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Comparison of the interpersonal perceptions of the parents of autistic and normal children Kubo, Richard Hidenhiko 1965

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A COMPARISON OF THE INTERPERSONAL PERCEPTIONS OP THE PARENTS OP. AUTISTIC AND NORMAL CHILDREN.  by RICHARD H. KTJBO B.A., The University of B r i t i s h Columbia, 1963  A THESIS SUBMITTED IN PARTIAL FULFILMENT OF . . THE REQUIREMENTS FOR THE DEGREE OF . MASTER OF ARTS  i n the Department of Psychology  We accept t h i s thesis as conforming to the required standard  THE UNIVERSITY OF BRITISH COLUMBIA February, 1965  In presenting  t h i s thesis i n p a r t i a l fulfilment of  the requirements f o r 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 It f r e e l y available f o r reference  and study.  I further  agree that permission f o r extensive copying of t h i s thesis for scholarly purposes may be granted by the Head of my Department or by h i s representatives.  It i s understood  that copying or publication of t h i s thesis f o r f i n a n c i a l gain s h a l l not be allowed without my written permission.  Department of The University of B r i t i s h Columbia, Vancouver 8, Canada Date  i ABSTRACT  The  p r e s e n t s t u d y sought t o examine the  between " E a r l y I n f a n t i l e A u t i s m " and sonality i n the  c h a r a c t e r i s t i c s and  The  o f empathy" and Interpersonal and  certain parental  family relationships  l i t e r a t u r e as b e i n g a s s o c i a t e d  zophrenia*  three  relationship  reported  with childhood  schi-  f a c t o r s i n v e s t i g a t e d were t h e  " e m o t i o n a l detachment", "the  f  avoidance  of  wife  s u b m i s s i v e n e s s o f t h e h u s b a n d , e a c h o f w h i c h had  been  as  c h a r a c t e r i z i n g the  the  * lack  dominance o f t h e  reported  i n t e r a c t i o n s " and  per-  parents of  schizophrenic  children. E a c h o f t h e s e c h a r a c t e r i s t i c s was f i n e d and  measured w i t h i n t h e  operationally  framework of the  System of P e r s o n a l i t y Diagnosis*  de-  Interpersonal  U s i n g t h i s method, i t  was  p o s s i b l e t o o b t a i n measurements f r o m f o u r h y p o t h e s i z e d l e v e l s o f i n t e r p e r s o n a l f u n c t i o n i n g , c o n s i s t i n g o f how son  presents himself  t o or  his descriptions of himself  i s described and  by  others  a  (Level I ) ,  s i g n i f i c a n t others  I I ) , his fantasy  o r " p r o j e c t i v e " perceptions  ( L e v e l I I I ) , and  h i s ego  ideal (Level V),  of The  (Level  people data of i n -  t e r p e r s o n a l b e h a v i o r f r o m each o f t h e s e l e v e l s were i n terms of a c i r c u l a r eight  Interpersonal  competitive tive  classiflcatory  scored  s y s t e m made up  v a r i a b l e s o r ways o f i n t e r a c t i n g  - exploitive, skeptical - distrustful,  - overconventional,  etc).  per-  T r i g o n o m e t r i c and  of (e.g*  cooperaarithmetic  i i methods w e r e t h e n u s e d t o s u m m a r i z e i n t e r p e r s o n a l a t any l e v e l i n t o a s i n g l e p o i n t corporating  the eight  on a d i a g n o s t i c  interpersonal variables.  behavior grid i n -  This  made p o s s i b l e b y l o c a t i n g t h i s s i n g l e summary p o i n t of a v e r t i c a l tility  was I n terms  (dominance - s u b m i s s i o n ) and h o r i z o n t a l  - affiliation) axis.  As t h e summary p o i n t s  (hos-  from each  o f t h e f o u r l e v e l s w e r e s c o r e d i n t e r m s o f t h e same  eight  v a r i a b l e s , i t was p o s s i b l e t o o b t a i n o b j e c t i v e m e a s u r e s o f the  discrepancies  evident  w i t h i n o r between t h e d i f f e r e n t  hypothesized levels of functioning* F i v e h y p o t h e s e s were f o r m u l a t e d l n t h e p r e s e n t Hypothesis 1 postulated  that  as v i e w e d by o t h e r s  study.  (Level I ) ,  t h e m o t h e r s w o u l d be t h e d o m i n a n t members more o f t e n l n t h e patient  families than i n the control f a m i l i e s .  postulated  that the patient  Hypothesis 2  p a r e n t s w o u l d show g r e a t e r  p a r i t y t h a n t h e c o n t r o l parents between t h e i r s e l f tions The  ( L e v e l I I ) and t h e i r d e s c r i p t i o n s by others  t h i r d hypothesis postulated  that  descrip(Level I ) ,  the p a t i e n t parents  misperceive t h e c h a r a c t e r i s t i c s of t h e i r spouses t o a degree t h a n t h e c o n t r o l p a r e n t s a t L e v e l pothesis greater  postulated  that the patient  that  II,  the patient  control parents,  would  greater  The f o u r t h h y -  p a r e n t s w o u l d show  disagreement i n t h e i r d e s c r i p t i o n s  Level I I than the control parents.  dis-  of their c h i l d at  Hypothesis 5  parents would, t o a greater view people I n I n t e r p e r s o n a l  postulated  degree t h a n t h e i n t e r a c t i o n s as  i l l b e i n g h o s t i l e and Two  had  phrenic  of  The  The had  Of  the  c o n t r o l group c o n s i s t e d  no  c h i l d r e n who  d u a l l y matched a g a i n s t  one  had  o f the  B o t h groups were a d m i n i s t e r e d Check L i s t  and  t h e TAT.  i n t o s i n g l e summary p o i n t  The  Of t h e  between l e v e l s  suffered from prolonged E a c h c o u p l e was  patient the  n i f i c a n c e or b e t t e r .  couples.  MMPI, t h e  b e i n g h o s t i l e and  levels  of  the hypothesized r e l a t i o n s h i p s  tested.  The  two  groups at a  .05?  r e s u l t s showed t h a t  generally unloving.  I t was  l e v e l of the  current  widespread differences c h i l d r e n and  children.  sigpar-  as  hypothesized functioning  h a v e a n a d v e r s e e f f e c t on r e l a t i o n s h i p s w i t h t h e the  was  patient  situations  such a t t i t u d e s might i n t e r f e r e w i t h f a m i l y  In conclusion,  ing  Interperson-  r e s u l t s were t h e n t r a n s f o r m e d  ents tended t o view people i n i n t e r p e r s o n a l  tistic  indivi-  f i v e hypotheses formulated, only hypothesis 5  found t o d i f f e r e n t i a t e the  any  schizo-  of s i x married  scores f o r the various  i n t e r p e r s o n a l f u n c t i o n i n g and w i t h i n and  child  s i x c h i l d r e n , f i v e were d i a g n o s e d  p h y s i c a l or emotional disturbances.  and  patient  s i x married c o u p l e s , each h a v i n g a  children.  e o u p l e s who  that  fantasy.  been accepted i n t o a treatment program f o r  as a u t i s t i c .  al  l e v e l of  groups o f p a r e n t s were u t i l i z e d .  group c o n s i s t e d who  u n a f f i l l a t i v e at the  child.  Investigation f a i l e d to  between a group of p a r e n t s of  a group o f parents of adequately  find au-  function-  viii  ACMOWLEDGMENT  I would  l i k e t o e x p r e s s my a p p r e c i a t i o n t o D r . K.D.  C r a i g a n d D r . R, P o t a s h i n f o r t h e i r h e l p f u l c r i t i c i s m s a n d suggestions. I n a d d i t i o n , I would his  interest  throughout  l i k e t o thank Dr. L. Pulos f o r  a l l phases o f t h e s t u d y and D r . A.  Cashmore o f t h e M e n t a l H e a l t h C e n t r e who made a v a i l a b l e t h e subjects used extended  i n the study.  Sincerest appreciation i s also  t o t h e P u b l i c H e a l t h O f f i c e r and nurses o f t h e  B u r n a b y S c h o o l D i s t r i c t whose a i d i n g a t h e r i n g c o n t r o l j e c t s was i n v a l u a b l e .  sub-  i* TABLE OP CONTENTS ABSTRACT  i  TABLE OP CONTENTS  iv  L I S T OP T A B L E S .  v i  L I S T OF FIGURES  v i i  ACKNOWLEDGMENT  viii  CHAPTER  I -  STATEMENT OF THE PROBLEM  1  CHAPTER  II -  REVIEW OF THE RELEVANT LITERATURE  3  I.  H i s t o r y o f t h e Study o f Schizophrenia  I I . The P a r e n t s dren..  Childhood  of Schizophrenic  Chil-  I I I . The I n t e r p e r s o n a l S y s t e m o f P e r s o n ... a l l t y D i a g n o s i s CHAPTER  I I I - INTERPERSONAL HYPOTHESES  28  CHAPTER  IV -  32  METHOD...... I.  Subjects  II.  Procedure  III.Statistical  Analysis  CHAPTER V -  RESULTS  1+4  CHAPTER V I -  DISCUSSION AND CONCLUDING REMARKS  52  APPENDIX A APPENDIX B APPENDIX C -  The I n t e r p e r s o n a l Cheek L i s t . . . . . . . . . . . A Sample"MMPI P r o t o c o l R a t i o n a l e U n d e r l y i n g "Dom" a n d " L o v " Equations............ TAT M o l a r R a t i n g S h e e t - A S a m p l e Protocol Record Booklet f o r I n t e r p e r s o n a l Diagnos i s o f P e r s o n a l i t y - A Sample P r o t o c o l . Summary..of Raw S c o r e I n d i c e s f o r P a t i e n t and C o n t r o l F a m i l i e s  63 65  APPENDIX D .. . APPENDIX E APPENDIX F ... ..  ( c o n t *d n e x t  67 70 72 75  page)  V  APPENDIX G - Summary Patient APPENDIX H - Summary Patient BIBLIOGRAPHY. ~  o f Standard Scores f o r and C o n t r o l F a m i l i e s o f Octant Scores f o r and C o n t r o l F a m i l i e s  78 80 82  vi L I S T OP TABLES TABLE 1 - C o n t r o l D a t a on t h e A u t i s t i c C h i l d r e n and T h e i r N o r m a l C o u n t e r p a r t s  3>h  TABLE 2 - C o n t r o l D a t a on t h e F a m i l i e s o f A u t i s t i c 35  Children-and T h e i r Normal Counterparts TABLE 3 - S t a n d a r d S c o r e s O b t a i n e d b y P a t i e n t a n d C o n t r o l P a r e n t s on t h e D o m i n a n c e - S u b mission Dimension at L e v e l I TABLE k, - L e v e l I S e l f - L e v e l I I S e l f D i s c r e p a n c y . . .. Scores - Obtained by P a t i e n t and C o n t r o l Parents . (Index o f " S e l f - D e c e p t i o n " )  a  ii5  lj.6  TABLE 5 - "Spouse M i s p e r c e p t i o n " D i s c r e p a n c y S c o r e s Obtained by Pat l e n t a n d . C o n t r o l P a r e n t s • ( D i s c r e p a n c y Between S e l f P e r c e p t i o n o f W i f e at L e v e l . I I and Husband's P e r c e p t i o n o f H i s W i f e a t . L e v e l I I and v i c e v e r s a )  ij.8  TABLE 6 - L e v e l I I C h i l d ( H u s b a n d ) - L e v e l I I C h i l d ( W i f e ) . D i s c r e p a n c y Scores O b t a i n e d by P a t i e n t and C o n t r o l F a m i l i e s  I4.9  TABLE 7 - O c t a n t Summary P o i n t S c o r e s O b t a i n e d b y P a t i e n t and C o n t r o l P a r e n t s a t L e v e l I I I Other ,  51  L I S T OP FIGURES  FIGURE 1  -  D i a g n o s t i c G r i d Showing t h e E i g h t Interpersonal Variables In Relation t o t h e Two D i m e n s i o n s o f t h e C i r c l e .  FIGURE 2  -  I n t e r p e r s o n a l Check L i s t I l l u s t r a t i n g the C l a s s i f i c a t i o n o f Interpersonal Behavior i n t o Sixteen Variable Categories ,  1 A COMPARISON  OP THE INTERPERSONAL PERCEPTIONS  OP THE PARENTS OP A U T I S T I C AND NORMAL CHILDREN CHAPTER  I  STATEMENT OP THE The  present  PROBLEM  I n v e s t i g a t i o n was u n d e r t a k e n i n a n e f f o r t t o  examine t h e h y p o t h e s i s  that  schizophrenic disorders i n c h i l d -  hood a r e a s s o c i a t e d w i t h d i s t u r b a n c e s lationship.  The l i t e r a t u r e  p e r s o n a l i t y t r a i t s present comitant  disturbances  suggests that c e r t a i n  isstill  and con-  i n f a m i l i a l r e l a t i o n s h i p s a c t on t h e development.  a c o n s i d e r a b l e amount o f i n f o r m a t i o n h a s now  accumulated about t h e parents field  unhealthy  i n e i t h e r or both parents  c h i l d t o i n t e r f e r e w i t h h i s normal Although  i n the parent-child r e -  been  of schizophrenic children, the  c h a r a c t e r i z e d by disagreement and c o n f u s i o n .  T h i s c a n be a t t r i b u t e d i n p a r t t o t h e wide v a r i e t y o f methods used t o assess and  p a r e n t a l p e r s o n a l i t i e s and f a m i l y r e l a t i o n s h i p s  t o the heterogeneity  under t h e category  o f t h e g r o u p s o f c h i l d r e n subsumed  of childhood  schizophrenia.  A l s o , few a t -  t e m p t s h a v e b e e n made t o more o b j e c t i v e l y a n d c l e a r l y the t r a i t s child.  and r e l a t i o n s h i p s o f parents  with a  schizophrenic  A u t h o r s have tended t o r e m a i n a t a v e r y vague,  adjectival level. submissive The teristics  Traits  define  general  such as unerapathic, unemotional and  a r e w i d e l y used but seldom d e f i n e d .  a s s u m p t i o n h a s a l s o b e e n made t h a t t h e p a r e n t a l and r e l a t i o n s h i p s i n f a m i l i e s h a v i n g  charac-  a schizophrenic  2  c h i l d are d i f f e r e n t from the parental c h a r a c t e r i s t i c s and relationships i n families without a schizophrenic  child.  This  assumption, however, has seldom been put to the test by i n cluding a control group of parents without a  schizophrenic  child. What was sought i n the present study, therefore, was a more objective means of defining and measuring some of the r e ported personality c h a r a c t e r i s t i c s and family relationships of the parents of schizophrenic  children.  An attempt was made  to operationally define these c h a r a c t e r i s t i c s and relationships within the framework of the Interpersonal Diagnosis (Leary, 1 9 5 6 ; Leary, 1 9 5 7 ) . ty assessment w i l l be discussed  System of Personality  This method of personali-  In Chapter I I .  At the same time a control group of parents of normal children was included for purposes of comparison.  Each of the  patient families was i n d i v i d u a l l y matched with a control family having no children who had suffered from emotional or prolonged physical  disturbances.  Having operationally defined certain of the personality c h a r a c t e r i s t i c s and family relationships reported  i n the l i t e r -  ature, s p e c i f i c hypotheses were formulated and tested.  CHAPTER I I REVIEW OP THE RELEVANT LITERATURE I.  HISTORY OP THE STUDY OP CHILDHOOD SCHIZOPHRENIA In recent  years  t h e r e has been a r a p i d l y expanding  t u r e on t h e p r o b l e m o f c h i l d h o o d was c o n s i d e r a b l e  schizophrenia.  litera-  Initially  there  s k e p t i c i s m and doubt about t h e e x i s t e n c e o f  s c h i z o p h r e n i c d i s o r d e r s i n y o u n g c h i l d r e n and q u e s t i o n s  were  r a i s e d a s t o w h e t h e r t h e u n d e r l y i n g d e f e c t was n o t r e a l l y one of i n t e l l i g e n c e .  With increasing diagnostic s o p h i s t i c a t i o n ,  however, t h i s p o s t u l a t e d d i s e a s e - e n t i t y r e c e i v e d  growing  acceptance from workers and has c u r r e n t l y achieved  a position  of fashionable p o p u l a r i t y . Bender  (191^2* p . 138) * j u s t t w e n t y y e a r s  ago, acknowledged  that: " T h e r e a r e t h o s e who do n o t b e l i e v e i n childhood s c h i z o p h r e n i a , not having s e e n a::case. A t t h e b e s t none o f u s has s e e n v e r y many c a s e s i n w h i c h we c o u l d make a d e f i n i t e d i a g n o s i s . . . . n o t knowing t h e a c c e p t a b l e c r i t e r i a . " Previous  t o t h i s statement by Bender, t h e p o s s i b i l i t y o f  schizophrenia o c c u r r i n g i n c h i l d r e n had a t t r a c t e d the a t t e n t i o n of i n d i v i d u a l workers such as Bradley Despert  (1938), K a s a n i n  (19ltl), B r i l l  (192£)  a n d K a u f m a n (1929), L u r i a , T i e t z a n d  Herzman (1936) a n d P o t t e r (1933). In these  pioneering accounts the primary  on a t t e m p t s t o d e m o n s t r a t e t h a t of c h i l d r e n d i d i n f a c t  exist  emphasis  such a g r o s s l y deviant  fell group  and t o e s t a b l i s h a g e n e r a l s e t  of c r i t e r i a for the d i f f e r e n t i a l diagnosis of schizophrenia In childhood (Bradley, 19i\l; Despert, 1938j Potter, 1933).  At that  time, most authors did not present e x p l i c i t hypotheses about the possible e t i o l o g i c a l factors which might account for a c l i n i c a l entity which at the time was very vaguely defined and f a r from universally accepted as a v a l i d and d i s t i n c t disorder of c h i l d hood.  These few scattered reports, then, constituted the sum  t o t a l of knowledge which had been gained about childhood schizophrenia over a period of 15 years and t h i s was the state of a f f a i r s which had caused many to doubt the v a l i d i t y of the nosol o g i c a l class, thus prompting Bender's comments i n 19l|2. Controversy concerning the existence of t h i s group of grossly disturbed children abated somewhat, however, following Kanner's delineation In 19^3 of a syndrome he later named "Early I n f a n t i l e Autism".  The  i s o l a t i o n of t h i s syndrome represented  the f i r s t major contribution to the d i f f e r e n t i a t i o n of s p e c i f i c c l i n i c a l types within the broader sphere of childhood schizophrenia. Kanner, presenting 11 case h i s t o r i e s , l i s t e d the following f i v e c h a r a c t e r i s t i c s ag d i s t i n c t i v e of children with early infant i l e autism: 1«  An i n a b i l i t y to relate themselves i n the ordinary way to people and situations from the beginning of l i f e .  2.  Failure to use language for the purpose of  3.  An anxiously obsessive desire for the maintenance of sameness.  11.  Fascination f o r objects, and  communication,  5 5.  Good c o g n i t i v e p o t e n t i a l i t i e s The  ( K a n n e r , I9I4.3) •  p s y c h i a t r i c l i t e r a t u r e from  19^3  i n g a d d i t i o n a l c o n t r i b u t i o n s f r o m Kanner by  a paucity o f confirmatory  number o f a r t i c l e s  appearing  L a u r i e r s and Halpern, I9I4.8),  Since  papers by o t h e r s .  Although the  19^7JDespert,  1914-7J G e l e e r d ,  I9I16; Putman,  19^9> h o w e v e r , t h e d i a g n o s i s h a s a p p e a r e d w i t h  specific  and o t h e r  (Mahler,  1952),  Escalona,  symptomatology and course  " c h i l d r e n w i t h unusual  I9I4.9) > " a t y p i c a l c h i l d "  l i n e psychosis"  everf-  i n v e s t i g a t o r s have begun t o r e p o r t  subgroupings which seemingly  time o f onset,  Kanner  was m a r k e d  was i n c r e a s i n g ( B e n d e r , 1 9 i t 7 ; d e s  s u l t i n g i n syndromes v a r i o u s l y c a l l e d  and  I9I4.6)»  entity.  i n c r e a s i n g frequency  by  (19i|4*  includ-  t h e r e seemed t o b e r e s e r v a t i o n I n a c c e p t i n g a u t i s m a s a  diagnostic  other  t o 1914.8, w h i l e  c o u l d be d i s t i n g u i s h e d of the disorder,r e -  "symbiotic  psychosis"  sensitivities"  (Bergman  ( R a n k , 19l}-9) a n d  ( E k s t e i n a n d W a l l e r s t e i n , 19f?lj.) •  "border-  E i s e n b e r g and  (1956) r e p o r t e d a n o t h e r d i s o r d e r , s e c o n d a r y a u t i s m , I n  which t h e c h i l d seemingly  developed normally  through  the f i r s t  18  t o 20 months, "only t o undergo a t t h i s p o i n t a severe -withdrawal o f a f f e c t , manifested by t h e l o s s o f language f u n c t i o n , f a i l u r e t o progress s o c i a l l y , and t h e gradual g i v i n g up o f i n t e r e s t i n n o r m a l a c t i v i t i e s " ( p . 558) With t h e growing r e c o g n i t i o n of t h e r e a l i t y s c h i z o p h r e n i a and t h e d i f f e r e n t i a t i o n o f other tinctive  of childhood  apparently  dis-  subgroupings f o l l o w i n g Kanner's p i o n e e r i n g c o n t r i b u t i o n ,  6  Investigators began to address themselves to the problem of etiology. Although c l e a r statements on the causal role of various factors had not been advanced In early publications, from the beginning the r o l e of interpersonal relationships within the family, and more s p e c i f i c a l l y , the r e l a t i o n s h i p between the schizophrenic  c h i l d and h i s mother, had attracted  attention (Despert,,1938; Kanner, 19^3,  considerable  Potter, 1 9 3 3 ) .  This interest i n the r o l e of the parents In the genesis of the disorder arose p a r t i a l l y from the fact that physical examination of these children f a i l e d to show any signs of a possible c o n s t i t u t i o n a l or organic foundation.  With t h i s d i s -  covery, attention turned to the parents and the examination seemed j u s t i f i e d as workers appeared to f i n d highly pathological attitudes toward c h i l d - r e a r i n g and the family and these were hypothesized as being the cause of childhood  schizophrenia.  Other orientations were soon to appear (Bender, Bender, 1956; 1958)  Bergman and Escalona,  1953;  I9I4.9; Gold$arb, 1961;  Mahler,  s t r e s s i n g the importance of c o n s t i t u t i o n a l , hereditary  and  organic f a c t o r s , but interest i n the psychogenic or psychodynamic aspects remained strong and continued to receive widespread study. II.  THE PARENTS OP SCHIZOPHRENIC CHILDREN Notwithstanding the fact that intensive study of the  parents of schizophrenic  children was  not to occur before  19^9,  even the i n i t i a l exploratory reports alluded to t h e i r possible etiological significance.  7 As  e a r l y a s 1933 P o t t e r h a d s u g g e s t e d t h a t t h e p a r e n t s  appeared t o be d i r e c t l y schizophrenia.  Involved  H i s observation  i n t h e genesis  of childhood  t h a t m o t h e r s seemed t o p l a y a  dominant r o l e i n t h e f a m i l y whereas t h e f a t h e r p l a y e d missive  r o l e h a s c h a r a c t e r i z e d many o f t h e r e p o r t s  u n t i l the present his  s i x cases  a sub-  appearing  d a y . He n o t e d i n r e l a t i o n t o t h e f i r s t o f  ( p . 12f>7):  A search f o r c o n s t i t u t i o n a l or organic f a c t o r s i n t h e s i t u a t i o n d i s c l o s e s not even a suggestion. A dominant o v e r p r o t e c t i v e mother w i t h a submissive type of father i s likely to fost e r an a t t i t u d e o f dependence, espec i a l l y d i r e c t e d toward t h e mother. Again,  i n t h e second case, P o t t e r remarked ( p . 12^9): In t h e background i s a q u i e t , unobtrus i v e , emotionally unresponsive father and a n a n x i o u s , p o o r l y a d j u s t e d , o v e r p r o t e c t i v e mother There I s l i t t l e or n o t h i n g t o p o i n t t o an o r g a n i c subs t r a t u m i n t h i s c a s e , and a s i d e f r o m an a s t h e n i c h a b i t u s t h e r e I s l i t t l e o f the c o n s t i t u t i o n a l here. Psychodynamic a l l y , however, t h e u n a s s e r t i v e f a t h e r and t h e o v e r - p r o t e c t i v e mother.....may have h a d a p r o f o u n d I n f l u e n c e on t h e emotional l i f e o f t h i s c h i l d  In the four remaining  cases P o t t e r repeated  t h a t demonst r a t a b l e c o n s t i t u t i o n a l o r o r g a n i c  his  observations  s i g n s were c o n s i s -  t e n t l y a b s e n t a n d drew a t t e n t i o n t o t h e p o t e n t i a l p s y c h o d y n a m i c influence of the parents. Following these i n i t i a l in  considerations  1938* r e p o r t i n g o n 29 s c h i z o p h r e n i c  t o 1937*  o f P o t t e r , Despert  c h i l d r e n s e e n f r o m 1930  l i k e w i s e o b s e r v e d t h a t a f a m i l y p a t t e r n w i t h a dominant  8 over s o l i c i t o u s mother and a s u b m i s s i v e , subdued f a t h e r c l e a r l y d i s c e r n i b l e i n 19 o f t h e 29 The  next  c o n t r i b u t i o n was  was  cases.  t h a t o f Kanner  t h a t p h y s i c a l e x a m i n a t i o n o f t h e c h i l d r e n he  (1914-3) who called  found"  autistic  f a i l e d t o r e v e a l any c o n s i s t e n t o r g a n i c a b n o r m a l i t i e s . P a r e n t a l p e r s o n a l i t i e s , however, were s t r i k i n g i n t h e u n i v e r s a l of  h i g h I n t e l l i g e n c e and marked o b s e s s i v e n e s s •  nent  f e a t u r e n o t e d was  to  other  t h e l a c k o f warmness and l i m i t e d  i n p e o p l e shown b y t h e s e p a r e n t s . seemingly  One  presence  stable with l i t t l e  The  marriages,  promi-  interest  although  evidence o f open c o n f l i c t ,  be r a t h e r c o l d a n d f o r m a l a f f a i r s w i t h l i m i t e d  appeared  communication  b e t w e e n h u s b a n d and w i f e . W i t h o n l y these h i g h l y d e s c r i p t i v e f i n d i n g s t o work Kanner f e l t observed  t h a t , n o t w i t h s t a n d i n g the probable importance  parental personalities  the extreme aloneness 557) to  and f a m i l i a l  to a t t r i b u t e early i n f a n t i l e autism  of e a r l y p a r e n t - c h i l d r e l a t i o n s h i p s a n d  e x p e r i e n c e d by t h e s e c h i l d r e n .  of  the  interrelationships,  "present from the beginning of l i f e "  made i t d i f f i c u l t the type  from,  T h i s l e d him t o the  (p. solely  environment tentative  c o n c l u s i o n t h a t t h e s e c h i l d r e n had been b o r n w i t h an i n n a t e i n ability  t o form normal  "affective contact" w i t h people,  the exact nature of t h i s  " i n n a t e i n a b i l i t y " was  left  Following h i s three earlier descriptive reports, (19li9) d e v o t e d h i s f u l l  although  undefined,. Kanner  a t t e n t i o n t o t h e problems of nosology  psychodynamics of e a r l y i n f a n t i l e autism*  By t h i s t i m e  had  l o o k e d upon t h e  s e e n more t h a n f i f t y  s u c h c h i l d r e n and  Kanner  and  9 d i s o r d e r as b e i n g the e a r l i e s t p o s s i b l e m a n i f e s t a t i o n of  child-  hood s c h i z o p h r e n i a *  had  H i s o r i e n t a t i o n as regards e t i o l o g y  swung s h a r p l y t o the psychodynamic, although he was  to return  again i n l a t e r p u b l i c a t i o n s ( E i s e n b e r g & Kanner, 1 9 5 6 ; & E i s e n b e r g , 1955)  Kanner  to the p o s s i b l e o p e r a t i o n of some i n n a t e  factor. I n t e r e s t f o c u s e d on t h e p o s s i b l e r e l a t i o n s h i p between the type of e a r l y environment p r o v i d e d by the parents he had and the presence children.  of a s c h i z o p h r e n i c d i s o r d e r i n one of t h e i r  I n f o r m a t i o n c o n t i n u e d t o show that almost  parents were h i g h l y i n t e l l i g e n t chosen c a r e e r s .  a l l o f the  and q u i t e s u c c e s s f u l i n t h e i r  In a d d i t i o n , the parents were c h a r a c t e r i z e d by  the f o l l o w i n g a t t r i b u t e s , o u t s t a n d i n g among which was Kanner c a l l e d a "mechanization is,  seen  what  of human r e l a t i o n s h i p s " .  a c c o r d i n g to Kanner, these parents were not  That  comfortable  In  the company o f p e o p l e , p r e f e r r i n g r e a d i n g , p a i n t i n g or some other s i m i l a r n o n - i n t e r p e r s o n a l a c t i v i t y .  Married l i f e  was  a g a i n a c o l d and f o r m a l a f f a i r and both husbands and wives desc r i b e d themselves and t h e i r spouses as b e i n g undemonstrative unemotional.  F u r t h e r , t h e i r behaviour  towards the c h i l d r e n  concentrated mainly on the achievement of r i g i d obedience,  q u i e t , good e a t i n g , t o i l e t  memory and v o c a b u l a r y . of  standards  and was  of  t r a i n i n g and f e a t s of  S i m i l a r l y , genuine warmth and  the c h i l d were c o n s p i c u o u s l y absent.  enjoyment  In view of such p a r e n t a l  c h a r a c t e r i s t i c s , e a r l y i n f a n t i l e autism r e p r e s e n t e d f o r Kanner, a t u r n i n g away and withdrawal  o f the c h i l d from the mechanized  care and a t t e n t i o n f u r n i s h e d by p a r e n t s who  were l i t t l e  more  10 than "emotional r e f r i g e r a t o r s " . Rank's (I9I19) findings were consistent with the observations of Kanner.  She found the mothers o f schizophrenic children to be  incapable of emotional r e l a t i o n s h i p s , tending to r e l y on a l l the new " s c i e n t i f i c " methods of upbringing while being unable to involve themselves i n any spontaneous interplay with their children.  The husbands were passive individuals who, though o f -  ten professionally successful, were aloof and inadequate as family members* Other authors, commenting on the dominance - submission factor i n families with a schizophrenic c h i l d , also observed that the mother was l i k e l y to play a dominant r o l e with the f a thers being weak and i n e f f e c t u a l (Anthony, 1 9 5 8 j Clardy, 1 9 5 1 ; Slimp, 1 9 5 D . Elaborating her e a r l i e r findings, Despert  (1951) s i m i l a r l y  noted that the mothers had been mechanical and r i g i d i n r a i s i n g their c h i l d .  Other characteristics of the mothers included imma-  t u r i t y , narcissism, compulsiveness  and perfectionism. Most s i g -  n i f i c a n t , however, was the fact that so many of these mothers were emotionally detached and sought g r a t i f i c a t i o n from i n t e l l e c t u a l sources rather than from contact with people.  As with  Kanner, Despert stressed the e t i o l o g i c a l importance of the pers o n a l i t i e s of the parents, the emotional quality of the parent c h i l d relationships and the early noxious environmental i n f l u ences . Eisenberg (1957)»  commenting on the widespread preoccupation  with the mothers of schizophrenic children, presented the results  11  of a study conducted on the fathers of a u t i s t i c c h i l d r e n seen by himself and Kanner at the Johns Hopkins H o s p i t a l .  He found that  these f a t h e r s tended to be obsessive, detached and humourless men who demanded conformity from t h e i r c h i l d r e n , seeking t o r a i s e "the perfect c h i l d - I.e., one who obeys, who performs, and who makes no demands" (p. 722).  This c h a r a c t e r i z a t i o n of the f a t h e r  d i f f e r e d somewhat from the submissive, passive i n d i v i d u a l portrayed by other authors. As f o r marriage.;, i t seemed t o be looked upon as a convenient arrangement  f o r board and room, w i t h work  t a k i n g precedence over any kind of family l i f e .  I n a l l of t h e i r  i n t e r p e r s o n a l r e l a t i o n s h i p s , the fathers displayed a "remarkable l a c k of empathy f o r and s e n s i t i v i t y t o the f e e l i n g s o f others" (p. 722). When a b r i e f survey of the f a t h e r s of f i f t y non-schizophreni c c h i l d p a t i e n t s was made f o r purposes of comparison, what stood out most prominently i n the c o n t r o l fathers was the absence of the c o l d l y mechanical a t t i t u d e toward c h i l d r e a r i n g and the cold and f o r m a l i s t i c approach t o marriage so evident i n the a u t i s t i c group.  Thus i t was concluded that any f u r t h e r studies which  might be conducted on the parents o f disturbed c h i l d r e n would have t o include t h e f a t h e r s , not only f o r t h e i r p o s s i b l e d i r e c t influence on the c h i l d but a l s o because of the adverse e f f e c t s they might have on the a b i l i t y o f the mothers t o adequately d i s charge t h e i r r o l e s • In England, Anthony's  (195>8)  observations proved l a r g e l y  consistent w i t h the f i n d i n g s of the e a r l i e r r e p o r t s .  The mothers  12 were seen as lacking emotional s e n s i t i v i t y and responsiveness and unable to f u l f i l their role as a mother naturally and spontaneously, turning instead to books on c h i l d - r e a r i n g . Esman, Kohn and Nyman (1959)» reporting data from a project i n the outpatient treatment of the parents of 11 schizophrenic children tending towards Mahler's symbiotic type, f e l t that, despite the absence of any common family structure o r personality t r a i t s , i n a l l cases there was a grossly disturbed i n t r a f a m i l i a l pattern, and i n almost a l l oases both parents were c l e a r l y disturbed i n d i v i d u a l s .  The family r o l e patterns were  found to be f l u i d , unclear or grossly deviant with the parents f a i l i n g to present themselves or each other to the c h i l d as consistent objects. The communication among family members was invariably seriously disrupted, the disruption ranging from nonspeaking to a type of double-bind communication (Bateson, Jackson, Haley and Weakland, 1956). Speers and Lansing (196ii), also reporting information from therapeutic oontact with schizophrenic children and t h e i r parents, observed that physical and emotional i s o l a t i o n was outstanding l n these f a m i l i e s , t h i s use of Isolation being p a r t i c u l a r l y noticeable i n the fathers. Although Esman, Kohn and Nyman had been unable to f i n d any common c h a r a c t e r i s t i c s i n t h e i r investigation, Kaufaman, Prank, Helms, Herrick and W i l i e r (1959) distinguished four types of parents having schizophrenic children: ( l ) pseudoneurotic (2) somatic (3) pseudodelinquent or (ii) psychotic. Although the  13 names are s e l f - d e s c r i p t i v e the pseudoneurotic category w i l l be developed further as Kaufman's description of these parents was s t r i k i n g l y consistent with others' findings about parents of schizophrenic c h i l d r e n .  This type o f parent was found to demon-  strate r i g i d compulsive behavior and a stereotypy of l i f e patterns.  Many were quite competent i n t h e i r work but  marriage  appeared to be a highly controlled and subdued relat ionship with l i m i t e d emotional i n t e r a c t i o n between husband and wife and child.  Attention was drawn once again to the fact that the  primary means of r a i s i n g the c h i l d had been by reference to the books.  "These people (p.  I4.66),  the authors noted, "went through  s o c i a l relationships i n a seemingly adequate fashion, but i n r e a l i t y t h e i r relationships were more impersonal than Interpersonal" • Adhering strongly to a psychodynamic approach to etiology, Kaufman et a l concluded that i n a l l of the cases they had diagnosed as childhood schizophrenia there seemed l i t t l e doubt that the condition had arisen from emotional disturbances i n the parent-child i n t e r a c t i o n . It  can be seen from the Information reviewed thus f a r that  the role of the parent i n Interaction with the c h i l d who shows schizophrenia of childhood In i t s various forms i s at the center of  the question about etiology for a great many investigators. Beyond t h i s there has been surprising consistency i n the  findings reported i n the l i t e r a t u r e .  Studies by varied i n d i v i -  duals ranging over a number of years have repeatedly come up  Ik with comparable results i n d i c a t i n g a t y p i c a l c h i l d r e a r i n g pract i c e s , personalities and intrafamilial' relationships i n the parents of schizophrenic  children,  It i s important to remember,  however, that despite the apparent uniformity, differences did arise and descriptions given generally f a i l e d to Include a l l of the parents seen.  Also, the fact that descriptions were often  expressed i n very general, subjective terms made i t d i f f i c u l t  to  determine whether the various workers were r e a l l y describing common c h a r a c t e r i s t i c s or whether the uniformity was merely a superficial  one.  Another caution is the fact that these findings have been based largely upon incidental contacts with parents which arose i n the process of diagnosis and treatment of t h e i r c h i l d r e n . attempts have been made to examine more d i r e c t l y the  Pew  reliability  and v a l i d i t y of findings derived from p s y c h i a t r i c impressions by the use  of more standardized  or objective techniques for assessing  personality t r a i t s and family r e l a t i o n s h i p s .  Furthermore,  despite an implicit assumption that the d i s t o r t i o n s of persona l i t y and family discovered were not to be found i n families having normal children, i n c l u s i o n of such a control group has been conspicuously  absent.  The following s i x studies attempted, by various means, to r e c t i f y some of the shortcomings noted above. Block, Patterson, Block & Jackson (1958)» using parents of a u t i s t i c children and a control group of parents of neurotic children, employed psychological t e s t s .  On the basis of the test  15  r e s u l t s , they c l a s s i f i e d the parents by means of a Q-sort method i n an effort to determine whether differences could be established. Though the r e s u l t s were rather equivocal, with  considerable  overlap between the two groups, a cluster analysis characterized the mothers of a u t i s t i c children as being more egocentric, manipulative  and e x p l o i t i v e . Their attitudes about interpersonal  relationships were characterized by d i s t r u s t , h o s t i l i t y emotional nonparticipation, and i t was  and  f e l t that such a mother  would be slow to perceive and s a t i s f y the psychological requirements of others.  The fathers of the a u t i s t i c children i n t h i s  study were described as being more assertive and expressing  their  h o s t i l i t i e s more d i r e c t l y than the fathers of neurotic c h i l d r e n . It i s important to note, however, that the above descriptions accounted f o r only some hfi% of the mothers and father with a u t i s t i c children, the remaining 60$ either being similar to parents of neurotic children or f a l l i n g into r e s i d u a l categories. Working i n conjunction with Anthony, Bene (Anthony, 1958) tested the hypothesis that mothers of schizophrenic children who show no signs of organicity would exhibit less capacity to form satisfactory human relationships than mothers of children with organic signs.  She used c e r t a i n Rorschach c r i t e r i a proposed by  Ainsworth and Klopfer, and an analysis of the data disclosed that the hypothesized tendency was  present.  A d i f f e r e n t and more complex approach to the study of family environment of schizophrenic  children was  followed by  G-oldfarb  and h i s colleagues at the Henry I t t l e s o n Center for Child Research.  16 Their project represented an attempt  to develop, through an ex-  tensive battery of rating scales used l n conjunction with open ended interviews and participant observation techniques, an appraisal that would d i f f e r e n t i a t e families with schizophrenic children from families with nonschizophrenic children.  Their  r e s u l t s showed (Behrens & G-oldfarb, 1958? Meyers & G-oldfarb, 1961)  that an atmosphere of confusion and disorganization charac-  t e r i z e d the homes having schizophrenic children. t i o n between parents was cation.  There was  Basic i s o l a -  evident i n the lack of genuine communi-  also a lack of pleasure and spontanaiety i n  the family and an absence of empathy with the c h i l d , a nonawareness of the child's wants and desires, r e s u l t i n g i n the use of i n f l e x i b l e and mechanical means of c h i l d - r e a r i n g .  On the basis  of these f i n d i n g s , Goldfarb and h i s colleagues defined a syndrome which they c a l l e d "parental perplexity". In a study of f i v e parents of schizophrenic children and a control group of parents of normal children, Perr (1958)  found  that the parents of h i s schizophrenic group tended to misperceive their impact on others, a f i n d i n g congruent with the ideas expressed by Bateson, Jackson, Haley & Weakland ( 1 9 5 6 ) .  These  parents also saw the "other" i n "self-other" Interactions as being domineering and h o s t i l e , presenting the picture of a rather unfriendly and f e a r f u l world.  There was close i d e n t i f i c a t i o n  between spouse and mother i n the patient group and a general lack of psychological d i f f e r e n t i a t i o n , as evidencedby r i g i d stereotypy i n their perception of people.  c o n s t r i c t i o n and  17  Singer and Wynne (I963) studied the parents of twenty a u t i s t i c children while u t i l i z i n g control groups of twenty neurotic c h i l d r e n and twenty schizophrenics who became overtly i l l i n l a t e adolescence or young adulthood.  On the basis of  TAT-* data, they found that parents of a u t i s t i c children were c l e a r l y d i f f e r e n t i a t e d from control parents by t h e i r use of " d i s a f f i l i a t i o n and d i s s a t i s f a c t i o n as c h a r a c t e r i s t i c and pervasive expectancies about the way any i n t e r a c t i o n i s going to turn out" (p. 2 3 6 ) . As regards " d i s a f f i l i a t i o n " , i n t e r a c t i o n with others was seen as an uncomfortable experience which was viewed with d i s trust and pessimism.  Persons were seen as avoiding closeness  and interactions with others appeared f a i l e d to provide any  inherently unpleasant  and  satisfaction.  Pour modes of d i s a f f i l i a t i o n were noted i n these parents. The f i r s t was i n the nature of a "cynical outlook" with the parents expecting the worst motivation l n people.  Secondly, there  appeared to be "passivity and apathy about i n t e r a c t i n g " based on the f e e l i n g that things were sure to turn out poorly. mode was  A third  " s u p e r f i c i a l i t y " , characterized by the denial of any  warm and genuine feelings or motives i n others.  Finally,  some  of the parents communicated a sense of d i s a f f i l i a t i o n by t h e i r use of obsessive, i n t e l l e c t u a l i z e d distance. Associated with t h i s d i s a f f i l i a t i o n was d i s s a t i s f a c t i o n , a quality which was  expressed by TAT characters "having l i v e s that  * Thematic Apperception Test (Morgan & Murray, 1935)  18 are non-rewarding".  A l l of their l i f e patterns emerged as being  completely d i s s a t i s f y i n g and negatively toned. Singer and Wynne hypothesized that such "intense, d i s a f f i l i a t i n g , distancing, unempathic tendencies" would necessarily impede the formation of satisfactory relationships between the parents and the c h i l d and lead to a schizophrenic disorder. In re-examining the foregoing review of the l i t e r a t u r e , i t becomes apparent that the primary emphasis has been'.in the general area of interpersonal r e l a t i o n s h i p s .  Within t h i s broader  sphere, more s p e c i f i c components such as the dominance-submission f a c t o r , the i n a b i l i t y t o enjoy and function s a t i s f a c t o r i l y i n interpersonal s i t u a t i o n s , and the lack of empathy and emotional s e n s i t i v i t y have a l l been implicated as of e t i o l o g i c s i g n i f i c a n c e . It was noted e a r l i e r , however, that many of the findings had been based on psychiatric impressions gained during secondary contacts with parents.  The few studies attempting more  controlled assessment seemed to provide some support of the c l i n i cal  evidence.  Differences did a r i s e , however, and parents were  often seen who f a i l e d to conform to commonly observed patterns. An obvious question i s whether the c r i t e r i a for defining or recognizing childhood schizophrenia were equivalent across the various studies. Furthermore,  despite the fact that many workers  have presented evidence of the existence of various  subgroupings  within the broader sphere of childhood schizophrenia, few a r t i cles have attempted to u t i l i z e t h i s information i n their examinat i o n of parents.  I f the sub-groupings  are indeed meaningful,  19  i n c l u s i o n of heterogeneous groups of children might very well have confounded the results of research on the The majority of the studies concentrated  parents. on the maternal  rather than the paternal r o l e , for the simple reason that the mothers were more accessible p r a c t i c a l l y .  Despite t h i s f a c t ,  however, t r a i t s , such as p a s s i v i t y , have Invariably been a t t r i buted to the fathers, on the basis of such b r i e f contacts  as  were made and on mothers' reports. Again, although references were seldom made, except i n the most vague manner, to variables such as age,  intelligence, social  c l a s s , ethnic background and r e l i g i o n , these factors undoubtedly played an important part i n the type of material obtained  from  the parents, whether by interview, case h i s t o r y , or psychological tests.  Disregard of such variables can not only impede the  discovery of s i g n i f i c a n t information, but also lead to  spurious  findings which would not have a r i s e n had adequate attention been paid to c o n t r o l s . The  present  study, therefore, was  undertaken i n an effort  to more o b j e c t i v e l y measure some of the reported parental charact e r i s t i c s and interrelat ionships while at the same time endeavoring to control important variables neglected i n e a r l i e r reports. III.  THE  INTERPERSONAL SYSTEM OP PERSONALITY DIAGNOSIS  Consideration of the f a c t o r s summarized above led to t h i s study's choice of the Interpersonal System of Personality Diagnosis (Leary, 1956;  Leary, 1957)•  This technique of m u l t i l e v e l  20 interpersonal diagnosis of personality evolved by Leary and h i s co-workers attempted to set up a systematic,  operationally de-  fined method of personality diagnosis or assessment which yielded Information relevant to the Interpersonal functioning of the individual.  The term " m u l t i l e v e l " referred to the fact that i n  studying the i n d i v i d u a l , responses were obtained from a variety of sources, each of them being t h e o r e t i c a l l y related t o d i f f e r ent hypothesized l e v e l s of behavior.  Since responses at a l l  levels were measured or scored i n terms of the same set of eight Interpersonal variables or ways of i n t e r a c t i n g with others, measurements at any one l e v e l could be compared with and related to measurements of behavior at a l l other l e v e l s . The levels of functioning that the system attempted to assess were as follows: Level I - the l e v e l of public communication, referred to the interpersonal impact of the subject on other people. The most frequently used method of measuring t h i s l e v e l was through MMPI* indices which apparently  r e f l e c t e d the i n -  terpersonal pressure generated by the subject.  There was,  of course, a methodological weakness In the use of the MMPI.  Level I by d e f i n i t i o n referred to the interpersonal  impact of the subject as perceived by others.  The MMPI,  however, was a s e l f - d e s c r i p t i o n instrument and thus was not a pure Level I measure.  Ideally, persons well acquain-  ted with the subject would be asked to rate the subject on the Interpersonal  Check L i s t  The Minnesota Multiphasic McKinley, 19^1).  (a t r u e - f a l s e l i s t of 128  Personality Inventory (Hathaway &  21 phrases (see Appendix A).  As t h i s was generally not  f e a s i b l e , the MMPI indices employed by Leary 1956)  were u t i l i z e d i n the present  (Leary,  study.  Level I I - the l e v e l of conscious communication referred to the subject's view of himself and others as he projected i t through conscious verbal report. The usual method for measuring t h i s l e v e l was to have the subject rate himself and the Important people i n h i s l i f e on the Interpersonal Check L i s t . Level I I I - the l e v e l of preconscious  symbolization, r e -  ferred to "the interpersonal themes expressed by the subject In the form of fantasies, projective test s t o r i e s , dreams and the l i k e " (Leary, 1956,  p. 17)•  The usual method f o r measuring Level III was t o have the subject write out s t o r i e s i n response to a standard set of ten TAT cards.  These stories were then  scored for the same set of variables that were used i n the measurement of Levels I and I I , sub-levels to Level I I I : III Other,  There were two  Level III Hero and Level  Level III Hero referred to the interper-  sonal themes a t t r i b u t e d to the heroes who appeared In the s t o r i e s .  Level I I I Other consisted of the  interpersonal themes attributed to a l l of the persons with whom the fantasy heroes interacted. Level IV - the l e v e l of the unexpressed unconscious, r e f e r r e d to "the interpersonal themes which are systemat i c a l l y and compulsively  avoided by the subject at a l l  22 the  other l e v e l s o f personality,....(Leary,  1957* P«  So f a r t h i s l e v e l o f p e r s o n a l i t y h a s n o t b e e n s t u d i e d and no s t a n d a r d methods  f o r tapping  80}.  systematically  i t have been de-  veloped. Level V - the l e v e l of values, d a r d s o f what was  -referred t o the subject's  stan-  r i g h t o r I d e a l as he p r e s e n t e d t h e m b y means  of conscious verbal report.  The s t a n d a r d m e t h o d o f m e a s u r i n g  t h i s l e v e l was t o h a v e t h e s u b j e c t Cheek L i s t a c c o r d i n g  f i l l  out t h e  Interpersonal  t o t h e way h e w o u l d I d e a l l y l i k e t o b e .  I n t h e c l a s s i f i c a t i o n scheme u t i l i z e d  i n t h e system,  eight  i n t e r p e r s o n a l v a r i a b l e s o r ways o f I n t e r a c t i n g have b e e n i s o l a t e d and  arranged i n a c i r c u l a r  to Leary, the eight  c o n t i n u u m , (See F i g u r e  1),  i n t e r p e r s o n a l v a r i a b l e s were t h o s e  According conscious  or u n c o n s c i o u s p r o c e s s e s w h i c h people used t o d e a l w i t h o t h e r s t o a s s e s s o t h e r s and themselves I n r e l a t i o n t o  and  others.  The l o c a t i o n o f e a c h v a r i a b l e o n t h e c i r c u l a r  c o n t i n u u m was  d e t e r m i n e d by I t s r e l a t i o n s h i p t o t h e two m a j o r d i m e n s i o n s o f t h e c i r c l e , a dominance-submission d i m e n s i o n and a h o s t i l i t y t i o n dimension.  I t was  affilia-  f o u n d t h a t when d o m i n a n c e - s u b m i s s i o n was  t a k e n as t h e v e r t i c a l a x i s and h o s t i l i t y - a f f i l i a t i o n as t h e h o r i z o n t a l a x i s , a l l o f t h e i n t e r p e r s o n a l v a r i a b l e s c o u l d be as  combinations o f these four  ship  fixed points.  b e t w e e n a n y two v a r i a b l e s was  separation  The d e g r e e o f r e l a t i o n -  a decreasing  on t h e p e r i m e t e r o f t h e c i r c l e .  expressed  function of t h e i r  Thus, v a r i a b l e s  juxta-  p o s e d o n t h e p e r i m e t e r o f t h e c i r c l e w e r e s i m i l a r a n d mttre h i g h l y c o r r e l a t e d t h a n v a r i a b l e s on o p p o s i t e  sides  of the  circle.  23  The complete scoring system, as o r i g i n a l l y developed, s i s t e d of sixteen variables (Leary, 1 9 5 7 ) •  con-  To indicate the  nature o f the sixteen v a r i a b l e s , the litli words which comprise the Interpersonal Check L i s t have been arranged i n clusters i n the c i r c u l a r schema according to t h e i r interpersonal score or meaning.  This arrangement is shown i n Figure 2 .  The  designa-  tions for the 16 variables are the l e t t e r s A through P indicated i n the center of the c i r c l e .  For almost a l l c l i n i c a l and r e -  search purposes, however, the system has been s i m p l i f i e d into eight broader descriptive categories by combining adjacent variables into octants, as AP, BC  NO,  There are two standard methods of summarizing the interpersonal behavior presented by the subject at any given l e v e l of measurement, (Leary, 1 9 5 7 ) . vestigation was  The method used i n the present i n -  to locate a summary point i n the area  comprising  the c i r c l e that represented the central tendency of the interpersonal behavior of the subject.  This was  achieved by summarizing  a l l the scores i n terms of two major axes, the v e r t i c a l (dominance-submission) and the h o r i z o n t a l ( h o s t i l i t y - a f f i l i a t i o n ) . Thus, a l l eight interpersonal scores from one l e v e l could be summarized by locating a single point with reference to the  two  axes • Once the summary point had', been computed, i t was ted Into a numerical code.  This code was  based on the p a r t i c u -  l a r octant i n which the summary point f e l l and how ary point was  from the center of the  transla-  circle.  f a r the summ-  Figure 1. Diagnostic grid showing the eight interpersonal variables i n relation to the two dimensions of the oirole.  Figure 2 . Interpersonal Check List i l l u s t r a t i n g the olassifioation of interpersonal behavior into sixteen variable categories*  26 In the c i r c u l a r g r i d shown i n Figure 1 a small dotted c i r c l e appears one-half inch from the center point.  This  c i r c l e intersects both the v e r t i c a l and horizontal dimensions of the g r i d at one sigma from the mean ( i . e . , i t i n t e r s e c t s o a t the standard scores of LLO and 60 on both dimensions}.  The  standard scores obtained by a subject at any l e v e l were determined from a table of norms provided by Leary (1956).  Summary  points that f e l l within the dotted l i n e were considered to be moderate, while those f a l l i n g outside were c l a s s i f i e d a3 extreme• One  of the basic and most important  aspects of the i n t e r -  personal system of diagnosis was that the same system of v a r i ables was used to measure behavior at a l l l e v e l s . tage of t h i s procedure was  The advan-  that i t made possible the objective  comparison of scores at different  levels.  The diagnostic grid  allowed p l o t t i n g of scores for a l l levels on the same two-dimensional surface and thus yielded a measure of the kind and amount of differences or c o n f l i c t s which existed.  Thus at Level I I ,  s e l f , a subject might obtain standard scores of 70 on the dominance-submission axis and 53 on the h o s t i l i t y - a f f i l i a t i o n axis whereas at Level V ego-ideal, he might obtain standard scores of I4.8 on the dominance-submission axis and 65 on the h o s t i l i t y - a f f i l i a t i o n axis.  His octant summary point scores  would thus be 1 and 7 at Levels II and V r e s p e c t i v e l y . Furthermore, both would f a l l outside of the 1 sigma area designated  on  27 the c i r c u l a r g r i d .  With t h i s information we can see that the  subject communicates that he would i d e a l l y l i k e to be less dominant and more a f f i l l a t i v e than he f e e l s he i s at present. The amount o f t h i s discrepancy could be determined numerically by reference t o a t a b l e of weighted scores provided by Leary (1956).  The s p e c i f i c meaning of a p a r t i c u l a r v a r i a b i l i t y  index would depend, of course, on the l e v e l s being compared.  28 CHAPTER I I I INTERPERSONAL HYPOTHESES On the basis of the theory and research advanced by those investigators concerned with the psychodynamic aspects of childhood schizophrenia, f i v e interpersonal hypotheses were formulated.  Each referred to an attribute reported i n the  l i t e r a t u r e as being c h a r a c t e r i s t i c of parents of schizophrenic children. The f i r s t hypothesis was formulated i n order to determine whether the family pattern of a dominant wife with a submissive husband would emerge as being more c h a r a c t e r i s t i c of our patient f a m i l i e s .  Within the framework of the Interpersonal  System of Personality Diagnosis, the hypothesis was  as folloxos:  Hypothesis 1 - At Level I, the family pattern of a dominant wife with a more submissive husband ( i . e . , score of the wife higher than that of the husband on the dominance-submission dimension) w i l l occur more frequently i n the families of the a u t i s t i c children than i n the families of normal children. Hypotheses 2 and 3 were formulated i n an effort to define more objectively the "empathy" and "emotional detachment" f a c tors so widely reported i n the l i t e r a t u r e .  Hypothesis 2 was  related s p e c i f i c a l l y to the degree to which the parents i n the two groups were aware of the c h a r a c t e r i s t i c s of their behavior as viewed by others.  Would the parents of normal children show  29 greater understanding parents  of a u t i s t i c  sis  as f o l l o w s :  was  Hypothesis  and  insight  children?  2 - T h e r e w i l l be crepancy  a  i n t o t h e i r behavior  The  exact  score f o r the  c h i l d r e n than  of the normal c h i l d r e n . is Hypothesis  an  index  to  of their  criptions  attributed  p o t h e s i s was Hypothesis  on t h e  and  parents  f o r the  of  parents  (This discrepancy  were a t t u n e d  spouses.  the p a t i e n t parents would e x h i b i t self-descriptions  score  assess the degree to w h i c h  i n a family unit  sonal c h a r a c t e r i s t i c s  dis-  of s e l f - d e c e p t i o n . )  3 attempted  h u s b a n d and w i f e  greater  between the L e v e l I s e l f  the a u t i s t i c  the  I n t e r p e r s o n a l hypothe-  significantly  the L e v e l II s e l f  than  t o the  I t was  greater disparity  their  spouses.  interper-  postulated that  I n t e r p e r s o n a l Check L i s t  t o them by  the  between  and  The  the  their  des-  specific  hy-  as f o l l o w s :  3 - There w i l l crepancy wife  be  a significantly  ( L e v e l I I ) as  compared w i t h t h e  v i c e v e r s a f o r the parents  tistic  Hypothesis  index  ii was  hus-  of the  auof  (This discrepancy i s  of spouse m i s p e r c e p t i o n ) •  formulated  t o w h i c h t h e m o t h e r and  the  (Level II)  c h i l d r e n than f o r the p a r e n t s  the normal c h i l d r e n . an  dis-  between the s e l f - p e r c e p t i o n o f  band's p e r c e p t i o n o f h i s w i f e and  greater  i n order  to assess  the  degree  f a t h e r i n a f a m i l y were i n agreement  about t h e i n t e r p e r s o n a l b e h a v i o r  of the  child  selected for  this  3G study.  It was postulated that the patient parents would show  greater disagreement  than the parents of normal children i n  their descriptions of the c h i l d on the Interpersonal Check L i s t . The s p e c i f i c hypothesis was as follows: Hypothesis ii - There w i l l be a s i g n i f i c a n t l y greater d i s crepancy between the mother and father i n t h e i r perception of their c h i l d at Level II for the parents of the a u t i s t i c  child-  ren than f o r the parents of the normal children. Hypothesis 5 was formulated i n order to assess the a t t i tudes of the two groups of parents regarding the nature of i n terpersonal r e l a t i o n s h i p s .  The l i t e r a t u r e indicated that a  c h a r a c t e r i s t i c t r a i t of parents of schizophrenic children was the avoidance of interpersonal i n t e r a c t i o n .  Relationships with  other people seemed to be an unpleasant experience and were viewed with d i s t r u s t , h o s t i l i t y and pessimism. In order to assess these findings, It was decided that an inspection of the scores at Level I I I might prove u s e f u l .  At  Level III two measures were obtained, Level I I I Hero and Level III Other.  The l a t t e r score provided an i n d i c a t i o n of the i n -  terpersonal behavior which was  attributed to the "Other" i n  "Hero-Other" interactions occurring i n TAT s t o r i e s .  In light  of the previous l i t e r a t u r e , i t was postulated that at Level III Other the scores obtained by the patient parents would f a l l to a greater extent than for the normal parents into Octants  1,2,  31  3 , and l i .  An Inspection of Figures 1 and 2 shows that these  octants are indicators of interpersonal behavior related to the managerial  - a u t o c r a t i c , competitive - e x p l o i t i v e , blunt-  aggressive, and s k e p t i c a l - d i s t r u s t f u l v a r i a b l e s . In other words, scores i n these II octants would a l l be situated at the "hostility"  end of the h o s t i l i t y - a f f i l i a t i o n dimension.  s p e c i f i c hypothesis was as follows: Hypothesis  5> - At Level I I I Other, s i g n i f i c a n t l y more summary point scores w i l l f a l l Into octants 1 , 2 , 3 and 11 f o r the parents of the a u t i s t i c children than for the parents of the normal children.  The  32  CHAPTER IV METHOD Each married couple taking part i n thia investigation was administered a battery of three psychological tests consisting of the MMPI, the Interpersonal Check L i s t , and the TAT.  The  tests were then scored according to the Leary method and the experimental and control parents compared on the Leary dimensions u t i l i z e d i n the present I.  study,  Subjects A t o t a l of twelve married couples were assessed.  The ex-  perimental group consisted of 6 couples, each having a c h i l d who had been accepted into a treatment  program for schizophre-  nic children at the Mental Health Centre i n Burnaby, B.C. The formal diagnoses of these 6 children were as follows: li early i n f a n t i l e autism according to the c r i t e r i a of Kanner, 1 secondary autism, again according to Kanner's c r i t e r i a , and 1 c h i l d hood schizophrenia with cerebral l e s i o n . therefore, f a l l within Kanner's a u t i s t i c  Five of the s i x cases, classification.  Using the parents of the a u t i s t i c group as a base, a cont r o l group of parents o f normal children was then selected. F i l e s of the Public Health Officer and Superintendent  of Public  Health Nurses f o r the Burnaby School D i s t r i c t were examined for families suitable as controls.  The families of the normal  c h i l d r e n were screened for the following v a r i a b l e s :  33 1) C h a r a c t e r i s t i c a  of the c h i l d r e n ; a c h i l d who  ded as c l o s e l y as p o s s i b l e dren on t h e f o l l o w i n g  correspon-  t o one- of the a u t i s t i c  chil-  variables:  a) sex b) age c) o r d i n a l p o s i t i o n I n b i r t h order d) number o f s i b l i n g s 2) Absence o f a h i s t o r y o f n e u r o l o g i c a l , chronic  p s y c h i a t r i c or  p h y s i c a l I l l n e s s i n any o f t h e c h i l d r e n ,  3) Age o f t h e parents li) E d u c a t i o n o f the parents 5>) Income o f the parents 6) E t h n i c  o r i g i n o f the parents  7) R e l i g i o n o f the parents Families  from t h i s p o p u l a t i o n who roughly corresponded t o  the c h a r a c t e r i s t i c s o f experimental f a m i l i e s were then c o n t a c t e d and asked t o a s s i s t  i n the present i n v e s t i g a t i o n .  From t h e  approximately  20 f a m i l i e s who v o l u n t e e r e d , the 6 best matching  the 6 p a t i e n t  f a m i l i e s were u t i l i z e d i n the study.  the s e l e c t e d  c h i l d r e n were n a t i v e  had r a i s e d t h e c h i l d r e n themselves  born Canadians.  In a l l cases The parents  and a l l were a l s o the n a t u r -  a l p a r e n t s , e x c e p t i n g 2 cases comprirised o f a p a t i e n t  family  and i t s c o n t r o l counterpart where the c h i l d r e n concerned were adopted  at an e a r l y age.  The c h a r a c t e r i s t i c s o f the c h i l d r e n are shown i n T a b l e I . The  a u t i s t i c c h i l d r e n had a mean age o f £ years and II months  TABLE 1  3IL  CONTROL DATA ON THE AUTISTIC CHILDREN . AND THEIR NORMAL,COUNTERPARTS.  FAMILY  CHILDREN'S CH ARACTERISTICS - AGE AT ORDINAL SEX ASSESS* POSITION NUMBER OF MENT OF OF BIRTH DATE CHILD (YEARS & CHILD SIBLINGS MONTHS)  A*  Male  a*  Male  B  April 22/59  1  1  5:0  May 29/59  1  1  Male  6:2  Nov. 5 / 5 8  1  0  b  Male  6:2  May 2IL/58  1  0  C  Male  i}-:7  A p r i l 28/59  k  3  c  Male  5:0  April 21/59  k  3  D  Male  7:6  May 3 1 / 5 6  3  3  d  Male  7:7  Oct. 1 6 / 5 6  3  2  E  Female  Aug. 9/59  3  2  e  Female  Sept. 7/59  3  2  F  Male  April 23/59  k  3  f  Male  Sept. 3 / 5 9  k  3  li:8  !L:8  - * (Families with c a p i t a l l e t t e r s are those having an a u t i s t i c c h i l d , while families with small l e t t e r s are the corresponding normal c o n t r o l s ) .  TABLE 2 CONTROL DATA ON THE FAMILIES OF AUTISTIC CHILDREN ..... .. AND THEIR NORMAL _ COUNTERPARTS . . PARENTS' CHARACTERISTICS  PARENT  BIRTH DATE  AGE AT ASSESSMENT (YEARS & . MONTHS)  EDUCATION (YEARS)  ETHNIC ORIGIN  (WAIS)  ANNUAL INCOME (I's)  102 Ukranian Mr. A*fr 28:10 11 Jan. 20/35" 5.000 Mrs. A 11 English 111 Oct. 26/3H 29:3 11 Danish 103 Mr. a * Jan. 16/23 hlik 11,500 8 English 100 Mrs. a Feb. 2 3 / 2 3 111: 3 English 110 Mr. B April 27/lli 9 li.9:6 Oct. 28/20 German ll,600 Mrs.. B K.3:2. 109 9 10 English 12k Mr. b. June 17/19 hk:2 Mrs. b iil:l German 122 June 28/23 5.000 9 . Mr. C . English May 2k/21t 39:6 13 131 Mrs. C. Feb. 2ii/30 33.8 English ii,800 103 9 Mr. c Dec. 10/25 English 116 13 38.5 Mrs. o . May 8 / 3 0 3ii.0 10 English 121 6,000 Mr. D 12 32.8 English 108 A p r i l 1/31 Mrs . .D. Aus. 2 / 2 8 10 English 35:k 125 1I..900 Mr. cL Sept. It/25 10 English 116 38:9 Mrs.. d Nov. ILL/29 3k:6 12 Italian 5,000 107 Mr. E May l t / 2 3 English 100 LL0:7 9 Mrs. E Nov. 8/28 12 English li,500 35:1 115 Mr. e Sept. 3/32 31:8 12 English 125 Mrs . e June 2 k / 3 2 31:10 12 122 English 5.000 Mr. F 38:8 16 English 128 Jan. 8/25 Mrs.~.F Aug. 2/27 English 7,200 36 :k 127 Mr . f , May 2 5 / 2 2 El:l English ll 119 Mrs. f Dec* I I L / 2 1 English 6,000 U2:k 12 113 * (Famil ies with cap It a l l e t t e r s arei those having an a u t i s t i c c h i l d while families with small l e t t e r s are the corresponding normal c o n t r o l s ) . # (The i n t e l l i g e n c e quotients were obtained from a separate study on.the above families.)  RELIGION  United Protestant None United United United Protestant Protestant United Protestant Protestant Prot estant  36 whereas the control children had a mean age of 5 years 6 months.  The c h a r a c t e r i s t i c s of the parents are shown i n  Table I I . The mean age of the patient fathers was 38 years and ii months whereas the control fathers had a mean age of 39 years and 5 months.  The patient mothers had a mean age of  35 years and 6 months with the control mothers having a mean age o f 37 years and 6 months.  On the average, therefore, the  control parents were s l i g h t l y older than the patient parents. In terms of years of education the patient fathers had a mean of 11 years 7 months while the control fathers had a mean of 12 years 2 months.  The patient mothers obtained a mean edu-  cational l e v e l of 10 years 8 months with the control mothers having a mean of 10 years 5 months.  Intelligence quotients on  the Wechsler Adult Intelligence Scale (Wechsler, 1955)  showed  the patient fathers to have a mean I.Q. of 113 and the control fathers to have a mean of 117.  Patient mothers attained a  mean I.Q> of 115 and control mothers a mean I.Q. of l l i i .  The  mean annual income of the patient families was $5*167.00 while the mean annual income of the control families was $5*250.00. The summary of control data shows that the two groups of parents were c l o s e l y matched. ables  takBn  Considering the number of v a r i -  into account, the matching achieved was very  factory. II.  Procedure Each married couple was contacted by telephone and an  appointment was arranged.  A l l tests administered  included  satis-  37  standard written instructions and were completed at one sitting.  The investigator gave no assistance to the subjects  except i n those cases where c l a r i f i c a t i o n of the instructions was requested.  Husband and wife were placed i n i n d i v i d u a l  rooms and not allowed to communicate with each other u n t i l completion of a battery consisting of the following three tests: 1) MMPI Husband and wife were each given the group form of the MMPI. Administration and scoring was done i n the standard manner, and the "T" (standard) scores for each scale computed. The corrected "T" scores were then used i n the following a r i t h metical formulae and the v e r t i c a l  (dominance-submission) and  horizontal ( h o s t i l i t y - a f f i l i a t i o n ) indices derived. Dora = (MA - D) + (Hs - Pt) Lov = (K - F) V (Hy -  s) c  The r e s u l t i n g figures were the MMPI "raw score" Indices. (See Appendix B for a sample protocol and a derivation of the raw score i n d i c e s ) . 2) Interpersonal Check L i s t  (ICL)  Husband and wife were each administered the ICL according to the standard instructions printed on the f i r s t page (See Appendix A for the test form and i n s t r u c t i o n s ) . The subject was asked to describe himself i n column 1, h i s mother i n column 2, his father i n column 3, his c h i l d i n column 11 (this being the a u t i s t i c  c h i l d i n the patient group  38  and his normal counterpart i n the control group), h i s i d e a l s e l f i n column 5 , and his spouse i n column 6 . Following the Leary system the frequency of characterizing each i n d i v i d u a l with adjectives derived from the ICL octants was  summed and substituted into the following equations. Dom = 0 . 7 (BC + NO - FG - JK) + AP - HI Lov = 0i-7 (JK * NO - BC - FG) + LM - DE  where AP » score i n octant AP, e t c . The r e s u l t i n g figures were the "raw score" indices for the ICL. The above equations were devised by Leary i n order to locate a summary point i n the area comprising the c i r c l e that best represented the central tendency of the interpersonal behavior of a subject. (See Appendix C for the rationale underlying these equations). 3) TAT  Ten TAT cards recommended by Leary ( 1 9 5 6 , p. 17) were u t i l i z e d , the s p e c i f i c cards d i f f e r i n g " somewhat for males and females.  The cards used were: a) for women, cards 1 , 2 , 3  k, 6 BM, 6 GF, 7 GF, 12 M, 13 MF, and 18 GF;. b) for men, cards 1 , 2 , 3 BM, k, 6 BM, 6 GF, 7 BM, 12 M, 13 MF, and 18 BM, i n  that order.  The subjects wrote t h e i r stories alone, with pen-  c i l on ordinary paper, and followed Leary's instructions (Leary, 1 9 5 6 , p. 1 7 ) .  The investigator looked over the s t o r -  ies p e r i o d i c a l l y as the subject wrote them and suggested add i t i o n a l material i f necessary to conform to the instructions  39  e.g.,  development of a theme or a more s p e c i f i c outcome.  The task of the experimenter was to direct the subject to respond with ratable s t o r i e s . The  scoring sheet used to rate the TAT s t o r i e s i s shown  i n Appendix D. Each TAT story was scored as a separate unit and no attempt was made to single out froipri any one story theme si iwhich might have emerged as a result of reading over the entire protocol. The f i r s t step i n r a t i n g a story was to select the "Hero" and the "Other".  The "Hero" was the character i n the story  with whom the subject evidently i d e n t i f i e d . The  "Other" referred to any character, except the "Hero"  involved i n the story, to whom feelings or actions were exp l i c i t l y assigned by the subject. At Level I I I , therefore, measures were obtained not only of interpersonal themes attributed to the s e l f or s e l f - i d e n t i f i e d heroes, but also the interpersonal themes attributed to the others with whom the fantasy s e l f interacted. A r a t i n g i n terms of the l e t t e r codes from the interpersonal c i r c l e was assigned to the "Hero" and to each "Other". In scoring the TAT, two raters and a judge were employed. The f i r s t two raters made t h e i r scoring decisions independently. The  judge then inspected these ratings and made a t h i r d and  decisive r a t i n g only when the f i r s t two independent raters were i n disagreement• The  columns "Hero Role" and "Other Role" on the r a t i n g  sheet provided  space for the codes assigned to each character  and once scoring was  completed the codes for "Hero" and "Other"  were t a l l i e d and the sums entered into the same formulae as those which were used with data from the Interpersonal Check List. The r e s u l t i n g figures were the "raw  score" indices for  the TAT and y i e l d e d a measure of the interpersonal themes r e vealed at the l e v e l of fantasy or indirect  expression.  The three preceding sections have outlined the administrat i o n and scoring of the tests used at Levels I, II and I I I and the computation of the raw score indices for each l e v e l .  These  scores provided a composite measure which r e f l e c t e d the r e l a t i v e strength of each of the 8 variables of the c i r c u l a r continuum at a particular l e v e l .  The raw score indices were  converted to standard scores by use of norms developed Leary (1956).  by  (For example of the procedure, see Record Book-  let for Interpersonal Diagnosis of Personality, Appendix E ) . The standard scores were then used to plot the l o c a t i o n of the summary point on the diagnostic c i r c l e , with summary points f a l l i n g within one sigma of the mean assigned a moderate diagnosis and those f a l l i n g beyond assigned an extreme diagnosis. The numerical code summarizing the p o s i t i o n of the score i n the c i r c l e depended upon the p a r t i c u l a r octant i n which the summary point f e l l and the degree of deviation of the score from the mean. Having determined the numerical code diagnoses, the v a r i a b i l i t y indices were calculated by use of a table of weights  kl provided by Leary ( 1 9 5 6 ) .  These expressed d i r e c t l y the  amount and kind of discrepancy between any pair of diagnost i c code numerals, thus permitting the hypothesized sons to be made.  compari-  There were l k possible discrepancies, rang-  ing at unequal intervals from 0 to I l k . The cutting point which defined a high or low discrepancy was the point kk, with discrepancies of more than Ilk denoting a "high" discrepancy, i . e . more than one octant. With the above data, i t was possible to test the f i v e hypotheses formulated i n Chapter I I I . III.  S t a t i s t i c a l Analysis Hypotheses 2., 5. and 4 i n t h i s study involved a compari-  son of s p e c i f i c v a r i a b i l i t y Indices between the two groups of parents.  Leary ( 1 9 5 6 ) ,  as noted previously, has evolved a  system of weighted scores ranging at unequal intervals from 0 to I l k ( 0 , 2 3 , 26, k l , kk, k8, 62, 66, 68, 8 l , 8k, 9 1 , Ilk) which r e f l e c t the amount of discrepancy between any  105,  two  summary point scores.  The cutting points'which defined a high  or low discrepancy was  the point kk, with more than kk de-  noting a "high" discrepancy.  As the number of octants i n t e r -  vening between any two summary point scores increased, the weighted score assigned to the p a r t i c u l a r v a r i a b i l i t y index correspondingly increased to a maximum of I l k . In order to test whether two groups of subjects d i f f e r i n the amount of discrepancy a r i s i n g i n r e l a t i o n to some v a r i a b i l i t y index, Leary has recommended that a c h i square test of  significance be u t i l i z e d . By using kk as the c r i t i c a l score, one could then assign members of the two groups to the c e l l s of a 2 X 2 contingency table and In t h i s way determine whether a s i g n i f i c a n t l y l a r ger proportion of subjects i n any particular group had obtained scores above the cutting point of kk. This method, however, had certain weaknesses.  Firstly,  the p a r t i c u l a r reasoning behind the choice of a score of kk as a cutting point was somewhat vague.  It was a r b i t r a r i l y chosen  as the determining value simply because of the fact that v a r i a b i l i t y scores above kk represented a discrepancy between two summary points of more than 1 octant. Thus, f o r example, i f a l l members of a group had d i s c r e pancy scores of kk on some p a r t i c u l a r v a r i a b i l i t y index while members of a second group had discrepancy values of k8, c h i square would indicate a s t a t i s t i c a l l y s i g n i f i c a n t difference between the two. The actual numerical difference, however, would be quite small. Furthermore, i f a l l members of a group were to obtain d i s crepancy  scores of 62 while a l l the members of a second group  were to obtain discrepancy scores of I l k , one would f e e l that the numerical difference was substantial and indicative of some basic difference between the two groups.  A c h i square  t e s t , however, would not corroborate the difference s t a t i s t i c a l l y as a l l the discrepancy scores would have f a l l e n on the  ^3 same s i d e o f t h e c r i t i c a l v a l u e o f k k . As a r e s u l t  o f the draw-backs i n h e r e n t i n u s e o f the c h i  s q u a r e m e t h o d , i t was d e c i d e d t h a t t h e W i l c o x o n Signed-Ranks cal  Test  ( S i e g e l , 1956) was a more s u i t a b l e  technique f o r t e s t i n g Hypotheses  a nonparametric  Matched-Pairs  2, 3 a n d 4.  This test i s  t e c h n i q u e f o r u s e w i t h 2 matched samples.  takes i n t o account  It  t h e d i r e c t i o n and t h e magnitude o f t h e d i f -  f e r e n c e s w i t h i n p a i r s o f s c o r e s , g i v i n g more w e i g h t showing  statisti-  a l a r g e d i f f e r e n c e t h a n t o a p a i r showing  to a pair  a small dif-  f e r e n c e , a n d t h u s made f a r b e t t e r u s e o f t h e d a t a t h a n t h e c h i square method s u g g e s t e d by L e a r y . In Hypotheses  „1. a n d 5» t h e d a t a a l l f e l l  i n t o one o r t h e  o t h e r o f two m u t u a l l y e x c l u s i v e c l a s s e s a n d c o u l d be r e p r e s e n ted  by frequencies i n a 2 X 2 contingency  table.  As t h e number o f c a s e s i n H y p o t h e s i s .1 was s m a l l , t h e F i s h e r E x a c t P r o b a b i l i t y T e s t was u s e d  ( S i e g e l , 1956).  t h e s i s 5 was t e s t e d b y t h e c o n v e n t i o n a l c h i s q u a r e  Hypo-  method.  CHAPTER V RESULTS  The  results  potheses  statistical  are presented below.  s c o r e s , and parent  of the  octant  a n d H,  Hypothesis  raw  of the  I , I I , and  at  Tie  standard  the  3*  c o n t r o l group the dominance  er  t h a n t h a t o f t h e h u s b a n d i n two  F i s h e r Exact  Test  short  significance  Thus d i f f e r e n c e s The  second  of S i g n i f i c a n c e  than the  control parents.  score  families. yielded  than  from  the  pa-  dimension this  was  the  husband. high-  A n a l y s i s by  the  a p value of  .14-09,  study.  observed. patient  parents  interpersonal characteristics  on t h e  s c o r e s o b t a i n e d by  s e l f - d e c e p t i o n index  i n s p e c t i o n of the data  t r e n d toward l a r g e r  in  w i f e was  .0£ s e t f o r t h i s  Discrepancy  c o n t r o l parents An  of the  p o s t u l a t e d t h a t the  aware o f t h e i r  shown i n T a b l e L L . a slight  l e v e l of  hypothesis  less  and  seen  i n o n l y one  b e t w e e n g r o u p s were n o t  w o u l d be  patient  I t c a n be  o f the w i f e h i g h e r t h a n t h a t o f t h e  the  the  s c o r e s o b t a i n e d by  s i x pat l e n t - f a m i l i e s ,  In  of the  l n Appen-  on t h e d o m i n a n c e - s u b m i s s i o n  L e v e l I a r e shown i n T a b l e  dominance s c o r e  two  1 p o s t u l a t e d t h a t t h e m o t h e r s w o u l d be  control parents  table that o f  hy-  respectively.  the control f a m i l i e s . and  the  I I I are p r e s e n t e d  dominant members more o f t e n I n t h e p a t i e n t f a m i l i e s  tient  five  score Indices, standard  summary p o i n t s c o r e s o b t a i n e d by  groups a t L e v e l s  d i c e s F, G,  The  analysis  the  are  i n T a b l e I4. shows  discrepancy scores f o r the  control  TABLE 1 STANDARD SCORES OBTAINED BY PATIENT AND CONTROL PARENTS ON THE DOMINANCE-SUBMISSION DIMENSION AT LEVEL I  Patient Parents Standard Score  Control Parents Standard Score  Mr. A  61*  Mr. a  Mrs. A  59  57  Mrs. a  55  Mr. B"  62  Mr. b  65  Mrs. B  56  Mrs. b  51  Mr. C  58  Mr. c  55  Mrs. C  k$  Mrs. c  61  Mr. D~  58  Mr. d  56  Mrs. D  63  Mrs. d  Mr. E  61  1*6  Mr. e  69  Mrs. E  54  Mrs . e  56  Mr. P  58  Mr. f  58  Mrs. P  51  Mrs. f  61  * High scores represent tendencies towards the dominance end of the dominance-submission dimension.  k6  TABLE lj. LEVEL I SELF - LEVEL I I SELF DISCREPANCY SCORES OBTAINED BY.PATIENT AND.CONTROL PARENTS . (INDEX OF "SELF DECEPTION")  Patient Parent a Discrepancy .Score  Control Parents Discrepancy Score  Mr. A  23  Mr. a  kl  Mrs. A  66  Mrs. a  00  Mr. B  kl  Mr. b  00  Mrs. B  kl  Mrs. b  8k  Mr. C  8k  Mr. c  8k  Mrs. C  00  Mrs. c  84  Mr. D  kl  Mr. d  kl  Mrs. D  kl  Mrs. d  23  Mr. E  kk  Mr. e  kk  Mrs. E  kk  Mrs. e  k8  Mr. F"  kl  Mr. f.  66  Mrs. F  kl  Mrs. f  66  X  =  k2.25  X  =  k8.k2  1*7 parents, a trend opposite to the hypothesized d i r e c t i o n . Analysis by the Wilcoxon test yielded a T value of 16.5. This f a i l e d to reach a .05 l e v e l of s i g n i f i c a n c e .  The hypothesis  was not supported. Hypothesis 3 postulated that the patient parents would misperceive the c h a r a c t e r i s t i c s of their spouses to a greater degree than the control parents.  The discrepancy scores ob-  tained by the patient and control parents are shown i n Table 5»  Inspection of the data i n Table 5 shows no trend toward  d i f f e r e n t i a t i o n of the two groups on the basis of scores obtained on the index of spouse misperception.  Analysis by the  Wilcoxon test yielded a T value of 32 and t h i s f a i l e d to reach the .05 l e v e l of s i g n i f i c a n c e .  The hypothesis was thus not  supported. Hypothesis It postulated that the patient parents would show greater disagreement  i n their perceptions of t h e i r c h i l d  than the control parents.  The discrepancy scores obtained by  the patient and control families are shown i n Table 6. Inspection of the data i n Table 6 shows that there Is l i t t l e to choose between the two groups i n terms of the discrepancy a r i sing between mother and father i n t h e i r perception of the c h i l d involved i n t h i s study. a T value of 10. significance.  Analysis by the Wilcoxon test yielded  This again f a i l e d to reach the .05 l e v e l of  The hypothesis was thus not confirmed.  Hypothesis 5 postulated that the patient parents would, to a greater degree than the control parents, view people i n  TABLE £ "SPOUSE MISPERCEPTION" DISCREPANCY SCORES OBTAINED BY PATIENT AND CONTROL PARENTS. (DISCREPANCY BETWEEN.SELF PERCEPTION OF WIFE AT LEVEL II AND HUSBAND'S PERCEPTION OF.HIS WIFE .AT LEVEL II AND VICE VERSA  Patient Parents Discrepancy . Score  Control Parents Discrepancy Score  Mr. A  32  Mr. a  Mrs.A  Mrs. a Mr. b  kk  Mrs. B  kl kl kl  kk kk  Mrs. b  23  Mr. C  kl  Mr. c  23  Mrs. C  23  Mrs. c  8Ji  Mr. D  Qk  Mr. d  kl  Mrs. D  ki  Mrs. d  66  Mr. E  00  Mr. e  00  Mrs . E  kk  Mrs. e  26  Mr. F  00  Mr. f  62  Mrs. F  81  Mrs. f  k8  Mr. B  k9  TABLE 6 LEVEL I I CHILD (HUSBAND) - LEVEL II CHILD (WIPE) .. DISCREPANCY SCORES OBTAINED.BY PATIENT AND CONTROL FAMILIES  Patient  Control Families Discrepancy Score  Families - Discrepancy -Score  kl  A  26  a  B  62  b  C  66  c  105  D  26  d  kk  E  kd  e  23  F  62  f  1*8  X  li.-8.33  X  =  ,  50.33  50  interpersonal interactions as being h o s t i l e and u n a f f i l i a t i v e . More s p e c i f i c a l l y , i t was hypothesized that at Level I I I , the patient parents would, to a greater degree than the control parents, perceive the "Other" In "Hero-Other" interactions as being h o s t i l e and u n a f f i l i a t i v e ( i . e . , receive scores f a l l i n g into octants 1, 2, 3» and k ) .  The octant scores obtained by  the patient and control parents at Level I I I Other are shown i n Table 7«  Inspection of the data i n Table 7 shows that i n  the patient f a m i l i e s , 9 parents obtained summary point scores which f e l l into octants 1, 2, 3» and k whereas, i n the control f a m i l i e s , only 2 parents obtained summary point scores at Level I I I Other which f e l l into these same k octants.  A chi  square analysis yielded a value of 6.0k. Por df = 1, t h i s was s i g n i f i c a n t at better than the .02 l e v e l .  The two groups  were thus d i f f e r e n t i a t e d at an acceptable l e v e l of s i g n i f i cance by the octant scores obtained at Level I I I Other. Of the f i v e hypotheses formulated, therefore, only Hypothesis 5 was confirmed.  51  TABLE X OCTANT SUMMARY POINT SCORES OBTAINED BY PATIENT AND CONTROL PARENTS AT LEVEL I I I OTHER  Pat 1 ent Paren13 Level I I I Other Score  Control Parents Level I I I Other Score  Mr. A  2*  Mr. a  Mrs. A  k  Mrs. a  8  Mr. B"  k  Mr. b  I  Mrs. b  1  Mrs. B Mr. C  1  Mr. c  8  Mrs. C  8  Mrs. c  1  Mr. D  8  Mr. d  8  Mrs. D  2  Mrs. d  6  Mr. E  1  Mr.  1  Mrs. E  3  e Mrs. e  Mr. F  1  Mr. f  I 5  Mrs. F  1  Mrs. f  8  *  Underlined figures denote extreme summary points while unlined figures denote moderate summary points.  52  CHAPTER VI DISCUSSION AND The present  CONCLUDING REMARKS  study attempted to test the v a l i d i t y of  c l i n i c a l and research findings on the parents of children.  schizophrenic  Certain personality t r a i t s and family relationships  thought to be c h a r a c t e r i s t i c of such parents were operationally defined and measured within the framework of the System of Personality Diagnosis associates (Leary, 1 9 5 6 ;  Interpersonal  developed by Leary and h i s  Leary, 1 9 5 7 ) •  An analysis of the data f a i l e d to reveal any widespread differences between a group of parents of a u t i s t i c children and a control group of parents of normal children. hypotheses formulated was  Of f i v e  on the basis of previous work, only  found to d i f f e r e n t i a t e the two  one  groups.  Hypothesis 1 tested the widely held assumption that the t y p i c a l pattern to be found i n the families of schizophrenic children was  that of a dominant wife and passive f a t h e r .  In  order to test this hypothesis  the scores on the dominance-sub-  mission dimension were used.  The hypothesis  tiated.  was  not  The f a i l u r e of the analysis to confirm the  must be assessed  i n l i g h t of the following three  substanhypothesis  considerations.  F i r s t l y , this pattern, although widely speculated upon i n the l i t e r a t u r e (Clardy, 1 9 5 l ; 1949;  Despert, 1 9 3 8 ;  Potter, 1 9 3 3 ; Rank,  Slimp, 1951)> has been found In only 1 of the 1 studies  which s p e c i f i e d that the children being referred to were diagnosed as a u t i s t i c  (Anthony, 1 9 5 8 ) .  53  Secondly, the scores used to test the present hypothesis were derived on the basis of the MMPI, an instrument which was f e l t by Leary to provide an indirect measure of how  an  individual is perceived by others. As noted e a r l i e r , t h i s use of a self-referent technique was Inconsistent with the d e f i n i t i o n of Level I, the interpersonal impact of a subject as perceived by others.  Studies by Klopfer (1961) and Laforge  (1963) would seem to indicate that this was more than a methodological weakness.  Both authors found that the MMPI f a i l e d  to predict Level I behavior as measured with ratings of a subject by others on the Interpersonal Check L i s t . The t h i r d consideration involved a close examination of the rationale used by Leary i n h i s c a l c u l a t i o n of the (dominance-submission  dimension) and "Lov"  a t i o n dimension) scores.  (See Appendix C).  "Dom"  (hostility-affiliMany of the  assumptions made by Leary regarding the geometric and t r i g o nometric properties of h i s c i r c u l a r continuum have come under strong attack (Baumrind, I960; Klopfer, 1 9 5 7 ; T e r r i l l , 1961). Problems concerning the interrelationships between the eight modes of Interpersonal relationships, and the assumption that the "Dom"  and "Lov" dimensions were orthogonal and  Independent  have raised some doubts as to the v a l i d i t y of the mathematical procedures used by Leary i n c a l c u l a t i n g a single summary point score. Thus, insofar as the data obtained In t h i s study were meaningful, the negative results for Hypothesis 1 seem to  54 support the view that although the pattern of a dominant wife and passive father may from other subgroupings  occur i n families of children suffering of childhood schizophrenia, i t does not  occur i n families with a u t i s t i c children. Hypotheses 2 and 3 were formulated i n order to more obj e c t i v e l y define the "empathy" and "emotional detachment" f a c tors • The negative results raise questions as to whether the tests were actually related to "empathy" and "emotional ment".  detach-  The problem i s inherent i n many studies attempting to  translate c l i n i c a l terms and concepts into more objective and operational d e f i n i t i o n s amenable to rigorous study and analysis.  Frequently the greatest doubt i n such studies surrounds  not the v a l i d i t y of the constructs themselves but rather the v a l i d i t y of the operations that were used to measure the constructs* A l l that can be stated is that the operational measures used i n Hypotheses 2 and 3 f a i l e d to support the many studies (Anthony, 1 9 5 8 ; Behrens and Goldfarb, 1 9 5 8 ; Block et a l , 1 9 5 8 ; Eisenberg, 1 9 5 7 ;  Kanner, 1 9 4 9 ; Singer and Wynne, 1963)  finding  the parents of schizophrenic children to be unempathic and emotionally  detached.  Even this conclusion i s only tentative In l i g h t of possible weaknesses i n the Leary system. r e l a t i o n to Hypothesis 1,  As was  discussed i n  there exists some question as to the  v a l i d i t y of the mathematical procedures used by Leary to arrive  55 at a summary point score.  These problems at the l e v e l of  mathematical operations lead i n turn to doubts as to the v a l i d i t y of discrepancy scores as these are based on summary point scores.  This must be emphasized i n r e l a t i o n to Hypothe-  ses 2, 3 and k as discrepancy scores a r i s i n g between different individuals or different levels formed the basic data for a l l three. There i s also a temporal variahle involved here.  It i s  possible that the absence of empathy and s e n s i t i v i t y was  not  in the sense of an absolute deficiency but rather a c e r t a i n slowness In the operation of these a b i l i t i e s 1958).  (Block et a l ,  It might be that the parents f a i l e d to respond to t h e i r  c h i l d because they could not be s u f f i c i e n t l y sensitive to h i s f l u c t u a t i n g needs and wishes.  Thus, l n the present  study where  these a b i l i t i e s were being assessed i n r e l a t i o n to the " s e l f " and individuals i n the family u n i t , such an impairment  may  not have become evident. A f i n a l variable which must be accounted f o r i s that of s o c i a l d e s i r a b i l i t y i n responding to the MMPI n d the Intera  personal Check L i s t .  This response set was  particularly likely  to have influenced responses to the l a t t e r instrument  as the  adjectives are systematically categorized with the more extreme adjectives, some of which are c l e a r l y undesirable ones, i n the last two columns of the check l i s t .  This may  have  affected Hypotheses 2, 3 and k i n which parts of the data were obtained from the Interpersonal Check L i s t .  56  It i s obvious from the above observations that the f a i l u r e to confirm Hypotheses 2 and 3 does not preclude the p o s s i b i l i t y that the parents of a u t i s t i c children are i n fact unempathic and emotionally  detached.  Hypothesis it was  related to the degree to which the par-  ents were i n agreement as to the Interpersonal t r a i t s of t h e i r children.  The f a i l u r e to f i n d any differences between the two  groups was unwittingly confounded by the very nature of the autistic child.  These children, i t must be remembered, suf-  fered from a r e s t r i c t e d range of behavior and an I n a b i l i t y to relate themselves i n the ordinary way quently It was  to other people.  Conse-  discovered that many of the adjectives on the  Interpersonal Check L i s t simply were not applicable. As a r e s u l t , eleven of the twelve summary point scores received by the a u t i s t i c children f e l l i n the moderate range.  As the d i s -  tance between adjacent octants i n t h i s region i s minimal (see Figure 1} this resulted i n a concomitant  decrease i n a l l d i s -  crepancy score values pertaining to these children. An i n t e r e s t i n g trend which did emerge i n r e l a t i o n to the patient group was that the fathers tended to attribute more " h o s t i l e " t r a i t s to the children whereas the mothers tended to describe these very same children as being more "loving" and "affiliative".  The control parents f a i l e d to show this same  systematic pattern i n the descriptions of t h e i r children. This difference; was not s i g n i f i c a n t , however, as analysis by  57 the Fisher Exact Test yielded a p value of only As no independent attempted,  .10.  assessment of the children had been  i t was not possible t o determine which of the  parents had the more r e a l i s t i c perception.  The two alterna-  tives suggesting themselves were that the patient mothers might be evidencing a certain amount of over-protectiveness or that the patient fathers were reacting with anger and host i l i t y to a c h i l d who d i d require an extraordinary amount of time and attention. Hypothesis 5 was the one hypothesis confirmed i n the study and was formulated i n an attempt  to assess the attitudes  of the two groups of parents regarding the nature o f interpersonal r e l a t i o n s h i p s . The results showed that i n the patient group the parents had a generalized stereotype o f other people i n interpersonal interactions as being "Managerial - Autocratic", "Competitive Exploitive","Blunt - Aggressive", and "Skeptical - - D i s t r u s t f u l " while the parents i n the control group perceived such people as being more accepting and generous.  Looked at i n terms of  the love dimension of the Interpersonal c i r c l e , the majority of the patient parents assigned low love scores to "Others" whereas the control parents' "Other" scores showed higher values 6nr the love dimension. These findings appear to support the studies (Block et a l , 1958; Despert, 1951; Wynne, 1963)  Kanner, 191*9; Perr, 1958; Singer and  reporting that the parents of schizophrenic  58  children were d i s t r u s t f u l and f e a r f u l about interacting with others.  More s p e c i f i c a l l y , the patient parents i n t h i s study  seemed to view others as being rather h o s t i l e , exploitive and unloving.  Such attitudes might be expected to lead to h e s i t a -  t i o n and doubts as to the value of interpersonal interactions and a r e s u l t i n g i n a b i l i t y to form s a t i s f a c t o r y human r e l a t i o n ships • If these attitudes were strong enough they might very well pervade and i n t e r f e r e with adequate functioning of the family and influence adversely relationships with the c h i l d . A further examination of the data on s e l f or s e l f - i d e n t i f i e d heroes at Level III showed that 9 patient parents and 7 control parents obtained scores i n "Managerial - Autocratic", Competitive - E x p l o i t i v e " , "Blunt - Aggressive", and "Skeptical  - D i s t r u s t f u l " octants of the c i r c u l a r continuum (octants  1, 2, 3 and k ) .  These same four octants, i t w i l l be remembered,  had d i f f e r e n t i a t e d the two groups at Level III Other. Of s p e c i a l interest at Level III Hero, however, was the fact that of the 9 patient parents scoring i n these octants, 6 obtained scores which f e l l into octant k, the s k e p t i c a l d i s t r u s t f u l octant.  In the control group, on the other hand,  none of the 7 parents received scores which f e l l  specifically  into octant k. In  other words, the patient parents not only saw other  people as being h o s t i l e and unloving but i n 6 of the 12 cases saw themselves as being skeptical and d i s t r u s t f u l .  This f i n d i n g  59  would seem to offer more direct support for the view that the parents of schizophrenic children are s k e p t i c a l about i n t e r personal r e l a t i o n s h i p s *  In such circumstances It might be  expected that these people would make attempts to avoid such Interactions.  Once i n such a situation, they might also f a i l  to respond i n an appropriate manner.  It should be noted,  however, that this held true for only one-half of the patient parents• It Is interesting to note that o f the f i v e  hypotheses,  only the one involving the TAT, the more projective aspect of the assessment, yielded a significant r e s u l t .  This leads one  to the general question of the degree of defensiveness which may have been aroused In the patient parents by the tests and circumstances of the study.  It must be remembered that the  patient group consisted of the parents of severely disturbed children and as such they very probably had experienced some apprehension as to the possible r o l e they might have played i n the genesis of the disorder. t h i s factor was not present.  In the control group, however,  Thus, i n the present investiga-  t i o n , i t may very w e l l be that the patient parents were at least somewhat aware that an attempt was being made to correlate autism with c e r t a i n abnormalities i n t h e i r p e r s o n a l i t i e s . This i n turn may have led to defensiveness i n responding to such self-referent tests as the MMPI and the Interpersonal Check L i s t , although the absence o f high scores on the v a l i d i t y scales of the MMPI would seem to lessen the probability that  60 t h i s had exerted an undue influence on that instrument* such measures were available, however, for the  No  Interpersonal  Check L i s t scales* In the present  investigation i t must also be remembered  that 5 of the 6 children i n the patient f a m i l i e s had been diagnosed as a u t i s t i c .  Many of the e a r l i e r studies suffered  from a f a i l u r e to specify the exact diagnoses of t h e i r subjects. There has been a tendency for a l l children to be lumped t o gether within the broader category of childhood  schizophrenia  and t h i s has made meaningful comparison of r e s u l t s across these various studies d i f f i c u l t . Furthermore, only a t o t a l of 12 f a m i l i e s , 6 patient 6 control, were studied.  and  The sample size, therefore, was  ex-  tremely small and a larger sample might have allowed for the emergence of more s i g n i f i c a n t f i n d i n g s . Another issue running throughout the study involves the retrospective nature of the methodology used.  It i s f e a s i b l e  to argue that although the parents do not presently show the t r a i t s usually attributed to parents of schizophrenic children, they may have possessed these t r a i t s during the early infancy of t h e i r a u t i s t i c c h i l d . Longitudinal study of t h i s question would, of course, be c r u c i a l , but at present  i t does not seem p r a c t i c a l to attempt  selecting a group of parents on the basis of the fact that they show t r a i t s usually associated with childhood  schizophrenia.  Although the evidence for the importance of family and  parental  61 factors i n the background of childhood schizophrenia i s quite compelling, these factors need to be more c l e a r l y defined and corroborated before such an undertaking would be worthwhile. In conclusion the attempt made i n the present study to operationally define and test some of the characteristics of the parents and families of schizophrenic children reported i n the l i t e r a t u r e has f a i l e d to arrive at any clear-cut differences between a group of parents of a u t i s t i c children and a control group o f parents of adequately  functioning c h i l -  dren. Despite the great efforts to cope with the problem of etiology i n childhood schizophrenia, It s t i l l poses a major dilemma.  The lack of consistency i n the findings can be large-  l y a t t r i b u t e d to a p a r t i a l or t o t a l neglect of important variables.  Designs i n future research should deal with such  variables as social class, ethnic o r i g i n , age, diagnostic categories and r e l i g i o n .  U n t i l these variables are accounted  for and specified i n research p r o j e c t s , inconsistency and confusion w i l l hinder r e a l progress towards a better  understanding  of the problem. More importantly, a continuation of attempts at global assessment of the parents would only add to the present  chaos.  The l i t e r a t u r e reported up to this period, although often f a u l t y i n design, has provided s u f f i c i e n t leads f o r other  62  workers t o I n v e s t i g a t e .  E f f o r t s should be made t o s i n g l e out  more l i m i t e d aspects of the problem such as "empathy".  Until  the parameters o f these i n d i v i d u a l v a r i a b l e s are more f u l l y explored and made e x p l i c i t , t r u l y e f f e c t i v e study of the more general problem w i l l not be p o s s i b l e .  APPENDIX A  THE INTERPERSONAL CHECK LIST A SAMPLE PROTOCOL  The Interpersonal Check List  Name  "--  Age  Sex  Addres s  C ity  Occupation  Marital Status  Group  Other  Date  Testing #_  Phone  E ducat ion  64  Referred by  DIRECTIONS: This booklet contains a list of descriptive words and phrases which you will use in describing yourself and members of your family or members of your group. The test administrator will indicate which persons you are to describe. Write their names in the spaces prepared at the top of the inside pages. In front of each item are columns of answer spaces. The first column is for yourself,and there is another column for each of the persons you will describe. Read the items quickly and fill in the first circle in front of each item you consider to be generally descriptive of yourself at the present time. Leave the answer space blank when an item does not describe you. In the example below, the subject (Column 1) has indicated that Item A is true and and item B is false as applied to him. Item 1 2 3 U 5 6 7 8  A # 0 0 0 0 0 0 0  well-behaved  1 2 3 1 + 5 6 7 8  B OOOOOOOO  suspicious  After you have gone through the list marking those items which apply to you, return to the beqinning and consider the next person you have been asked to describe, marking the second column of answer spaces for every item you consider to be descriptive of him (or her). Proceed in the same way to describe the other persons indicated by the test administrator. Always complete your description of one person before starting the next. Your first impression is generally the best so work quickly and don't be concerned about duplications, contradictions, or being exact. If you feel much doubt whether an item applies, leave it blank.  This booklet has been prepared by Timothy Leary, Ph.D., and published by the Psychological Consultation Service, 1230 Queens Road, Berkeley 8, California. The Interpersonal Check L i s t was developed by Rolfe LaForge, Ph.D., and Robert Suczek, Ph.D., and other staff members of the Kaiser Foundation Research Project in Psychology.  Column 1  Self SUBJECT'S  NAME  SAMPLE: 1  2  3  4  5  6  7  8  2  3  4  5  6  7  P  2  3  l  O  l  1  2  3  4  5  o  6  8  7  M  4  5  2  3  4  5  6  2  3  4  5  6  2  3  4  5  6  2  3  4  5  6  7  1  2  3  4  5  6  7  1  2  3  4  5  6  8  D l O l O l l O O ,1  2  3  4  5  6  7  8  1  2  3  4  5  6  7 8  2  3  4  5  6  7  E O O O O O O O O 1  2  3  4  5  6  7  8  1 2  3  4  5  6  1  2  3  4  5  6  G l l l O f 1  2  3  4  7  8  8  6  7  8  2  3  4  5  6  7  8  1  2  3  4  5  6  7  I  I  J J  1  2  3  O  O  O  1  2  3  4 O 4  5  6  O 5  7 O  6  8  O  1 2  3  4  5  6  7  8  i l l O l l O O 1  2  3  4  5  6  7  8  O O O O O O O O 1  2  3  4  5  6  7  8  K##4C##00 1  2  3  4  5  6  7  8  K O O O O O O O O 1  2  3  4  5  6  7  8  L l l O O l l O O 1  2  3  4  5  6  7  8  L l i l O l t O O 1  2  3  4  5  6  7  8  M i i l l M O O 1  2  3  4  5  6  7  8  M # # # 0 # # 0 0 1  2  3  4  5  6  7  8  N I H O I A O O 1  2  3  4  5  6  7  8  N l l l O l l O O 1  2  3  4  5  6  7  8  0 © # « O « * O O 1  2  3  4  5  6  7  Col. 1  Date  Self  8  O O O O O O O O O  5  4  3  6  5  4  3  2  7  7  6  8  6  7  5  6  7  4  5  6  3  4  5  6  2  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  6  7  Self  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  6  7  45 46  1  2  3  4  5  6  7  1  c a n be obedient  21  3  4  5  6  7  2  3  4  5  6  7  1  2  3  4  5  6  7  1  22 a d m i r e s a n d Imitates others  3  4  5  6  2  3  4  5  6  7  1  24 very a n x i o u s to be approved of  1  25  2  3  4  5  6  7  2  3  4  5  6  55  8  cooperative  1  26 e a g e r t o g e t alcjng w i t h o t h e r s  3  4  5  6  7  2  3  4  5  6  8  7  1  28 a f f e c t i o n a t e anr) u n d e r s t a n d i n g  3  4  5  6  7  8  I l l f l l l O O 1  29  2  2  3  4  5  6  7  8  1  30 others  31 helpful 32 big-hearted and unselfish  2  3  4  5  6  7  1  2  3  4  5  6  7  2  3  4  5  6  7  O O O O O l O O  59 neighborly  60 61  63 enjoys taking care of others  8  7  3  4  5  1  1  8  6  7  4  5  6  7  4  5  6  3  4  5  6  8  2  3  4  5  6  7  3  4  5  6  7  2  3  4  5  6  7  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  6  7  2  3  4  5  64 gives freely of self  6  7  2  3  4  5  6  7  2  3  4  5  6  7  4  5  6  3  4  5  6  7  74  3  4  5  6  7  75  3  4  5  6  2  3  4  5  6  77  2  3  4  5  6  7  2  3  4  5  6  1  2  3  4  5  6  2  3  4  5  6  7  4  5  6  7  8  2  3  4  5  6  7  8  2  3  4  5  6  7  8  2  3  4  5  6  7  8  82  87  91  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  2  3  4  92  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  5  6  7  8  ;  o v e r s y mpOthotic  95 generous t o a fault  96 overprotectlve of others  4  2  3  5  6  7  8  OOooo 4  5  6  7  8  2  3  4  5  6  7  8  2  3  4  5  6  7  8  2  3  4  5  6  7  8  2  3  4  2  3  5  6  7  8  OOooo 4  5  6  7  8  2  3  4  5  6  7  8  O O O O l O O O 1  forgives anything  3  oooooooo 1  93  2  ooo 1  fond o f everyone  94  8  oooooooo 1  l i k e s everybody  8  7  oooooooo 1  w i l l confide in anyone  8  8  fooled  90  8  oooooooo  88 89  8  O O  6  oooooooo 1  too e a s i l y influenced by friends  8  5  2  3  4  5  6  7  8  oooooooo 1  2  3  4  5  6  7  8  O O O O l O O O 1  2  3  4  5  6  7  8  oooooooo 1  2  3  4  5  6  7  Col. 4  Col. 5  Id. Moth, F a t h , C h i l e S e l f Initials  Initials  Initials  Initials  Col. 6  Col. 7  Col. 8  Initials  Initials  AP  AP  BC  BC  DE  DE  FG  FG  HI  HI  Sp. Initials  .3  P  AP  AP  99 manages others  7  ]0O dictatorial  4  3 4  BC  BC  DE  DE  AP  AP  p  c BC  AP  BC  BC  r. AP  7 BC  101 somewhat snobbish  4-  102 egotistical andconceited  , 6 DE  2 DE  5 DE  5 DE  103  8  oooooooo 1  lets others make d e c i s i o n s  8  #o O  4  OOO 1  w a n t s t o be l e d  easily  7  O O O O O O O O  1  86  8  3  6  O O O O O O O O  1  dependent  8  2  5  O O O O O O O O  '  85  8  1  1  84  8  4  O O O O O O O O  1  p a s s i v e and u n a g g r e s s i v e  meek  3  O O O O O O O O  83  8  8  1  shy  8  2  oooloooo  Bl self-punishing  8  oooooooo 1  3  expects everyone to admire him  O O O O O O O O 1  slow to forgive o wrong  8  7  7  2  Col. 3  P  98  8  O O O O O O O O  1  80  8  oooooooo  78 complain in< |  jealous  oooooooo 1  7  O O O O O O O O  1  79  8  oooooooo 1  6  O O O O O O O O  bitter .„  8  1  1  often unfriendly  8  7  7  5  O O O O O O O O  76  oooo#ooo 1  4  tries to be toos u c c e s s f u l  O O O O O O O O  1  outspoken  8  O O O O O O O O 2  mistakes  |  self-seeking  O O O O O O O O 2  3  Col. 2  97  8  O O O O O O O O 1  i m p a t i e n t w|ith o t h e r s '  O O O O O O O O 2  |  73 '.  8  7  72  1  shrewd.ond c a l c u l a t i n g  8  7  2  O O O  t h i n k s only) o f h i m s e l f  8  7  7  O O O O O O O O  O O O O O O O O  1  tender and soft-hearted 8  6  6  O O O O O O O O  8  O O O O O O O O  1  62  6  0 0 O O O # O O 1  58  kind a n d r e a s s u r i n g  O O O O O I O O  7  oooloooo  1  worm  l l l o l i o o  considerate  57  sociable and  6  5  1 2 3  wants everyone to like him 8  l « « O I I O O  friendly  56  a l w a y s pleasant and agreeable  ooo»»ooo 1  27  2  1  8  l o o l o o o o  1  trusting a n deager to please  O O O O I O O O  7  O O O O O O O O  1  accepts a d v i c e readily  8  7  54 vary r e s p e c t f u l t o authority  M I I I I O O  6  5  O O O O O O O O  O O O O O O O O  1  often h e l p e d by others  8  1  8  O O O O O O O O  53  O O O O O O O O  appreciative  5  5  4  3  2  1  modest  7 8  7  O O O O O O O O  52  # 0 0 0 0 0 0 0 1  23  2  4  4  3  2  1  easily led  8  6  4  O O O O O O O O  O J O O O O O O  1  51  0 0 0 * 0 0 0 0  grateful  emborrossed  50  O M O I I O O  1  8  O O O O O O O O  1  locks self-confidence  8  2  2  1 hurt  8  8  7  O O O O O O O O  48  O O O O O O O O 1  usually gives ii  2  5  3  3  2  1  touchy and e a s i l y  8  6  O O O O O O O O  1  47  O i O S O O O O  apologetic  5  3  O O O O O O O O  O O O OOO O O  hard t o impress  O O O O O O O O  4  3  2  1 bossed  skeptical  easily  1  8  O O O O O O O O  1  straightforward and direct  8  7  O O O O O O O O  44  O O O I O O O O  6  4  2  2  1  irritable  8  5  2  O O O O O O O O  O O O O O O O O  43  O O O l O O O O  1 self  2  necessary  42  8  4  3  2  1  resents being  1  8  O O O O I O O O  1  stern but f a i r  8  7  O O O O O O O O  1  hard-boiled when  O O O O O O O O  6  O O O O O O O O  41  8  2  1  40  O O I I O O O O  5  O O O O O O O O  1  l i k e s to compete with others  8  3  1  businesslike  8  4  O O O O O O O O  39  8  7  37 38  8  7  responsibility  self-reliant a n d assertive  8  2  1  self-confident  8  7  5  4  3  2  1  frequently disappointed  encourages  6  3  O O O O O O O O  36 likes  2  1 2 3  good leader  O O O O O O O O  1  a b l e t o d o u b t oljhers  20  O O O O O O O O  35  8  7 8  5  4  3  2  1  19  8  6  1  respected by others  7  O O O O O O O O  18  8 O  7  14 often gloomy  able to criticize  H O O ' O O O O O O  6  1  34  8  o o o M o o  1  17  H # # # 0 ® 0 0 0  7  f l M H o o  16  C O O O O O O O O 1  Col. 8  O O O O O O O O  often admired  O O O O O O O O  1  15  l O O  5  honest  12  13  7  5  4  3  2  1  11  c a n c o m p l a i n if |necessary  F O O O O O O O O  33  8  t««oi#oo  c r i t i c a l o f other^  F I I I I I I O O  6  5  4  3  2  1 just  c a n be frank a m 8  5  4  3  2  1  ID  E l i l O l i O O 1  2  to others  9  f i r m but  4  3  -2  Indifferent  c a n be strict if jiecessary  D l l i O l l O O  7  O O l O O O O O  8  7  3  2  1  can be  6  l o l o l i o o  a b l e to take care of self  C i l l l l l O O  5  O I I O H O O  1  7  8  2  1  6  C # # # 0 # # 0 0  4  l o i o i # o o  independent  8  3  O O O O O O O O  5  8  2  1  self-respecting  B l l l O l l O O 1  orders  forceful  8  7  Impression  4  B M I O M O O 1  Ideal  1  able to give  8  7  flood  3  A O O O l O l O O 1  Col. 5  1  molce« «  8  7  Father  O O O O O O O O  2  A M I O I I O O 1  Col. 3' 1  1  O  7  Child  Initials  well thought of  8  O 6  Col. 4  well-behaved  P l I l M l O O 1  •otaer  0  A I O I O I I O O 1  Col. 2  8  oooooooo  selfish  2  104 cold and unfeeling  FG  105  3 FG  2 FG  4 FG  2  2  FG  FG  sarcastic  106  2  cruel and unkind  HI  107  3 HI  2 HI  C. HI  2 HI  1 HI  frequently angry  108  4  hard-hearted  109  JK  3 JK  •%  J JK  4 JK  3 JK  3 JK  JK  JK  LM  LM  NO  NO  DOM  DOM  resentful  110  6  rebels against everything  111  LM  stubborn  3 LM  LM  LM  10 LM  6 LM  112 distrusts everybody  4  113  NO  timid  4 NO  4 NO  0 NO  5 NO  7 NO  114 always ashamed of self  D  obeys too willingly  116  12.0  3.4  13.1  7.2  5.5  7.6  5.5  4.5  11 . 6 1 0 . 9  9.9  vz. P  15.6  13.0  6.2  12.0  1 1.3  s  spineless  117 hardly ever talks  6.2  P  back L  118 clinging  14.  8.6  1C.7.  115  vine  119 likes to be taken care o f  H  11.3  120 will believe anyone  P. Q  11.6  121 wants everyone's  love  agrees with everyone  - 4 . 2 ' 7 . 6 10.3  1.4  122  DOM  DOM  DOM  c.3  ? o -1.7  LOV  LOV  DOM  DOM  DOM  123 f r i e n d l y a l l the t i m e  124 loves everyone  125 too lenient with others  126 tries to comfort everyone  127 too w i l l i n g t o g i v e to others  128 spoils people with  kindness  LOV  -0.4 LOV  3.6 LOV  1 .7 LOV  LOV  LOV  1  APPENDIX B A SAMPLE M.M.P.I. PROTOCOL  Profile and Case Summary  The Minnesota Multiphasic Personality Inventory Starke R. Hathaway and J. Charnley McKinley  Address.  Scorer's Initials 3 Hy  115  -  110—  4 Pdt.4K  S Ml  6 Pa  i'ir. D  Name  Date Tested  Occupation_  7 8 9 Pi +1K Sc + IK Ma+.2K  Tor Tc  Male  For Recording Additional Scales  _Age  — 120  Education^  r  Marital Status  115  .Referred by.  —no  105 -_  105  r  100-^  NOTES  ^-100 70-  95 ;  65-;  Fractions of K  90-T 6085 ^ 130 —  80^ 75 -_ 70—65 -  120110-  -  75  IXM.  =  LOV.  45-^-70  TT  10090-  40  2515*  605040-  85  M  -D  H3 - Fr  50-  30-  35  55 -  -  55-  20*  r  65  50——30 —  -5 -1  Total  =  -6  = 70-46 = 69-59  = =  24 10  = 34  HAW SCORE INDICES FOR LEVEL I: L-vri =  30^ ~- 55  5-  = =  Total  - ^-60  20-  K-F Hv-Sc  = 53-58 = 59-60  LOV  -6  = 34  '25-=- ^-50  45 -  0—  20^  45  r  40 —  W-_ ~ 35  35 30  T  -_-  25 -  - r 25  20  j-20  46  0 — TorTc  Haw Score  46 70 K  59 58 69 69 Hs<-.5K 1  1_ K to be added 12_ Raw Score with K 15  Printed in U.S.A.  Hy 3  Pd+.4K 4  65 59 60 59 53 Mf 5  Pa 6  PMK 7  Sc+IK Ma+.2K 8 9  — 0 Si  TorTc  ±2^JL.^23-1^2§L2±5-$-±1 J± 22-2328 27 18 27  Copyright 1948. All rights reserved. THE PSYCHOLOGICAL CORPORATION 304 East 45th Street New York 17. New York  Signature. 60-142S  _Date  Profile and Case Summary  The Minnesota Multiphasic Personality Inventory Starke R. Hathaway and J. Charnley McKinley  l  Hy  4  5  6  Pd + .4K  Mf  Pa  7 Pt+1K  8  9  0  Sc+IK M O K 2 K  SI  TorTc  Female  For Recording Additional Scales  Marital Status.  105 -  • 105  100-  -100  95 -  • 95 65-  90-  -90 60 • 85 5  T  130-  75 -  70-  • 75 4 5  ~ -70  100-  40-  90-  65 -  -80  50  110-  - 65  -60  606050-  55 -  30-  4050-  -30-  -25-  45 -  i5-  40-  35 -  20;  • 45  15-  -40  1010-  305-  25 -  -30  • 25  20-  0Hs-.5K  1  Hy 3  Pdr.4K  Mf  Pa  Pt-IK  4  5  6  7  Sc*lK Ma-.2K  8  9  Si  .Age. Referred by NOTES  -110  5  Date Tested_  Education  60-  120-  Female  Occupation^  115  60-  F  —  Address.  Scorer's Initials.  Hs-.5K  N a m e  TorTc  0  Raw Score. K to be added Raw Score with K  Signature  67  APPENDIX C RATIONALE UNDERLYING -'Dom" and "Lov" EQUATIONS  68  Dom = 0.7. (BC + NO - FG - JK) + AP - HI Lov = 0.7 (JK + NO - BC - FG) + LM - DE In a r r i v i n g at these equations, the c i r c l e was considered to be a two-dimensional array In ordinary E u c l i d i a n space and conventional trigonometric and analytic  formulae,  therefore, related the 16 variables shown i n Figure 2. Each c i r c l e was viewed as a set of eight vectors or points i n a two-dimensional space.  The vector mean of these points was  selected as a measure of central tendenoy. A vector i n two-dimensional space could be represented numerically by the magnitude of i t s components i n two a r b i t r a r i l y selected d i r e c t i o n s . as reference d i r e c t i o n s .  AP and LM were chosen by Leary  The designations Dom and Lov r e -  spectively were given to the components of the vector sum i n these two d i r e c t i o n s . The formulae f o r the two components of the vector sum were: (see Leary, 1957. p. 6 9 ) . 16 1) Dom = R i s i n and . 1=1  2) Lov = R* cos where R. i  the score i n i - t h . category the angle made by moving i n counter-clockwise  direction.  from L to the i - t h . category (from LM i f octant scores are used).  69  In the present study octant scores were used and, as recommended by Leary, 0.7 was taken as the value of s i n Thus the following s i m p l i f i e d formulae  resulted:  Dom = 0.7 (BC + NO - FG - JK) + AP - HI Lov = 0.7 (JK + NO - BC - FG) + LM - DE where AP = score i n octant AP, e t c .  APPENDIX D TAT MOLAR RATING SHEET A SAMPLE PROTOCOL  TAT MOLAR RATING SHEET S u b j e c t . . . MB..D  Group  Rater....!  # I 2  oBM  .?SU? t... n  TAT No.  Rater OTHER HERO ROLE  .A  Date Judge  2  HERO ROLE  OTHER ROLE  .?9Y. t . ? t  M  .?<?*  .V?Y3  9 t  HERO ROLE  OTHER ROLE  HERO  HERO ROLE  boy family  1<  boy family  JP M  boy family  boy  I  boy man man man  I H H NM  woman  N N  woman  M  OTHER  JP  OTHER  HERO  OTHER  JP L  GF  boy  I  il- -  man man man  H H NM  woman woman woman  N N M  man man man  H H NM  woman woman woman  N  J  man  PL  boy hypno.  J  man  PL  A  bo^ hypno•  J A  man  PL  J  6BM 6GP 7  BM  'GF  12M.  13MP -oBM 1°GF  boy hvono•  A  0 M  woman  man  PH  woman  0  man  PH  woman -  N  man  PH  woman  N  man  r  hands  0  man  r  others  0  man  r  others  0  AP  :BO :DE ~FG HI L_JK "LM NO ; Total Dom Lov  HERO  OTHER  2  1  1  $  2 2 1  -lull  34  2 h  3.8  IL.8  TOTAL  APPENDIX E RECORD BOOKLET POR INTERPERSONAL DIAGNOSIS OP PERSONALITY A SAMPLE PROTOCOL  73  Code for the Interpretation of the Symbols Pound on Page 3 of the Record Booklet Por  the Interpersonal Diagnosis of Personality  IS-  MMPI = Measure of "Self" at the l e v e l of public coramunicat ion as-determined by MMPI i n dices .  II S - ICL = Measure o f "Self" at the l e v e l of conscious communication as-determined by scores from the Interpersonal Check L i s t . III H- TAT = Measure of the interpersonal themes attributed to the Hero at the l e v e l of preconscious symb o l i z a t i o n as determined from ratings of TAT stories. I l l 0- TAT = Measure of the interpersonal themes attributed to Others at the l e v e l of preconscious symb o l i z a t i o n as determined from ratings of TAT stories. II M - ICL = Measure of the subject's view of h i s mother at the l e v e l of 'conscious communication as determined by scores from the Interpersonal Check L i s t . II P - ICL = Measure of the subject's view of his father . . . at the l e v e l of conscious communication as determined by scores from the Interpersonal Check L i s t . II Sp- ICL = Measure of the subject's view of his spouse at the l e v e l of conscious communication as determined by scores ftfom the Interpersonal Check L i s t . II Ch- ICL = Measure of the subject's view of his c h i l d .. . „ at the l e v e l of conscious communication as determined by scores from the Interpersonal Check L i s t . V Id - ICL = Measure of the subject's view of what i s right or i d e a l at the l e v e l of conscious communicat i o n as determined by scores from the Interpersonal Check L i s t .  Record Booklet For  7k-  Interpersonal Diagnosis of Personality Subject  LAST  r.EsT  NAME  NAME  Address.  A  9  e  S  e  X  D  .City  Occupation  0  t  e  .Testing  •  .Phone  .Education. Occupation of Spouse  Marital Status  Referred by  #.  .Therapist.  Group.  Other  Identifying Codes for Clinical and Sociological Data Sex  Therapist  17  Age  T y p e of Therapy  18  Religion  T i m e s Seen  19  Number of Siblings .  Disposition  20  Marital Status . . . .  Condition  21  .  ,  T e s t s covered by this record:  . ,  ,  34  Name  35  MMPI  Form  Testing #  ICL .  37  IFT TAT  Number of Children  Subject's Occupation . .  7  Occupation of Mother . .  8  Occupation of Father . .  9  Occupation of Spouse . .  10  _40  -24  -41  -42 _43  Subject's Education . . .  11  Mother's Education . . .  12  Father's Education . . .  13  Spouse's Education . . .  14  _44 -28  -29  Referred by .  -15  -31  Previous  _16  .32  Consultations  This booklet was prepared by Timothy L eary. P h . D . , and published by the P s y c h o l o g i c a l Consultation Service, 1230 Queens Road, Berkeley 8, C a l i f o r n i a . C h e c k l i s t s , booklets, templates, norms, and instruction manuals can be obtained from the P s y c h o l o g i c a l Consultation Service. R e v i s e d 7/1/57. - 1-  Indices of Variability Among Levels of Personality Raw  Level and Person  Score  Standard Score  Test D  IP Diagnosis  D  L  Verbal Definition of Index  SELF-DECEPTION  'is I II  MMPI  s s  III H  III MM II M II F II  Sp  ICL  TAT  III M  ICL ICL ICL  ICL  IFT  III  IFT  III _ III _  65  8*  REPRESSION Other  4 . 5 - 4 . 4 3 . 8  0 . 3 3 . 4 4 . 8  .  59 54 66  49 61 70  1#  8  8  1 . 4  2 . 0  6 . 5 - 1 . 7 1 0 . 3 - 4 . 2  7 . 6  1.7 - 0 . 4  3 . 6  55  50  62  46  67 48  4 4  1 2  50 4 8  4 4  4  4  IFT  III F Sp  58  MMPI  ICL V Id  3 4  Socio.  TAT  III 0  - 6  IFT IFT  ; # Un<i e r l i n e d f i g ' j r e s den Dte s x t r Sur unary  po i n t s v/hl' Le u i l i n 3d  f i ; cures de note mod-;rat 2 su; nmar po: .nts.  REPRESSION Hero  CONSCIOUS Maternal  IDENTIFICATION  CONSCIOUS Paternal  IDENTIFICATION  CONSCIOUS Marital  IDENTIFICATION  CONSCIOUS  IDENTIFICATION  Operational De finition of Index  is  K i n d of Discrepancy D  L  Amount of Discrepancy  ns  81  41  ns  IIIH  18  41  iis  mo  18  41  IIS  HM  11  0  IIS  IIF  12  41  IIS  II Sp  1  1  23  ns  iiid  EQUATION Mother-Father  IIM  HF  12  41  EQUATION Mother-Spouse  IIM  IISp  11  23  EQUATION Father-Spouse  HF  IISp  21_  4 4  CONSCIOUS SELF-ACCEPTANCE  IIS  VId  14  62  IS  VId  8 4  91  PRECONSCIOUS SELF-ACCEPTANCE  IIIH  VId  8 4  91  PRECONSCIOUS SELF-ACCEPTANCE  SELF ACTUALIZATION  mo  vid  8 4  91  MATERNAL IDEALIZATION  HM  VId  14  62  PATERNAL IDEALIZATION  IIF  VId  2 4  66  SPOUSE IDEALIZATION  nsp vid  14  8 4  PRECONSCIOUS IDENTIFICATION—Maternal  IIS  HIM  PRECONSCIOUS IDENTIFICATION—Paternal  IIS  IIIF  PRECONSCIOUS IDENTIFICATION—Marital  IIS  IIISp  PRECONSCIOUS I D E N T I F I C A T I O N -Maternal  IIIH  IIM  PRECONSCIOUS IDENTIFICATION—Paternal  HIH  IIF  PRECONSCIOUS IDENTIFICATION-Marital  nm  lisp  FUSION Maternal  IIM IIIM  FUSION Paternal  IIF  FUSION Spouse  nsp iiisp  DISPLACEMENT Maternal—Paternal  IIM niF  DISPLACEMENT Maternal—Cross-sex  IIM IIISp  DISPLACEMENT Paternal—Maternal  IIF  IIIM  DISPLACEMENT Paternal—Cross-sex  IIF  IIISp  DISPLACEMENT Spouse—Maternal  nsp IIIM  DISPLACEMENT Spouse—Paternal  IISp I D F  IIIF  Sp.. M i s p e r c e p t i c n (Mr. I I S - M r s . I ISp.) i  Diagnostic Codes  Mr. Ch.-Mrs. Ch.  14  8 4  4 5  26  -  4 -  Verbal Summaries of Variability Indices Subject misperceives h i s o w n .  Subject's preconscious acceptance of s e l f is_  Subject is c o n s c i o u s l y identified w i t h .  Subject's preconscious acceptance of s e l f (deeper) i s .  Subject i s consciously disidentified with_  Subject c o n s c i o u s l y i d e a l i z e s .  Subject r e p r e s s e s .  Subject c o n s c i o u s l y d e v a l u a t e s .  Subject represses  (deeper)L_  Subject c o n s c i o u s l y equates. Subject's conscious acceptance of s e l f i s _ _ _ _ _ Subject's selfactualization is _  Subject displaces his preconscious image o f .  Subject is preconsciously identified with_ Subject is preconsciously d i s i d e n t i f i e d with_ Subject fuses his conscious and preconscious images  of_  Subject diffuses his conscious and preconscious images of_ _onto his conscious perception of_  Clinical Notes  APPENDIX P SUMMARY OP RAW SCORE INDICES FOR PATIENT AND CONTROL FAMILIES  Patient Parents V0  Parent  D Mr. A. 1 -2 Mrs. A Mr. B. 5 Mf s .. B -9 • r< Mr.' G. Mrs. G -36 c Mr. 'D -u Mrs. D 6 2 Mr. "E Mrs. E -15 Mr. "F -4 Mrs. F - 2 3  IS  .L 9 21 7  22 32  20 34 -1  t->  IIS  D . L k.ti 1.8 -2.0 2.4 0,2 9.6 2.5  5.5  0,1  -9.8 k.5 -1,7 6.5  22 10.2 3 16.5 18 -10.6 Parent  -5.9 18,2 0*3 2.1 -3.5  7.2 -•10.. -\ 13.0  D  9.6 Mr. A Mrs. A 8 . 9 Mr. B 3.9 Mrs B 6.9 Mr. a - 2 . 3 Mrs. G 7 . 8 Mr. D 1 0 . 3 Mrs. ,T>- 5 . 7 Mr. E . 7 . 9 Mrs. E 7 . 1 Mr. F 1.6 Mrs . -F 8 . 7  IIIH IIM . rao L D L D . .L D 9.9 4.9 -2.3 2.1 2.1 -2.7 - 7 . 3 -2.1 -1.1 -4.1 3.7 -4.7 -2.1 5.2 1 5 , 8 - 8 . 5 -k.5 -0.7 -6.8 - 2 . 4 5.9 6.9 l.k -3.6 -6,1 -1.7 0.1 0.7 -2.1 3,7 1,0 1.0 2 3 . 7 -119 -7.4 -2.k 3.8 4.8 -a.it 34 l.k 2.0 2.1 - 1 . 7 - I . I L -5.6 - i . 7 -2.5 3.0 0.0 11.5 -3.1 -6.6 -2.8 -2.0 -1.8 10.9" 6.9 1.4 - 0 . 4 0.0 1,0 -5.2 -7.8 8.7-I4.I - 6 . 4 -l.k 0 , 3 13,0^ 0.6 2,5  IISp. L 5.2 0.7 11.7 5.5 7.5 -10.6 1.7 -13.9  -k«5 -5.i  23.6  -7-5  IlCh. L D . -k.2 -o.k 0.7 -1.7 1.1 -3.1 -10.7 -4.2 -6.2 -4.5  -k.8 -0.7 -0.7  -2.1 -1.1 8.7 0.3 -0.5  -O.k  0.0 -5.1 2.8 -6.7 7-3  VId. D . L 6.5 10.0 5.2 6.6 10.6 12.7 7.6 6.3 9.9 11.3  lk.O 8.2  1.7 1.0 12.0 4.8 -1.0 15.3 3.6 6.9 -0.3 6.5 -4.8 6.2  IIF D . L 7.4  14 5.5 5.1 - 8 . 1 2.3 -7.5 0.7  5.8 -5.8  10.7  6.5  16,9 -1-7  6.9  1.3  -2.7  2.7  12.6  -0.6  11.6- •10.6 1 5 . 7 -6,1  Control  IS  Parent Mr. Mrs Mr. Mrs Mr. Mrs Mr. Mrs Mr. Mrs Mr. Mrs  D  a  . a  b . b c  .  a  0  i-  . -e f . f  -7 -12 12 -23 -13 1 -10 -31+  21 -9 -5 3  L  13 37 3 13 -1 -11 31 27 13  8  ik  .; 3  IIS  Mrs. a Mr. b Mrs . b Mr. 0 Mrs. c Mr. d Mrs. d Mr. e Mrs. e Mr. f Mrs. f  2.6 13.6 0.7 -I4..1 -6.8 3,5 0.7 6.2 4.7 5.8 -64  IISp.  Parent  Mr. a  IIIH  "D. . L  7.2 5.6 2.8 7.9 -9.6 -I+.3 1.5 -5.0 10.5 -7.4 -7.2 -0.6  L  6.5 6.1 8.8  0.2 -5.1 5.2 3.1  -k.k 7.7 3,7  Parents  2.7 8.9 -1.2 -9.6 -12.2 -2.3 5.8 9.3 8.2 -9.3 0.3 2.9  D  IIIO  . L -3.5  -0.-9  -1.0 1.8 k.o -5.2 -04 -0.1 3.8 -2.1 0.2 -1.7 0.0  -2.k  -3.8 -8.0  -k.O  -8,8 -7.5 -3.6 -6.1  -2.3 -5.0 D  5.8 04 -1.5 10.1  -14  -9.6 -1.7 0.0 3.8 2.0 2.7 -1.0  IIM  D. . L  -0.6 1.1  -1.0 1.7  -1.3 0.7 -1.7  3.0 0.7  k-k 1L,8  -0.6 3.8 -2.1 -14 1.1  HCh.  L  10.8 3.8  0.1  -2.9 -8.6 6.0 11.9 12.6 4.2 74 6,3 0.2  k.o lj-5  6.8 0.0 0.0 3.3 0.0 0.7  D  24 12.7 8,9 8.5 10.6 14 6.2 11.3 9.9 7.8 6.2  D.  L  D  IIP  . L  1.8 5 4 9.2 2.0 6.3 17.1 3.1 11.9 -1.2 4 . 3 -12.0 0.5 -9.8 20.0 114-13.8 7.9 6.1 -3.9 -0.7 5.1 -6.1 6.5 0.1 1.5 5.5 -0.3 1.7 7.9 10.3 3.1 7.5 3.3 3.7 11.2 -5.6 94 -04 3.7-10,7 0.9 -5.9 12.6 7.0 10,0 5.8 1+.3-10.3  VId.  L  13.8 -1.7 6.7 1.8 1.0 9.6 -3.5 8.5  k.k 74  APPENDIX G SUMMARY OF STANDARD SCORES FOR PATIENT AND CONTROL FAMILIES  Patlent Parents Mr. A. Mra. A Mr. B Mrs B Mr. C Mra. G MT%  T)  D  M m . Mr>.  Mra, MK.  V,  1?  E  w  Control Parents Mr.  a  IS  D. 61 56 •59 60 62 55 56 60 58 6i| 1+5 60 58 65 63 52 61 5I| *h 60 58 53 51 59 IS  P u  Mrs. a Mr. b Mr a . h Mr. <3  55  Mr. d Mr a . d Mr. o Mra . e Mr. f  56 Ii6 69 56  65  51 55  -5B61  IIIH  IIS  D 60 57 *}| 57 hi 59  51  69 >|2  It 9  51  62 >i'i 67 56 37 75 1—«»*— — ^ i —  ho  IIS  L 57 66 53 57 52  —  L 50 1+6 59 5f|  6^  D L 63 50 61 63 62 53 6|| _ k k in in _ i 8 52 6*1 56 J|9 62 l]7 fe 57 67 1+3 55 hh 55 -57- ||5 53 53 in  IIIO  L L D D 60 57 59 1+1 1+5 1+3 1+6 35 35 kl 1+3 17 U 37 1+9 10+ 51 65 l|5 p 51+ •55 61 66 70 5f| 62 1+1 59 kk 1+7 So 63 51 61 1+9 1+1+ )|fi 50 5!l 31 Ji5 61 5?  D 66 58 60 61 55 81+ 55 52 68 67 65  IIIH  IIM  D 61+ 60 56 1+3 55 1+1 1|5 56 1+9 51+ 60 52  1110  L 38 1+6 56 63 32 1+8 59 62 1+3 50 l|l| 50  HP  IIIM  70  D  L D 1+7 56 55 58 62 68 66 52 1+5 63 i+l 53 1+3 68 70 77 56 1+8 51 % 66 51 53 111 61+ 66 1+1+ 51 55 55 % 66  H  L  D 51+ 63 55 66 60 56 57 1+6 61 1+6 67 50 62 1+2 70 1+5 62 56 68 32 71+ Il9 50 IIP  L  D 65 67 58 1+3 38 71 68 kl 61+ 1+8 60 51+ 53 60 58 52 68 1,8 58 1+2 70 55 59  r  HSp.  IlCh.  V Id.  L L D 1+3 1+0 1+0 1+6 51 39 1+7 36 62 58 1+0 1+7 1+9 53 35 58 60 68 1+8 kk 1+1+ P 39 51 1+2 51 36 51 55 5o 1+1 61+ 27 56 It 5 5© V Id. Ch.  D 66 65 59 62 k 51 67 61+ 1+6 67 1+8 1+6 50 61+ 36 63 111 56 *T—H 51 65  L 51+ 1+9 61 51+ 57 36 50 33 1+3 1+2 75  L 50  D L D L 51 61 60 1+5 k8 58 5«+ 52 27 1+6 1*7 52 1+8 60 65 37 662 1+8 33 38 31+ ? 1+6 51 " 5 1+6 T i 55 3 55 51 62 21+ 39 59 51+ 62 62 57 61+ 55 30 38 56 51 5 T 1+9 57 55 1+1+ ~W f l ^52 1+8 "39 ~52-  L 50 51+ 39 1+0 2  IISp.  D 62 b'd 61 1+9 55 33 65 55 51+  l+l  5o  &36 ?7  56  37  kl  60 58 1+8  63  58 58 ~  D 53 55 51 55 50 1+0  U56s  1+8  W  53  53 II  L  ~f8  ~w _  APPENDIX H-SUMMARY''OF OCTANT SCORES FOR PATIENT AND CONTROL FAMILIES  Pat l e n t Parents  IS  IIS I I I H IIIO IIM I I P IISp. I l C h . V I d .  Mr. A  1* 1*  3  Mrs. A  8  2  k  Mr. B~  1  8  k  Mrs. B  8  1  Mr. C  8  1  1  1  3  2  8  1  2  k  8  2  8  3  k  }  1  2  1  8  3  3  1  2  2  7  3  Mra.C  L_ 7  k  8  1  8  2  8  Mr. D  8  1  8  8  1  2  1  k  Mrs. D  1  8  2  2  3  1  Mr. E  1  2  Ik  1  2  1  2  8  1  1  3  1  2  Mr. P  1  2  2  2  Mrs. P Control Parents Mr. a  1 2 1 8 . 7 6 7 1+ $ IS I I S I I I H IIIO IIM I I P IISp. I l C h . v i d . 8  1 "  2  k  8  1  1  8  Mrs. a  8  8  2  8  8  8  8  1  Mr. b  1  1  8  8  3  &  2  2  8  Mrs. b  7  2  I  1  2  2  2  2  1  Mr. c  1  k  i  8  1  1  Mra. c  1  6  Mr. d  8  1  Mrs. d  I  7  Mr. e  1  Mrs. e Mr. £  Mr s. E  Mrs.  f  —BBI  2  it. 2  2  5  j  2  6  1  8  3  6  I  i  2  k  6  3  8  8  1  1  2  5  8  6  8  8  8  8  8  2  3  1  1  2  7  8  1  8  6  1  2  1  1  2  8  8  8  6  2  3  1  1  8  5  1  3  1  1  2  1  2  8  •i  # Underlined f i g u r e s denote extreme summary points while u n l i n e d f i g u r e s denote moderate summary points  82 BIBLIOGRAPHY Anthony, J.. An experimental approach t o the psychopath©logy of childhood autism. B r i t . J , of Med, Psychol., 1958, i i ,  211-225.  Bateson, G., Jackson, D.D., Haley, W., and Weakland, J . Towards a theory o f s c h i z o p h r e n i a . B e h a v i o r a l Science,, 195*6, 1, 251-261+. Baumrind, D., Ah a n a l y s i s of some aspects of the "Interpersona l System". P s y c h i a t r y , i 9 6 0 , 2£, 3 9 5 4 0 2 . Behrens, M.L., and Goldfarb, W.A., A study o f patterns of i n t e r a c t i o n of f a m i l i e s . o f schizophrenic c h i l d r e n i n r e s i d e n t i a l treatment. Amer. J . Orthopsychiat., 1958, 28, 300-312.  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