Journal of Consulting and Clinical Psychology 1977, Vol. 45, No. 5, 949-950
Validation of the Schizophrenia-Organicity Scale with Brain-Damaged and Non-Brain-Damaged Schizophrenics Keith M. Halperin, Charles Neuringer, and Patricia Sacca Davies University of Kansas Gerald Goldstein Veterans Administration Hospital, Pittsburgh, Pennsylvania Watson had developed a Schizophrenia-Organicity (Sc-0) Minnesota Multiphasic Personality Inventory scale that successfully distinguished schizophrenic from braindamaged patients. The present study used this Sc-0 scale to distinguish organically impaired schizophrenics from nonimpaired schizophrenics. Forty-eight schizophrenic subjects were divided into the organic and nonorganic groups by findings from both their Halstead-Reitan Impairment rating and the physical neurological examination. £-test analyses and cutting scores were calculated for the two groups. The results demonstrated that the Sc-0 scale could not distinguish impaired from nonimpaired schizophrenics. Future research and clinical implications are discussed.
The separation of brain-damaged from schizophrenic patients has long been a difficult problem for both the researcher and the practitioner because the overt behavior of these two groups often appears to be the same. One test that has successfully differentiated between nonschizophrenic brain-damaged and non-brain-damaged schizophrenic patients is the Schizophrenic-Organicity (Sc-0) scale (long, unweighted form) derived from the Minnesota Multiphasic Personality Inventory (MMPI; Watson, 1971). A further critical test of this scale's practical clinical usefulness depends on whether it can adequately differentiate between schizophrenics with brain damage and schizophrenics without brain damage. The records of 48 schizophrenic patients who had undergone neurological evaluations at the Topeka Veterans Administration Hospital were reviewed. The two criteria used for establishing brain dysfunction were (a) the Halstead-Reitan Neuropsychological Battery (Halstead, 1947; Reitan, 1966) and (b) the standard neurological examination. MMPIs of 25 schizophrenics who were diagnosed by the Halstead average impairment rating as having brain damage and 23 schizophrenics diagnosed as being free of neurological disturbance were scored on the Sc-0 scale. The neurological examination diagnosed 14 of these schizophrenic patients as having brain damage, whereas 12 were found to be totally clear of neurological involvement. The Sc-0 scale scores of these two groups were also analyzed. Patients
Requests for reprints should be sent to Charles Neuringer, Department of Psychology, University of Kansas, Lawrence, Kansas 6604S.
with questionable neurological findings were eliminated, thereby creating a different sample size for the two diagnostic criteria. High scores on the Sc-0 scale indicate the presence of brain damage. When the average impairment rating of the Halstead-Reitan Neuropsychological Battery was the criterion for neurological dysfunction, the mean Sc-0 scale score for the brain-damaged group was 48.08 (S£> = 8.63) and 49.22 (SD = 9.17) for the non-brain-damaged group, 2(47) = .43, ns. When the neurological examination criterion was applied, the mean Sc-0 score for the brain-damaged schizophrenics was 48.53 (SD =• 9.18), whereas the mean score for the non-braindamaged schizophrenic group was 47.83 (SD = 9.86), t(30)-.l9, ns. Although the Sc-0 scale can differentiate "pure" schizophrenics from "pure" brain-damaged patients, the results of this study suggests that the scale has difficulty in separating a population of brain-damaged from non-brain-damaged schizophrenics. Since the latter kind of differentiation is the more difficult of the two, it appears that the Sc-0 scale's inability to make such identifications seriously limits its utility. These results imply that the Sc-0 scale may only be sensitive to schizophrenia and not to organic dysfunctions. The test's original standardization comparison groups were schizophrenics without brain damage and brain-damaged patients without schizophrenia. In this case, even if the neurological status of the patients were irrelevant, the Sc-0 scale would still be successful in differentiating the two groups because one sample was schizophrenic and the other was not. Such a conclusion is supported by the data in this study, since the test could make no differentiation be-
949
950
BRIEF REPORTS
tween two schizophrenic groups, even though one of the groups suffered from neurological impairment. References Halstead, W. Brain and intelligence. Chicago: University of Chicago Press, 1947. Reitan, R. A research program on the psychological
effects of brain lesions in human beings. In H. R. Ellis (Ed.), International review in mental retardation (Vol. 1). New York: Academic Press, 1966. Watson, C. An MMPI scale to separate brain damaged from schizophrenic men. Journal of Consulting and Clinical Psychology, 1971, 36, 121-125. Received February 23, 1976 •
Validation of the Schizophrenia-Organicity Scale with Brain-Damaged and Non-Brain-Damaged Schizophrenics Keith M. Halperin, Charles Neuringer, and Patricia Sacca Davies University of Kansas Gerald Goldstein Veterans Administration Hospital, Pittsburgh, Pennsylvania Watson had developed a Schizophrenia-Organicity (Sc-0) Minnesota Multiphasic Personality Inventory scale that successfully distinguished schizophrenic from braindamaged patients. The present study used this Sc-0 scale to distinguish organically impaired schizophrenics from nonimpaired schizophrenics. Forty-eight schizophrenic subjects were divided into the organic and nonorganic groups by findings from both their Halstead-Reitan Impairment rating and the physical neurological examination. £-test analyses and cutting scores were calculated for the two groups. The results demonstrated that the Sc-0 scale could not distinguish impaired from nonimpaired schizophrenics. Future research and clinical implications are discussed.
The separation of brain-damaged from schizophrenic patients has long been a difficult problem for both the researcher and the practitioner because the overt behavior of these two groups often appears to be the same. One test that has successfully differentiated between nonschizophrenic brain-damaged and non-brain-damaged schizophrenic patients is the Schizophrenic-Organicity (Sc-0) scale (long, unweighted form) derived from the Minnesota Multiphasic Personality Inventory (MMPI; Watson, 1971). A further critical test of this scale's practical clinical usefulness depends on whether it can adequately differentiate between schizophrenics with brain damage and schizophrenics without brain damage. The records of 48 schizophrenic patients who had undergone neurological evaluations at the Topeka Veterans Administration Hospital were reviewed. The two criteria used for establishing brain dysfunction were (a) the Halstead-Reitan Neuropsychological Battery (Halstead, 1947; Reitan, 1966) and (b) the standard neurological examination. MMPIs of 25 schizophrenics who were diagnosed by the Halstead average impairment rating as having brain damage and 23 schizophrenics diagnosed as being free of neurological disturbance were scored on the Sc-0 scale. The neurological examination diagnosed 14 of these schizophrenic patients as having brain damage, whereas 12 were found to be totally clear of neurological involvement. The Sc-0 scale scores of these two groups were also analyzed. Patients
Requests for reprints should be sent to Charles Neuringer, Department of Psychology, University of Kansas, Lawrence, Kansas 6604S.
with questionable neurological findings were eliminated, thereby creating a different sample size for the two diagnostic criteria. High scores on the Sc-0 scale indicate the presence of brain damage. When the average impairment rating of the Halstead-Reitan Neuropsychological Battery was the criterion for neurological dysfunction, the mean Sc-0 scale score for the brain-damaged group was 48.08 (S£> = 8.63) and 49.22 (SD = 9.17) for the non-brain-damaged group, 2(47) = .43, ns. When the neurological examination criterion was applied, the mean Sc-0 score for the brain-damaged schizophrenics was 48.53 (SD =• 9.18), whereas the mean score for the non-braindamaged schizophrenic group was 47.83 (SD = 9.86), t(30)-.l9, ns. Although the Sc-0 scale can differentiate "pure" schizophrenics from "pure" brain-damaged patients, the results of this study suggests that the scale has difficulty in separating a population of brain-damaged from non-brain-damaged schizophrenics. Since the latter kind of differentiation is the more difficult of the two, it appears that the Sc-0 scale's inability to make such identifications seriously limits its utility. These results imply that the Sc-0 scale may only be sensitive to schizophrenia and not to organic dysfunctions. The test's original standardization comparison groups were schizophrenics without brain damage and brain-damaged patients without schizophrenia. In this case, even if the neurological status of the patients were irrelevant, the Sc-0 scale would still be successful in differentiating the two groups because one sample was schizophrenic and the other was not. Such a conclusion is supported by the data in this study, since the test could make no differentiation be-
949
950
BRIEF REPORTS
tween two schizophrenic groups, even though one of the groups suffered from neurological impairment. References Halstead, W. Brain and intelligence. Chicago: University of Chicago Press, 1947. Reitan, R. A research program on the psychological
effects of brain lesions in human beings. In H. R. Ellis (Ed.), International review in mental retardation (Vol. 1). New York: Academic Press, 1966. Watson, C. An MMPI scale to separate brain damaged from schizophrenic men. Journal of Consulting and Clinical Psychology, 1971, 36, 121-125. Received February 23, 1976 •
