Journal oj Consulting and Clinical Psychology 1975, Vol. 43, No. 2, 217-222
Relationship Between Formal Thought Disorder and Retardation in Schizophrenia D. Romney Laurentian University, Sudbury, Ontario, Canada
E. Leblanc Sudbury Algoma Sanatorium, Sudbury, Ontario, Canada
Schizophrenics recently admitted into the hospital were compared on Bannister's Grid Test of Schizophrenic Thought Disorder with schizophrenics admitted some time ago and with a group of nonschizophrenic, psychiatric controls under three conditions: fast rate of responding, slow rate of responding, and in-between rate of responding. It was predicted that the schizophrenics would show more thought disorder under fast than slow conditions and that the recently admitted schizophrenics would be more thought disordered than the earlier admitted schizophrenics. Contrary to expectations, the patients tended to show less thought disorder on the test when their responses were speeded than when they were encouraged to take their time. Moreover, the earlier admitted schizophrenics showed more thought disorder than the recently admitted schizophrenics under all three conditions.
The general aim of this study was to clarify the relationship between formal schizophrenic thought disorder and retardation. Formal thought disorder is a disorder of the form, process, or structure of thinking, and is characterized by looseness of associations, overinclusion, neologisms, and in extreme cases, verbigeration. It should not be confused with disturbances in the content of thinking, exemplified by ideas of reference and ideas of influence, nor with disturbances in the progression of thinking, for example, thought blocking or flight of ideas. Yates (1966) speculated that schizophrenics may evince thought disorder because they cannot process information fast enough; relevant information is then shunted to the shortterm memory store, which becomes overloaded and the information is subsequently lost. As a result the schizophrenic responds to incomplete information, appearing thought disordered. The idea that schizophrenics learn to compensate for their thought disorder by slowing down their rate of responding was advanced by Romney (1967) in an unpublished doctoral thesis and later presented by Hawks and Marshall (1971) as a "parsimonious theory." In his thesis, Romney proposed that The authors are grateful to the medical .and nursing staff at the Sudbury Algoma Sanatorium, Sudbury, Ontario, Canada, and North Bay Psychiatric Hospital, North Bay, Ontario, Canada, for their cooperation; and to the administrator of the Sudbury Algoma Sanatorium
given ample time . . . the schizophrenic may be able to process sufficient relevant information and to effect thereby a rational response. Retarded schizophrenics who do not show overinclusive thinking may not do so precisely because they take their time. (p. 201)
Another possibility is that the schizophrenic will pause until he can concentrate before he performs . . . he may be able to concentrate intermittently, so if he takes enough time he may be able to make a normal response—if, in fact, he is retarded, (p. 205)
Moreover, it is suggested that as schizophrenics become chronic they learn to compensate for their thought disorder by means of retardation, A corollary of the preceding arguments is that a retarded schizophrenic will show thought disorder if his rate of responding is increased. But it may be more difficult to demonstrate this hypothesis because the natural tendency is for the schizophrenic to appear to shift from thought disordered to retarded and not the other way around. In any case, retardation that occurs as an adjustment to thought disorder may be irreversible. for her financial support. We are also very much indebted to Joan Simic, who kindly spent so many hours scoring Bannister tests for us; without her help we doubt if this project could have been finished. Requests for reprints should be sent to D. Romney, Department of Psychology, Laurentian University, Sudbury, Ontario, Canada. E. Leblanc is now at Windsor University, Windsor, Ontario, Canada.
217
218
D. ROMNEY AND E. LEBLANC
Hawks and Marshall (1971) used a card- was related to poor Bannister test performance sorting task to measure overinclusiveness in on the grounds that the relationship was a their study; in the present study, the Grid general one and not restricted to the schizoTest of Schizophrenic Thought Disorder phrenics classified as thought disordered by the (Bannister & Fransella, 1967) was used to test. This seems to be attaching too much assess formal thought disorder. This test is importance to Bannister's cutoff point; while supposed to measure the degree of association there may be no relationship between slowness between concepts (intensity) and also the on the test and the presence/absence of thought stability of the pattern of relationships among disorder as determined by the test, there is concepts (consistency). The test has been nevertheless a significant, inverse relationship validated against the clinical diagnosis of between slowness and the intensity score. thought disorder. In fact the intensity score, The specific aims of the current study were when low, seems to be directly comparable (a) to investigate the relationship between rate with the psychiatric assessment of "looseness of response and the ability to think normally, of association of ideas," a first-rank symptom using as a measuring instrument an established, of schizophrenia. For this reason, and for quantitative test of disordered thinking; (b) to reasons of economy, we decided to make use of determine if this relationship holds for schizothe intensity score alone. Mention must be phrenics exclusively or has a more general made, however, of some recent studies (Frith application; (c) to compare the performance of & Lillie, 1972; Haynes & Phillips, 1973a, schizophrenics recently admitted to the hos1973b) that have challenged the, validity of pital with the performance of those who have the Bannister test. The findings of these been hospitalized for some time on the variables studies suggest that schizophrenics may merely being studied; and (d) to find out to what be making more "errors" on the test than other extent the psychometric assessments of thought people. So far, Bannister has refused to accept disorder and retardation correspond with the criticisms leveled against his test (Ban- ward ratings of psychotic behavior. nister, 1972; Haynes & Phillips, 1973b). Strong support for Bannister's position comes METHOD from a more recent study by McPherson, Subjects Blackburn, Draffan, and McFadyen (1973). These authors argue that "not only has the While the majority of subjects were taken from a Bannister-Fransella test been successfully community mental health center, the more chronic cases cross-validated as a measure of thought were found in a psychiatric hospital. Altogether 58 patients were seen: 41 schizophrenics and 17 controls. disorder, but that the results also support The schizophrenic group was split in two, with those Bannister's explanation that low scores on the patients (22) who had been in the hospital for less than test reflect a loose construct system" (p. 420). 6 months in one subgroup and those patients (19) for more than 6 months in the other. The In two previous studies one failed to obtain hospitalized mean length of hospitalization of the recently admitted a significant correlation between speed of schizophrenics was just over a week, whereas many of response and Bannister score while the other the earlier admitted schizophrenics in the other group succeeded. Foulds, Hope, McPherson, and had been in hospital for several years. Despite the Mayo (1969) found no relationship between difference in length of hospitalization between the schizophrenic groups, they were both fairly well Digit Symbol and Bannister intensity score two matched for age and vocabulary (see Table 1 for for a sample of 48 schizophrenics. Moreover, details). there were no significant differences between In the control group, 4 were diagnosed as suffering acute and chronic patients on the speed mea- from affective psychosis and the remaining 13 from sures. Presly (1969), however, managed to neurotic or personality disorders. Their mean length stay in hospital at the time of testing was approxobtain a significant correlation between time of imately 3 weeks. The group as a whole did not differ taken on the Bannister test and the intensity appreciably from the combined schizophrenic group score, such that longer times were associated either in age or vocabulary (/ = .91 for the latter). None of the patients included in the study had been with more thought-disordered scores with a given electroshock therapy for at least 3 months prior sample of 15 schizophrenics. But, oddly to testing; none had a history of alcoholism or organicenough, Presly did not conclude that slowness ity. Nearly all of them, however, were on maintenance
219
THOUGHT DISORDER AND RETARDATION IN SCHIZOPHRENIA doses of medication, which probably diminished the intensity of their symptoms.
a high degree of interobserver reliability. In most cases the Bannister Grid test and the WAIS Vocabulary and Digit Symbol subtests were all administered to the patients in one sitting.
Procedure The Bannister-Fransella, Grid Test, Each administration, which followed the instructions given in the test manual, consisted of two trials; and the intensity scores calculated for each grid were combined into a single grand intensity score. The first administration was quite standard; the second was prefaced by telling the subjects not to hurry but to take their time; in the third administration, on the other hand, they were told to respond as fast as they could without being careless. Each administration was accurately timed. A pilot attempt to vary the order of the "slow" and "fast" conditions proved fruitless: The subjects invariably responded faster on the third administration than on the second. The fact that it was impossible to randomize the order of the slow and fast conditions is admittedly a flaw in the experimental design. But we did not consider the flaw, which could not be avoided, serious enough to abandon the study. Sometimes a subject, despite exhortation, would complete the second administration faster than the first, or complete the third administration slower than the first. When this occurred, the first administration was counted as either the slow or fast condition; and the second and third administrations became the "in-between" condition. Ideally, of course, the first administration should have always been the in-between condition. The Wechsler Adult Intelligence Scale (WAIS) Vocabulary subtest was used as a measure of verbal intelligence: Wechsler found that the vocabulary subtest correlated .90 with the Verbal scale. The purpose of using this test was to screen out mental defectives from our study and to partial out any effects that intelligence might have had on thought disorder (Bannister test score), should our three groups not have been well matched on intelligence. For convenience the Vocabulary scores were expressed as deviation quotients. The WAIS Digit Symbol subtest was considered to provide a suitable index of psychomotor speed or, conversely, retardation, However, instead of recording the length of time it took the subject to complete the test, a measure that does not take errors into account, we counted the number the subject got right in 90 sec. Nobody finished the test in that time limit. The Psychotic Reaction Profile (Lorr, O'Connor, & Stafford, 1960) is a scale for rating easily observable behaviors in psychotic patients, Lorr factor analyzed ratings of the behaviors noted on the scale and discovered four factors, namely, Withdrawal, Paranoid Belligerence, Thinking Disorganization, and Agitated Depression. (Unfortunately, the latest version of this scale was not available to us when we started our study.) Nurses were trained by us on how to use the scale. Whenever possible, two nurses were assigned to a patient at the same time, and their ratings were averaged. On these occasions the discrepancies between their ratings made independently were small, suggesting
RESULTS The scores of the three groups of patients on all the variables under study are summarized in Table 1. The first three variables in Table 1—length of hospitalization, age, and vocabulary—have already been discussed as TABLE 1 SCORES OF THREE GROUPS OP PATIENTS ON 10 VARIABLES
Variable
Length of hospitalization M SD Age in years M SD WAIS Vocabulary IQ M SD Digit Symbol M SD Withdrawal M SD Thinking Disorganization M SD Paranoid Belligerence M SD Agitated Depression M SD Initial time on Bannister test (in minutes) M SD Initial intensity score on Bannister test M SD « In days. >>0 In years. n = 4.
Schizo- Schizophrenics phrenics recently admitted Psychiatric admitted some controls into time hospital ago
11.14" 11.42
3.63b 3.79
19.65 • 12.97
32.00 8.44
35.21 9.90
35.56 9.86
98.00 12.07
98.05 11.51
102.12 16.56
6.41 1.23
5.58 3.03
7.82 1.38
20.87 8.10
18.16 8.93
9.88« 5.65
4.58 3.7S
5.87 4.44
2.38° 2.25
1.55 2.54
5.95 6.27
2.50° 2.72
1.74 1.44
1.68 1.69
.88°
19.86 11.58
19.74 8.88
17.35 7.65
1,049
639 246
1,018
584
.65
496
220
D. ROMNEY AND E. LEBLANC
part of our description of the subjects. The next variable in the table, namely, Digit Symbol, used to measure psychomotor retardation, was significantly different between schizophrenics and controls (p < .01); the difference between the two groups of schizophrenics themselves was not significant. This result indicates that, although the schizophrenics were more retarded than the controls, retardation was independent of length of hospitalization. On the four clinical variables, only one significant difference emerged: The schizophrenics admitted earlier were significantly more paranoid than those admitted later (p < .01). Perhaps the more hostile, suspicious schizophrenics are kept longer in hospital; or perhaps they become that way as a result of being hospitalized for a long period. It is noteworthy that, contrary to expectation, the long-stay schizophrenics did not show less thinking disturbance than those recently admitted. On the Bannister test, in fact, under standard administration, they showed considerably more thought disorder than the latter group, who were not significantly different in this respect from the control group. However, even though there is a significant difference on the Bannister test between earlier and recent schizophrenic admis sions, between chronic and acute groups, that is, those who have been in hospital continuously for more than 2 years and those who have been hospitalized for less than 2 years, the significant difference disappears (/ = ,50). Finally, it is worth pointing out that the time taken to complete the Bannister test under the initial, standard condition failed to differentiate between the groups. Nine of the 10 variables measured (length of hospitalization was omitted) were intercorrelated for all cases. Only 3 out of the 36 correlations were statistically significant. Not surprisingly, Vocabulary IQ and Digit Symbol intercorrelated significantly (r = .38), but the correlation was much lower than Wechsler's correlation of .60. The correlation between the ward ratings of Withdrawal and Agitated Depression was also highly significant (r= .56), higher than Lorr's et al.'s correlation of .36. The correlation between Agitated Depression and time taken to complete the Bannister test initially (r = .30) was barely significant at the .05 level. There was virtually no relationship
TABLE 2 MEANS AND STANDARD DEVIATIONS OF TIMES (IN MINUTES) TO COMPLETE BANNISTER TEST UNDES THE THREE CONDITIONS Group Recently admitted schizophrenics M SD t Schizophrenics admitted some time ago M SD t Psychiatric controls M SD t
Fast
In-between
Slow
11.04 18.45 25.63 7.14 20.28 9.93 5.1-8** 2.79*
11.10 18.15 27.63 5.05 8.60 18.09 5.26** 3.41*
9.29 15.41 22.52 4.00 7.13 11.81 6.05** 3.82**
*f < .01. **t
Relationship Between Formal Thought Disorder and Retardation in Schizophrenia D. Romney Laurentian University, Sudbury, Ontario, Canada
E. Leblanc Sudbury Algoma Sanatorium, Sudbury, Ontario, Canada
Schizophrenics recently admitted into the hospital were compared on Bannister's Grid Test of Schizophrenic Thought Disorder with schizophrenics admitted some time ago and with a group of nonschizophrenic, psychiatric controls under three conditions: fast rate of responding, slow rate of responding, and in-between rate of responding. It was predicted that the schizophrenics would show more thought disorder under fast than slow conditions and that the recently admitted schizophrenics would be more thought disordered than the earlier admitted schizophrenics. Contrary to expectations, the patients tended to show less thought disorder on the test when their responses were speeded than when they were encouraged to take their time. Moreover, the earlier admitted schizophrenics showed more thought disorder than the recently admitted schizophrenics under all three conditions.
The general aim of this study was to clarify the relationship between formal schizophrenic thought disorder and retardation. Formal thought disorder is a disorder of the form, process, or structure of thinking, and is characterized by looseness of associations, overinclusion, neologisms, and in extreme cases, verbigeration. It should not be confused with disturbances in the content of thinking, exemplified by ideas of reference and ideas of influence, nor with disturbances in the progression of thinking, for example, thought blocking or flight of ideas. Yates (1966) speculated that schizophrenics may evince thought disorder because they cannot process information fast enough; relevant information is then shunted to the shortterm memory store, which becomes overloaded and the information is subsequently lost. As a result the schizophrenic responds to incomplete information, appearing thought disordered. The idea that schizophrenics learn to compensate for their thought disorder by slowing down their rate of responding was advanced by Romney (1967) in an unpublished doctoral thesis and later presented by Hawks and Marshall (1971) as a "parsimonious theory." In his thesis, Romney proposed that The authors are grateful to the medical .and nursing staff at the Sudbury Algoma Sanatorium, Sudbury, Ontario, Canada, and North Bay Psychiatric Hospital, North Bay, Ontario, Canada, for their cooperation; and to the administrator of the Sudbury Algoma Sanatorium
given ample time . . . the schizophrenic may be able to process sufficient relevant information and to effect thereby a rational response. Retarded schizophrenics who do not show overinclusive thinking may not do so precisely because they take their time. (p. 201)
Another possibility is that the schizophrenic will pause until he can concentrate before he performs . . . he may be able to concentrate intermittently, so if he takes enough time he may be able to make a normal response—if, in fact, he is retarded, (p. 205)
Moreover, it is suggested that as schizophrenics become chronic they learn to compensate for their thought disorder by means of retardation, A corollary of the preceding arguments is that a retarded schizophrenic will show thought disorder if his rate of responding is increased. But it may be more difficult to demonstrate this hypothesis because the natural tendency is for the schizophrenic to appear to shift from thought disordered to retarded and not the other way around. In any case, retardation that occurs as an adjustment to thought disorder may be irreversible. for her financial support. We are also very much indebted to Joan Simic, who kindly spent so many hours scoring Bannister tests for us; without her help we doubt if this project could have been finished. Requests for reprints should be sent to D. Romney, Department of Psychology, Laurentian University, Sudbury, Ontario, Canada. E. Leblanc is now at Windsor University, Windsor, Ontario, Canada.
217
218
D. ROMNEY AND E. LEBLANC
Hawks and Marshall (1971) used a card- was related to poor Bannister test performance sorting task to measure overinclusiveness in on the grounds that the relationship was a their study; in the present study, the Grid general one and not restricted to the schizoTest of Schizophrenic Thought Disorder phrenics classified as thought disordered by the (Bannister & Fransella, 1967) was used to test. This seems to be attaching too much assess formal thought disorder. This test is importance to Bannister's cutoff point; while supposed to measure the degree of association there may be no relationship between slowness between concepts (intensity) and also the on the test and the presence/absence of thought stability of the pattern of relationships among disorder as determined by the test, there is concepts (consistency). The test has been nevertheless a significant, inverse relationship validated against the clinical diagnosis of between slowness and the intensity score. thought disorder. In fact the intensity score, The specific aims of the current study were when low, seems to be directly comparable (a) to investigate the relationship between rate with the psychiatric assessment of "looseness of response and the ability to think normally, of association of ideas," a first-rank symptom using as a measuring instrument an established, of schizophrenia. For this reason, and for quantitative test of disordered thinking; (b) to reasons of economy, we decided to make use of determine if this relationship holds for schizothe intensity score alone. Mention must be phrenics exclusively or has a more general made, however, of some recent studies (Frith application; (c) to compare the performance of & Lillie, 1972; Haynes & Phillips, 1973a, schizophrenics recently admitted to the hos1973b) that have challenged the, validity of pital with the performance of those who have the Bannister test. The findings of these been hospitalized for some time on the variables studies suggest that schizophrenics may merely being studied; and (d) to find out to what be making more "errors" on the test than other extent the psychometric assessments of thought people. So far, Bannister has refused to accept disorder and retardation correspond with the criticisms leveled against his test (Ban- ward ratings of psychotic behavior. nister, 1972; Haynes & Phillips, 1973b). Strong support for Bannister's position comes METHOD from a more recent study by McPherson, Subjects Blackburn, Draffan, and McFadyen (1973). These authors argue that "not only has the While the majority of subjects were taken from a Bannister-Fransella test been successfully community mental health center, the more chronic cases cross-validated as a measure of thought were found in a psychiatric hospital. Altogether 58 patients were seen: 41 schizophrenics and 17 controls. disorder, but that the results also support The schizophrenic group was split in two, with those Bannister's explanation that low scores on the patients (22) who had been in the hospital for less than test reflect a loose construct system" (p. 420). 6 months in one subgroup and those patients (19) for more than 6 months in the other. The In two previous studies one failed to obtain hospitalized mean length of hospitalization of the recently admitted a significant correlation between speed of schizophrenics was just over a week, whereas many of response and Bannister score while the other the earlier admitted schizophrenics in the other group succeeded. Foulds, Hope, McPherson, and had been in hospital for several years. Despite the Mayo (1969) found no relationship between difference in length of hospitalization between the schizophrenic groups, they were both fairly well Digit Symbol and Bannister intensity score two matched for age and vocabulary (see Table 1 for for a sample of 48 schizophrenics. Moreover, details). there were no significant differences between In the control group, 4 were diagnosed as suffering acute and chronic patients on the speed mea- from affective psychosis and the remaining 13 from sures. Presly (1969), however, managed to neurotic or personality disorders. Their mean length stay in hospital at the time of testing was approxobtain a significant correlation between time of imately 3 weeks. The group as a whole did not differ taken on the Bannister test and the intensity appreciably from the combined schizophrenic group score, such that longer times were associated either in age or vocabulary (/ = .91 for the latter). None of the patients included in the study had been with more thought-disordered scores with a given electroshock therapy for at least 3 months prior sample of 15 schizophrenics. But, oddly to testing; none had a history of alcoholism or organicenough, Presly did not conclude that slowness ity. Nearly all of them, however, were on maintenance
219
THOUGHT DISORDER AND RETARDATION IN SCHIZOPHRENIA doses of medication, which probably diminished the intensity of their symptoms.
a high degree of interobserver reliability. In most cases the Bannister Grid test and the WAIS Vocabulary and Digit Symbol subtests were all administered to the patients in one sitting.
Procedure The Bannister-Fransella, Grid Test, Each administration, which followed the instructions given in the test manual, consisted of two trials; and the intensity scores calculated for each grid were combined into a single grand intensity score. The first administration was quite standard; the second was prefaced by telling the subjects not to hurry but to take their time; in the third administration, on the other hand, they were told to respond as fast as they could without being careless. Each administration was accurately timed. A pilot attempt to vary the order of the "slow" and "fast" conditions proved fruitless: The subjects invariably responded faster on the third administration than on the second. The fact that it was impossible to randomize the order of the slow and fast conditions is admittedly a flaw in the experimental design. But we did not consider the flaw, which could not be avoided, serious enough to abandon the study. Sometimes a subject, despite exhortation, would complete the second administration faster than the first, or complete the third administration slower than the first. When this occurred, the first administration was counted as either the slow or fast condition; and the second and third administrations became the "in-between" condition. Ideally, of course, the first administration should have always been the in-between condition. The Wechsler Adult Intelligence Scale (WAIS) Vocabulary subtest was used as a measure of verbal intelligence: Wechsler found that the vocabulary subtest correlated .90 with the Verbal scale. The purpose of using this test was to screen out mental defectives from our study and to partial out any effects that intelligence might have had on thought disorder (Bannister test score), should our three groups not have been well matched on intelligence. For convenience the Vocabulary scores were expressed as deviation quotients. The WAIS Digit Symbol subtest was considered to provide a suitable index of psychomotor speed or, conversely, retardation, However, instead of recording the length of time it took the subject to complete the test, a measure that does not take errors into account, we counted the number the subject got right in 90 sec. Nobody finished the test in that time limit. The Psychotic Reaction Profile (Lorr, O'Connor, & Stafford, 1960) is a scale for rating easily observable behaviors in psychotic patients, Lorr factor analyzed ratings of the behaviors noted on the scale and discovered four factors, namely, Withdrawal, Paranoid Belligerence, Thinking Disorganization, and Agitated Depression. (Unfortunately, the latest version of this scale was not available to us when we started our study.) Nurses were trained by us on how to use the scale. Whenever possible, two nurses were assigned to a patient at the same time, and their ratings were averaged. On these occasions the discrepancies between their ratings made independently were small, suggesting
RESULTS The scores of the three groups of patients on all the variables under study are summarized in Table 1. The first three variables in Table 1—length of hospitalization, age, and vocabulary—have already been discussed as TABLE 1 SCORES OF THREE GROUPS OP PATIENTS ON 10 VARIABLES
Variable
Length of hospitalization M SD Age in years M SD WAIS Vocabulary IQ M SD Digit Symbol M SD Withdrawal M SD Thinking Disorganization M SD Paranoid Belligerence M SD Agitated Depression M SD Initial time on Bannister test (in minutes) M SD Initial intensity score on Bannister test M SD « In days. >>0 In years. n = 4.
Schizo- Schizophrenics phrenics recently admitted Psychiatric admitted some controls into time hospital ago
11.14" 11.42
3.63b 3.79
19.65 • 12.97
32.00 8.44
35.21 9.90
35.56 9.86
98.00 12.07
98.05 11.51
102.12 16.56
6.41 1.23
5.58 3.03
7.82 1.38
20.87 8.10
18.16 8.93
9.88« 5.65
4.58 3.7S
5.87 4.44
2.38° 2.25
1.55 2.54
5.95 6.27
2.50° 2.72
1.74 1.44
1.68 1.69
.88°
19.86 11.58
19.74 8.88
17.35 7.65
1,049
639 246
1,018
584
.65
496
220
D. ROMNEY AND E. LEBLANC
part of our description of the subjects. The next variable in the table, namely, Digit Symbol, used to measure psychomotor retardation, was significantly different between schizophrenics and controls (p < .01); the difference between the two groups of schizophrenics themselves was not significant. This result indicates that, although the schizophrenics were more retarded than the controls, retardation was independent of length of hospitalization. On the four clinical variables, only one significant difference emerged: The schizophrenics admitted earlier were significantly more paranoid than those admitted later (p < .01). Perhaps the more hostile, suspicious schizophrenics are kept longer in hospital; or perhaps they become that way as a result of being hospitalized for a long period. It is noteworthy that, contrary to expectation, the long-stay schizophrenics did not show less thinking disturbance than those recently admitted. On the Bannister test, in fact, under standard administration, they showed considerably more thought disorder than the latter group, who were not significantly different in this respect from the control group. However, even though there is a significant difference on the Bannister test between earlier and recent schizophrenic admis sions, between chronic and acute groups, that is, those who have been in hospital continuously for more than 2 years and those who have been hospitalized for less than 2 years, the significant difference disappears (/ = ,50). Finally, it is worth pointing out that the time taken to complete the Bannister test under the initial, standard condition failed to differentiate between the groups. Nine of the 10 variables measured (length of hospitalization was omitted) were intercorrelated for all cases. Only 3 out of the 36 correlations were statistically significant. Not surprisingly, Vocabulary IQ and Digit Symbol intercorrelated significantly (r = .38), but the correlation was much lower than Wechsler's correlation of .60. The correlation between the ward ratings of Withdrawal and Agitated Depression was also highly significant (r= .56), higher than Lorr's et al.'s correlation of .36. The correlation between Agitated Depression and time taken to complete the Bannister test initially (r = .30) was barely significant at the .05 level. There was virtually no relationship
TABLE 2 MEANS AND STANDARD DEVIATIONS OF TIMES (IN MINUTES) TO COMPLETE BANNISTER TEST UNDES THE THREE CONDITIONS Group Recently admitted schizophrenics M SD t Schizophrenics admitted some time ago M SD t Psychiatric controls M SD t
Fast
In-between
Slow
11.04 18.45 25.63 7.14 20.28 9.93 5.1-8** 2.79*
11.10 18.15 27.63 5.05 8.60 18.09 5.26** 3.41*
9.29 15.41 22.52 4.00 7.13 11.81 6.05** 3.82**
*f < .01. **t
