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UBC Theses and Dissertations

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 British Columbia, 1963 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF . . THE REQUIREMENTS FOR THE DEGREE OF . MASTER OF ARTS in the Department of Psychology We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA February, 1965 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of B r i t i s h Columbia, I agree that the Library shall make It freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the Head of my Department or by his representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of The University of Bri 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 t h e r e l a t i o n s h i p between " E a r l y I n f a n t i l e A u t i s m " and c e r t a i n p a r e n t a l p e r -s o n a l i t y c h a r a c t e r i s t i c s and f a m i l y r e l a t i o n s h i p s r e p o r t e d i n t h e 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 w i t h c h i l d h o o d s c h i -z o p h r e n i a * The t h r e e f a c t o r s i n v e s t i g a t e d were t h e * f l a c k o f empathy" and " e m o t i o n a l detachment", "the a v o i d a n c e o f I n t e r p e r s o n a l i n t e r a c t i o n s " and t h e dominance o f t h e w i f e and s u b m i s s i v e n e s s o f t h e husband, each o f w h i c h had been r e p o r t e d as c h a r a c t e r i z i n g t h e p a r e n t s o f s c h i z o p h r e n i c c h i l d r e n . Each o f t h e s e c h a r a c t e r i s t i c s was o p e r a t i o n a l l y de-f i n e d and measured w i t h i n t h e framework o f t h e I n t e r p e r s o n a l System o f P e r s o n a l i t y D i a g n o s i s * 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 from 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 a p e r -son p r e s e n t s h i m s e l f t o or i s d e s c r i b e d by o t h e r s ( L e v e l I ) , h i s d e s c r i p t i o n s o f h i m s e l f and s i g n i f i c a n t o t h e r s ( L e v e l I I ) , h i s f a n t a s y o r " p r o j e c t i v e " p e r c e p t i o n s o f p e o p l e ( L e v e l I I I ) , and h i s ego i d e a l ( L e v e l V ) , The d a t a o f 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 s c o r e d i n terms o f a c i r c u l a r c l a s s i f l c a t o r y system made up of e i g h t I n t e r p e r s o n a l v a r i a b l e s or ways o f i n t e r a c t i n g ( e . g * c o m p e t i t i v e - e x p l o i t i v e , s k e p t i c a l - d i s t r u s t f u l , c o o p e r a -t i v e - o v e r c o n v e n t i o n a l , e t c ) . T r i g o n o m e t r i c and a r i t h m e t i c i i methods were t h e n used t o summarize i n t e r p e r s o n a l b e h a v i o r at any l e v e l i n t o a s i n g l e p o i n t on a d i a g n o s t i c g r i d i n -c o r p o r a t i n g t h e e i g h t i n t e r p e r s o n a l v a r i a b l e s . T h i s was made p o s s i b l e by l o c a t i n g t h i s s i n g l e summary p o i n t I n terms o f a v e r t i c a l (dominance - s u b m i s s i o n ) and 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 ) a x i s . As t h e summary p o i n t s f r o m e a c h o f t h e f o u r l e v e l s were s c o r e d i n terms o f t h e same e i g h t 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 measures o f the d i s c r e p a n c i e s e v i d e n t w i t h i n o r between t h e d i f f e r e n t h y p o t h e s i z e d l e v e l s o f f u n c t i o n i n g * 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 s t u d y . H y p o t h e s i s 1 p o s t u l a t e d t h a t as v i e w e d by o t h e r s ( L e v e l I ) , t h e mothers w o u l d be t h e dominant members more o f t e n l n t h e p a t i e n t f a m i l i e s t h a n i n t h e c o n t r o l f a m i l i e s . H y p o t h e s i s 2 p o s t u l a t e d t h a t t h e p a t i e n t p a r e n t s would show g r e a t e r d i s -p a r i t y t h a n t h e c o n t r o l p a r e n t s between t h e i r s e l f d e s c r i p -t i o n s ( 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 o t h e r s ( L e v e l I ) , The t h i r d h y p o t h e s i s p o s t u l a t e d t h a t the p a t i e n t p a r e n t s would m i s p e r c e i v e 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 g r e a t e r 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 I I , The f o u r t h h y -p o t h e s i s p o s t u l a t e d t h a t t h e p a t i e n t p a r e n t s would show g r e a t e r disagreement i n t h e i r d e s c r i p t i o n s o f t h e i r c h i l d a t L e v e l I I t h a n t h e c o n t r o l p a r e n t s . H y p o t h e s i s 5 p o s t u l a t e d t h a t t h e p a t i e n t p a r e n t s w o u l d , t o a g r e a t e r degree t h a n t h e c o n t r o l p a r e n t s , view p e o p l e I n I n t e r p e r s o n a l 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 u n a f f i l l a t i v e at t h e l e v e l o f f a n t a s y . Two groups o f p a r e n t s were u t i l i z e d . The p a t i e n t group c o n s i s t e d of s i x m a r r i e d c o u p l e s , each h a v i n g a c h i l d who had been a c c e p t e d i n t o a t r e a t m e n t program f o r s c h i z o -p h r e n i c c h i l d r e n . Of the 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 as a u t i s t i c . The c o n t r o l group c o n s i s t e d o f s i x m a r r i e d e o u p l e s who h a d no c h i l d r e n who had s u f f e r e d f r o m p r o l o n g e d p h y s i c a l o r e m o t i o n a l d i s t u r b a n c e s . Each c o u p l e was i n d i v i -d u a l l y matched a g a i n s t one o f the p a t i e n t c o u p l e s . B o t h groups were a d m i n i s t e r e d t h e MMPI, t h e I n t e r p e r s o n -a l Check L i s t and t h e TAT. The r e s u l t s were t h e n t r a n s f o r m e d i n t o s i n g l e summary p o i n t s c o r e s f o r t h e v a r i o u s 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 and t h e h y p o t h e s i z e d r e l a t i o n s h i p s w i t h i n and between l e v e l s t e s t e d . Of t h e f i v e hypotheses f o r m u l a t e d , o n l y h y p o t h e s i s 5 was f o u n d t o d i f f e r e n t i a t e t h e two groups at a .05? l e v e l o f s i g -n i f i c a n c e o r b e t t e r . The r e s u l t s showed t h a t t h e p a t i e n t p a r -e n t s t e n d e d t o view p e o p l e i n i n t e r p e r s o n a l s i t u a t i o n s as b e i n g h o s t i l e and g e n e r a l l y u n l o v i n g . I t was h y p o t h e s i z e d t h a t 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 f u n c t i o n i n g and have an 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 c h i l d . I n c o n c l u s i o n , t h e c u r r e n t I n v e s t i g a t i o n f a i l e d t o f i n d any w i d e s p r e a d d i f f e r e n c e s between a group o f p a r e n t s o f a u -t i s t i c c h i l d r e n and a group o f p a r e n t s o f a d e q u a t e l y f u n c t i o n -i n g c h i l d r e n . v i i i ACMOWLEDGMENT I w o u l d l i k e t o express my a p p r e c i a t i o n t o Dr . K.D. C r a i g and 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 and s u g g e s t i o n s . I n a d d i t i o n , I would l i k e t o t h a n k D r . L. P u l o s f o r h i s i n t e r e s t t hroughout a l l phases o f the study and Dr. A. Cashmore o f t h e M e n t a l H e a l t h Centre who made a v a i l a b l e t he s u b j e c t s u s e d i n t h e s t u d y . S i n c e r e s t a p p r e c i a t i o n i s a l s o extended 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 n u r s e s o f t h e Burnaby 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 sub-j e c t s was i n v a l u a b l e . i * TABLE OP CONTENTS ABSTRACT i TABLE OP CONTENTS i v LIST OP TABLES. v i LIST OF FIGURES v i i ACKNOWLEDGMENT v i i i CHAPTER I - STATEMENT OF THE PROBLEM 1 CHAPTER I I - REVIEW OF THE RELEVANT LITERATURE 3 I . H i s t o r y o f t h e Study o f C h i l d h o o d S c h i z o p h r e n i a I I . The P a r e n t s o f S c h i z o p h r e n i c C h i l -dren.. I I I . The I n t e r p e r s o n a l System 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 - METHOD...... 32 I . S u b j e c t s I I . P r o c e d u r e I I I . S t a t i s t i c a l A n a l y s i s CHAPTER V - RESULTS 1+4 CHAPTER V I - DISCUSSION AND CONCLUDING REMARKS 52 APPENDIX A - The I n t e r p e r s o n a l Cheek L i s t . . . . . . . . . . . 63 APPENDIX B - A Sample"MMPI P r o t o c o l 65 APPENDIX C - R a t i o n a l e U n d e r l y i n g "Dom" and "Lov" E q u a t i o n s . . . . . . . . . . . . 67 APPENDIX D - TAT M o l a r R a t i n g Sheet - A Sample .. . P r o t o c o l 70 APPENDIX E - R e c o r d B o o k l e t f o r I n t e r p e r s o n a l D i a gno-s 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 . 72 APPENDIX F - Summary..of Raw Score I n d i c e s f o r Pa-... .. t i e n t and C o n t r o l F a m i l i e s 75 (cont *d next page) V APPENDIX G - Summary o f S t a n d a r d S c o r 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 78 APPENDIX H - Summary o f Octant S c o r 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 80 BIBLIOGRAPHY. ~ 82 v i LIST OP TABLES TABLE 1 - C o n t r o l Data 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 Normal C o u n t e r p a r t s 3>h TABLE 2 - C o n t r o l Data on t h e F a m i l i e s o f A u t i s t i c C h i l d r e n - a n d T h e i r Normal C o u n t e r p a r t s 35 TABLE 3 - S t a n d a r d S c o r e s O b t a i n e d by P a t i e n t and C o n t r o l P a r e n t s on t h e Dominance-Sub-m i s s i o n D i m e n s i o n at L e v e l I a i i5 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 . . .. S c o r e s - O b t a i n e d by P a t i e n t and C o n t r o l P a r e n t s . (Index o f " S e l f - D e c e p t i o n " ) 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 O b t a i n e d 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 (Husband) - 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 S c o r e s 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 - Octant Summary P o i n t S c o r e s O b t a i n e d by 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 LIST 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 I n t e r p e r s o n a l V a r i a b l e s I n R e l a t i o n t o t h e Two Dimensions 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 t h e C l a s s i f i c a t i o n o f I n t e r p e r s o n a l B e h a v i o r i n t o S i x t e e n V a r i a b l e C a t e -g o r i e s , 1 A COMPARISON OP THE INTERPERSONAL PERCEPTIONS OP THE PARENTS OP AUTISTIC AND NORMAL CHILDREN CHAPTER I STATEMENT OP THE PROBLEM The p r e s e n t 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 an e f f o r t t o examine t h e h y p o t h e s i s t h a t s c h i z o p h r e n i c d i s o r d e r s 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 i n t h e p a r e n t - c h i l d r e -l a t i o n s h i p . The l i t e r a t u r e s u g g e s t s t h a t c e r t a i n u n h e a l t h y p e r s o n a l i t y t r a i t s p r e s e n t i n e i t h e r o r b o t h p a r e n t s and co n -c o m i t a n t d i s t u r b a n c e s 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 c h i l d t o i n t e r f e r e w i t h h i s normal development. A l t h o u g h 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 has now been accumulated about t h e p a r e n t s o f s c h i z o p h r e n i c c h i l d r e n , t h e f i e l d i s s t i l l 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 can 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 a s s e s s 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 and t o t h e h e t e r o g e n e i t y o f t h e groups o f c h i l d r e n subsumed under t h e c a t e g o r y o f c h i l d h o o d s c h i z o p h r e n i a . A l s o , few a t -tempts have been made t o more o b j e c t i v e l y and c l e a r l y d e f i n e t h e t r a i t s and r e l a t i o n s h i p s o f p a r e n t s w i t h a s c h i z o p h r e n i c c h i l d . A u t h o r s have tended t o r e m a i n at a v e r y vague, g e n e r a l a d j e c t i v a l l e v e l . T r a i t s such as unerapathic, u n e m o t i o n a l and s u b m i s s i v e a r e w i d e l y used but seldom d e f i n e d . The a s s u m p t i o n has a l s o been made t h a t t h e p a r e n t a l c h a r a c -t e r i s t i c s 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 a s c h i z o p h r e n i c 2 child are different from the parental characteristics and relationships in 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 in the present study, therefore, was a more objective means of defining and measuring some of the re-ported personality characteristics and family relationships of the parents of schizophrenic children. An attempt was made to operationally define these characteristics and relationships within the framework of the Interpersonal System of Personality Diagnosis (Leary, 1 9 5 6 ; Leary, 1 9 5 7 ) . This method of personali-ty assessment w i l l be discussed In Chapter II. At the same time a control group of parents of normal children was included for purposes of comparison. Each of the patient families was individually matched with a control family having no children who had suffered from emotional or prolonged physical disturbances. Having operationally defined certain of the personality characteristics and family relationships reported in the l i t e r -ature, specific hypotheses were formulated and tested. CHAPTER I I REVIEW OP THE RELEVANT LITERATURE I . HISTORY OP THE STUDY OP CHILDHOOD SCHIZOPHRENIA I n r e c e n t y e a r s t h e r e has been a r a p i d l y expanding l i t e r a -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 s c h i z o p h r e n i a . I n i t i a l l y t h e r e was c o n s i d e r a b l e 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 young 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 as t o whether t h e u n d e r l y i n g d e f e c t was not r e a l l y one o f i n t e l l i g e n c e . W i t h i n c r e a s i n g d i a g n o s t i c 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 a c c e p t a n c e f r o m w o r k e r s and has c u r r e n t l y a c h i e v e d a p o s i t i o n o f f a s h i o n a b l e p o p u l a r i t y . Bender (191^2* p. 138) * j u s t twenty y e a r s ago, acknowledged t h a t : "There a r e t h o s e who do not b e l i e v e i n c h i l d h o o d s c h i z o p h r e n i a , not h a v i n g seen a::case. At t h e b e s t none o f us has s e e n v e r y many cases 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 . " P r e v i o u s 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 s c h i z o p h r e n i a 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 t h e a t t e n t i o n o f i n d i v i d u a l w orkers s u c h as B r a d l e y (19ltl), B r i l l (192£) Despert (1938), K a s a n i n and Kaufman (1929), L u r i a , T i e t z and Herzman (1936) and P o t t e r (1933). I n t h e s e p i o n e e r i n g a c c o u n t s t h e p r i m a r y emphasis f e l l on a t t e m p t s t o demonstrate t h a t such a g r o s s l y d e v i a n t group o f c h i l d r e n d i d i n f a c t e x i s t 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 differential diagnosis of schizophrenia In childhood (Bradley, 19i\l; Despert, 1938j Potter, 1933). At that time, most authors did not present explicit hypotheses about the possible etiological factors which might account for a c l i n i c a l entity which at the time was very vaguely defined and far from universally accepted as a valid and distinct disorder of child-hood. These few scattered reports, then, constituted the sum total of knowledge which had been gained about childhood schizo-phrenia over a period of 15 years and this was the state of affairs which had caused many to doubt the validity of the noso-logical class, thus prompting Bender's comments in 19l|2. Controversy concerning the existence of this group of grossly disturbed children abated somewhat, however, following Kanner's delineation In 19^3 of a syndrome he later named "Early Infantile Autism". The isolation of this syndrome represented the f i r s t major contribution to the differentiation of specific c l i n i c a l types within the broader sphere of childhood schizo-phrenia. Kanner, presenting 11 case histories, l i s t e d the following five characteristics ag distinctive of children with early infan-t i l e autism: 1« An inability to relate themselves in the ordinary way to people and situations from the beginning of l i f e . 2. Failure to use language for the purpose of communication, 3. An anxiously obsessive desire for the maintenance of sameness. 11. Fascination for objects, and 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 (Kanner, I9I4.3) • The p s y c h i a t r i c l i t e r a t u r e f r o m 19^3 t o 1914.8, w h i l e i n c l u d -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 (19i|4* I9I4.6)» was marked by a p a u c i t y o f c o n f i r m a t o r y papers by o t h e r s . A l t h o u g h the number o f a r t i c l e s a p p e a r i n g was i n c r e a s i n g (Bender, 19it7; des L a u r i e r s and H a l p e r n , 1 9 ^ 7J D e s p e r t , 1914-7J G e l e e r d , I9 I16; Putman, I9I4.8), t h e r e seemed t o be 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 as a d i a g n o s t i c e n t i t y . S i n c e 19^9> however, t h e d i a g n o s i s has appeared w i t h e v e r f -i n c r e a s i n g f r e q u e n c y and o t h e r i n v e s t i g a t o r s have begun t o r e p o r t o t h e r s p e c i f i c s u b g r o u p i n g s w h i c h se e m i n g l y c o u l d be d i s t i n g u i s h e d by t i m e o f o n s e t , symptomatology and co u r s e o f t h e d i s o r d e r , r e -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 " s y m b i o t i c p s y c h o s i s " ( M a h l e r , 1 9 5 2 ) , " c h i l d r e n w i t h u n u s u a l s e n s i t i v i t i e s " (Bergman and E s c a l o n a , I9I4.9) > " a t y p i c a l c h i l d " (Rank, 19l}-9) and " b o r d e r -l i n e p s y c h o s i s " ( E k s t e i n and W a l l e r s t e i n , 19f?lj.) • E i s e n b e r g and Kanner (1956) r e p o r t e d a n o t h e r d i s o r d e r , secondary a u t i s m , I n w h i c h t h e c h i l d s e e m i n g l y d e v e l o p e d n o r m a l l y t h r o u g h t h e f i r s t 18 t o 2 0 months, " o n l y t o undergo a t t h i s p o i n t a s e v e r e - w i t h d r a w a l o f a f f e c t , m a n i f e s t e d 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 p r o g r e s s s o c i a l l y , and t h e g r a d u a l g i v i n g up o f i n t e r e s t i n normal a c t i v i -t i e s " ( p . 558) W i t h t h e g r o w i n g r e c o g n i t i o n o f t h e r e a l i t y o f c h i l d h o o d s c h i z o p h r e n i a and the d i f f e r e n t i a t i o n o f o t h e r a p p a r e n t l y d i s -t i n c t i v e s u b g r o u p i n g s 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 clear statements on the causal role of various factors had not been advanced In early publications, from the beginning the role of interpersonal relationships within the family, and more specifically, the relationship between the schizophrenic child and his mother, had attracted considerable attention (Despert,,1938; Kanner, 19^3, Potter, 1933) . This interest i n the role of the parents In the genesis of the disorder arose partially from the fact that physical examination of these children f a i l e d to show any signs of a possible constitutional or organic foundation. With this dis-covery, attention turned to the parents and the examination seemed justifi e d as workers appeared to find highly pathological attitudes toward child-rearing and the family and these were hypothesized as being the cause of childhood schizophrenia. Other orientations were soon to appear (Bender, 1953; Bender, 1956; Bergman and Escalona, I9I4.9; Gold$arb, 1961; Mahler, 1958) stressing the importance of constitutional, hereditary and organic factors, 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 their possible etiological significance. 7 As e a r l y as 1933 P o t t e r had 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 I n v o l v e d i n t h e g e n e s i s o f c h i l d h o o d s c h i z o p h r e n i a . H i s o b s e r v a t i o n t h a t mothers 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 a sub-m i s s i v e r o l e has 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 a p p e a r i n g u n t i l t h e p r e s e n t day. 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 h i s s i x cases ( p . 12f>7): A s e a r c h f o r c o n s t i t u t i o n a l o r o r g a n i c 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 s u g g e s t i o n . A dominant o v e r -p r o t e c t i v e mother w i t h a s u b m i s s i v e t y p e o f f a t h e r i s l i k e l y t o f o s -t e r an a t t i t u d e o f dependence, espe-c i a l l y d i r e c t e d t o w a r d t h e mother. A g a i n , i n t h e second c a s e , P o t t e r remarked ( p . 1 2 ^ 9 ) : I n t h e background i s a q u i e t , u n o b t r u -s i v e , e m o t i o n a l l y u n r e s p o n s i v e f a t h e r and an 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 sub-s 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 t h e c o n s t i t u t i o n a l h e r e . Psychodynami-c 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 had a p r o f o u n d I n f l u e n c e on t h e e m o t i o n a l l i f e o f t h i s c h i l d I n t h e f o u r r e m a i n i n g c a s e s P o t t e r r e p e a t e d h i s o b s e r v a t i o n s 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 or o r g a n i c s i g n s were c o n s i s -t e n t l y absent and drew a t t e n t i o n t o t h e p o t e n t i a l psychodynamic i n f l u e n c e o f t h e p a r e n t s . F o l l o w i n g t h e s e i n i t i a l c o n s i d e r a t i o n s o f P o t t e r , Despert i n 1938* r e p o r t i n g on 29 s c h i z o p h r e n i c c h i l d r e n seen f r o m 1930 t o 1937* 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 was 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 c a s e s . The next c o n t r i b u t i o n was t h a t o f Kanner (1914-3) who found" 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 c a l l e d a u t i s t i c 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 p r e s ence o f 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 • One o t h e r p r o m i -nent f e a t u r e n o t e d was t h e l a c k o f warmness and l i m i t e d i n t e r e s t i n p e o p l e shown by t h e s e p a r e n t s . The m a r r i a g e s , a l t h o u g h s e e m i n g l y s t a b l e w i t h l i t t l e e v i d e n c e o f open c o n f l i c t , appeared t o be r a t h e r c o l d and f o r m a l a f f a i r s w i t h l i m i t e d communication between husband and w i f e . W i t h o n l y t h e s e 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 f r o m , Kanner f e l t t h a t , n o t w i t h s t a n d i n g t h e p r o b a b l e importance o f t h e o b s e r v e d 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 i a l i n t e r r e l a t i o n s h i p s , t h e extreme a l o n e n e s s " p r e s e n t f r o m t h e b e g i n n i n g o f l i f e " ( p . 557) made i t d i f f i c u l t t o a t t r i b u t e e a r l y i n f a n t i l e a u t i s m s o l e l y t o t h e t y p e 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 and environment 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 . T h i s l e d him t o t h e t e n t a t i v e 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 -a b i l i t y t o f o r m normal " a f f e c t i v e c o n t a c t " w i t h p e o p l e , a l t h o u g h t h e exact n a t u r e o f t h i s " i n n a t e i n a b i l i t y " was l e f t undefined,. F o l l o w i n g h i s t h r e e e a r l i e r d e s c r i p t i v e r e p o r t s , Kanner (19li9) d e v o t e d h i s f u l l a t t e n t i o n t o t h e problems o f n o s o l o g y and psychodynamics o f e a r l y i n f a n t i l e a u t i s m * By t h i s t i me Kanner had seen more t h a n f i f t y s u c h c h i l d r e n and l o o k e d upon t h e 9 disorder as being the e a r l i e s t possible manifestation of c h i l d -hood schizophrenia* His orie n t a t i o n as regards etiology had swung sharply to the psychodynamic, although he was to return again i n l a t e r publications (Eisenberg & Kanner, 1 9 5 6 ; Kanner & Eisenberg, 1955) to the possible operation of some innate f a c t o r . Interest focused on the possible r e l a t i o n s h i p between the type of early environment provided by the parents he had seen and the presence of a schizophrenic disorder i n one of t h e i r c h i l d r e n . Information continued to show that almost a l l of the parents were highly i n t e l l i g e n t and quite successful i n t h e i r chosen careers. In addition, the parents were characterized by the following a t t r i b u t e s , outstanding among which was what Kanner c a l l e d a "mechanization of human re l a t i o n s h i p s " . That i s , according to Kanner, these parents were not comfortable In the company of people, preferring reading, painting or some other similar non-interpersonal a c t i v i t y . Married l i f e was again a cold and formal a f f a i r and both husbands and wives des-cribed themselves and t h e i r spouses as being undemonstrative and unemotional. Further, t h e i r behaviour towards the children was concentrated mainly on the achievement of r i g i d standards of obedience, quiet, good eating, t o i l e t t r a i n i n g and feats of memory and vocabulary. S i m i l a r l y , genuine warmth and enjoyment of the c h i l d were conspicuously absent. In view of such parental c h a r a c t e r i s t i c s , early i n f a n t i l e autism represented f o r Kanner, a turning away and withdrawal of the c h i l d from the mechanized care and attention furnished by parents who were l i t t l e more 10 than "emotional refrigerators". Rank's (I9I19) findings were consistent with the observations of Kanner. She found the mothers of schizophrenic children to be incapable of emotional relationships, tending to rely 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 of-ten professionally successful, were aloof and inadequate as family members* Other authors, commenting on the dominance - submission factor i n families with a schizophrenic child, also observed that the mother was li k e l y to play a dominant role with the f a -thers being weak and ineffectual (Anthony, 1958j Clardy, 1 9 5 1 ; Slimp, 1 9 5 D . Elaborating her earlier findings, Despert (1951) similarly noted that the mothers had been mechanical and r i g i d in raising their child. Other characteristics of the mothers included imma-turity, narcissism, compulsiveness and perfectionism. Most sig-nificant, however, was the fact that so many of these mothers were emotionally detached and sought gratification from intellec-tual sources rather than from contact with people. As with Kanner, Despert stressed the etiological importance of the per-sonalities of the parents, the emotional quality of the parent -child 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 1 1 of a study conducted on the fathers of a u t i s t i c children seen by himself and Kanner at the Johns Hopkins Hospital. He found that these fathers tended to be obsessive, detached and humourless men who demanded conformity from t h e i r children, seeking to raise "the perfect c h i l d - I.e., one who obeys, who performs, and who makes no demands" (p. 722). This characterization of the father d i f f e r e d somewhat from the submissive, passive i n d i v i d u a l por-trayed by other authors. As for marriage.;, i t seemed to be looked upon as a convenient arrangement for board and room, with work taking precedence over any kind of family l i f e . In a l l of t h e i r interpersonal r e l a t i o n s h i p s , the fathers displayed a "remarkable lack of empathy f o r and s e n s i t i v i t y to the feelings of others" (p. 722). When a b r i e f survey of the fathers of f i f t y non-schizophren-i c c h i l d patients was made for purposes of comparison, what stood out most prominently i n the control fathers was the absence of the coldly mechanical attitude toward c h i l d rearing and the cold and f o r m a l i s t i c approach to marriage so evident i n the a u t i s t i c group. Thus i t was concluded that any further studies which might be conducted on the parents of disturbed children would have to include the fathers, not only for t h e i r possible direct influence on the c h i l d but also because of the adverse effects they might have on the a b i l i t y of the mothers to adequately d i s -charge t h e i r r o l e s • In England, Anthony's (195>8) observations proved largely consistent with the findings of the e a r l i e r reports. The mothers 12 were seen as lacking emotional sensitivity and responsiveness and unable to f u l f i l their role as a mother naturally and spon-taneously, turning instead to books on child-rearing. Esman, Kohn and Nyman (1959)» reporting data from a project in 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 or personali-ty t r a i t s , in a l l cases there was a grossly disturbed intra-familial pattern, and in almost a l l oases both parents were clearly disturbed individuals. The family role 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 child as consistent objects. The communication among family members was invariably seriously disrupted, the disruption ranging from non-speaking 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 their parents, observed that physical and emotional isolation was out-standing ln these families, this use of Isolation being particu-larly noticeable i n the fathers. Although Esman, Kohn and Nyman had been unable to find any common characteristics i n their investigation, Kaufaman, Prank, Helms, Herrick and Wilier (1959) distinguished four types of parents having schizophrenic children: (l) pseudoneurotic (2) somatic (3) pseudodelinquent or (ii) psychotic. Although the 13 names are self-descriptive the pseudoneurotic category w i l l be developed further as Kaufman's description of these parents was strikingly consistent with others' findings about parents of schizophrenic children. This type of parent was found to demon-strate r i g i d compulsive behavior and a stereotypy of l i f e pat-terns. Many were quite competent i n their work but marriage appeared to be a highly controlled and subdued relat ionship with limited emotional interaction between husband and wife and child. Attention was drawn once again to the fact that the primary means of raising the child had been by reference to the books. "These people (p. I4.66), the authors noted, "went through social relationships i n a seemingly adequate fashion, but i n reality their relationships were more impersonal than Inter-personal" • Adhering strongly to a psychodynamic approach to etiology, Kaufman et a l concluded that i n a l l of the cases they had diag-nosed as childhood schizophrenia there seemed l i t t l e doubt that the condition had arisen from emotional disturbances in the parent-child interaction. It can be seen from the Information reviewed thus far that the role of the parent i n Interaction with the child who shows schizophrenia of childhood In i t s various forms is at the center of the question about etiology for a great many investigators. Beyond this there has been surprising consistency i n the findings reported i n the literature. Studies by varied i n d i v i -duals ranging over a number of years have repeatedly come up Ik with comparable results indicating atypical childrearing prac-tices, personalities and intrafamilial' relationships in the par-ents of schizophrenic children, It is important to remember, however, that despite the apparent uniformity, differences did arise and descriptions given generally failed to Include a l l of the parents seen. Also, the fact that descriptions were often expressed in very general, subjective terms made i t d i f f i c u l t to determine whether the various workers were really describing common characteristics 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 in the process of diagnosis and treatment of their children. Pew attempts have been made to examine more directly the r e l i a b i l i t y and validity of findings derived from psychiatric impressions by the use of more standardized or objective techniques for assessing personality traits and family relationships. Furthermore, despite an implicit assumption that the distortions of person-ality and family discovered were not to be found in families having normal children, inclusion of such a control group has been conspicuously absent. The following six studies attempted, by various means, to rectify some of the shortcomings noted above. Block, Patterson, Block & Jackson (1958)» using parents of autistic children and a control group of parents of neurotic children, employed psychological tests. On the basis of the test 15 results, they classified the parents by means of a Q-sort method in an effort to determine whether differences could be established. Though the results were rather equivocal, with considerable overlap between the two groups, a cluster analysis characterized the mothers of autistic children as being more egocentric, manipulative and exploitive. Their attitudes about interpersonal relationships were characterized by distrust, h o s t i l i t y and emotional nonparticipation, and i t was f e l t that such a mother would be slow to perceive and satisfy the psychological require-ments of others. The fathers of the autistic children in this study were described as being more assertive and expressing their h o s t i l i t i e s more directly than the fathers of neurotic children. It is important to note, however, that the above descrip-tions accounted for only some hfi% of the mothers and father with autistic children, the remaining 60$ either being similar to parents of neurotic children or f a l l i n g into residual categories. Working in 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 certain 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 different and more complex approach to the study of family environment of schizophrenic children was followed by G-oldfarb and his colleagues at the Henry Ittleson Center for Child Research. 16 Their project represented an attempt to develop, through an ex-tensive battery of rating scales used ln conjunction with open ended interviews and participant observation techniques, an appraisal that would differentiate families with schizophrenic children from families with nonschizophrenic children. Their results showed (Behrens & G-oldfarb, 1958? Meyers & G-oldfarb, 1961) that an atmosphere of confusion and disorganization charac-terized the homes having schizophrenic children. Basic i s o l a -tion between parents was evident in the lack of genuine communi-cation. There was also a lack of pleasure and spontanaiety i n the family and an absence of empathy with the child, a nonaware-ness of the child's wants and desires, resulting in the use of inflexible and mechanical means of child-rearing. On the basis of these findings, Goldfarb and his colleagues defined a syndrome which they called "parental perplexity". In a study of five parents of schizophrenic children and a control group of parents of normal children, Perr (1958) found that the parents of his schizophrenic group tended to misperceive their impact on others, a finding congruent with the ideas ex-pressed by Bateson, Jackson, Haley & Weakland ( 1 9 5 6 ) . These parents also saw the "other" in "self-other" Interactions as being domineering and hostile, presenting the picture of a rather unfriendly and fearful world. There was close identification between spouse and mother in the patient group and a general lack of psychological differentiation, as evidencedby constriction and r i g i d stereotypy in their perception of people. 17 Singer and Wynne (I963) studied the parents of twenty autistic children while u t i l i z i n g control groups of twenty neurotic children and twenty schizophrenics who became overtly i l l i n late adolescence or young adulthood. On the basis of TAT-* data, they found that parents of autistic children were clearly differentiated from control parents by their use of " d i s a f f i l i a t i o n and dissatisfaction as characteristic and perva-sive expectancies about the way any interaction is going to turn out" (p. 2 3 6 ) . As regards " d i s a f f i l i a t i o n " , interaction with others was seen as an uncomfortable experience which was viewed with dis-trust and pessimism. Persons were seen as avoiding closeness and interactions with others appeared inherently unpleasant and failed to provide any satisfaction. Pour modes of d i s a f f i l i a t i o n were noted in these parents. The f i r s t was i n the nature of a "cynical outlook" with the par-ents expecting the worst motivation ln people. Secondly, there appeared to be "passivity and apathy about interacting" based on the feeling that things were sure to turn out poorly. A third mode was "superficiality", 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 their use of obsessive, intellectualized distance. Associated with this d i s a f f i l i a t i o n was dissatisfaction, a quality which was expressed by TAT characters "having lives 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 dissatisfying 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 child and lead to a schizophrenic disorder. In re-examining the foregoing review of the literature, i t becomes apparent that the primary emphasis has been'.in the general area of interpersonal relationships. Within this broader sphere, more specific components such as the dominance-submission factor, the in a b i l i t y to enjoy and function satisfactorily in interpersonal situations, and the lack of empathy and emotional sensitivity have a l l been implicated as of etiologic significance. It was noted earlier, however, that many of the findings had been based on psychiatric impressions gained during secon-dary 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 arise, however, and parents were often seen who fai l e d to conform to commonly observed patterns. An obvious question is 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 this information i n their examina-tion of parents. If the sub-groupings are indeed meaningful, 19 inclusion of heterogeneous groups of children might very well have confounded the results of research on the parents. The majority of the studies concentrated on the maternal rather than the paternal role, for the simple reason that the mothers were more accessible practically. Despite this fact, however, t r a i t s , such as passivity, have Invariably been a t t r i -buted to the fathers, on the basis of such brief contacts as were made and on mothers' reports. Again, although references were seldom made, except in the most vague manner, to variables such as age, intelligence, social class, ethnic background and religion, these factors undoubtedly played an important part i n the type of material obtained from the parents, whether by interview, case history, or psychologi-cal tests. Disregard of such variables can not only impede the discovery of significant information, but also lead to spurious findings which would not have arisen had adequate attention been paid to controls. The present study, therefore, was undertaken i n an effort to more objectively measure some of the reported parental charac-t e r i s t i c s and interrelat ionships while at the same time endeavor-ing to control important variables neglected i n earlier reports. III. THE INTERPERSONAL SYSTEM OP PERSONALITY DIAGNOSIS Consideration of the factors summarized above led to this study's choice of the Interpersonal System of Personality Diag-nosis (Leary, 1956; Leary, 1957)• This technique of multilevel 20 interpersonal diagnosis of personality evolved by Leary and his 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 "multilevel" referred to the fact that in studying the individual, responses were obtained from a variety of sources, each of them being theoretically related to d i f f e r -ent hypothesized levels of behavior. Since responses at a l l levels were measured or scored in terms of the same set of eight Interpersonal variables or ways of interacting with others, measurements at any one level could be compared with and related to measurements of behavior at a l l other levels. The levels of functioning that the system attempted to assess were as follows: Level I - the level of public communication, referred to the interpersonal impact of the subject on other people. The most frequently used method of measuring this level was through MMPI* indices which apparently reflected 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 definition referred to the interpersonal impact of the subject as perceived by others. The MMPI, however, was a self-description 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 List (a true-false l i s t of 128 The Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 19^1). 21 phrases (see Appendix A). As this was generally not feasible, the MMPI indices employed by Leary (Leary, 1956) were u t i l i z e d in the present study. Level II - the level 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 this level was to have the subject rate himself and the Important people in his l i f e on the Interpersonal Check L i s t . Level III - the level of preconscious symbolization, re-ferred to "the interpersonal themes expressed by the subject In the form of fantasies, projective test stories, dreams and the like " (Leary, 1956, p. 17)• The usual method for measuring Level III was to have the subject write out stories i n response to a stan-dard set of ten TAT cards. These stories were then scored for the same set of variables that were used in the measurement of Levels I and II, There were two sub-levels to Level III: Level III Hero and Level III Other, Level III Hero referred to the interper-sonal themes attributed to the heroes who appeared In the stories. Level III Other consisted of the interpersonal themes attributed to a l l of the persons with whom the fantasy heroes interacted. Level IV - the level of the unexpressed unconscious, re-ferred to "the interpersonal themes which are systema-t i c a l l y and compulsively avoided by the subject at a l l 22 t h e o t h e r l e v e l s o f p e r s o n a l i t y , . . . . ( L e a r y , 1957* P« 8 0 } . 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 has not been s y s t e m a t i c a l l y s t u d i e d and no s t a n d a r d methods f o r t a p p i n g i t have been de-v e l o p e d . L e v e l V - t h e l e v e l o f v a l u e s , - r e f e r r e d t o t h e s u b j e c t ' s s t a n -dards o f what was r i g h t o r I d e a l as he p r e s e n t e d them by means o f c o n s c i o u s v e r b a l r e p o r t . The s t a n d a r d method o f measuring t h i s l e v e l was t o have t h e s u b j e c t f i l l out t h e I n t e r p e r s o n a l Cheek L i s t a c c o r d i n g t o t h e way he 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, e i g h t i n t e r p e r s o n a l v a r i a b l e s or ways o f I n t e r a c t i n g have been i s o l a t e d and a r r a n g e d i n a c i r c u l a r c ontinuum, (See F i g u r e 1), A c c o r d i n g t o L e a r y , t h e e i g h t 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 c o n s c i o u s 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 pe o p l e u s e d t o d e a l w i t h o t h e r s and 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 o t h e r s . The l o c a t i o n o f each v a r i a b l e on t h e c i r c u l a r continuum 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 major d i m e n s i o n s o f t h e c i r c l e , a d o m i n a n c e - s u b m i s s i o n d i m e n s i o n and a h o s t i l i t y a f f i l i a -t i o n d i m e n s i o n . I t was f o u n d t h a t when domi 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 e x p r e s s e d as c o m b i n a t i o n s o f t h e s e f o u r f i x e d p o i n t s . The degree o f r e l a t i o n -s h i p between any two v a r i a b l e s was a d e c r e a s i n g f u n c t i o n o f t h e i r s e p a r a t i o n on t h e p e r i m e t e r o f t h e c i r c l e . Thus, v a r i a b l e s j u x t a -posed on t h e p e r i m e t e r o f t h e c i r c l e were s i m i l a r and 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 s i d e s o f t h e c i r c l e . 23 The complete scoring system, as originally developed, con-sisted of sixteen variables (Leary, 1957)• To indicate the nature of the sixteen variables, the litli words which comprise the Interpersonal Check List have been arranged in clusters in the circular schema according to their interpersonal score or meaning. This arrangement is shown in Figure 2 . The designa-tions for the 16 variables are the letters A through P indicated in the center of the c i r c l e . For almost a l l c l i n i c a l and re-search purposes, however, the system has been simplified into eight broader descriptive categories by combining adjacent variables into octants, as AP, BC NO, There are two standard methods of summarizing the interper-sonal behavior presented by the subject at any given level of measurement, (Leary, 1 9 5 7 ) . The method used in the present i n -vestigation was to locate a summary point i n the area comprising the circle that represented the central tendency of the interper-sonal behavior of the subject. This was achieved by summarizing a l l the scores i n terms of two major axes, the vertical (domi-nance-submission) and the horizontal ( 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 level could be summarized by locating a single point with reference to the two axes • Once the summary point had', been computed, i t was transla-ted Into a numerical code. This code was based on the particu-lar octant in which the summary point f e l l and how far the summ-ary point was from the center of the c i r c l e . Figure 1. Diagnostic grid showing the eight interpersonal variables in relation to the two dimensions of the oirole. Figure 2 . Interpersonal Check List illustrating the olassifioation of interpersonal behavior into six-teen variable categories* 26 In the circular grid shown i n Figure 1 a small dotted circle appears one-half inch from the center point. This circle intersects both the v e r t i c a l and horizontal dimensions of the grid at one sigma from the mean (i.e., i t intersectsoat the standard scores of LLO and 60 on both dimensions}. The standard scores obtained by a subject at any level were deter-mined from a table of norms provided by Leary (1956). Summary points that f e l l within the dotted line were considered to be moderate, while those f a l l i n g outside were classified a3 extreme• One of the basic and most important aspects of the inter-personal system of diagnosis was that the same system of v a r i -ables was used to measure behavior at a l l levels. The advan-tage of this procedure was that i t made possible the objective comparison of scores at different levels. The diagnostic grid allowed plotting of scores for a l l levels on the same two-dimen-sional surface and thus yielded a measure of the kind and amount of differences or conflicts which existed. Thus at Level II, self, 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 respectively. Further-more, 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 this 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 feels he i s at present. The amount o f t h i s discrepancy could be determined numerically by reference to a table of weighted scores provided by Leary (1956). The s p e c i f i c meaning of a pa 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 levels 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, five interpersonal hypotheses were formulated. Each referred to an attribute reported i n the literature as being characteristic of parents of schizophrenic children. The f i r s t hypothesis was formulated in order to determine whether the family pattern of a dominant wife with a submissive husband would emerge as being more characteristic of our pa-tient families. 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 dimen-sion) w i l l occur more frequently i n the families of the autistic children than in the families of normal children. Hypotheses 2 and 3 were formulated in an effort to define more objectively the "empathy" and "emotional detachment" fac-tors so widely reported in the literature. Hypothesis 2 was related specifically to the degree to which the parents i n the two groups were aware of the characteristics of their behavior as viewed by others. Would the parents of normal children show 29 g r e a t e r understanding and i n s i g h t i n t o t h e i r behavior than the parents of a u t i s t i c c h i l d r e n ? The exact I n t e r p e r s o n a l hypothe-s i s was as f o l l o w s : Hypothesis 2 - There w i l l be a s i g n i f i c a n t l y g r e a t e r d i s -crepancy between the L e v e l I s e l f score and the L e v e l I I s e l f score f o r the parents of the a u t i s t i c c h i l d r e n than f o r the parents of the normal c h i l d r e n . (This d i s c r e p a n c y i s an index of s e l f - d e c e p t i o n . ) Hypothesis 3 attempted to assess the degree to w h i c h the husband and w i f e i n a f a m i l y u n i t were attuned t o the i n t e r p e r -s o n a l c h a r a c t e r i s t i c s o f t h e i r spouses. It was p o s t u l a t e d that the p a t i e n t parents would e x h i b i t g r e a t e r d i s p a r i t y between t h e i r s e l f - d e s c r i p t i o n s on the I n t e r p e r s o n a l Check L i s t and the des-c r i p t i o n s a t t r i b u t e d t o them by t h e i r spouses. The s p e c i f i c hy-p o t h e s i s was as f o l l o w s : Hypothesis 3 - There w i l l be a s i g n i f i c a n t l y g r e a t e r d i s -crepancy between the s e l f - p e r c e p t i o n of the w i f e ( L e v e l I I ) as compared w i t h the hus-band's p e r c e p t i o n o f h i s wife ( L e v e l I I ) and v i c e v e r s a f o r the parents of the au-t i s t i c c h i l d r e n than f o r the p a r e n t s o f the normal c h i l d r e n . (This d i s c r e p a n c y i s an index of spouse m i s p e r c e p t i o n ) • Hypothesis ii was f o r m u l a t e d i n order to assess the degree to which the mother and 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 behavior of the c h i l d s e l e c t e d f o r t h i s 3G study. It was postulated that the patient parents would show greater disagreement than the parents of normal children in their descriptions of the child on the Interpersonal Check L i s t . The specific hypothesis was as follows: Hypothesis ii - There w i l l be a significantly greater dis-crepancy between the mother and father i n their perception of their child at Level II for the parents of the autistic child-ren than for the parents of the normal children. Hypothesis 5 was formulated in order to assess the a t t i -tudes of the two groups of parents regarding the nature of i n -terpersonal relationships. The literature indicated that a characteristic t r a i t of parents of schizophrenic children was the avoidance of interpersonal interaction. Relationships with other people seemed to be an unpleasant experience and were viewed with distrust, 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 III might prove useful. At Level III two measures were obtained, Level III Hero and Level III Other. The latter score provided an indication of the i n -terpersonal behavior which was attributed to the "Other" in "Hero-Other" interactions occurring in TAT stories. In light of the previous literature, 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 - autocratic, competitive - exploitive, blunt-aggressive, and skeptical - distrustful variables. 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. The specific hypothesis was as follows: Hypothesis 5> - At Level III Other, significantly more summary point scores w i l l f a l l Into oc-tants 1 , 2 , 3 and 11 for the parents of the autistic children than for the par-ents of the normal children. 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 dimen-sions u t i l i z e d in the present study, I. Subjects A total of twelve married couples were assessed. The ex-perimental group consisted of 6 couples, each having a child who had been accepted into a treatment program for schizophre-nic children at the Mental Health Centre in Burnaby, B.C. The formal diagnoses of these 6 children were as follows: li early infantile autism according to the c r i t e r i a of Kanner, 1 secon-dary autism, again according to Kanner's c r i t e r i a , and 1 child-hood schizophrenia with cerebral lesion. Five of the six cases, therefore, f a l l within Kanner's autistic classification. Using the parents of the autistic group as a base, a con-t r o l group of parents of normal children was then selected. Files of the Public Health Officer and Superintendent of Public Health Nurses for the Burnaby School District were examined for families suitable as controls. The families of the normal children were screened for the following variables: 33 1) Characteristica of the children; a c h i l d who correspon-ded as closely as possible to one- of the a u t i s t i c c h i l -dren on the following v a r i a b l e s : a) sex b) age c) o r d i n a l p o s i t i o n In b i r t h order d) number of s i b l i n g s 2) Absence of a history of neurological, p s y c h i a t r i c or chronic physical I l l n e s s i n any of the children, 3) Age of the parents li) Education of the parents 5>) Income of the parents 6) Ethnic o r i g i n of the parents 7) Religion of the parents Families from t h i s population who roughly corresponded to the c h a r a c t e r i s t i c s of experimental families were then contacted and asked to assist i n the present i n v e s t i g a t i o n . From the approximately 20 families who volunteered, the 6 best matching the 6 patient f a m i l i e s were u t i l i z e d i n the study. In a l l cases the selected c h i l d r e n were native born Canadians. The parents had raised the ch i l d r e n themselves and a l l were also the natur-a l parents, excepting 2 cases comprirised of a patient family and i t s control counterpart where the children concerned were adopted at an early age. The c h a r a c t e r i s t i c s of the children are shown i n Table I. The a u t i s t i c c h i l d r e n had a mean age of £ years and II months TABLE 1 3IL CONTROL DATA ON THE AUTISTIC CHILDREN . AND THEIR NORMAL,COUNTERPARTS. CHILDREN'S CH ARACTERISTICS FAMILY SEX OF CHILD - AGE AT ASSESS* MENT (YEARS & MONTHS) BIRTH DATE ORDINAL POSITION OF CHILD NUMBER OF SIBLINGS A* Male April 22/59 1 1 a* Male 5 : 0 May 29/59 1 1 B Male 6 : 2 Nov. 5/58 1 0 b Male 6 : 2 May 2IL/58 1 0 C Male i}-:7 April 28/59 k 3 c Male 5 : 0 April 21 /59 k 3 D Male 7 : 6 May 31/56 3 3 d Male 7 : 7 Oct. 16/56 3 2 E Female Aug. 9/59 3 2 e Female l i : 8 Sept. 7/59 3 2 F Male April 23 /59 k 3 f Male !L:8 Sept. 3/59 k 3 - * (Families with capital letters are those having an autistic child, while families with small letters are the corresponding normal controls). 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) RELIGION Mr. A*fr Jan. 20/35" 28:10 11 Ukranian 102 5 . 0 0 0 United Mrs. A Oct. 26/3H 29:3 11 English 111 Mr. a * Jan. 16/23 hlik 11 Danish 103 11,500 Protestant Mrs. a Feb. 2 3 / 2 3 111: 3 8 English 100 Mr. B April 2 7 / l l i li.9:6 9 English 110 None Mrs.. B Oct. 28/20 K.3:2. 9 German 109 ll,600 Mr. b. June 17/19 hk:2 10 English 12k 5 . 0 0 0 United Mrs. b June 28/23 i i l : l 9 German 122 . Mr. C . May 2k/21t 3 9 : 6 13 English 131 i i , 8 0 0 United Mrs. C. Feb. 2ii/30 3 3 . 8 9 English 103 Mr. c Dec. 10/25 3 8 . 5 13 English 116 6 , 0 0 0 United Mrs. o . May 8/30 3 i i . 0 10 English 121 Mr. D April 1/31 3 2 . 8 12 English 108 1I..900 Protestant Mrs . .D. Aus. 2/28 35:k 10 English 125 Mr. cL Sept. It/25 3 8 : 9 10 English 116 5 , 0 0 0 Protestant Mrs.. d Nov. I L L / 2 9 3 k : 6 12 Italian 107 Mr. E May l t/23 L L 0 : 7 9 English 100 li , 5 0 0 United Mrs. E Nov. 8/28 35:1 12 English 115 Mr. e Sept. 3/32 31:8 12 English 125 Protestant Mrs . e June 2 k / 3 2 3 1 : 1 0 12 English 122 5 . 0 0 0 Mr. F Jan. 8/25 3 8 : 8 16 English 128 7 ,200 Protestant Mrs.~.F Aug. 2/27 36 :k English 127 Mr . f , May 25/22 E l : l ll English 119 6 , 0 0 0 Prot estant Mrs. f Dec* I I L / 2 1 - U2:k 12 English 113 * (Famil ies with cap It a l letters are i those having an autistic child while families with small letters are the corresponding normal controls). # (The intelligence quotients were obtained from a separate study on.the above families.) 36 whereas the control children had a mean age of 5 years 6 months. The characteristics of the parents are shown in Table II. 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 of 37 years and 6 months. On the average, therefore, the control parents were slightly 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 level 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 closely matched. Considering the number of va r i -ables t a k B n into account, the matching achieved was very satis-factory. II. Procedure Each married couple was contacted by telephone and an appointment was arranged. A l l tests administered included 37 standard written instructions and were completed at one sitt i n g . The investigator gave no assistance to the subjects except in 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 in individual 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 arith-metical formulae and the vertical (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 resulting figures were the MMPI "raw score" Indices. (See Appendix B for a sample protocol and a derivation of the raw score indices). 2) Interpersonal Check List (ICL) Husband and wife were each administered the ICL accord-ing to the standard instructions printed on the f i r s t page (See Appendix A for the test form and instructions). The subject was asked to describe himself i n column 1, his mother in column 2, his father in column 3, his child in column 11 (this being the autistic child in the patient group 38 and his normal counterpart i n the control group), his ideal-self i n column 5 , and his spouse in column 6 . Following the Leary system the frequency of characterizing each individual 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 in octant AP, etc. The resulting figures were the "raw score" indices for the ICL. The above equations were devised by Leary in order to locate a summary point i n the area comprising the circle 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 ut i l i z e d , the specific cards differing" 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, in that order. The subjects wrote their 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 stor-ies periodically as the subject wrote them and suggested ad-ditional material i f necessary to conform to the instructions 3 9 e.g., development of a theme or a more specific outcome. The task of the experimenter was to direct the subject to respond with ratable stories. The scoring sheet used to rate the TAT stories is shown in 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 in rating a story was to select the "Hero" and the "Other". The "Hero" was the character in the story with whom the subject evidently identified. The "Other" referred to any character, except the "Hero" involved in the story, to whom feelings or actions were ex-p l i c i t l y assigned by the subject. At Level III, therefore, measures were obtained not only of interpersonal themes attributed to the self or self-identi-fied heroes, but also the interpersonal themes attributed to the others with whom the fantasy self interacted. A rating in terms of the letter codes from the interper-sonal 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 their scoring decisions independently. The judge then inspected these ratings and made a third and decisive rating only when the f i r s t two independent raters were in disagreement• The columns "Hero Role" and "Other Role" on the rating 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 L i s t . The resulting figures were the "raw score" indices for the TAT and yielded a measure of the interpersonal themes re-vealed at the level of fantasy or indirect expression. The three preceding sections have outlined the administra-tion and scoring of the tests used at Levels I, II and III and the computation of the raw score indices for each l e v e l . These scores provided a composite measure which reflected the rela-tive strength of each of the 8 variables of the circular con-tinuum at a particular level. The raw score indices were converted to standard scores by use of norms developed by Leary (1956). (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 location of the summary point on the diagnostic ci r c l e , with summary points f a l l i n g within one sigma of the mean assigned a moderate diag-nosis and those f a l l i n g beyond assigned an extreme diagnosis. The numerical code summarizing the position of the score in the circle depended upon the particular octant in 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 variability indices were calculated by use of a table of weights kl provided by Leary ( 1 9 5 6 ) . These expressed directly the amount and kind of discrepancy between any pair of diagnos-t i c code numerals, thus permitting the hypothesized compari-sons to be made. There were lk possible discrepancies, rang-ing at unequal intervals from 0 to Ilk. 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 five hypotheses formulated i n Chapter III. III. S t a t i s t i c a l Analysis Hypotheses 2., 5. and 4 in this study involved a compari-son of specific variability 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 Ilk ( 0 , 2 3 , 26, k l , kk, k8, 62, 66, 68, 8 l , 8k, 9 1 , 1 0 5 , Ilk) which reflect the amount of discrepancy between any 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 inter-vening between any two summary point scores increased, the weighted score assigned to the particular variability index correspondingly increased to a maximum of Ilk. In order to test whether two groups of subjects differ in the amount of discrepancy arising i n relation to some varia-b i l i t y index, Leary has recommended that a chi 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 cells of a 2 X 2 contingency table and In this way determine whether a significantly l a r -ger proportion of subjects in any particular group had obtained scores above the cutting point of kk. This method, however, had certain weaknesses. F i r s t l y , the particular reasoning behind the choice of a score of kk as a cutting point was somewhat vague. It was arbitrarily 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, for example, i f a l l members of a group had discre-pancy scores of kk on some particular variability index while members of a second group had discrepancy values of k8, chi square would indicate a s t a t i s t i c a l l y significant 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 dis-crepancy scores of 62 while a l l the members of a second group were to obtain discrepancy scores of Ilk, one would feel that the numerical difference was substantial and indicative of some basic difference between the two groups. A chi square test, however, would not corroborate the difference s t a t i s t i -cally as a l l the discrepancy scores would have fallen 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 use o f the c h i square method, 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 M a t c h e d - P a i r s Signed-Ranks T e s t ( S i e g e l , 1956) was a more s u i t a b l e s t a t i s t i -c a l t e c h n i q u e f o r t e s t i n g Hypotheses 2, 3 and 4. T h i s t e s t i s a n o n p a r a m e t r i c t e c h n i q u e f o r use w i t h 2 matched samples. I t t a k e s i n t o account 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 weight t o a p a i r showing 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 a s m a l l d i f -f e r e n c e , and t h u s made f a r b e t t e r use 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 . I n Hypotheses „1. and 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 of 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 and c o u l d be r e p r e s e n -t e d by f r e q u e n c i e s i n a 2 X 2 c o n t i n g e n c y t a b l e . As t h e number o f cases 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 est was us e d ( S i e g e l , 1956). Hypo-t h e s i s 5 was t e s t e d by t h e c o n v e n t i o n a l c h i square method. CHAPTER V RESULTS The r e s u l t s o f the s t a t i s t i c a l a n a l y s i s of the f i v e hy-potheses are presented below. The raw s c o r e I n d i c e s , standard s c o r e s , and octant summary p o i n t scores o b t a i n e d by the two parent groups at L e v e l s I, I I , and I I I are presented l n Appen-d i c e s F, G, and H, r e s p e c t i v e l y . Hypothesis 1 p o s t u l a t e d t h a t the mothers would be the dominant members more o f t e n In the p a t i e n t f a m i l i e s than i n the c o n t r o l f a m i l i e s . Tie standard s c o r e s o b t a i n e d by the pa-t i e n t and c o n t r o l p a r e n t s on the dominance-submission dimension at L e v e l I are shown i n T a b l e 3* It can be seen from t h i s t a b l e t h a t o f the s i x pat l e n t - f a m i l i e s , i n only one was the dominance score of the wife h i g h e r than that of the husband. In the c o n t r o l group the dominance score of the wife was h i g h -er than t h a t of the husband i n two f a m i l i e s . A n a l y s i s by the F i s h e r Exact Test of S i g n i f i c a n c e y i e l d e d a p v a l u e of .14-09, short of the s i g n i f i c a n c e l e v e l o f .0£ set f o r t h i s study. Thus d i f f e r e n c e s between groups were not observed. The second hypothesis p o s t u l a t e d that the p a t i e n t parents would be l e s s aware of t h e i r i n t e r p e r s o n a l c h a r a c t e r i s t i c s than the c o n t r o l p a r e n t s . Discrepancy s c o r e s o b t a i n e d by the p a t i e n t and c o n t r o l parents on the s e l f - d e c e p t i o n index are shown i n Table L L . An i n s p e c t i o n of the data i n Table I4. shows a s l i g h t t r e n d toward l a r g e r d i s c r e p a n c y s c o r e s f o r the c o n t r o l TABLE 1 STANDARD SCORES OBTAINED BY PATIENT AND CONTROL PARENTS ON THE DOMINANCE-SUBMISSION DIMENSION AT LEVEL I Patient Parents Control Parents Standard Standard Score Score Mr. A 61* Mr. a 57 Mrs. A 59 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 1*6 Mr. E 61 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. k 6 TABLE lj. LEVEL I SELF - LEVEL II SELF DISCREPANCY SCORES OBTAINED BY.PATIENT AND.CONTROL PARENTS . (INDEX OF "SELF DECEPTION") Patient Parent a Control Parents Discrepancy Discrepancy .Score Score Mr. A 23 Mr. a kl Mrs. A 66 Mrs. a 00 Mr. B k l 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 k 8 Mr. F" kl Mr. f. 66 Mrs. F k l Mrs. f 66 X = k 2 . 2 5 X = k 8 . k 2 1*7 parents, a trend opposite to the hypothesized direction. Analysis by the Wilcoxon test yielded a T value of 16.5. This failed to reach a .05 level of significance. The hypothesis was not supported. Hypothesis 3 postulated that the patient parents would misperceive the characteristics of their spouses to a greater degree than the control parents. The discrepancy scores ob-tained by the patient and control parents are shown in Table 5» Inspection of the data in Table 5 shows no trend toward differentiation of the two groups on the basis of scores ob-tained on the index of spouse misperception. Analysis by the Wilcoxon test yielded a T value of 32 and this failed to reach the .05 level of significance. The hypothesis was thus not supported. Hypothesis It postulated that the patient parents would show greater disagreement in their perceptions of their child than the control parents. The discrepancy scores obtained by the patient and control families are shown in Table 6. In-spection of the data in Table 6 shows that there Is l i t t l e to choose between the two groups in terms of the discrepancy a r i -sing between mother and father in their perception of the child involved i n this study. Analysis by the Wilcoxon test yielded a T value of 10. This again fa i l e d to reach the .05 level of significance. 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 HUS-BAND'S PERCEPTION OF.HIS WIFE .AT LEVEL II AND VICE VERSA Patient Parents Control Parents Discrepancy Discrepancy . Score Score Mr. A 32 Mr. a kk Mrs.A kl Mrs. a kk Mr. B kl Mr. b kk Mrs. B kl Mrs. b 2 3 Mr. C kl Mr. c 2 3 Mrs. C 2 3 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 2 6 Mr. F 00 Mr. f 62 Mrs. F 8 1 Mrs. f k 8 k9 TABLE 6 LEVEL II CHILD (HUSBAND) - LEVEL II CHILD (WIPE) .. DISCREPANCY SCORES OBTAINED.BY PATIENT AND CONTROL FAMILIES Patient Families Control Families - Discrepancy -Score Discrepancy Score A 26 a kl 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 = , 5 0 . 3 3 50 interpersonal interactions as being hostile and unaff i l i a t i v e . More specifically, i t was hypothesized that at Level III, the patient parents would, to a greater degree than the control parents, perceive the "Other" In "Hero-Other" interactions as being hostile and unaffiliative (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 III Other are shown in Table 7« Inspection of the data in Table 7 shows that i n the patient families, 9 parents obtained summary point scores which f e l l into octants 1, 2, 3» and k whereas, in the control families, 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, this was significant at better than the .02 level. The two groups were thus differentiated at an acceptable level of s i g n i f i -cance by the octant scores obtained at Level I I I Other. Of the five hypotheses formulated, therefore, only Hy-pothesis 5 was confirmed. 51 TABLE X OCTANT SUMMARY POINT SCORES OBTAINED BY PATIENT AND CONTROL PARENTS AT LEVEL III OTHER Pat 1 ent Paren13 Control Parents Level III Level III Other Score Other Score Mr. A 2* Mr. a Mrs. A k Mrs. a 8 Mr. B" k Mr. b I Mrs. B Mrs. b 1 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. e 1 Mrs. E 3 Mrs. e I Mr. F 1 Mr. f 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 CONCLUDING REMARKS The present study attempted to test the validity of c l i n i c a l and research findings on the parents of schizophrenic children. Certain personality traits and family relationships thought to be characteristic of such parents were operationally defined and measured within the framework of the Interpersonal System of Personality Diagnosis developed by Leary and his associates (Leary, 1 9 5 6 ; Leary, 1 9 5 7 ) • An analysis of the data failed to reveal any widespread differences between a group of parents of autistic children and a control group of parents of normal children. Of five hypotheses formulated on the basis of previous work, only one was found to differentiate the two groups. Hypothesis 1 tested the widely held assumption that the typical pattern to be found i n the families of schizophrenic children was that of a dominant wife and passive father. In order to test this hypothesis the scores on the dominance-sub-mission dimension were used. The hypothesis was not substan-tiated. The failure of the analysis to confirm the hypothesis must be assessed in light of the following three considerations. F i r s t l y , this pattern, although widely speculated upon in the literature (Clardy, 1 9 5 l ; Despert, 1 9 3 8 ; Potter, 1 9 3 3 ; Rank, 1 9 4 9 ; Slimp, 1951)> has been found In only 1 of the 1 studies which specified that the children being referred to were diag-nosed as autistic (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 earlier, this use of a self-referent technique was Inconsistent with the definition 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 metho-dological weakness. Both authors found that the MMPI failed to predict Level I behavior as measured with ratings of a subject by others on the Interpersonal Check L i s t . The third consideration involved a close examination of the rationale used by Leary in his calculation of the "Dom" (dominance-submission dimension) and "Lov" ( h o s t i l i t y - a f f i l i -ation dimension) scores. (See Appendix C). Many of the assumptions made by Leary regarding the geometric and trigo-nometric properties of his circular continuum have come under strong attack (Baumrind, I960; Klopfer, 1957; 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 validity of the mathematical procedures used by Leary in calculating a single summary point score. Thus, insofar as the data obtained In this 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 occur i n families of children suffering from other subgroupings of childhood schizophrenia, i t does not occur in families with autistic children. Hypotheses 2 and 3 were formulated in order to more ob-jectively define the "empathy" and "emotional detachment" fac-tors • The negative results raise questions as to whether the tests were actually related to "empathy" and "emotional detach-ment". The problem is inherent in many studies attempting to translate c l i n i c a l terms and concepts into more objective and operational definitions amenable to rigorous study and analy-s i s . Frequently the greatest doubt i n such studies surrounds not the validity of the constructs themselves but rather the validity of the operations that were used to measure the con-structs* A l l that can be stated is that the operational measures used in Hypotheses 2 and 3 failed 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 is only tentative In light of possible weaknesses in the Leary system. As was discussed in relation to Hypothesis 1 , there exists some question as to the validity of the mathematical procedures used by Leary to arrive 55 at a summary point score. These problems at the level of mathematical operations lead in turn to doubts as to the validity of discrepancy scores as these are based on summary point scores. This must be emphasized in relation to Hypothe-ses 2, 3 and k as discrepancy scores arising between different individuals or different levels formed the basic data for a l l three. There is also a temporal variahle involved here. It is possible that the absence of empathy and sensitivity was not in the sense of an absolute deficiency but rather a certain slowness In the operation of these a b i l i t i e s (Block et a l , 1958). It might be that the parents failed to respond to their child because they could not be sufficiently sensitive to his fluctuating needs and wishes. Thus, ln the present study where these a b i l i t i e s were being assessed in relation to the "self" and individuals i n the family unit, such an impairment may not have become evident. A f i n a l variable which must be accounted for is that of social desirability i n responding to the MMPI and the Inter-personal Check L i s t . This response set was particularly l i k e l y to have influenced responses to the latter instrument as the adjectives are systematically categorized with the more ex-treme adjectives, some of which are clearly undesirable ones, in the last two columns of the check l i s t . This may have affected Hypotheses 2, 3 and k in which parts of the data were obtained from the Interpersonal Check L i s t . 56 It is obvious from the above observations that the failure to confirm Hypotheses 2 and 3 does not preclude the possibility that the parents of autistic children are in 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 traits of their children. The failure to find 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 restricted range of behavior and an Inability to relate themselves i n the ordinary way to other people. Conse-quently It was discovered that many of the adjectives on the Interpersonal Check List simply were not applicable. As a result, eleven of the twelve summary point scores received by the autistic children f e l l in the moderate range. As the dis-tance between adjacent octants i n this region is minimal (see Figure 1} this resulted in a concomitant decrease in a l l dis-crepancy score values pertaining to these children. An interesting trend which did emerge in relation to the patient group was that the fathers tended to attribute more "hostile" traits to the children whereas the mothers tended to describe these very same children as being more "loving" and " a f f i l i a t i v e " . The control parents failed to show this same systematic pattern in the descriptions of their children. This difference; was not significant, however, as analysis by 57 the Fisher Exact Test yielded a p value of only .10. As no independent assessment of the children had been attempted, it was not possible to 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 hos-t i l i t y to a child who did 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 of interper-sonal relationships. The results showed that in the patient group the parents had a generalized stereotype of other people i n interpersonal interactions as being "Managerial - Autocratic", "Competitive -Exploitive","Blunt - Aggressive", and "Skeptical --Distrustful" while the parents i n the control group perceived such people as being more accepting and generous. Looked at in 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; Kanner, 191*9; Perr, 1958; Singer and Wynne, 1963) reporting that the parents of schizophrenic 58 children were distrustful and fearful about interacting with others. More specifically, the patient parents in this study seemed to view others as being rather hostile, exploitive and unloving. Such attitudes might be expected to lead to hesita-tion and doubts as to the value of interpersonal interactions and a resulting inability to form satisfactory human relation-ships • If these attitudes were strong enough they might very well pervade and interfere with adequate functioning of the family and influence adversely relationships with the child. A further examination of the data on self or self-iden-t i f i e d heroes at Level III showed that 9 patient parents and 7 control parents obtained scores in "Managerial - Autocratic", Competitive - Exploitive", "Blunt - Aggressive", and "Skepti-cal - Distrustful" octants of the circular continuum (octants 1, 2, 3 and k). These same four octants, i t w i l l be remembered, had differentiated the two groups at Level III Other. Of special interest at Level III Hero, however, was the fact that of the 9 patient parents scoring in these octants, 6 obtained scores which f e l l into octant k, the skeptical-distrustful 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 hostile and unloving but in 6 of the 12 cases saw themselves as being skeptical and distrustful. This finding 59 would seem to offer more direct support for the view that the parents of schizophrenic children are skeptical about inter-personal relationships* In such circumstances It might be expected that these people would make attempts to avoid such Interactions. Once in such a situation, they might also f a i l to respond in 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 of the five hypotheses, only the one involving the TAT, the more projective aspect of the assessment, yielded a significant result. 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 role they might have played in the genesis of the disorder. In the control group, however, this factor was not present. Thus, in the present investiga-tion, i t may very well be that the patient parents were at least somewhat aware that an attempt was being made to corre-late autism with certain abnormalities i n their personalities. This in turn may have led to defensiveness in responding to such self-referent tests as the MMPI and the Interpersonal Check L i s t , although the absence of high scores on the validity scales of the MMPI would seem to lessen the probability that 60 this had exerted an undue influence on that instrument* No such measures were available, however, for the Interpersonal Check List scales* In the present investigation i t must also be remembered that 5 of the 6 children i n the patient families had been diagnosed as a u t i s t i c . Many of the earlier studies suffered from a failure to specify the exact diagnoses of their subjects. There has been a tendency for a l l children to be lumped to-gether within the broader category of childhood schizophrenia and this has made meaningful comparison of results across these various studies d i f f i c u l t . Furthermore, only a total of 12 families, 6 patient and 6 control, were studied. The sample size, therefore, was ex-tremely small and a larger sample might have allowed for the emergence of more significant findings. Another issue running throughout the study involves the retrospective nature of the methodology used. It is feasible to argue that although the parents do not presently show the traits usually attributed to parents of schizophrenic children, they may have possessed these tr a i t s during the early infancy of their autistic child. Longitudinal study of this question would, of course, be crucial, but at present i t does not seem practical to attempt selecting a group of parents on the basis of the fact that they show traits usually associated with childhood schizophrenia. Although the evidence for the importance of family and parental 61 factors in the background of childhood schizophrenia is quite compelling, these factors need to be more clearly defined and corroborated before such an undertaking would be worthwhile. In conclusion the attempt made in the present study to operationally define and test some of the characteristics of the parents and families of schizophrenic children reported in the literature has fai l e d to arrive at any clear-cut differences between a group of parents of autistic children and a control group of parents of adequately functioning c h i l -dren. Despite the great efforts to cope with the problem of etiology in childhood schizophrenia, It s t i l l poses a major dilemma. The lack of consistency in the findings can be large-ly attributed to a pa r t i a l or total neglect of important variables. Designs in future research should deal with such variables as social class, ethnic origin, age, diagnostic categories and religion. Until these variables are accounted for and specified i n research projects, inconsistency and con-fusion w i l l hinder real 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 literature reported up to this period, although often faulty i n design, has provided sufficient leads for other 62 workers to Investigate. E f f o r t s should be made to single out more limi t e d aspects of the problem such as "empathy". U n t i l the parameters of these i n d i v i d u a l variables 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 possible. APPENDIX A THE INTERPERSONAL CHECK LIST A SAMPLE PROTOCOL 64 The Interpersonal Check List Name "-- Age Sex Date Testing #_ Addres s C ity Phone E ducat ion Occupation Marital Status Referred by Group Other 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 administra-tor 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 O O O O O O O O suspicious After you have gone through the list marking those items which apply to you, return to the beqin-ning 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 duplica-tions, 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 List 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 S e l f Col. 2 •otaer S U B J E C T ' S NAME SAMPLE: 1 2 3 4 5 6 7 8 0 A I O I O I I O O w e l l - b e h a v e d Col. 3' F a t h e r Col. 4 C h i l d  Col. 5 I d e a l S e l f 1 2 3 4 5 6 7 8 1 P l I l M l O O w e l l t h o u g h t of 1 2 3 4 5 6 7 8 2 P l O l o M O O m o l c e « « flood Impre s s i on 1 2 3 4 5 6 7 8 3 A M I O I I O O a b l e t o g i v e orders 1 2 3 4 5 6 7 8 4 A O O O l O l O O f o r c e f u l 1 2 3 4 5 6 7 8 5 B M I O M O O s e l f - r e s p e c t i n g 1 2 3 4 5 6 7 8 6 B l l l O l l O O i n d e p e n d e n t 1 2 3 4 5 6 7 8 7 C # # # 0 # # 0 0 a b l e t o t a k e c a r e of s e l f 1 2 3 4 5 6 7 8 8 C i l l l l l O O c a n be Indifferent to o thers 1 2 3 4 5 6 7 8 9 D l O l O l l O O c a n b e s t r i c t i f j i e c e s s a r y ,1 2 3 4 5 6 7 8 ID D l l i O l l O O f i r m but ju s t 1 2 3 4 5 6 7 8 11 E l i l O l i O O c a n b e f r a n k a m h o n e s t 1 2 3 4 5 6 7 8 12 E O O O O O O O O c r i t i c a l o f o t h e r ^ 1 2 3 4 5 6 7 8 13 F I I I I I I O O c a n c o m p l a i n i f |necessary 1 2 3 4 5 6 7 8 14 F O O O O O O O O o f t e n g l o o m y 1 2 3 4 5 6 7 8 15 G l l l O f l O O a b l e to d o u b t oljhers 1 2 3 4 5 6 7 8 16 C O O O O O O O O f r e q u e n t l y d i s a p p o i n t e d 1 2 3 4 5 6 7 8 17 H # # # 0 ® 0 0 0 a b l e to c r i t i c i z e s e l f 1 2 3 4 5 6 7 8 18 H O O ' O O O O O O a p o l o g e t i c 1 2 3 4 5 6 7 8 19 I O O O O O O O O c a n be o b e d i e n t 1 2 3 4 5 6 7 8 20 I O O O O O O O O u s u a l l y g i v e s i i 1 2 3 4 5 6 7 8 21 J i l l O l l O O g r a t e f u l 1 2 3 4 5 6 7 8 22 J O O O O O O O O a d m i r e s a n d Imitates o the r s 1 2 3 4 5 6 7 8 23 K # # 4 C # # 0 0 a p p r e c i a t i v e 1 2 3 4 5 6 7 8 24 K O O O O O O O O v e r y a n x i o u s to b e a p p r o v e d of 1 2 3 4 5 6 7 8 25 L l l O O l l O O c o o p e r a t i v e 1 2 3 4 5 6 7 8 26 L l i l O l t O O e a g e r t o g e t alcjng w i th o thers 1 2 3 4 5 6 7 8 27 M i i l l M O O f r i e n d l y 1 2 3 4 5 6 7 8 28 M # # # 0 # # 0 0 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 1 2 3 4 5 6 7 8 29 N I H O I A O O c o n s i d e r a t e 1 2 3 4 5 6 7 8 30 N l l l O l l O O e n c o u r a g e s o the r s 1 2 3 4 5 6 7 8 31 0 © # « O « * O O h e l p f u l 1 2 3 4 5 6 7 8 32 O O O O O O O O O b i g - h e a r t e d a n d u n s e l f i s h 1 2 3 4 5 6 7 8 O O O O O O O O 1 2 3 4 5 6 7 8 O I I O H O O 1 2 3 4 5 6 7 8 O O l O O O 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 l o i o i # o o 1 2 3 4 5 6 7 8 l o l o l i o o 1 2 3 4 5 6 7 8 O O O O O O O O -2 3 4 5 6 7 8 o o o M 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 t « « o i # o o 1 2 3 4 5 6 7 8 O O I I O O O O 1 2 3 4 5 6 7 8 f l M H 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 O O O O O O O O 1 2 3 4 5 6 7 8 O O O l O O O O 1 2 3 4 5 6 7 8 O O O I O O 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 O i O S O O 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 O M O I I O O 1 2 3 4 5 6 7 8 0 0 0 * 0 0 0 0 1 2 3 4 5 6 7 8 # 0 0 0 0 0 0 0 1 2 3 4 5 6 7 8 O O O O O O O O 1 2 3 4 5 6 7 8 M I I I I O O 1 2 3 4 5 6 7 8 O O O O I O O O 1 2 3 4 5 6 7 8 o o o » » o o o 1 2 3 4 5 6 7 8 l « « O I I O O 1 2 3 4 5 6 7 8 I l l f l l l O O 1 2 3 4 5 6 7 8 l l l o l i o o 1 2 3 4 5 6 7 6 O O O O O I O O 1 2 3 4 5 6 7 8 0 0 O O O # O O 1 2 3 4 5 6 7 8 O O O O O l O O 33 of ten a d m i r e d 34 r e s p e c t e d by o the r s 35 good l e a d e r 36 l i k e s r e s p o n s i b i l i t y 37 s e l f - c o n f i d e n t 38 s e l f - r e l i a n t a n d a s s e r t i v e 39 b u s i n e s s l i k e 40 l i k e s to c o m p e t e w i t h o ther s 41 h a r d - b o i l e d when n e c e s s a r y 42 s te rn but f a i r 43 i r r i t a b l e 44 s t r a i g h t f o r w a r d a n d d i r e c t 45 r e s e n t s b e i n g b o s s e d 46 s k e p t i c a l 47 hard to i m p r e s s 48 t o u c h y and e a s i l y hurt e a s i l y e m b o r r o s s e d 50 l o c k s s e l f - c o n f i d e n c e 51 e a s i l y l ed 52 modest 53 o f ten h e l p e d by others 54 vary r e s p e c t f u l t o au thor i t y 55 a c c e p t s a d v i c e r e a d i l y 56 t ru s t i n g a n d eager to p l e a s e 57 a l w a y s p l e a s a n t and a g r e e a b l e 58 wants everyone to like him 59 s o c i a b l e a n d n e i g h b o r l y 60 worm 61 k ind a n d r e a s s u r i n g 62 tender a n d s o f t - h e a r t e d 63 e n j o y s t a k i n g c a r e of o ther s 64 g i v e s f r e e l y of s e l f 1 2 3 4 5 6 7 8 O O O O O O 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 O O O O O O 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 O O O O O O O O 1 2 3 4 5 6 7 8 O O O O I O 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 O O O O O O 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 O O O O O O 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 O O O O O O O O 1 2 3 4 5 6 7 8 O J O O O O 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 O O O O O O 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 O O O O O O O O 1 2 3 4 5 6 7 8 l o o l o o 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 O O O O O O O O 1 2 3 4 5 6 7 8 o o o l o o 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 O O O O O O 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 O O O O O O 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 o o o o # o 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 o o o o o o 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 o o o o o o o o 1 2 3 4 5 6 7 8 o o o o o o o o t h i n k s only) of h i m s e l f 72 | shrewd.ond c a l c u l a t i n g 73 '. impat ient w|ith o t h e r s ' m i s t a k e s 74 | s e l f - s e e k i n g 75 o u t s p o k e n 76 of ten unf r iend ly 77 b i t te r .„ 78 complain in< | 79 j e a l o u s 80 slow to forgive o wrong B l self-punishing 82 shy 83 p a s s i v e and u n a g g r e s s i v e 84 meek ' 85 dependent 86 want s to be l e d 87 lets others make decisions 88 e a s i l y foo led 89 t oo e a s i l y i n f l uenced by f r i e n d s 90 w i l l con f i de in a n y o n e 91 fond o f everyone 9 2 l i k e s everybody 93 f o r g i v e s anyth ing 94 ; o v e r s y mpOthotic 95 generous t o a fau l t 96 ove rp ro tec t l ve of o t h e r s Col. 8 Date 1 2 3 4 5 6 7 8 O O O O O O 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 O O O O O O 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 O O O O O O 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 O O O #o O 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 O O O O O O 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 O O O O O O 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 O O O O O O 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 o o o l o o 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 O O O O O O 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 O O O O O O 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 O O O O O o 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 o o o o o o 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 o o o o o o 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 o o o o o o o o 1 2 3 4 5 6 7 8 O O O O l O 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 O O O O l O 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 o o o o o o o o 97 t r i e s to b e t o o s u c c e s s f u l P 98 expects everyone to admire him P 99 manages others ]0O d i c t a t o r i a l 101 s o m e w h a t s n o b b i s h 102 e g o t i s t i c a l a n d c o n c e i t e d 103 s e l f i s h 104 c o l d a n d u n f e e l i n g 105 s a r c a s t i c 106 c r u e l a n d u n k i n d 107 f r e q u e n t l y ang ry 108 h a r d - h e a r t e d 109 r e s e n t f u l 110 r e b e l s a g a i n s t e v e r y t h i n g 111 s t u b b o r n 112 d i s t r u s t s e v e r y b o d y 113 t i m i d 114 a l w a y s a s h a m e d o f s e l f 115 o b e y s t oo w i l l i n g l y 116 s p i n e l e s s 117 h a r d l y e v e r t a l k s b a c k 118 c l i n g i n g v i n e 119 l i k e s to be t a k e n c a r e o f 120 w i l l b e l i e v e a n y o n e 121 w a n t s e v e r y o n e ' s l o v e 122 a g r e e s w i t h e v e r y o n e 123 f r i e n d l y a l l the t i m e 124 l o v e s e v e r y o n e 125 t oo l e n i e n t w i t h o t h e r s 126 t r i e s to c o m f o r t e v e r y o n e 127 t oo w i l l i n g t o g i v e to o t h e r s 128 s p o i l s p e o p l e w i t h k i n d n e s s Col. 1 S e l f Co l . 2 Moth, Col. 3 F a t h , Col. 4 Chile Col. 5 I d . S e l f Col . 6 Sp. Col. 7 Co l . 8 Initials Initials Initials Initials Initials Initials Initials Initials 1 .3 3 4 r. A P A P A P A P A P A P A P A P 7 4 c p 7 B C B C B C B C B C B C B C B C 4 - , 6 2 5 5 D E D E D E D E D E D E D E D E 2 3 2 4 2 2 F G F G F G F G F G F G F G F G 2 3 2 C. 2 1 HI HI HI HI HI HI HI HI 4 3 •% J 4 3 3 J K J K J K J K J K J K J K J K 6 3 10 6 L M L M L M L M L M L M L M L M 4 4 4 0 5 7 N O N O N O N O N O N O N O N O D 1 C . 7 . 8 . 6 1 2 . 0 3 . 4 13 .1 1 4 . P s 6 . 2 7 . 2 5 . 5 7 . 6 5 . 5 4 . 5 L 11 . 6 1 0 . 9 9 . 9 vz. P 1 5 . 6 1 3 . 0 H 1 1 . 3 P. Q 1 1 . 6 6 . 2 1 2 . 0 1 1.3 1.4 - 4 . 2 ' 7 . 6 1 0 . 3 D O M D O M D O M D O M D O M D O M D O M D O M c . 3 ? o - 1 . 7 - 0 . 4 3 . 6 1 . 7 L O V L O V L O V L O V L O V L O V L O V L O V 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 Scorer's Initials 115 -110— 105 -_ 100-^ 95 ; 90-T 85 ^ 8 0 ^ 75 -_ 7 0— -65 -55 -Male 130 — 120-110-100-9 0 -60 -5 0 -4 0 -5 0——30 — 45 -40 — 35 -30 -_ -25 -20 0 — 5 -0— 46 46 70 3 4 S Hy Pdt.4K Ml 6 7 8 9 Pa Pi +1K Sc + IK Ma+.2K For Recording Tor Tc Additional Scales 30-TT 25-15* 2 0 * 70 -65-; 6 0 -55 -— 120 r 115 —no r 105 ^-100 - 85 50-45-40 35 2 0 -59 58 69 69 65 59 60 59 53 - 75 -^-70 r 65 - ^-60 30^ ~- 55 '25-=- ^-50 20^ r 45 W-_ ~T 35 - r 25 j-20 — 0 TorTc K Hs<-.5K 1 Hy Pd+.4K Mf 3 4 5 Pa 6 PMK Sc+IK Ma+.2K 7 8 9 Si TorTc Haw Score 1 _ ±2^JL.^23-1^2§L2±5-$-±1 K to be added 12_ J± 22-23-Raw Score with K 15 27 28 27 18 Name i'ir. D Address. Occupation_ Education^ Date Tested Marital Status Fractions of K .Referred by. NOTES I X M . = LOV. M - D H3 - Fr K-F Hv-Sc = 53-58 = 59-60 Total = 70-46 = 69-59 = -5 = -1 = -6 = 24 = 10 Total = 34 HAW SCORE INDICES FOR LEVEL I: L-vri = -6 LOV = 34 _Age Printed in U.S.A. Copyright 1948. All rights reserved. THE PSYCHOLOGICAL CORPORATION 304 East 45th Street New York 17. New York 60-142S Signature. _Date Profile and Case Summary The Minnesota Multiphasic Personality Inventory N a m e — Starke R. Hathaway and J. Charnley McKinley Address. F Female Scorer's Initials. l Hs-.5K Female 105 -100-95 -90-75 -70-65 -60-55 -50-45 -40-35 -30-25 -20-0-130-120-110-100-90-6 0 -50-40--30-Hy 4 Pd + .4K 5 Mf 6 Pa 7 8 9 0 Pt+1K Sc+IK M O K 2 K SI TorTc For Recording Additional Scales 60- 60-6 5 -60 5 5 T 50 4 5 ~ 4 0 -3 0 -- 2 5 -i 5 - 2 0 ; 15 -10-10-5 -115 -110 • 105 -100 • 95 - 9 0 • 85 - 8 0 • 75 - 7 0 - 65 - 6 0 • 45 -40 -30 • 25 Hs-.5K 1 Hy 3 Pdr.4K 4 Mf 5 Pa 6 Pt-IK 7 Sc*lK Ma-.2K Si TorTc 8 9 0 Raw Score. Occupation^ Education Date Tested_ Marital Status. K to be added Raw Score with K .Age. Referred by NOTES 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 arriving at these equations, the circle was consi-dered to be a two-dimensional array In ordinary Euclidian space and conventional trigonometric and analytic formulae, therefore, related the 16 variables shown in Figure 2. Each circle 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 in two-dimensional space could be represented numerically by the magnitude of its components in two arbi-t r a r i l y selected directions. AP and LM were chosen by Leary as reference directions. The designations Dom and Lov re-spectively were given to the components of the vector sum in these two directions. The formulae for the two components of the vector sum were: (see Leary, 1957. p. 69). 16 1) Dom = Ri sin and . - 1=1 2) Lov = R* cos where R. the score in i - th. category i the angle made by moving in 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 sin Thus the following simplified formulae resulted: Dom = 0.7 (BC + NO - FG - JK) + AP - HI Lov = 0.7 (JK + NO - BC - FG) + LM - DE where AP = score in octant AP, etc. APPENDIX D TAT MOLAR RATING SHEET A SAMPLE PROTOCOL TAT MOLAR RATING SHEET Su b j e c t . . . MB..D Group . ? S U ? n t . . . TAT No. .A Date .?9Y. t . ? < ? * .V?Y3 R a t e r . . . . ! Rater 2 Judge . ? t M 9 t # HERO HERO ROLE OTHER OTHER ROLE HERO HERO ROLE OTHER OTHER ROLE HERO HERO ROLE OTHER OTHER ROLE I boy JP boy JP boy JP 2 f a m i l y 1< f a m i l y M f a m i l y L oBM JGF boy I boy I boy I il- - man H woman N man H woman 0 man H woman N 6BM man H woman N man H woman N man H woman N 6GP man NM woman M man NM woman M man NM woman M 7 B M 'GF boy J man PL boy J man PL bo^ J man PL 12M. hvono• A hypno. A hypno• A 13MP man PH woman 0 man PH woman - N man PH woman N -oBM 1°GF man r hands 0 man r o t h e r s 0 man r others 0 HERO OTHER TOTAL AP 2 1 :BO :DE ~FG 1 HI $ L_JK 2 2 "LM 2 h NO ; 1 T o t a l Dom - l u l l 3.8 Lov 34 IL.8 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 I S - MMPI = Measure of "Self" at the level of public coramunicat ion as-determined by MMPI in -dices . II S - ICL = Measure of "Self" at the level 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 level of preconscious sym-bolization as determined from ratings of TAT stories. I l l 0- TAT = Measure of the interpersonal themes attributed to Others at the level of preconscious sym-bolization as determined from ratings of TAT stories. II M - ICL = Measure of the subject's view of his mother at the level 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 level 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 child . . .„ at the level 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 is right or ideal at the level of conscious communica-tion as determined by scores from the Inter-personal Check L i s t . Record Booklet For Interpersonal Diagnosis of Personality 7k-Subject L A S T N A M E Address. Occupation Referred by r . E s T N A M E A 9 e S e X D 0 t e • .City .Phone Marital Status .Therapist. Group. .Testing #. .Education. Occupation of Spouse Other Sex Age Religion Number of Siblings . Marital Status . . . . Number of Children Subject's Occupation . . 7 Occupation of Mother . . 8 Occupation of Father . . 9 Occupation of Spouse . . 10 Subject's Education . . . 11 Mother's Education . . . 12 Father 's Education . . . 13 Spouse 's Education . . . 14 Referred by . -15 -24 -28 -29 Identifying Codes for Clinical and Sociological Data Therapist 17 . , Type of Therapy 18 . Times Seen 19 , , Disposit ion 20 Condition 21 . 34 35 37 -31 _40 -41 -42 _43 _44 Tests covered by this record: Name Form Test ing # MMPI I C L I F T T A T Previous Consultations _16 .32 This booklet was prepared by Timothy L eary. Ph. D . , and published by the Psychological Consultation Service, 1230 Queens Road, Berkeley 8, California. Checklists, booklets, templates, norms, and instruction manuals can be obtained from the Psychological Consultation Service. Revised 7/1/57. - 1 -Indices of Variability Among Levels of Personality L e v e l and Person Tes t Raw Score Standard Score IP Diag-nosis D L D 'is MMPI - 6 3 4 5 8 6 5 8 * I s S o c i o . II s ICL 4 . 5 0 . 3 . 5 9 4 9 1# III H TAT - 4 . 4 3 . 4 5 4 6 1 8 III 0 TAT 3 . 8 4 . 8 6 6 7 0 8 III MM MMPI II M ICL 1 . 4 2 . 0 5 5 5 0 1 II F ICL 6 . 5 - 1 . 7 6 2 4 6 2 II S p ICL 1 0 . 3 1 . 7 6 7 5 0 ICL - 4 . 2 - 0 . 4 4 8 4 8 4 V Id ICL 7 . 6 3 . 6 4 4 4 4 4 III M IFT III F IFT III S p IFT III _ IFT III _ IFT ; # Un< i e r l i n e d f i g ' j r e s den Dte sxtr 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. i Verbal Definition of Index Opera-tional De fini-tion of Index Diag-nostic Codes K i n d of Discrepancy Amount of Dis-crep-ancy D L S E L F - D E C E P T I O N is ns 8 1 4 1 R E P R E S S I O N Hero ns IIIH 1 8 4 1 R E P R E S S I O N Other iis mo 1 8 4 1 CONSCIOUS I D E N T I F I C A T I O N Maternal IIS HM 1 1 0 CONSCIOUS I D E N T I F I C A T I O N Paternal IIS IIF 1 2 4 1 CONSCIOUS I D E N T I F I C A T I O N Marital IIS II Sp 11 23 CONSCIOUS I D E N T I F I C A T I O N ns iiid E Q U A T I O N Mother-Father IIM H F 1 2 4 1 E Q U A T I O N Mother-Spouse IIM IISp 1 1 23 E Q U A T I O N Father-Spouse H F IISp 2 1 _ 4 4 CONSCIOUS S E L F - A C C E P T A N C E IIS VId 1 4 6 2 S E L F A C T U A L I Z A T I O N IS VId 8 4 91 P R E C O N S C I O U S S E L F - A C C E P T A N C E IIIH V I d 8 4 91 P R E C O N S C I O U S S E L F - A C C E P T A N C E mo vid 8 4 91 M A T E R N A L I D E A L I Z A T I O N HM V I d 1 4 6 2 P A T E R N A L I D E A L I Z A T I O N IIF V I d 2 4 6 6 S P O U S E I D E A L I Z A T I O N nsp vid 14 8 4 P R E C O N S C I O U S IDENTIFICATION—Maternal IIS HIM P R E C O N S C I O U S IDENTIFICATION—Paternal IIS IIIF P R E C O N S C I O U S IDENTIFICATION—Marital IIS IIISp P R E C O N S C I O U S I D E N T I F I C A T I O N -Maternal IIIH IIM P R E C O N S C I O U S IDENTIFICATION—Paternal HIH IIF P R E C O N S C I O U S I D E N T I F I C A T I O N - M a r i t a l nm lisp FUSION Maternal IIM IIIM FUSION Paternal IIF IIIF FUSION Spouse nsp iiisp D I S P L A C E M E N T Maternal—Paternal IIM niF D I S P L A C E M E N T Maternal—Cross-sex IIM IIISp D I S P L A C E M E N T Paternal—Maternal IIF IIIM D I S P L A C E M E N T Paternal—Cross-sex IIF IIISp D I S P L A C E M E N T Spouse—Maternal nsp IIIM D I S P L A C E M E N T Spouse—Paternal IISp IDF Sp.. Misperceptic n 1 4 8 4 (Mr. IIS-Mrs. I ISp.) Mr. Ch.-Mrs. Ch. 4 5 2 6 - 4 -Verbal Summaries of Variability Indices Subject misperceives his own. Subject is consciously identified wi th . Subject's preconscious acceptance of self is_ Subject's preconscious acceptance of self (deeper) i s . Subject is consciously disidentified with_ Subject consciously ideal izes . Subject represses. Subject represses (deeper)L_ Subject consciously equates. Subject's conscious acceptance of self i s _ _ _ _ _ Subject's self-actualization is _ Subject consciously devaluates. Subject is preconsciously identified with_ Subject is preconsciously disidentified with_ Subject fuses his conscious and preconscious images of_ Subject diffuses his conscious and preconscious images of_ Subject displaces his preconscious image of . _onto his conscious perception of_ Clinical Notes APPENDIX P SUMMARY OP RAW SCORE INDICES FOR PATIENT AND CONTROL FAMILIES Patient Parents V0 Parent I S I I S IIIH . rao IIM IIF D .L D . L D . . L D L D L D . L Mr. A. 1 9 k.ti 1.8 -2.3 2.1 2.1 -2 .7 9.9 4.9 7.4 1 4 Mrs. A -2 21 2.4 -2.0 - 7 . 3 -2.1 -1.1 -4.1 3 . 7 -4 .7 0 .7 5 . 5 Mr. B. 5 7 0,2 9.6 - 8 . 5 -k .5 -0 .7 -2.1 5.2 1 5 , 8 5.1 - 8 . 1 Mf s .. B -9 22 2 . 5 5 . 5 -6.8 - 2 . 4 l.k -3.6 5.9 6 . 9 2 . 3 - 7 . 5 Mr.' G. • r< 32 0,1 -5.9 -6,1 -1 .7 0.1 3 , 7 0 .7 -2.1 5.8 -5.8 Mrs. G -36 20 -9.8 18,2 -7.4 -2.k 1,0 1.0 2 3 . 7 -119 1 0 . 7 16,9 Mr. 'D c -u 34 k . 5 0*3 - a . i t 3 4 3 . 8 4 . 8 l.k 2.0 6 .5 -1-7 Mrs. D 6 -1 - 1 , 7 2.1 - i . 7 -2.5 2.1 - 1 . 7 - I . I L -5.6 1 2 . 6 -0.6 Mr. "E 2 t-> 6 .5 -3 .5 -6.6 -2.8 3.0 0.0 11.5 -3.1 6 . 9 1.3 Mrs. E -15 22 10.2 7.2 -2.0 1.4 - 0 . 4 -1.8 10 .9" 6.9 11.6-•10.6 Mr. "F -4 3 16 .5 -•10.. -\ -7.8 0.0 1,0 -5.2 8 . 7 - I 4 . I 1 5 . 7 -6,1 Mrs. F - 2 3 18 -10.6 1 3 . 0 - 6 . 4 -l.k 2 ,5 0 , 3 13,0^  0.6 - 2 . 7 2 .7 Parent IISp. IlCh. VId. D L D . L D . L Mr. A 9 . 6 5 . 2 - o . k -k.2 6 . 5 1 . 7 Mrs. A 8 . 9 0 . 7 0 . 7 - 2 . 1 1 0 . 0 1 . 0 Mr. B 3 . 9 1 1 . 7 - 1 . 7 - 1 . 1 5 . 2 1 2 . 0 Mrs B 6 . 9 5 . 5 1 . 1 8 . 7 6 . 6 4 . 8 Mr. a - 2 . 3 7 . 5 - 3 . 1 0 . 3 1 0 . 6 - 1 . 0 Mrs. G 7 . 8 - 1 0 . 6 - 1 0 . 7 - 0 . 5 1 2 . 7 1 5 . 3 Mr. D 1 0 . 3 1 . 7 - 4 . 2 -O.k 7 . 6 3 . 6 Mrs. ,T> - 5 . 7 - 1 3 . 9 - 6 . 2 0 . 0 6 . 3 6 . 9 Mr. E. 7 . 9 -k«5 - 4 . 5 - 5 . 1 9 . 9 - 0 . 3 Mrs. E 7 . 1 - 5 . i -k . 8 2 . 8 1 1 . 3 6 . 5 Mr. F 1 . 6 2 3 . 6 - 0 . 7 - 6 . 7 lk.O - 4 . 8 Mrs . -F 8 . 7 -7-5 - 0 . 7 7 - 3 8 . 2 6 . 2 C o n t r o l P a r e n t s Parent IS I I S I I I H I I I O I I M I I P D L "D. . L D . L D. . L D. L D . L Mr. a -7 13 7.2 2.6 -0.-9 -3 .5 -0.6 -1.0 1.8 5 4 17.1 9.2 2.0 Mrs . a -12 37 5.6 13.6 -2.k -1.0 1.1 1.7 6.3 3.1 11.9 Mr. b 12 3 2.8 0.7 -3.8 -8.0 1.8 k-k k.o -1.2 4 . 3 -12.0 0.5 Mrs . b -23 13 7.9 -I4..1 k.o -1.3 3.0 -9.8 20.0 114-13.8 Mr. c -13 -1 -9.6 -I+.3 -6.8 -k.O -5.2 0.7 0.7 -3.9 -0.7 7.9 6.1 5.1 -6.1 Mrs . 0 1 -11 3,5 -8,8 - 0 4 -1.7 l j - 5 6.5 0.1 Mr. a -10 31 1.5 0.7 -7.5 -0.1 1L,8 6.8 1.5 5.5 -0.3 1.7 Mrs -31+ 27 -5.0 6.2 -3.6 3.8 -0.6 0.0 7.9 10.3 3.1 7.5 Mr. i- 21 13 10.5 4 . 7 -6.1 -2.1 3.8 0.0 3.3 3.7 11.2 -5.6 Mrs . -e -9 8 -7.4 5.8 0.2 -2.1 3.3 9 4 - 0 4 3.7-10,7 Mr. f -5 ik -7.2 -2.3 -1.7 - 1 4 0.0 0.9 -5.9 12.6 7.0 Mrs . f 3 .; 3 -0.6 - 6 4 -5.0 0.0 1.1 0.7 10,0 5.8 1+.3-10.3 P a r e n t IISp. HCh. VId. L D L D L Mr. a 6.5 2.7 5.8 10.8 Mrs. a 6.1 8.9 0 4 3.8 2 4 Mr. b -1.2 -1.5 0.1 12.7 13.8 Mrs . b 8.8 -9.6 10.1 -2.9 8,9 -1.7 Mr. 0 0.2 -12.2 -14 -8.6 8.5 6.7 Mrs. c -5.1 -2.3 -9.6 6.0 10.6 1.8 Mr. d 5.2 5.8 -1.7 11.9 1 4 1.0 Mrs. d 3.1 9.3 0.0 12.6 6.2 9.6 Mr. e -k.k 8.2 3.8 4 . 2 11.3 -3.5 Mrs. e 7.7 -9.3 2.0 7 4 9.9 8.5 Mr. f 3,7 0.3 2.7 6,3 7.8 k.k M r s . f 2.9 -1.0 0.2 6.2 7 4 APPENDIX G SUMMARY OF STANDARD SCORES FOR PATIENT AND CONTROL FAMILIES P a t l e n t P a r e n t s I S I I S I I I H I I I O I I I M H P r H S p . I l C h . V I d . Mr. A. D . D L D L D L D L D L D L D L D L 61 56 60 50 60 57 59 1+1 66 51+ 63 50 66 51+ 53 1+3 1+0 1+0 Mra. A •59 60 57 1+6 1+5 1+3 1+6 35 58 55 51+ 65 1+9 55 1+6 51 39 Mr. B 62 55 *}| 59 35 kl 1+3 60 66 60 39 59 61 51 1+7 36 62 Mrs B 56 60 57 5f| 17 U 37 61 56 57 1+0 62 51+ 55 58 1+0 1+7 Mr. C 58 6i| — >|2 1+9 10+ 51 65 55 1+6 61 k2 51 57 50 1+9 53 35 Mra. G 1+5 60 hi 69 l|5 p 51+ •55 81+ 1+6 67 67 61+ 36 1+0 58 60 68 M T % T) 58 65 59 It 9 5f| 61 66 70 55 50 62 1+6 67 50 U s 1+8 kk 1+1+ M m . D 63 52 51 51 62 1+1 59 kk 52 1+2 70 1+8 1+6 33 56 P 39 51 M r > . V, 61 5I| 62 >i'i 1+7 So 63 51 68 1+5 62 50 61+ 1+3 1+8 1+2 51 36 Mra, E *h 60 67 56 61 1+9 1+1+ 67 56 68 36 63 1+2 W 51 55 5o M K . 1? 58 53 75 37 )|fi 50 5!l 31 65 32 71+ 111 56 75 53 1+1 61+ 27 w 51 59 1—«»*— ho — ^ i — 6^  Ji5 61 5? 70 Il9 50 * T — H 51 65 53 56 It 5 5© C o n t r o l P a r e n t s IS I I S I I I H 1110 I I M I I P I I S p . I I Ch. V I d . Mr. a P L D L D L D L D L D L D L D L D L u 57 63 50 61+ 38 1+7 56 65 50 62 51 61 60 1+5 k8 M r s . a 55 66 61 63 60 1+6 55 58 62 67 58 b'd 61 58 5«+ 52 27 1+6 Mr. b 65 53 62 53 56 56 68 66 52 1+3 38 1+9 55 1*7 52 1+8 60 65 Mr a. h 51 57 6|| _ k k 1+3 63 1+5 63 i+l 71 68 33 65 37 66 1+8 33 Mr. <3 55 52 in in 55 32 53 kl 61+ 55 51+ 31+ ?2 38 1+6 51 Mr. d 56 6*1 _ i 8 52 1+1 1+8 1+3 68 H 1+8 60 l+l kl 1+6 T i 55 " 5 3 56 J|9 1|5 59 70 77 56 51+ 53 5o 60 55 51 62 21+ 39 Mr a . d Ii6 62 l]7 fe 56 62 1+8 51 % 60 58 ?7 58 59 51+ 62 62 ~w Mr. o 69 57 67 1+3 1+9 1+3 66 51 53 52 68 & 1+8 57 ~ f 8 61+ 55 30 Mra . e 56 55 hh 55 51+ 50 111 61+ 66 1,8 58 36 63 38 56 51 _ 5 T Mr. f -5B- -57- ||5 60 l|l| 1+1+ 51 55 1+2 70 56 58 1+9 57 55 1+1+ ~W 61 53 53 in 52 50 55 % 66 55 59 37 58 ~ f l ^52 1+8 "39 ~52-APPENDIX H--SUMMARY''OF OCTANT SCORES FOR PATIENT AND CONTROL FAMILIES Pat lent Parents IS IIS IIIH IIIO IIM IIP IISp. IlC h . V Id. Mr. A 1* 1* 3 2 1 1 1 3 i t . Mrs. A 8 2 k 2 8 1 2 Mr. B~ 1 8 k k 8 2 8 3 2 Mrs. B 8 1 k } 1 2 1 8 Mr. C 8 3 3 1 2 2 7 3 2 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 5 j Mr. E 1 2 Ik 1 2 1 2 Mr s. E 8 —BBI 1 1 3 1 2 2 6 1 Mr. P 1 2 2 2 8 3 Mrs. P 7 6 1+ 1 1 7 2 8 . $ -Control Parents IS IIS IIIH IIIO IIM IIP IISp. IlCh. v id . Mr. a 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 6 Mra. c 1 6 I i 2 k 6 3 Mr. d 8 1 8 8 1 1 2 5 Mrs. d I 7 8 6 8 8 8 8 8 Mr. e 1 2 3 1 1 2 7 8 1 Mrs. e 8 6 1 2 1 1 2 8 8 Mr. £ 8 6 2 3 1 1 8 5 Mrs. f 1 3 1 8 1 2 1 2 • i # Underlined figures denote extreme summary points while unlined figures denote moderate summary points 82 BIBLIOGRAPHY Anthony, J.. An experimental approach to 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 of schizophrenia. Behavioral  Science,, 195*6, 1, 251-261+. 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