Journal of A bnormal Psychology 1975, Vol. 84, No. 5, 567-570

Daydreaming and Symptom Patterns of Psychiatric Patients: A Factor-Analytic Study Steven Starker West Haven Veterans Administration Hospital and Yale University

Jerome L. Singer Yale University

This study investigates the daydream activity of psychiatric patients and particularly explores the relation between symptom patterns and daydreaming styles. One hundred thirteen male psychiatric patients responded to a daydream questionnaire derived froni the Singer-Antrobus Imaginal Processes Inventory. Interviewers rated patients on the presence and severity of hallucinations, delusions, anxiety, depression, and other symptoms. Little relation was evidenced, in general, between daydream styles and particular symptom pictures. Patients with psychotic symptomatology could not be distinguished from others on the basis of daydream style. Relations were observed, however, between daydreaming subscales and ratings of depression.

Popular conceptions of mental illness and clinical folklore have often characterized psychiatric patients, especially schizophrenics, as persons who are lost in a world of fantasy. This view has cast suspicion on daydreaming as a potentially dangerous form of thinking. There have been few attempts, however, at direct inquiries of any sizable number of psychiatric patients about their daydreaming habits or stream of consciousness (Cazavelon & Epstein, 1966; Streissguth, Wagner, & Weschler, 1969). The study to be described here represents one of the first investigations designed to compare the symptom patterns of newly admitted psychiatric patients with their responses to questionnaires about daydreaming styles based on scales with a reasonably well-established factorial structure in normal samples (Singer & Antrobus, 1972; Starker, 1973; Isaacs, 1975). The data obtained from a variety of studies comparing the projective, test responses, particularly Rorschach patterns, of schizophrenic and normal individuals have generally suggested that the patients show relatively less varied and complex daydreaming tendencies despite a greater inclination to provide specifically bizarre responses (Singer, 1966). Such studies have not examined the patterns of

daydreaming that can be demonstrated if one makes more direct inquiry through the use of questionnaires about specific content areas or structural properties of ongoing fantasy activity. Streissguth et al. (1969) found some indications that psychiatric patients reported more daydreaming than controls on an inventory based on an early version of the Imaginal Processes Inventory (Singer & Antrobus, 1966), but this was largely a function of patients' greater reporting of dysphoric daydreaming content. In general, recent research with normal individuals across their life spans (Singer & Antrobus, 1963, 1972; Starker, 1973, 1974; Isaacs, 1975; Giambra, 1974) indicates fairly consistently that the scales of daydreaming that comprise the Imaginal Processes Inventory (Singer & Antrobus, 1972) reveal three recurring factors. One factor is characterized by high loadings for guilt daydreams, fear of failure in daydreaming, and hostileaggressive daydreams and may be termed a guilty-dysphoric pattern. The second factor, anxious-distractible daydreaming, generally has high loadings on distractibility in daydreaming, mind wandering in daydreaming, boredom, frightening experiences in daydreaming, and absorption in daydreaming. These scales suggest a pattern characterized This work was supported in part by NIDA Grant by fleeting, relatively unelaborated fantasies MH-072-28-8200. Bernard Segal and Jerome L. and much distractibility and difficulty in conSinger were the senior investigators. trolling the pattern of thought. They have Requests for reprints should 'be sent to Steven Starker, Psychology Department, West Haven Vet- correlated positively with measures of neuroticism. The third factor that emerges conerans Hospital, West Haven, Connecticut 06S16. 567

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sistently has its highest loadings on acceptance of daydreaming, positive content in daydreaming, visual imagery in daydreaming, problem solving in daydreaming, and future-oriented daydreaming. This factor, called positive-vivid daydreaming, has reflected a general stylistic pattern associated with a more constructive and positive orientation. METHOD Subjects The participants in this investigation were 113 male patients who were newly admitted to outpatient treatment at the West Haven Veterans Administration Hospital. They ranged in age from 20 to 68 years and presented a wide range of psychiatric problems. They had generally attended high school and were largely from low to lower middle-class socioeconomic strata. Procedure Upon applying for outpatient treatment, patients were asked, in the course of admissions interviews, to complete a brief daydreaming questionnaire derived from the Imaginal Processes Inventory (Singer & Antrobus, 1972). Although the order of the items in the questionnaire was scrambled, the questions were based on six subscales drawn from the larger inventory. These subscales were selected in pairs as representative of the three factors described above as recurring in a series of independent factor analytic studies. Specific subscales employed in this study include positive reactions to daydreams, visual imagery in daydreams, guilt daydreams, fear of failure in daydreams, mind wandering, and distractibility. The first two scales consistently show high loadings on the positive-vivid daydreaming factor, the second pair consistently shows high loadings on the guilt-dysphoric daydream factor, and the third is a pair of consistently high-loading scales on the anxious-distractible daydreaming factor. Immediately upon arriving at the interview room, the patients were administered the questionnaire by a secretary. The interviewer had no knowledge of patients' responses to these questions. The interviewer carried out the usual intake interview and proceeded to rate the patient on a symptom-oriented scale. A simple S-point rating scale that was developed at the hospital was shown to yield reliable results across interviewers. It involved specific symptoms that could be observed in the behavior and self-report of the patient. The symptoms included auditory or visual hallucinations, delusions, bizarre overt be-

havior, alcoholism, drug dependence, depressed affect, anxiety, obsessional or compulsive characteristics or behaviors, and impulsivity. Ratings were also obtained on the patient's relatedness to others, and the possibility of brain damage was assessed on the basis of the interview and history. Finally, history of psychosis in parent or sibling was obtained from the patient. The bulk of the interviewing and rating was done by psychiatric residents and psychological interns who had been given some training in the use of these scales. All procedures were in accordance with the ethical standards of the American Psychological Association.

RESULTS If one examines the range of symptomatology manifested by the patients, the largest means for specific complaints involved depression, anxiety, poor interpersonal relationships, and alcoholism. When subjects were examined in terms of their specific scores on the symptom complexes, it was possible to divide the sample into groups that clearly differed in degree of symptomatology. Each of the specific daydream scales could then be examined in relation to differences between high (rated 4-5) and low (rated 1-3) groups on particular symptoms. High and low groups on depression, for example, differed significantly in the occurrence of positive reactions in daydreaming, £(111) = 2.95, p < .'004. Interestingly enough, the more depressed group also showed significantly less guilt daydreams, 2(111) = 2.16, p < .033. None of the other daydreaming scales differentiated between the high- and low-depression groups. Another group of symptoms that was examined involved the scoring of symptom clusters (e.g., the occurrence of vsiual or auditory hallucinations, delusions, and bizarre behavior) to yield a score for psychosis. Analyses of high- versus lowscoring subjects on the variable emerging from the addition of these four measures failed to reveal any significant differences on any of the variables of the study. There is apparently no evidence that patients with different degrees of psychotic tendency within a psychiatric sample differ to any marked degree in the occurrence of the various styles of daydreaming measured in this investigation. Factor Analysis The factor analysis for the symptom clusters, some background variables, and the daydreaming scales are presented in Table 1. The analysis, using the principal-components methods and a vari-

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SHORT REPORTS max orthogonal rotation, yielded six factors which accounted for 62.6% of the total variance. Inspection of the rotated factor loadings indicates that the 'first factor reflects a variety of psychological symptoms with highest loadings for obsessive behavior, delusions, anxiety, and bizarre behavior. Interestingly, none of the daydream scales shows any loading on this factor. The second factor has its highest loadings for scales of distractibility, mind wandering, and fear of failure daydreams with more modest loadings in guilt daydreams and visual imagery in daydreaming. This factor clearly is the anxious-distractible daydreaming factor, which has occurred in most of the previous research. Of the psychiatric symptoms and other variables, only depression shows a modest loading on the factor. The third factor in the group is a factor defined by alcoholism and indications of organiclike behavior such as poor coordination, pattern vision, and memory difficulty. This factor also shows some loading for age, suggesting that the patients who would score high on this cluster are more likely to be older. There are somewhat modest negative correlations with hallucinations for this group. The fourth factor seems to be related to drug dependency with distinct indications that it is associated with: the more youthful sample, considerable impulsivity, poor interpersonal relationships, and somewhat less depression. None of the daydreaming scales shows any degree of loading on this factor. The fifth factor is the positive daydreaming factor reported in the previous research. The highest loading is for positive reactions to daydreams, with visual imagery in daydreams loading very high and a strong negative loading appearing for depression. The high loading of guilt daydreaming on this factor appears to be a function of its significant inverse relation with depression, as reported earlier. It has not loaded on positive daydreaming factors in previous studies. A less strong positive loading of auditory hallucinations also appears on this factor. The sixth factor is clearly a schizoid or schizophrenic symptom cluster. Its highest loadings appear in reports of the occurrence of psychotic parents or psychotic siblings, and there are also indications of auditory and visual hallucination, delusions, and bizarre behavior that cluster together here. There are no loadings of the daydreaming scales on the factor and only a modest correlation between age and symptomatology, with younger subjects more likely to show the schizophrenic symptom cluster.

TABLE 1 FACTOR ANALYSIS OT DAYDREAMING SCALES AND SYMPTOMS Symptom cluster

Factor loading

Factor 1 Obsessive Delusions Compulsive Bizarre behavior Anxiety

.676 .635 .607 .607

Factor 2 Distractibility in daydreams Fear of failure in daydreams Mind wandering in daydreams Guilt daydreams Visual imagery in daydreams Depression

.833 .792 .776 .516 .425 .254

%of total variance

18.1 .828

14.2

9.7

Factor 3 Alcoholic Organic Age Auditory hallucination Visual hallucination

.765 .690 .385 -.260 -.235

Factor 4 Drug dependent Age Impulsive Relatedness Depression

.771 -.686 .538 -.478 -.214

Factor 5 Positive reactions in daydreams Guilt daydreams Visual imagery in daydreams Depression Auditory hallucinations

.777 .627 .562 -.527 .363

7.5

Factor 6 Psychotic parent Psychotic sibling Visual hallucination Auditory hallucination Bizarre behavior Delusions Age Total

6.9

6.2 .743 .720 .692 .640 .528 .404 .232 62.6

DISCUSSION The major conclusion to be drawn from the results obtained in this investigation is that selfreports of frequency of daydreaming are not directly associated with the occurrence of specific psychiatric symptoms. In particular, it is noteworthy that the clearly schizophrenic symptom cluster which emerges from the factor analysis

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does not yield any significant loadings for the daydreaming tendency. One major exception to the general result is the inverse association between positively oriented fantasies and the occurrence of depression. This finding is quite similar to that reported by Rychlak (1973) with a different subject sample and different instruments. The latter finding suggests that one's orientation toward the future and one's mode of organization of fantasy may play a significant role in the onset and maintenance of depression. Naturally one cannot be certain of this because the data are correlational, and it may be that the negative tone of the daydreaming that characterizes the depressed subject may also reflect actual setbacks in life experience. There exists, however, the possibility that the production of negatively toned fantasies or the failure to generate positively oriented wish-fulfilling anticipations projected into the future (Rychlak, 1973) may reflect a learned adaptation or style that feeds back further negative consequences for the individual. Recent research on the use of imagery methods in behavior modifications and psychotherapy strongly suggests that, under appropriate clinical conditions, it may be possible to increase the level of pleasant or rich anticipatory imagery in individuals and to modify their psychological mood and subsequent behavior (Singer, 1974). The finding of an inverse relation between guilt daydreams and depression is also of interest. Clinically we are familiar with those severely depressed individuals who are tormented by guilt of delusional proportions (e.g., "I am a horrible person," "I am sinful and evil"), hence the curious nature of the above finding. It may be that many depressed patients do not consciously experience guilty fantasy due to intrapsychic defensive operations or that they tend consciously to deny such fantasy on questionnaires. Depression, conceived of as an end state of several possible processes rather than a psychologic disease entity, however, may not involve specific daydream contents (e.g., guilt) but only the broad category of dysphoric fantasy. This possibility is worth pursuing in further research. Although it should be obvious that research of this type is perhaps only a first step toward a more refined examination of the variety of pat-

terns of abnormal behavior in relation to daydreaming style, it seems clear that popular views linking fantasy and daydreams to psychopathology must be called into question. Using appropriate normal controls it will be necessary to examine just what dimensions of private experience are indeed differentiating between the disturbed and normal groups and also to ascertain whether some of these private processes are amenable to systematic modification. REFERENCES Cazavelon, J., & Epstein, S. Daydreams of female paranoid schizophrenics. Journal of Clinical Psychology, 1966, 22, 27-32. Giambra, L. Daydreaming across the life span: Late adolescence to senior citizen. Aging and Human Development, in press. Isaacs, D. Daydreaming and mind-wandering: A construct validation. Unpublished doctoral dissertation, City University of New York, 1975. Rychlak, J, F. Time orientation in the positive and negative free phantasies of mildly abnormal versus normal high school males. Journal of Consulting and Clinical Psychology, 1973, 41, 175-180. Singer, J. L. Daydreaming. New York: Random House, 1966, Singer, J. L. Daydreaming and the stream of thought: An empirical research program. American Scientist, 1974, 2, 417-425. Singer, J. L., & Antrobus, J. A. A factor analytic study of daydreaming and conceptually-related cognitive and personality variables. Perceptual and Motor Skills, 1963, 17, 187-209. Singer, J. L., & Antrobus, J. A. Daydreaming, imaginal processes and personality: A normative study. In P. Sheehan (Ed.), The nature and function of imagery. New York: Academic Press, 1972. Singer, J. L., & Antrobus, J. S. Imaginal Processes Inventory. New York: Authors, 1966. Starker, S. Aspects of inner experience: Autokinesis, daydreaming, dream recall and cognitive style. Perceptual and Motor Skills, 1973, 36, 663-673. Starker, S. Daydreaming styles and nocturnal dreaming. Journal of Abnormal Psychology, 1974, S3, 52-55. Streissguth, A. P., Wagner, N., & Weschler, J. Effects of sex, illness and hospitalization on daydreaming. Journal of Consulting and Clinical Psychology, 1969, 33, 218-225. (Received October 18, 1974; revision received March 19, 1975)

Daydreaming and symptom patterns of psychiatric patients: a factor-analytic study.

Journal of A bnormal Psychology 1975, Vol. 84, No. 5, 567-570 Daydreaming and Symptom Patterns of Psychiatric Patients: A Factor-Analytic Study Steve...
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