VALUE ACHIEVEMENT AND AUTHORITARIAN ATTITUDES I N PSYCHIATRIC PATIENTS

JOSEPH BECKER CHARLES D. SPIELBERGER

C'niversity of Illinois Duke University JOSEPH B. PARKER

I'niversity of Kentucky Medical Center

PROBLEM This study compares the performance of manic-depressives with schizophrenics

and neurotic-depressives on attitude measures (z ) which had significantly differ- entiated remitted manic-depressives from norn a1 controls. The original basis for the selection of the attitude measures stemmed from the work of Cohen, Baker, Cohen, Fromm-Reichniann and Weigart. C 4 )

Becker ( 2 ) compared groups of remitted manic-depressives and non-psychiatric controls in order to examine salient personality traits. As compared with nonpsychia- tric controls, manic-depressives described then: selves as more ambitious on the Value Achievement Scale(4) and had significantly higher scores on the California Fascism Scale than nonpsychiatric controls. Manic-depressives also professed a more autocratic ideology regarding husband-wife and parent-child relations on the Traditional Fawily Ideology Scalec7) than did his controls. All of these character- istics have been attributed to manic-depressives by Cohen el al. ( * )

Our specific aims were to determine whether attitude measures which differ- entiated manic-depressives from nonpsychiatric controls would also differentiate manic-depressives from schizophrenics and neurotic-depressives.

METHOD Subjects. The Ss were 30 manic-depressives12 23 neurotic-depressives, 20 schizo-

phrenics, and 30 nonpsychiatric controls. Diagnostic deteminations were based on case history data, personal interviews, and psychological tests which have been dis- cussed in detail elsewhere. C 2 ) Only ren itted patients were used in the study in order t o avoid confounding the experimental 11, easures with the effects of concurrent emo- tional disturbance or treatment regin;ens

Attitude and Control Measures. The attitude measures consisted of the Value Achievement Scale (V-Ach), the California Fascism Scale, Form 45 and 40 (F Scale], and the Traditional Family Ideology Scale (TFI). Since scores on the F and TFI scales are related to age, education, intelligence and social class ( l , 7), additional data were obtained in order to statistically control for the effects of these variables on the attitude n,easures. The Ohio Literacy Test(5) which correlated .69 with the Wech- sler Bellevue (Form I) Verbal I& for patients a t the Durham Veterans Hospital provided a measure of intelligence. No direct measure of social class was made, but educational attainment is a major determinant of social class. The Ss were also given the Hildreth Battery of Feeling and Attitude Scales@) to check the reliability of the clinical judgment of remission and to allow for the adjustn;ent of the possible effects of mood state on the experiniental n,easures.

Procedure. The Ss were tested individually. Each S was required to read the instructions for the Hildreth Mood Scale and to rate his present subjective mood state. He was then given the Ohio Literacy Test. Next, the Value Achievement Scale, F Scale, and TFI Scale were administered together. Since the instructions for each of these scales were similar, only one set of instructions was given.

'The data presented in this article were gathered when the authors were associated with the De-

*Of the Ss used in this study, 24 of the 30 manic-depressives and all of the nonpsychiatric controls partments of Psychology and Psychiatry, Duke University, and the Durham V. A. Hospital.

were also in Becker's(*) previous study.

58 JOSEPH BECKER, CHARLES D. SPIELBERGER AND JOSEPH B. PARKER

RESULTS Group medians, Ir,eans and standard deviations on the control variables for the

four experimental groups are presented in Table 1. Since the data for age, education,

CONCOMITANT VARIABLES OF AGE, EDUCATION, LITERACY, AND MOOD AND ON THE ADJUSTED ATTITUDE SCALE SCORES

TABLE 1. COMPARISON OF THE REMITTED PSYCHIATRIC AND NONPSYCHIATRIC GROUPS ON THE

Non- Manic- Neurotic Schizo- psychiatric

Depressives Depressives phrenics Controls Measure Statistic (N = 30) (N = 23) (N = 20) (N = 30) H

Age

Education

Ohio Literacy

Mood

Value Achievement F scale TFI scale

Median Mean SD Median Mean SD Median

Mean SD Median Mean SD

Mean Mean Mean

40.50 43.20 9.79

12.21 12.47 2.86

37.00

36.87 4.68

24.00 24.52 4.32

4.67 4.57 4.24

36.00 34.00 38.26 33.65 9.09 5.76

10.16 12.50 10.48 12.30 3.20 3.15

32.00 35.50

32.74 36.80 4.66 5.25

23.56 22.60 23.20 21.43 4.61 4.53

4.43 4.50 4.55 4.19 4.03 4.20

38.50 43.17 13.99*** 12.10 11.50 12.17 7.40 3.66

37.17

36.50 10.35** 5.98

25.15 8.16* 25.02 3.37

4.00 3.97 3.68

~

* p Significant at the .05 level; **p significant at the .02 level; ***p significant at the .01 level.

literacy, and mood were either skewed or rectangularly distributed, the Kruskal- Wallis nonparametric analysis of variance (I1) was used to deterixine whether the groups had been drawn from the same population with regard to the control var- iables. The experimental groups differed significantly with respect to age, literacy, and mood.

Differences among the experimental groups on the control variables of age, education, literacy, and mood were statistically controlled by covariance adjust- ments of the attitude scale scores. Adjusted mean scores for the experimental groups

VARIABLES FOR THE REMITTED PSYCHIATRIC AND CONTROL GROUPS TABLE 2. PRODUCT-MOMENT INTERCORRELATIONS OF THE CONCOMITANT AND DEPENDENT

~~

Ohio Group Measure Age Education Liter a c J Mood

Manic V Ach .40* - .03 .06 . 00 Depressives F scale .43* - .18 -.13 .1G (N = 30) TFI scale .05 -.22 -.24 .15

~~

Neurotic V Ach .62** - .55** - .28 .04

(N = 23) TFI scale .58** - .67** - .40 .3G Depressives F scale .47. - .77** - .49* -.23

Schizophrenics VAch - .37 .10 - .09 - .05 (N = 20) F scale -.37 - .27 - .19 - .18

TFI scale - .13 - .33 - .42 - .05

Nonpsychiatric V Ach Controls F scale (N = 30) TFI scale

.14 - .30 -.25 -.14

.50** - .65** - .31 - .34

.30 - .56** - .34 - .36*

* p Significant at the .05 level; **p eignificant at the .01 level.

VALUE ACHIEVEMENT AND AUTHORITARIAN ATTITUDES I N PSYCHIATRIC PATIENTS 59

on each of the attitude measures are also presented in Table 1. The manic-depress- ives consistently scored highest on each of the scales, and the controls consistently scored lowest.

Correlations between the four control variables and the three attitude measures were computed for each of the four experimental groups. These correlations are presented in Table 2 where only the schizophrenics have negative correlations be- tween their attitude scale scores and age, and the attitude scale scores of the normals and neurotics are considerably more influenced by the effects of education than are those of the psychotic groups.

The results of the covariance analyses of attitude scale scores are presented in Table 3. The differences among the experimental groups were significant for all three attitude measures.

TABLE 3. ANALYSES OF COVARIANCE OF ATTITUDE SCALE SCORES OF THE REMITTED PSYCHIATRIC AND NONPSYCHIATRIC GROUPS

Measure Source df MS F

Value Achievement Groups 3 23191.62 3.47*

F scale Groups 3 22898.61 3.83; Residual 95 6678.88

Residual 95 5981.18

Residual 95 4252.91 TFI scale Groups 3 18050.78 4.24**

* p Significant < .05 level of confidence; **p significant < .01 level of confidence.

Scheffes (lo) S-method of multiple comparisons was used (a) to determine differ- ences between individual experimental groups when compared with each other, and (b) to evaluate comparisons of all possible combinations of the psychopathological groups with the nonpsychiatric control^.^ An abridged summary of these results is presented in Table 4. The differences between the manic-depressives and non- TABLE 4. COMPARISONS OF THE SIGNIFICANCE OF DIFFERENCES IN ATTITUDE SCALE SCORES OF

REMIITED PSYCHIATRIC PATIENTS AND NONPSYCHIATRIC CONTROLS USING SCHEFFIYS METHOD OF JUDQING ALL CONTRASTS

Group Nonpsychiatric Controls (N = 30)

N V Ach F Scale TFI

Manic-Depressives 30 .05 .05 .05 Neurotic-Depressives 23 NS NS NS Schizo hrenics 20 NS NS NS M-D P N-D 53 NS .05 .05 M-D & Sch 50 .05 NS .05 All Patients 73 .05 .05 .05

psychiatric controls were significant for all three attitude scales. The psychiatric groups did not differ among themselves either singly or in any combination. The differences between the combined patient groups and the nonpsychiatric controls were significant for each of the three attitude scales. Attitude scale scores for the combined manic-depressive and neurotic-depressive groups were significantly higher than those of the nonpsychiatric controls on the F scale and the TFI. The com- bined psychotic groups were significantly higher on the V-Ach Scale and the TFI.

DISCUSSION The results of this study have relevance both for previous findings on the atti-

tudes of manic-depressives(*) and for the general controversy about the relationship

3We are indebted to Francis R. Watson for assistance with the statistical design of this study.

60 JOSEPH BECKER, CHARLES D. SPIELBERGER AND JOSEPH B. PARKER

between authoritarianism and emotional disturbance. (9) Limited support for the hypothesis that value achievexr.ent and authoritarian attitudes are relatively specific to manic-depressives was afforded by the findings that manic-depressives tended to score higher on the attitude scales than the other patient groups, but these differ- ences were not statistically significant.

The finding that all of the psychiatric patient groups obtained consistently higher scores on the attitude scales than the nonpsychiatric controls suggests that the attitude measures tap general defensive personality attributes more commonly found among the emotionally disturbed than among a nonpsychiatric population. Failure to find such relationships in a number of studies may be due to inadequate control for the effects of variables such as age, education, and intelligence. These variables were found in the present study to be significantly correlated with authori- tarianism for manic-depressives and neurotic-depressives.

The positive correlations between age and the attitude measures for the manic- depressive and neurotic-depressive groups accord with the general clinical observa- tion that authoritarian ego defenses tend to be more intensively utilized as the capacity to adjust to reality is lost with advancing age. (12) The negative correlations between age and attitude scores for the schizophrenics although not significant, possibly reflect the deterioration with advancing age of even those brittle defenses associated with authoritarian attitudes in schizophrenics. The pattern of correla- tions between education and attitude scores supports the clinical observation that lack of flexibility is an important component in eniotional disorders. The stronger negative correlations between education and F Scale and TFI Scale scores for the neurotic-depressives and the controls as con: pared with the psychotic groups suggest that the latter groups are relatively less accessible to modifying experience.

The methodological problems encountered in the investigation of attitudinal differences among psychiatric groups are considerable. The fact that age, mood, and education (social class) differences are associated with various psychiatric syndromes requires empirical or statistical control for differences in such variables. Failure to control for these may obscure meaningful differences between psychiatric groups on attitudinal variables. Correlations between attitude measures and age, education, and intelligence for psychopathological groups may also point up characteristics of patient groups which vary differentially with individual differences variables and thereby contribute to the understanding of psychopathological phenomena.

SUMMARY In this study the attitudes of remitted manic-depressive, neurotic-depressive,

and schizophrenic patients were compared with nonpsychiatric controls. A con- sistent order of mean differences on the Value Achievement, F and TFI Scales was obtained : manic-depressives scored highest, non-psychiatric controls lowest, and neurotic-depressives and schizophrenics were intermediate. The findings of this study suggested that (a) value achievement and authoritarian attitudes are gen- erally characteristic of psychiatric groups, (b) manic-depressives and neurotic- depressives adhere more rigidly to authoritarian defenses with increasing age, whereas schizophrenics seemed to lose their capacity for such defensive adaptation with age, (c) and that value achievement and authoritarian attitudes in normals and neurotics were more susceptible to modification by educational experience than was the case for psychotics. Methodological problems encountered in the study of attitudes in patient groups were discussed in terms of the importance of empirical or statistical control for individual difference variables such as age, intelligence, and education.

REFERENCES 1. ADORNO, T. W., FRENKEL-BRUNSWICK, E., LEVINSON, D. J. and SANFORD, R. N. The authori-

2. BECKER, J. Achievement related characteristics of manic-depressives. J . abnorm. soe. Psyehol., tarian personality. New York: Harper, 1950.

1960, 60, 334-339.

VALUE ACHIEVEMENT AND AUTHORITARIAN ATTITUDES IN PSYCHIATRIC PATIENTS 61

3. COHEN, MABEL B., BAKER, GRACE, COHEN, R . A., FROMM-REICHMANN, FRIEDA, and WEIGART, EDITH V. An inknsive st.udy of twelve cases of manic-depressive psychosis. Psychiatry, 1954, 17, 103-137.

DECHARMS, R., MORRISON, W. H., REITM.~N, W. and MCCLELLAND, D. c. Behavioral cor- relates of directly and indirectly measured achievement motivation, In D. C. McClelland (Ed.). Studies in motivation. New York: Appleton-Century-Crofts, 1955, Pp. 414-423.

5. FOSTER, V . H . and GODDARD, H. H. The Ohio literacy test. Pedagogical Seminary, 1924, 31,

6. HILDRETH, H. M. A battery of feeling and attitude scales for clinical use. J. clin. Psychol., 1946,

7. LEVINSON, D. J . and HUFFMAN, P. E. Traditional family ideology and its relation to personality.

8. LEWIS, X. D. C. and PIOTROWSKI, Z. A. Clinical diagnosis of manic-depressive psychosis. In

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P. H. Hoch and J . Zubin (Eds.). Depression. New York: Grune Kz Stratton, 1954. MCCANDLESH, B . R. Children and adolescents. New York: Holt, Rinehart, and Winston, 1961. SCHEFF~, H. The analysis of variance. New York: Wiley, 1959. SIEGEL, S. Nm-parametric statistics for the behavioral sciences. New York: McGraw-Hill, 1956. WOLFF, K. The biological, social, and psychological aspects of aging. Springfield: Thomas, 1959.

EGO STRENGTH AND EGO DISJUNCTION I N PRIMARY AND SECONDARY PSYCHOPATHS

JUDY PAGE VAN EVR.4 AND B. G. ROSENBERG

E . Lansing, Michigan Bowling &em State University

PROBLEM Contrary to the evidence in the literature suggesting a general lack of anxiety

in psychopathst3s 9 , l o , 1 3 ) , the work of T,ykkens(7) suggests the possibility of differ- entiating sociopaths who report litt,le anxiety (primary) and those who report much anxiety (neurotic). I t is possible that further differentiating characteristics may emerge using the dimension of reported anxiety t.0 distinguish subgroups of socio- paths. This study attempts to demonstrat’e that among a group of individuals possessing similar behavior (sociopaths) and dissimilar etiology, there exist sub- groups that differ not only on measures of anxiety, but, also on measures of ego- strength, and ego-disjunction.

METHOD Subjects. A group of 98 white, male patients from a state psychopathic hospital

comprised t,he sample. Selection was based on (a) independent psychiatric diagnosis of sociopath(’), (b) legal status@) of sociopathic personality, (c) a PD score in excess of 70 and a raw F score less than 16 on the RIMPI, and (d) lack of any clinical symptoms suggestive of psychosis.

Instmments. Each patient received the MMPI ( 6 ) and the Edwards Personal Preference Scale (EPPS)(4’. From the MMPI item pool, each subject received a score on the Ego-Strength Scale(?), and the Manifest Anxiety Scale‘ll). I t should be noted that the MAS has only a four item overlap with the PD scale; and of the 68 items on the Es scale, only six items are found in common with the MAS. The Hs, D, and HY scales of the MMPI were combined for a total score, and used as a neuro- tic triad(6).

Trehub’s(’*) rather ingenious use of eight EPPS scales to obtain a measure of ego-disjunction was employed. He used p&s of conflicting need variables Idefer- ence-aggression, autonomy-abasement, succorance-nurturance, order-change) of the EPPS based on the relative strength of these conflicting needs.

Procedure. The 98 subjects in the sample were examined for their performance on the MAS. In view of L y k k e n ’ ~ ‘ ~ ) findings, the sociopaths reporting most anxiety (the upper quartile (N = 25) on the MAS) were called “neurotic’) sociopaths;