 2 4  3 4 6  4 5 6 7 8 9 6 8 10 12 14 16 8 10 12 14 16 18  N  102  df  3  Chi Square  2.82241  Chi Prob  .72734  10 11 12 13 14 15 16 17 18 19 20 18 20 22 24 26 28 30 32 34 36 38 20 22 24 26 28 30 32 34 36 38 40  FIGURE 4 FREQUENCY DISTRIBUTION OF DOMINANCE SCORES AND GOODNESS OF FIT  FREQUENCY  CLASS 1 LOW SCORE 0 HIGH SCORE 2  2 2 4  3 4 6  4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40  FIGURE 5 FREQUENCY DISTRIBUTION OF COMPETITION SCORES AND GOODNESS OF FIT CO  FREQUENCY  1 CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 6 FREQUENCY DISTRIBUTION OF AGGRESSION SCORES AND GOODNESS OF FIT  FREQUENCY 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 CLASS 1 2 34  N df Chi Square Chi Prob  5  6  7  8  9 10 11 12 13 14 15 16 17 18 19 20  LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 7 FREQUENCY DISTRIBUTION OF MISTRUST SCORES AND GOODNESS OF FIT  102 5 3.30782 .65264  FREQUENCY  CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 8 FREQUENCY DISTRIBUTION OF DETACHMENT SCORES AND GOODNESS OF FIT  FREQUENCY 20 19 18 17 16 15 14 13 12 11 10 9 8  N df Chi Square Chi Prob  102 5 11.81324 .03744  7  6 5 4 3 2 1 CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 9 FREQUENCY DISTRIBUTION OF INHIBITION SCORES AND GOODNESS OF FIT  CO CO  FREQUENCY  CLASS HIGH SCORE LOW SCORE  1 2 3 4 5 6 7 8 9 10 111 12 13 14 15 16 17 18 19 20 0 2 4 6 8 10 12 14 16 1.8 20 22 24 26 28 30 32 34 36 38 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 10 FREQUENCY DISTRIBUTION OF SUBMISSIVENESS SCORES AND GOODNESS OF FIT  CO CO  FREQUENCY 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1  N df Chi Square Chi Prob  102 4 6.40916 .17060  1 2 3 4 5 6 7 8 9 10 "11 12 13 14 15 16 17 18 19 20 CLASS LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 11 FREQUENCY DISTRIBUTION OF SUCCORANCE SCORES AND GOODNESS OF FIT  o  CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 12 FREQUENCY DISTRIBUTION OF ABASEMENT SCORES AND GOODNESS OF FIT  FREQUENCY  CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 13 FREQUENCY DISTRIBUTION OF DEFERENCE SCORES AND GOODNESS OF FIT  FREQUENCY 30 N 29 df 28 Chi Square 27 Chi Prob 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40  102 3 6.36029 .27272  FIGURE 14 FREQUENCY DISTRIBUTION OF AGREEABLENESS SCORES AND GOODNESS OF FIT  CO  FREQUENCY  CLASS LOW SCORE HIGH SCORE  1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 15 FREQUENCY DISTRIBUTION OF NURTURANCE SCORES AND GOODNESS OF FIT  FREQUENCY 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 CLASS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 LOW SCORE 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 HIGH SCORE 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36  N df Chi Square Chi Prob  19 20 36 38 38 40  FIGURE 16 FREQUENCY DISTRIBUTION OF AFFECTION SCORES AND GOODNESS OF FIT  FREQUENCY  CLASS LOW SCORE HIGH SCORE  1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 17 FREQUENCY DISTRIBUTION OF SOCIABILITY SCORES AND GOODNESS OF FIT  FREQUENCY  CLASS LOW SCORE HIGH SCORE  1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 FIGURE 18 FREQUENCY DISTRIBUTION OF EXHIBITION SCORES AND GOODNESS OF FIT  TABLE 36 ITEM ANALYSIS 1, DOMINANCE QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  9 47 40 6  8.8 46.1 39.2 5.9  - .46 - .40 .52 .30  14.89 17. 17 19. 80 20. 83  2  1 2 3 4  1 2 3 4  53 41 6 2  52.0 40.2 5.9 2.0  - .66 .49 .26 .28  16. 68 19. 68 20. 50 22. 00  3  1 2 3 4  1 2 3 4  45 49 6 2  44.1 48.0 5.9 2.0  - .61 .45 .26 .20  16. 56 19. 35 20. 50 21. 00  4  1 2 3 4  1 2 3 4  49 44 8 1  48.0 43.1 7.8 1.0  - .54 .48 .15 .12  16. 86 19. 57 19. 37 16. 00  5  1 2 3 4  1 2 3 4  4 43 39 15  3.9 42.2 38.2 14.7  - .02 - .45 .15 .39  18. 00 16. 93 18. 69 20. 40  6  1 2 3 4  1 2 3 4  11 70 18 3  10.8 68.6 17.6 2.9  - .42 - .11 .36 .30  15.45 18. 03 20. 06 21. 67  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PRECENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  7  1 2 3 4  1 2 3 4  5 48 42 7  4.9 47.1 41.2 6.9  - .28 - .41 .29 .50  15.60 17.15 19.07 22.09  8  1 2 3 4  1 2 3 4  23 54 23 2  22.5 52.9 22.5 2.0  - .73 .04 .55 .50  15.00 18.30 20.65 25.00  9  1 2 3 4  1 2 3 4  52 34 15 1  51.0 33.3 14.7 1.0  - .65 .33 .50 .04  16.65 19.35 21.00 19.00  TABLE 37 ITEM ANALYSIS, COMPETITION QUESTION QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  10 31 38 23  9.8 30.4 37.3 22.5  - .5 - .36 .15 .58  16 .10 19 .23 21 .71 24 .65  2  1 2 3 4  1 2 3 4  46 39 12 5  45.1 38.2 11.8 4.9  - .45 .27 .19 .18  19 .39 22 .23 22 .75 23 .40  3  1 2 3 4  1 2 3 4  38 41 19 4  37.3 40.2 18.6 3.9  - .70 .22 .47 .31  18 .00 21 .48 24 .32 25 .50  4  1 2 3 4  1 2 3 4  10 41 25 26  9.8 40.2 24.5 25.5  - .37 - .35 .10 .55  17 .50 19 .61 21 .64 24 .19  5  1 2 3 4  1 2 3 4  36 38 21 7  35.3 37.3 20.6 6.9  - .33 - .09 .27 .40  19 .56 20 .68 22 .86 25 .57  6  1 2 3 4  1 2 3 4  14 45 28 15  13.7 44.1 27.5 14.7  - .34 - .31 .31 .37  18 .29 19 .89 22 .79 24 .00  QUESTION  STATEMENT  VALUE  NO. CHOSE  WHO  PERCENT WHO  BISERIAL  ITEM  CHOSE  COEFFICIENT  ITEM  CORRELATION B-ST  MEAN SCORE  7  1 2 3 4  1 2 3 4  31 51 18 2  30.4 50.0 17.6 2.0  - .45 - .11 .62 .29  18.77 20.69 25.50 26.50  8  1 2 3 4  1 2 3 4  19 53 23 7  18.6 52.0 22.5 6.9  - .67 - .12 .42 .63  16.42 20.68 23.65 28.14  9  1 2 3 4  1 2 3 4  34 53 11 4  33.3 52.0 10.8 3.9  - .48 .17 .32 .27  18.79 21.62 24.00 25.00  10  1 2 3 4  1 2 3 4  34 53 11 4  33.3 52.0 10.8 3.9  - .48 .17 .32 .27  18.79 21.62 24.00 25.00  TABLE 38 ITEM ANALYSIS, AGGRESSION QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO PERCENT WHO CHOSE ITEM , CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  30 56 9 6  29.4 54.9 8.8 5.9  - .75 .25 .56 .42  15.33 20.09 25.50  2  1 2 3 4  1 2 3 4  40 44 12 6  39.2 43.1 11.8 5.9  - .49 .22 .12 .45  17.20 20.18 20.42 24.83  3  1 2 3 4  1 2 3 4  39 54 5 4  38.2 52.9 4.9 3.9  - .61 .27 .34 .54  16.64 20.20 23.80 27.75  4  1 2 3 4  1 2 3 4  23 55 17 7  22.5 53.9 16.7 6.9  - .43 - .24 .54 .46  16.61 18.55 23.29 24.57  5  1 2 3 4  1 2 3 4  22 56 17 7  21.6 54.9 16.7 6.9  - .71 .06 .49 .35  14.77 19.50 22.94 23.29  6  1 2 3 4  1 2 3 4  27 60 12 3  26.5 58.8 11.8 2.9  - .56 .09 .57 .18  16.15 19.58 24.33 22.33  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  7  1 2 3 4  1 2 3 4  49 37 11 5  48.0 36.3 10.8 4.9  - .47 .12 .35 .41  17.63 19.84 22.55 24.80  8  1 2 3 4  1 2 3 4  14 44 33 11  13.7 43.1 32.4 10.8  - .36 - .35 .34 .47  16.36 17.91 21.00 23.64  9  1 2 3 4  1 2 3 4  39 55 7 1  38.2 53.9 6.9 1.0  - .67 .43 .41 .27  16.38 20.67 24.00 26.00  10  1 2 3 4  1 2 3 4  34 51 8 9  33.3 50.0 7.8 8.8  - .57 .19 .25 .43  16.53 19.98 22.00 23.67  TABLE 39 ITEM ANALYSIS, MISTRUST QUESTIONS QUESTION  STATEMENT  VALUE"  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  44 39 11 8  43 .1 38 .2 10 .8 7 .8  - .75 .23 .38 .61  16.82 20. 90 23. 55 26. 63  2  1 2 3 4  1 2 3 4  42 39 12 8  41 .2 38 .2 11 .8 7 .8  - .67 .10 .39 .61  17. 02 20. 33 23.42 26. 63  3  1 2 3 4  1 2 3 4  17 54 25 6  16 .7 52 .9 24 .5 5 .9  - .47 - .24 .53 .33  16. 24 19. 06 23. 12 24. 00  4  1 2 3 4  1 2 3 4  19 59 17 7  18 .6 57 .8 16 .7 6 .9  - .59 .08 .28 .33  15. 63 20. 10 22. 00 24. 29  5  1 2 3 4  1 2 3 4  18 68 11 5  17 .6 . 66.7 10 .8 4 .9  - .27 - .07 .24 .33  17.89 19. 69 22. 18 24. 40  6  1 2 3 4  1 2 3 4  20 57 18 7  19 .6 55 .9 17 .6 6 .9  - .43 - .21 .51 .37  16.85 19. 19 23. 67 24. 29  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  7  1 2 3 4  1 2 3 4  24 49 19 9  8  1 2 3 4  1 2 3 4  9  1 2 3 4  10  1 2 3 4  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  23.5 48.0 18.6 8.8  - .63 .00 .29 .60  15.92 19.88 22.00 26.22  38 46 13 5  37.3 45.1 12.7 4.9  - .56 .11 .38 .51  17.29 20.30 23.23 26.80  1 2 3 4  41 52 8 1  40.2 51.0 7.8 1.0  - .52 .27 .49 .00  17.61 20.81 25.38 20.00  1 2 3 4  19 62 15 6  18.6 60.8 14.7 5.9  - .57 - .14 .44 .63  15.79 19.48 23.47 27.83  TABLE 40 ITEM ANALYSIS, DETACHMENT QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  50 38 10 4  49.0 37.0 9.8 3.9  - .49 .05 .50 .51  20. 10 22. 45 27. 90 31. 00  2  1 2 3 4  1 2 3 4  6 56 27 13  5.9 54.9 26.5 12.7  - .08 - .32 .18 .31  21. 00 20. 98 23. 37 25. 31  3  1 2 3 4  1 2 3 4  66 20 11 5  64.7 19.6 10.8 4.9  - .70 .33 .32 .60  20. 06 24. 80 25. 73 31. 60  4  1 2 3 4  1 2 3 4  44 37 14 6  43.1 36.3 13.7 5.9  - .46 - .03 .31 .64  20. 22. 25. 21 31. 50  5  1 2 3 4  1 2 3 4  31 43 19 9  30.4 42.2 18.6 8.8  - .55 - .13 .35 .70  18. 77 21. 56 25. 05 30. 67  6  1 2 3 4  1 2 3 4  32 39 17 14  31.4 38.2 16.7 13.7  - .42 - .22 .19 .70  19. 66 21. 03 23. 88 29. 00  QUESTION  STATEMENT  VALUE 1 2 3 4  NO. WHO CHOSE ITEM 36 44 14 8  PERCENT WHO CHOSE ITEM 35.3 43.1 13.7 7.8  7  1 2 3 4  8  BISERIAL CORRELATION COEFFICIENT - .46 .00 .33 .45  MEAN SCORE 19.64 22.18 25.36 27.89  1 2 3 4  1 2 3 4  49 27 17 9  48. 26.5 16.7 8.8  - .63 - .02 .46 .62  19.47 22.00 26.24 29.67  9  1 2 3 4  1 2 3 4  27 51 19 5  26.5 50.0 18.6 4.9  « .53 - .07 .39 .64  18.59 21.88 25.37 32.20  10  1 2 3 4  :i 2 3 4  35 49 12 5  34.3 48.0 11.8 4.9  - .55 .03 .38 .66  19.06 22.31 26.17 32.60  11  1 2 3 4  1 2 3 4  13 23 43 23  12.7 22.5 42.2 22.5  - .05 - .38 .12 .28  21.62 19.35 22.74 24.22  TABLE 41 ITEM ANALYSIS, INHIBITION QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  20 36 29 17  19 .6 35 .3 28 .4 16 .7  - .51 - .38 .27 .72  13. 05 14. 67 17. 76 21. 47  2  1 2 3 4  1 2 3 4  12 36 29 25  11 .8 35 .3 28 .4 24 .5  - .44 - .45 .10 .72  12. 58 14. 36 16. 86 20.48  3  1 2 3 4  1 2 3 4  24 49 21 8  23 .5 48 .0 20 .6 7 .8  - .50 - .19 .37 .63  13. 46 15. 71 18. 71 22. 87  4  1 2 3 4  1 2 3 4  14 32 40 16  13 .7 31 .4 39 .2 15 .7  - .51 - .17 .09 .58  12. 36 15. 53 16. 72 20. 63  5  1 2 3 4  1 2 3 4  22 44 25 11  21 .6 43 .1 24 .5 10 .8  - .42 - .26 .29 .61  13. 77 15. 36 18. 00 21. 82  6  1 2 3 4  1 2 3 4  25 47 12 18  24 .5 46 .1 11 .8 17 .6  - .63 - .23 .13 .92  12. 80 15. 53 17. 50 22. 72  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  7  1 2 3 4  1 2 3 4  22 56 14 10  21.6 54.9 13.7 9.8  - .43 - .29 .41 .67  13.73 15.48 19.57 22.60  TABLE 42 ITEM ANALYSIS, SUBMISSIVENESS QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  47 41 10 4  46.1 40.2 9.8 3.9  - 0.22 - 0.04 .08 .63  20. 53 21. 15 22. 00 29. 75  2  1 2 3 4  1 2 3 4  26 42 24 9  25.5 41.2 23.5 8.8  - .40 - .24 .30 .58  19. 12 20. 38 23. 00 26. 78  3  1 2 3 4  1 2 3 4  24 40 31 7  23.5 39.2 30.4 6.9  - .38 - .25 .40 .43  19. 13 20. 27 23. 23 25.86  4  1 2 3 4  1 2 3 4  14 52 30 6  13.7 51.0 29.4 5.9  - .19 - .48 .38 .62  19.86 19. 79 23. 13 28. 33  5  1 2 3 4  1 2 3 4  1 30 57 14  1.0 29.4 55.9 13.7  .12 - .24 - .04 .37  24. 20. 21. 24. 14  6  1 2 3 4  1 2 3 4  8 66 24 4  7.8 64.7 23.5 3.9  - .17 - .32 .15 .79  19. 62 20. 53 22. 13 32. 00  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  7  1 2 3 4  1 2 3 4  46 38 9 9  8  1 2 3 4  1 2 3 4  9  1 2 3 4  10  1 2 3 4  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  45.1 37.3 8.8 8.8  - .62 .06 .44 .63  19.11 21.53 25.44 27.22  43 42 10 7  42.2 41.2 9.8 6.9  - .58 .09 .19 .82  19.12 21.64 23.00 30.00  1 2 3 4  8 36 39 19  7.8 25.3 38.2 18.6  -. .30 - .38 .15 .48  18.25 19.64 21.90 24.42  1 2 3 4  57 38 4 3  55.9 37.3 3.9 2.9  - .46 .10 .66 .53  19.96 21.68 30.25 29.33  TABLE 43 ITEM ANALYSIS, SUCCORANCE QUESTIONS  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  1  1 2 3 4  1 2 3 4  35 49 12 6  34.3 48.0 11.8. 5.9  - .46 .07 .38 .33  19.43 21.59 29.42 25.00  2  1 2 3 4  1 2 3 4  32 42 22 6  31.4 41.2 21.6 5.9  - .38 - .06 .27 .45  19.66 21.17 22.95 26.33  3  1 2 3 4  1 2 3 4  10 53 31 8  9.8 52.0 30.4 7.8  - .01 - .28 .20 .22  21.30 20.55 22.29 23.50  4  1 2 3 4  1 2 3 4  24 47 22 9  23.5 46.1 21.6 8.8  - .54 .06 .34 .24  18.46 21.57 23.32 23.44  5  1 2 3 4  1 2 3 4  16 47 27 12  15.7 46.1 26.5 11.8  - .53 - .27 .44 .43  17.75 20.49 23.59 24.75  6  1 2 3 4  1 2 3 4  31 59 7 5  30.4 57.8 6.9 4.9  - .40 .14 .12 .46  19.55 21.75 22.57 26.80  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  7  1 2 3 4  1 2 3 4  46 48 5 3  45.1 47.1 4.9 2.9  - .68 .43 .29 .50  19.09 22.77 24.80 28.67  8  1 2 3 4  1 2 3 4  37 51 11 3  36.3 50.0 10.8 2.9  - .69 .27 .46 .43  18.59 22.22 25.18 ' 27.67  9  1 2 3 4  1 2 3 4  35 54 10 3  34.3 52.9 9.8 2.9  - .47 .21 .28 .27  19.40 22.00 23.80 25.33  10  1 2 3 4  1 2 3 4  23 61 12 6  22.5 59.8 11.8 5.9  - .38 - .06 .30 .45  19.26 21.23 23.75 26.33  11  1 2 3 4  1 2 3 4  63 33 4 2  61.8 32.4 3.9 2.0  - .34 .18 .28 .33  20.56 22.18 25.00 27.00  TABLE 44 ITEM ANALYSIS, ABASEMENT QUESTIONS QUESTION  STATEMENT  VALUE-  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  38 37 22 5  37 .3 36 .3 21 .6 4 .9  - .61 - .05 .50 .62  15. 58 17. 92 21. 09 25.80  2  1 2 3 4  1 2 3 4  35 48 16 3  34 .3 47 .1 15 .7 2 .9  - .40 - .11 .62 .21  16. 37 17. 73 22. 50 21. 33  3  1 2 3 4  1 2 3 4  24 44 24 10  23 .5 43 .1 23 .5 9 .8  - .59 - .21 .55 .44  14. 75 17. 34 21. 25 22. 10  4  1 2 3 4  1 2 3 4  14 59 24 5  13 .7 57 .8 23 .5 4 .9  - .58 - .09 .27 .64  13. 71 17.88 19. 62 26. 00  5  1 2 3 4  1 2 3 4  39 35 18 10  38 .2 34 .3 17 .6 9 .8  - .71 .03 .43 .62  15. 23 18. 26 21. 00 23. 70  6  1 2 3 4  1 2 3 4  52 40 7 3  51 .0 9 .2 6 .9 2 .9  -..53 .37 .16 .32  16.46 19.86 19.86 23. 00  QUESTION  STATEMENT  VALUE  7  1 2 3 4  1 2 3 4:-  NO. WHO CHOSE ITEM 69 29 2 2  PERCENT WHO CHOSE ITEM 67.6 28.4 2.0 2.0  BISERIAL CORRELATION COEFFICIENT - .31 .20 .08 .41  MEAN SCORE 17.43 19.14 19.50 25.50  8  1 2 3 4  1 2 3 4  32 46 12 12  31.4 45.1 11.8 11.8  - .52 - .21 .36 .76  15.69 17.39 21.08 24.42  9  1 2 3 4  1 2 3 4  6 21 54 21  5.9 20.6 52.9 20.6  - .17 - .26 .02 .33  16.17 16.52 18.17 20.14  TABLE 45 ITEM ANALYSIS, DEFERENCE QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  9 10 52 31  8.8 9.8 51.0 30.4  - .48 - .29 - .16 .62  19.22 21.30 23.58 27.42  2  1 2 3 4  1 2 3 4  10 46 37 9  9.8 45.1 36.3 8.8  - .48 - .41 .50 .36  19.40 22.57 26.46 27.89  3  1 2 3 4  1 2 3 4  3 29 48 22  2.9 28.4 47.1 21.6  - .37 - .53 .22 .45  18.00 21.24 24.94 27.05  4  1 2 3 4  1 2 3 4  17 43 34 7  16.7 42.2 33.3 6.9  - .56 - .12 .37 .41  19.88 23.63 25.94 28.86  5  1 2 3 4  1 2 3 4  45 34 18 5  44.1 33.3 17.6 4.9  - .31 .03 .22 .32  22.91 24.26 25.78 28.40  6  1 2 3 4  1 2 3 4  25 51 17 9  24.5 . 50.0 16.7 8.8  - .31 - .20 .33 .43  22.24 23.45 26.65 28.56  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM 4 40 44 14  PERCENT WHO CHOSE ITEM 3.9 39.2 43.1 13.7  BISERIAL CORRELATION COEFFICIENT - .18 - .63 .21 .71  MEAN SCORE 21.50 21.40 24.98 30.07  7  1 2 3 4  1 2 3 4  8  1 2 3 4  1 2 3 4  24 39 28 11  23.5 38.2 27.5 10.8  - .56 - .20 .29 .69  20.67 23.26 25.79 30.64  9  1 2 3 4  1 2 3 4  12 39 40 11  11.8 38.2 39.2 10.8  - .63 - .33 .33 .65  18.50 22.67 25.57 30.27  10  1 2 3 4  1 2 3 4  13 61 26 2  12.7 59.8 25.5 2.0  - .36 - .16 .37 .33  21.00 23.67 26.31 30.50  TABLE 46 ITEM ANALYSIS, AGREEABLENESS QUESTIONS QUESTION  STATEMENT  VALUE  1  1 2 3 4  1 2 3 4  2  1 2 3 4  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  7 14 38 43  6.9 13.7 37.3 42.2  - .53 - .45 .11 .43  19.00 20. 79 23. 87 24. 79  1 2 3 4  5 14 58 24  4.9 13.7 56.9 23.5  - .60 - .26 - .06 .53  17. 60 21. 93 23. 36 25. 92  3  1 2 3 4  1 2 3 4  7 15 48 32  6.9 14.7 47.1 31.4  - .63 - .30 .01 .52  18. 14 21. 73 23. 52 25.47  4  1 2 3 4  1 2 3 4  3 18 61 19  2.9 17.6 59.8 18.6  - .23 - .21 - .03 .36  20.67 27. 39 23. 44 25. 37  5  1 2 3 4  1 2 3 4  5 22 40 35  4.9 21.6 39.2 34.3  - .38 - .44 - .11 .64  19. 80 21. 41 23. 15 25. 74  6  1 2 3 4  1 2 3 4  7 21 52 22  6.9 20.6 51.0 21.6  - .09 - .45 .05 .44  22. 71 21. 29 23. 62 25. 59  -  i  NO. WHO CHOSE ITEM  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE  ITEM  PERCENT WHO CHOSE  ITEM  BISERIAL  CORRELATION  COEFFICIENT  MEAN SCORE  7  1 2 3 4  1 2 3 4  5 30 47 19  4.9 29.4 46.1 18.6  - .19 - .46 .25 .35  21.60 21.70 24.19 25.32  8  1 2 3 4  1 2 3 4  7 27 51 17  6.9 26.5 50.0 16.7  - .35 - .42 .19 .46  20.57 21.74 23.98 26.06  TABLE 47 ITEM ANALYSIS, NURTURANCE QUESTIONS QUESTION  STATEMENT  1  1 2 3 4  VALUE 1  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  3 4  3 22 49 28  2.9 21.6 48.0 27.5  - .20 - .65 - .11 .79  23. 33 22. 45 26. 04 30. 54  cl  2  1 2 3 4  1 2 3 4  0 37 48 17  0 36.3 47.1 16.7  0.0 - .61 .20 .54  0. 0 23. 81 27. 10 30. 18  3  1 2 3 4  1 2 3 4  2 26 49 25  2.0 25.5 48.0 24.5  - .24 - .67 .13 .59  22. 0 22. 73 26.86 29. 76  4  1 2 3 4  1 2 3 4  14 45 27 16  13.7 44.1 26.5 15.7  - .10 - .40 + .20 .42  25. 64 24. 96 27.48 29. 44  5  1 2 3 4  1 2 3 4  5 38 45 14  4.9 37.3 44.1 13.7  - .32 - .57 .27 .61  22. 40 24. 03 27.42 31. 14  6  1 2 3 4  1 2 3 4  3 20 58 20  2.9 19.6 56.9 19.6  - .37 - .44 .16 .39  20. 67 23. 60 26. 88 28. 90  QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  7  1 2 3 4  1 2 3 4  7 61 29 5  6.9 59.8 28.4 4.9  - .38 - .32 .33 .46  22.86 25.56 28.10 32.20  8  1 2 3 4  1 2 3 4  3 35 43 21  2.9 34.3 42.2 20.6  - .54 - .53 .08 .73  18.00 24.06 26.72 30.95  9  1 2 3 4  1 2 3 4  4 . 43 49 6  3.9 42.2 48.0 5.9  - .43 - .46 .34 .60  20.50 24.67 27.59 33.33  10  1 2 3 4  1 2 3 4  24 59 17 2  23.5 57.8 16.7 2.0  - .49 .09 .42 .09  23.63 26.66 29.35 28.00  TABLE 48 ITEM ANALYSIS, AFFECTION QUESTIONS QUESTION  STATEMENT  VALUE  1  1 2 3 4  1 2 3 4  7 32 39 24  2  1 2 3 4  1 2 3 4  3  1 2 3 4  4  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  6.9 31.4 38.2 23.5  - .49 - .34 .04 .60  14.14 17.31 18.85 21.71  7 35 38 21  6.9 34.3 37.3 20.6  - .35 - .55 .30 .53  15.43 16.57 19.79 21.57  1 2 3 4  8 42 44 8  7.8 41.2 43.1 7.8  - .47 - .31 .36 .36  14.62 17.69 19.86 21.88  1 2 3 4  1 2 3 4  2 25 51 24  2.0 24.5 50.0 23.5  - .24 - .66 - .01 .75  15.00 15.52 18.69 22.42  5  1 2 3 4  1 2 3 4  6 28 40 28  5.9 27.5 39.2 27.5  - .44 - .45 .02 .64  14.33 16.68 18.77 21.61  6  1 2 3 4  1 2 3 4  10 50 33 8  9.8 49.0 32.4 7.8  - .55 - .28 .39 .49  14.40 17.90 20.30 23.00  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  QUESTION  STATEMENT  VALUE  7  1 2 3 4  1 2 3 4  NO. WHO CHOSE ITEM 11 38 41 12  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  10.8 37.3 40.2 11.8  - .69 - .36 .37 .64  13.55 17.39 19.98 23.33  TABLE 49 ITEM ANALYSIS, SOCIABILITY QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  1  1 2 3 4  1 2 3 4  12 46 34 10  11.8 45.1 33.3 9.8  - .68 - .15 .45 .27  18. 17 24. 24 27. 29 27. 80  2  1 2 3 4  1 2 3 4  12 32 40 18  11.8 31.4 39.2 17.6  - .52 - .39 .42 .36  19. 75 22. 72 26.88 27. 78  3  1 2 3 4  1 2 3 4  30 32 21 19  29.4 31.4 20.6 18.6  - .32 - .01 .14 .25  23. 03 24. 81 25. 90 26. 84  4  1 2 3 4  1 2 3 4  12 36 26 28  11.8 35.3 25.5 27.5  - .26 - .15 .04 .30  22. 33 24. 11 25. 15 26. 75  5  1 2 3 4  1 2 3 4  20 38 24 20  19.6 37.3 23.5 19.6  - .65 - .12 .16 .63  20. 00 24. 29 25. 96 29. 65  6  1 2 .3 4  1 2 3 4  8 46 26 22  7.8 45.1 25.5 21.6  - .61 - .24 .14 .52  17. 62 23. 89 25. 77 28. 59  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  QUESTION  STATEMENT  VALUE  7  1 2 3 4  1 2 3 4  20 37 28 17  19.6 36.3 27.5 16.7  - .70 - .17 .41 .47  19 .60 24 .05 27 .43 28 .76  8  1 2 3 4  1 2 3 4  14 52 21 15  13.7 51.0 20.6 14.7  - .70 - .17 .33 .55  18 .50 24 .25 27 .29 29 .73  9  1 2 3 4  1 2 3 4  21 37 34 10  20.6 36.3 33.3 9.8  - .60 - .07 .26 .53  20 .52 24 .54 26 .29 30 .60  10  1 2 3 4  1 2 3 4  5 29 55 13  4.9 28.4 53.9 12.7  - .37 - .52 .38 .43  19 .40 21 .76 26 .07 29 .00  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  TABLE 50 ITEM ANALYSIS, EXHIBITION QUESTIONS QUESTION  STATEMENT  VALUE  NO. WHO CHOSE ITEM  PERCENT WHO CHOSE ITEM  BISERIAL CORRELATION COEFFICIENT  MEAN SCORE  1  1 2 3 4  1 2 3 4  26 49 15 12  25.5 48.0 14.7 11.8  - .64 .00 .22 .66  12.69 15.90 17.40 20.92  2  1 2 3 4  1 2 3 4  31 49 16 6  30.4 48.0 15.7 5.9  - .56 .13 .34 .36  .13.39 16.29 18.12 19.67  3  1 2 3 4  1 2 3 4  7 48 34 13  6.9 47.1 33.3 12.7  - .22 - .47 .33 .41  13.71 14.42 17.26 18.92  4  1 2 3 4  1 2 3 4  26 50 19 7  25.5 49.0 18.6 6.9  - .69 - .02 .40 .66  12.46 15.84 18.32 22.43  5  1 2 3 4  1 2 3 4  42 40 12 8  41.2 39.2 11.8 7.8  - .63 .14 .33 .57  13.67 16.42 18.42 21.12  6  1 2 3 4  1 2 3 4  28 64 8 2  27.5 62.7 7.8 2.0  - .31 - .07 .61 .19  14.43 15.73 21.50 19.00  QUESTION  STATEMENT  VALUE  7  1 2 3 4  1 2 3 4  8  1 2 3 4  1 2 3 4  NO. WHO CHOSE ITEM 35 48 14 5 60 28 8 6  PERCENT WHO CHOSE ITEM 34.3 47.1 13.7 4.9 58.8 27.5 7.8 5.9  BISERIAL CORRELATION COEFFICIENT - .53 .19 .12 .62  MEAN SCORE 13.74 16.48 16.71 23.00  - .64 .79 .48 .53  14.32 16.79 20.38 21.50  

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