Cognitive and empathic factors in the role attitudes of schizophrenic and brain-damaged patients

Thesis (Ph.D.)--Boston UniversityThe purpose of this investigation was twofold: to study the nature of the role-taking performance in schizophrenic and brain-damaged patients, and to contribute thereby to an understanding of thought pathology in these clinical groups. Role-taking was defined as taking on the attitudes or points of view of another person or persons. It was stated that both empathic and cognitive capacities were required for an effective role-taxing performance. The empathic aspect of the task required the ability to use socially shared, conventional frames of reference about groups and group members in order to predict their responses. The cognitive aspect required (1) the ability to maintain a set to inhibit one's preferred responses and (2) the ability to reject irrelevant and to accept relevant connotations of a conceptual label. These cognitive capacities were termed mental set shifting and concept forming respectively. It has been generally agreed that brain damage is associated with cognitive deficit. With respect to cognitive deficit in schizophrenia, some theorists have maintained that schizophrenics demonstrate cognitive deficits not unlike those observed in brain-damaged patients. Other theorists have argued that what is lessened or lost in schizophrenia is not cognitive capacities so much as the intent or the ability to take the role of the other as a guide to effective communication with others. The following hypotheses were derived: Hypothesis I: Schizophrenic patients and brain-damaged patients are deficient in role-taking in comparison with normal subjects. Hypothesis II: Brain-damaged patients are deficient in cognitive capacities in comparison with schizophrenic patients. Hypothesis III: Schizophrenic patients are deficient in role-taking in comparison with brain-damaged patients, when differences in cognitive capacities are taken into account. Three male groups, 20 normals, 30 nonpsychotic brain-damaged patients, and 32 schizophrenic patients, equated on age, education and I.Q., were administered two types of role-taking tests. These were multiple-choice word association tests with empirical norms for the response preferences of men and women on one and of adults and children on the other. Subjects were instructed to choose the word associations that characterized each of these four groups. The mental set shifting test involved three presentations of fifty words from the Kent-Rosanoff List. Free associations were obtained on the first presentation, recall of these associations on the second, and the giving of different associations on the third. The number of times a subject responded with a different association was a measure of mental set shifting ability. In the concept forming test, taken from Capps, subjects were instructed to choose from seven response words the three that belong to the stimulus word in some way. With respect to Hypothesis I, normals were superior to both clinical groups on the ability to shift from a male to female and from an adult to child role. Hypothesis II was confirmed tor the mental set shifting test, but not for the concept forming test because of the low ceiling of the latter. Hypothesis III that schizophrenics are deficient in role-taking, in comparison with brain-damaged patients, when a correction is made tor differences in mental set shifting, was confirmed for male role only. On female and child scores there was no significant difference both before and after correction. On adult scores there was a significant difference in the opposite direction both before and after correction. The failure of the brain-damaged group on the adult-child polarity was attributed to further cognitive loadings in this polarity. All the results were interpreted as indicating that lowered role-taking performances in schizophrenic and brain-damaged patients were related to empathic and cognitive deficiencies respectively