RELATIONSHIP OF ’AUTONOMIC’ BLOOD PRESSURE PATTERN TYPES OF SUBJECT’S PERFORMANCE ON THE WECHSLER-BELLEVUE AND THE RORSCHACH TEST

90 Pages·03.148 MB·English

by  FICCA, SYLVESTER C

The Pennsylvania State College
The Graduate School
Department of Psychology
RELATIONSHIP OF "AUTONOMIC" BLOOD PRESSURE PATTERN
TYPES OF SUBJECT'S PERFORMANCE ON THE
VECHSLER-BELLEVUE AND THE
RORSCHACH TEST
A DISSERTATION
by
Sylvester Charles fFicca
Submitted in partial fulfillment of the
requirements for the degree of
DOCTOR OF PHILOSOPHY
June, 1950
6
A pproved *
R. G. ISernreuter, Professor of
Psychology
Approved
B. V• Foore, Head or tne Department
ACKNOWLEDGEMENT
Grateful acknowledgement is made to the medical
and psychological staffs of the Lyons Veterans Hospital
for their help in the collecting of the data for this
study.
Particular acknowledgement is made to Mrs. Jean
Fognano, nurse at the hospital, for her assistance
throughout the initial stages of the investigation; and
to Dean Clyde for his aid in the statistical treatment
of the data.
The members of my committee, Dr. &. V* Moore, Head
of the Department of Psychology; Dr. G. K. Lott, Psychi­
atrist; Miss M. J. Wyland, Professor in the Department of
Education; Dr. W. U. Snyder, Associate Professor of Psy­
chology have, during the years in which the author was a
student at The Pennsylvania State College, given him con­
siderable knowledge and, guidance.
It Is with deep and sihcere appreciation that I
acknowledge the personal and professional stimulation of
Dr. R. G. Bernreuter, Director of the Psychology Clinic.
343515
TABLE OF CONTENTS
Chapter Page
I INTRODUCTION ............................ 1
A. Statement of the Problem....... 2
E. Review of the Literature....... 2
II PROCEDURES................. 6
A. Selection of the Tests......... 6
1. The Rorschach T e s t ......... .. 6
2. The Wechsler-Bellevue • • • • • • 8
B. Selection of the Subjects.......10
C. The Drugs ................ 15
D. Specific Procedures ............... 17
III RESULTS............................. 21
A. The "Autonomic11 Groups.............21
B. Analysis of the Saline Injections • • 33
C. Analysis of Age and Education • • • • 33
D. Analysis of the Uechsler-Bellevue . • 35
1. General Attainment ............35
2- Wechsler-Bellevue Patterns . . . 42
3. The Scatter Measures.......46
a. Vocabulary Scatter • • • . • 47
b. Mean Scatter......... 47
c. Total Scatter ..........48
E. Analysis of the Rorschach • • • • . . 51
a. Normalizing the Distribution 51
b. Scoring Categories ........ 54
c. Schizophrenic "Signs" . . . 56
IV DISCUSSION........................... 69
V CONCLUSIONS............... 75
VI SUMMARY............................. 77
BIBLIOGRAPHY ..................................... 61
APPENDIX (Typical Reactions to the Drugs)
LIST OF TABLES
Table Page
I Distribution of Subjects in the Various Di­
agnostic Categories...................... 12
II Number of Subjects by Age................ 13
III Number of Subjects by Years of Formal Edu­
cation ................... . ........... 14
IV Distribution of Cases in the Various Diagnos­
tic Categories in Relation to the Seven "Auto­
nomic^ Groups.................... 25
V Total and Mean Systolic Blood Pressure Rise
after Saline Injection for the Five "Auto­
nomic" Groups ........... • • • • • • • • 34
VI Number of Subjects in the "Autonomic" Groups
by A g e .................................. 37
VII Number of Subjects by Years of Formal Educa­
tion in the "Autonomic" Groups . . . . . . 3#
VIII Data for Analysis of Variance in the "Auto­
nomic" Groups in Regard to Age and Years of
Formal Education........................ 39
IX Mean of IQ’s, Weighted Subtest Scores and
Deterioration Percent on the Wechsler-
Bellevue Adult Intelligence Scale Based on
the "Autonomic" Groups ................... 40
X F Ratio to Test the Significance of the Dif­
ference in Full Scale, Verbal and Perform­
ance IQ’s, Subtest Weighted Scores and De­
terioration Percent • • • • ............... 41
XI Means and Standard Deviations of Verbal
Subtests................................ 43
XII Rank Order of the Mean Subtest Scores in the
"Autonomic" Groups ...................... 44
XIII Coefficient of Profile Similarity Comparing
the Patterns of the Different "Autonomic"
Groups with Each Other • • • • ........... 45
Table Page
XIV F Ratios Obtained from Analysis of .Vari­
ance of Vocabulary Scatter Scores for the
Ten Subtests in the "Autonomic” Groups • • 49
XV F Ratios Obtained from Analysis of Vari­
ance of Mean Scatter Scores for the Eleven
Subtests in the "Autonomic" Groups • . • • 50
XVI Frequency Distribution of Number of Re­
sponses and Form Determined Responses for
All Subjects • • • ...................... 52
XVII Frequency Distribution of the Rorschach
Scoring Categories for All Subjects . . . 53
XVIII Calculation of T-Scores for FM, Animal
Movement Responses • • • • • • • • • • • • 5 5
XIX F Ratios Obtained from Analysis of Vari­
ance in the Rorschach Scoring Categories
in Regard to the Number of Responses • • • 56
XX F Ratios Obtained from Analysis of Vari­
ance in Regard to the Rorschach Scoring
Categories. Locations, Popular Responses
and Sum C m the "Autonomic" Groups . . . 57
XXI Occurrence of Schizophrenic "Signs" Among
Group I Subjects ............... • • • • 6 0
XXII Occurrence of Schizophrenic "Signs" Among
Group VI-VII Subjects.................. 61
XXIII Total Number of Rorschach "Signs" in Group
I and VI-VII . . . . . . . ............. 63
XXIV Data for Analysis of Variance between
Groups I and VI-VII in Regard to Number of
Responses and Rorschach Schizophrenic "Signs"
showing Source of Variation, Degrees of
Freedom, Sum of Squares, Mean Square and F
R a t i o ................................. 64
XXV Beta for Analysis of Covariance with Effect
of R Ruled out...........................65
1
CHAPTER I
INTRODUCTION
Funkenstein, Greenblatt and Solomon (13, 14, 15)
have been studying the effects of adrenergic* stimulation
(intravenous epinephrine) and cholinergic** stimulation
(intramuscular mecholyl) as a test of the autonomic ner­
vous system. After investigation of about one thousand
persons***, among them mentally ill patients, they were
able, largely on descriptive grounds, to separate seven
different patterns of blood pressure which are valuable
in predicting the clinical effects of electric shock
treatment. Reporting on the fifty most typical cases,
they found that of the six patients falling in Group I
there was no improvement, while in Croups VI and VII,
twenty-five of the twenty-seven cases showed "sufficient
maintained improvement to allow their discharge from the
hospital ten days to two weeks after the electric shock
treatments."
These blood pressure patterns identified by Funken-
stein will be referred to as "autonomic" types or "auto­
nomic" groups in this study.
* Activated or transmitted by adrenaline (epinephrine):
a term applied to those nerve fibers that liberate syspm-
thin at a synapse when a nerve impulse passes.
** Stimulated, activated or transmitted by choline (mecho
lyl): a term applied to those nerve fibers which liberate
acetylcholine at a synapse when a nerve impulse passes.
*** Reported in a lecture given by Dr. Funkensteln before
a group of clinical psychologists at Princeton University,
October 29, 1943.
2
A. State— nt of the Problem
Psychologists have developed a special interest in
finding common factors in physiological and psychological
reactions. Such factors may give rise to the hope of shed­
ding further light upon the psychological processed concom­
itant with various social, emotional and physical maladjust­
ments.
This study is an attempt to ascertain whether there
i
are any patterns, as found by means of psychological tests,
that will distinguish "autonomic" blood pressure groups
from each other.
B. Review of the Literature
The use of epinephrine in diagnosing disorders has had
limited investigation. Smith (34), Goetsch (17), and Boas
(5) investigated the possibility of using epinephrine diag-
noetlcally with patients suffering from thyroid disorders.
Peabody and Sturgis (28) found that the effect of the drug
seems to remain fairly constant in a given individual and
that "thb physiologic action of epinephrine is due to a
stimulation of the sympathetic nervous system." They found
no specific significance in the diagnosis of hyperthyroid­
ism. Freeman and Carmichael (11) studying the effect of
intravenous injections of epinephrine on systolic blood
pressure found that schisophrenic patients show less reac­
tion than normals. The diastolic pressure was variable.
*
That anxiety can ba produced la psychoneuroties by epine­
phrine injection has been shown by Goetseh (17), Boas (4)
and others*
Myerson, Loman and Dameshek (27), using mecholyl be­
cause of its rapidity and uniformity of action, and its
pure parasympathetic effect, found little change in the
mental status of schisophrenic and general paretic patients.
Lindermann and Flnesinger (25) found it was possible
to reactivate an anxiety attack typical for the patient in
one group by the intramuscular injection of mecholyl, in
another group by the intramuscular injection of epine­
phrine, and in a third group by either of these drugs* Mo
attempt was made to follow the blood pressure reactions of
the patients. Kraines' (24) findings agree with the above*
Also they found that in some cases latent symptoms were
activated by the injection of epinephrine*
Hoskins (Id) has stated that the entire group of
schisophrenics are less responsive to physiological and
psychological circumstances or agents and are consequently
handicapped in their adaptive capacities* Because of their
withdrawal they exert control of a sort over their adjus-
tlve capacities, but it is aligned to their peculiar apper­
ception of reality rather than to objective reality*
The life of the schisophrenic patient according tb
Angyal, Freeman and Hoskins (1) runs at a low ebb not only
psychologically but also physiologically and is manifested
4
in a lowering of the basal levels of various physiological
functions, such as the basal oxygen consumption rate,
basal blood pressure, and circulation tine* Freeman and
Rodnick (12) found marked differences in autonomic re­
sponsiveness of normal and schisophrenic subjects when a
rather severe stress situation was induced by having the
subjects breathe hot, moist oxygen, thus blocking the loss
of heat from the lungs*
Hoskins (Id) in his summary of these studies states
that the relationship between the psychological and phys­
iological is assumed rather than proved* Huston, Shakow,
and Riggs* (21) findings, in the study of reaction time,
isolated the preparatory reaction as a particularly sig­
nificant difference between the normal and schisophrenic
subjects* Schizophrenics are apparently less able to
maintain a preparatory set than are normal subjects* It
would seem possible that control in maintaining a partic­
ular orientation toward both the environment and one*s own
needs is an important factor in determining this set and
that the schisophrenic patients * either do exercise less
control than the normal subjects or can sustain their con­
trol for a shorter period of time*
The problem of investigating the depth or bounds of
the schizophrenic's emotional response is difficult be­
cause of its inappropriate quality. Many psychological
studies lead to the conclusion that the schisophrenic*s
5
behavior can be characterized as a general withdrawal from
reality and reduced adaptive efficiency of the organism in
handling its basic needs. There is evidence of unevenness
or variability in withdrawal which may have their physio­
logical counterparts. The findings of Huston, Shakow and
Erickson (2) suggest that under the influence of conflicts
the organism responds in a variable manner depending on the
significance of the association arouBed by the conflict.