Pmceptual and Motor Skills, 1977,45.807-810.

@ Perceptual and Motor Skills 1977

REACTIVE SCHIZOPHRENIA A N D PERCEPTUAL SENSITIZATION JOHN SAPPINGTON

Virginia Polytechnic Institute and State University1 ~ u r n m a r ~ . - ~ hperceptual e behavior of process and reactive schizophrenics under neutral and stress conditions suggests an hypothesis that the former employ a repressive ego defensive mode in these conditions while reactives employ a sensitization mode. The Repression-Sensitization scale of the MMPI was administered to a sample of hospitalized process and reactive schizophrenics to test the hypothesis. Scores of the process group did not indicate modal repression. Reactives' scores were, however, well toward the sensitization pole and significantly higher than those of the process group. Results support the concept of a sensitization defensive mode as a characteristic dimension in the etiology of reactive schizophrenia.

Reactive schizophrenia is most puzzling in that the presenting symptoms, developmental events, physiological activity and psychological capabilities are very dissimilar to those of the general population of schizophrenics (Kantor & Herron, 1966). Clearly reactive types exhibit enough psychotic behavior to earn the label schizophrenia, yet a prevailing suspicion is that they are essentially normal or mildly maladjusted people who briefly encounter more psychic stress than their ego resources can contain. The primary issues in understanding reactive schizophrenia seem to be environmental stress and the manner in which stimulus threat is handled. By contrast, process schizophrenia appears less contingent on acute stress than it does on genetic or developmental deficit. Our previous research on perceptual style in schizophrenic groups suggests distinct modes of response for process and reactive groups when confronted with immediate stress in a laboratory setting. When the task required recognition of neutral nonsense syllables, those groups were virtually identical in efficiency, i.e., the tachistoscopic exposure duration required by the groups for recognition did not differ significantly. By contrast, when the task required recognition of shock-paired syllables, process subjects needed prolonged exposures to reach criterion. Interestingly, the reactive subjects needed less exposure to reach recognition criterion on shock-paired stimuli even less than they needed for neutral stimuli. Thus the reactives gave the impression of being acutely attuned to external threat (Sappington, 1973a). In terms of the ego defensive modes indicated by low and high recognition thresholds, the process types were predominantly repressers and reactives predominantly sensitizers. Similarly, when asked to select a voltage level for finger tip shock, reactives reported reaching their limits of tolerance at significantly lower voltages than 'Requests for reprints should be sent to John Sappington, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061.

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process controls. Again the reactives behaved as though they were sensitized to potential threat from the environment (Sappington, 1973b). The conceptual accounting for these observed behaviors is accomplished efficiently by applying Byrne's (1961) approach/avoidance proposition in regard to ego defense. Byrne's Repression/Sensitization (R-S) Scale of the MMPI has served as the independent variable in dozens of personality studies, most dealing with nonpsychiatric populations. The R-S scale separates individuals with regard to their characteristic mode of ego defense. Repressers typically respond in the avoidance mode, e.g., using denial or other behaviors which reduce awareness of threat. Sensitizers, on the other hand, typically respond in the approach mode, e.g., intellectualization in which awareness of threat is maintained but its impact is blunted by a cognitive manipulation. The analogue with perceptual modes in schizophrenic groups is apparent. Process types handle threat by reduced awareness (avoidance) while reactives show maintained or enhanced awareness of threat (approach). In a previous test of this hypothesis, a small but significant relationship between prognostic scores and R-S scores was detected (Sappington, 1975). Examination of the data suggested that those with the highest prognostic scores, reactives, tended to score in the sensitization range of the scale. By contrast, those with low prognostic scores obtained ,a wide distribution of R-S scores. This outcome suggested that the correlational format was not optimal for assessing the relationship between the process/reactive dimension and ego defensive style. The present study compared distinct process and reactive groups with regard to their mean R-S scores and provides a more appropriate assessment of the relationship in question.

METHOD Subjects were all hospitalized males drawn from two separate psychiatric institutions. Included were 21 reactive types and 24 of the process variety. The mean age of the process group was 36.6 yr., with a range of 26 to 51. Reactives averaged 32.1 yr. of age, ranging between 24 and 41. Those carrying additional diagnoses of alcoholism or neurological damage were not included in the sample. It should be noted by cautious readers that no data are provided here on length of hospitalization, type and dosage of medication, and other demographic considerations, thus the conclusions drawn should be tempered accordingly. The Symptom Checklist (Zigler & Phillips, 1962) was used to derive prognostic scores for each subject based on presenting symptoms. Byrne's (1961) R-S scale of the MMPI served as the dependent measure of defensive style. In two psychiatric settings, the Symptom Checklist was applied to samples of inpatients for whom MMPIs were available. Subjects were designated process if the Checklist score fell in the .OO to .40 range. The reactive sample in-

cluded those subjects who earned Checklist scores of .60 or higher. The middle range was excluded to enhance contrast. R-S scores were then extracted from the subjects' MMPIs. A t test was applied to the mean R-S scores for the process and reactive groups. RESULTSAND DISCUSSION As anticipated, the mean R-S score of the reactives exceeded that of the process group (Table 1 ) by a significant degree. Note that the process mean, 66.75, approximates the mean for the group of normals on which this version of R-S was standardized (Byme, 1961). The reactive mean, 88.33, places the bulk of this group well into the sensitizing range. Using 80 as a median for the entire sample, only 6 process subjects fall above the mark and only 6 reactives fall below it. In view of previous research indicating that process schizophrenics respond like repressers on perceptual tasks (Sappington, 1973a, 1973b), it might be expected that they would cluster in the represser range on R-S scale rather than scattering so widely. It must be remembered, however, that a hospital population tends to accumulate chronic schizophrenics who tend to look uniformly process on process/reaaive measures although they have widely diverse etiologies. As an undifferentiated group it is not unreasonable to find a wide range of R-S scores despite a heavy representation in the represser end of the distribution. TABLE 1

MEANREPRESSION-SENSITIZATIONSCORESAND STANDARDDEVIATIONS AND REACTIVESCHIZOPHRENICS FORPROCESS Process (n,24)

Reactive ( n , 21

df

t

P*

Results support the notion of reactive schizophrenics having a predominantly approach defensive style. Further, it may be hypothesized that the dyn-mics of reactive schizophrenia involve an extreme of the sensitizer-style of ego defense. The data are consistent with the concept of reactive schizophrenia as a failure of overtaxed defenses to maintain the integrity of ego in the face of environmental stress. REFERENCES

BYRNE,D. The Repression-Sensitization Scale: rationale, reliability and validity. Journal of Personality, 1961, 29, 334-349.

KANTOR, R., & HERRON, W. Reactive and process schizophrenia. Palo Alto, CA.: Science and Behavior Books, 1966.

SAPPINGTON, J. Perception of threatening stimuli in process and reactive schizophrenics. Journal of Consulting and Clinical Psychology, 1973, 41, 48-50. ( a )

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J. Thresholds of shock-induced discomfort in process and reactive schizoSAPPINGTON, phrenics. Perceptual and Motor Skills, 1973, 37, 489-490. (b) SAPPINGTON, J. Psychometric correlates of defensive style in process and reactive schizophrenics. Journal of Consulting and Clinical Psychology, 1975, 43, 154-156. ZIGLBR, C., & PHILLIPS, L. Social competence and the process reactive distinction in psychopathology. J o u ~ n a ol f Abnormal and Social Psychology, 1962, 65, 215.222.

Accepted August 18, 1977.

Reactive schizophrenia and perceptual sensitization.

Pmceptual and Motor Skills, 1977,45.807-810. @ Perceptual and Motor Skills 1977 REACTIVE SCHIZOPHRENIA A N D PERCEPTUAL SENSITIZATION JOHN SAPPINGTO...
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