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Xerox University Microfilms 300 North Zeeb Road Ann Arbor, Michigan 48106 73-18,895

GOLDSTEIN, Stanley Melvin, 1939- THE AWARENESS OF PSYCHOLOGICAL CAUSALITY WITH REGARD TO THE CHOICE OF SYMPTOMATOLOGY IN CHILDHOOD PSYCHOPATHOLOGY.

The Ohio State University, Ph.D., 1973 Psychology, clinical

University Microfilms, A XEROX Company, Ann Arbor, Michigan

© Copyright by Stanley Melvin Goldstein

1973 THE AWARENESS OF PSYCHOLOGICAL CAUSALITY WITH REGARD TO THE

CHOICE OF SYMPTOMATOLOGY IN CHILDHOOD PSYCHOPATHOLOGY

DISSERTATION

Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University

by

Stanley Melvin Goldstein, B.S., M.A

The Ohio State University 1973

Approved by

Advxser Department of Psychology Lastly, X cannot conclude the present work, which is once again only a fragment of a larger whole, without fore-shadowing the two chief theses towards the estab­ lishment of which the libido theory of the neuroses and psychoses is advancing, namely, that the neuroses arise in the main from a conflict between the ego and the sexual instinct, and that the forms which the neuroses assume bear the imprint of the course of development followed by the libido— and by the ego. (Freud, 1911, p. 466) ACKNOWLEDGMENTS

It is a pleasure to thank those without whose aid the completion of this study would have been far longer in coining:

To the Graduate School of The Ohio State University for the grant of a Dissertation Fellowship which enabled me to work full-time on this study, and to the Department of Psychology for the additional funds which provided for expenses connected with this research;

To my adviser, Professor Charles Wenar, for his understanding and guidance and incisive criticism through­ out both the course of this research and my graduate study at The Ohio State University;

To Professor John Horrocks whose aid extended beyond his serving as a member of my dissertation committee, for the ideals and ideas expressed in his seminars, thoughts which strongly influenced my own;

To Professor Malcolm Helper, dissertation committee member, for his humor and guidance during the most important phases of this research, whose suggestions greatly aided me in finding my way toward productive approaches in the col­ lection and analysis of the data; To Loretta Cass, Ph.D., for her guidance and sug­ gestions both during the writing of the research proposal and throughout the collection of data at the Department of Child Psychiatry, Washington University School of Medicine, St. Louis, Missouri;

To John Sullivan, Ph.D., for his help in providing subjects and material aid from the North Area Branch of the Children's Mental Health Center, Columbus, Ohio, and his invaluable suggestions for the acquisition of further subjects;

To Marcel Hundziak, M.D., and Sister Mary Denis,

S.N.D., for their help in providing subjects from the out-patient clinic of the Diocesan Child Guidance Center;

To Mr. Earl W. Lane, Assistant Superintendent for

Instruction, and Mrs. Grace Wilson, School Psychologist of the Worthington City Schools, and Mr. Zenisek, Prin­ cipal of the Evening Street School, for their cooperation in providing students who served as members of the non- clinic subject groups;

To Miss Nancy Hultz and Mrs. Elwood of the Amerikid

Day Care Centers for their cooperation in providing some of the youngest members of the non-clinic subject groups;

To Roy Mendelsohn, M.D., child psychoanalyst, whose seminars on psychotherapy and diagnostic interviewing at

iv the Department of Child Psychiatry of the Washington

University School of Medicine contributed so greatly to

the formulation of my views on the development and

treatment of psychic disorders;

Finally to my subjects (both children and parents), whose cooperation despite personal discomfort was greater

than I would have thought possible at the inauguration of this study.

v VITA

September 7, 1939 Born - New York City, New York

1961 ...... B.S., City College of New York, New York City, New York

1963-1969 ...... Counselor, New York City Division of Employment and Rehabilitation, New York City, New York

1968 ...... M.A., Columbia Univer­ sity, New York City, New York

1969-1971 ...... Teaching Associate, Department of Psychology, The Ohio State Univer­ sity, Columbus, Ohio

1971-1972 ...... National Institute of Mental Health Clinical Psychology Trainee, Department of Child Psy­ chiatry, Washington University School of Medicine, St. Louis, Missouri

1972-1973 ...... University Dissertation Year Fellow, The Ohio State University, Columbus, Ohio FIELDS OF STUDY

Major Field: Child-Clinical Psychology

Studies in Developmental Psychology. Professors John Horrocks and George G. Thompson

Studies in Psychological Assessment. Professors Charles Wenar and Donald Smith

Studies in Psychotherapy. Professors Herbert Rie, Rahe Corlis, and Richard Van Sickle

Studies in Clinical Hypnosis. Professor Peter Gwynne

vii TABLE OF CONTENTS Page ACKNOWLEDGMENTS ...... iii

VITA ...... V

LIST OF TABLES ...... viii

Chapter I INTRODUCTION ...... 1

Preliminary Statement Historical, Theoretical and Research Antecedents of the Study Purpose of the Study Hypotheses Rationale of the Hypotheses

II P R O C E D U R E ...... 27

Subjects Measures III FINDINGS ...... 35

IV DISCUSSION OF THE FINDINGS ...... 59 V CONCLUSIONS ...... 78 Conclusions Recommendations for Further Research

APPENDIX A ...... 80 B ...... 83 C ...... 89 D ...... 94 REFERENCES ...... 103

viii Table Page 9. Chi-Square Values Testing the Differ­ ence Between Sub-Test Scores of the Younger and Older Subjects in the Clinic and Non-Clinic Groups...... 41

10. Age Period Between Which a Signifi­ cant Increase in Causality Sub-Test Score Occurred in the Non-Clinic and Clinic Groups ...... 41

11. Table of Chi-Square Values Testing the Relationship Between Internal- izing-Extemalizing Subjects and Total Causality Score 43

12. Table of Chi-Square Values Testing the Relationship Between Internal- izing-Externalizing Subjects and Causality Subtest Score ...... 43 13. Chi-Square Values Testing the As­ sociation Between Level of Anxiety and Total Causality Score for the Clinic Group ...<>...... 44 14. Chi-Square Values Testing the As­ sociation Between Early vs. Late Ego Defenses and Total Causality Score ...... 45 15. Chi-Square Values Testing the As­ sociation Between Users of Early vs. Late Ego Defenses and Age for the Clinic Groups ...... 46 16. Chi-Square Values Testing the As­ sociation Between Use and Aware­ ness of Several Ego Defenses ..... 46 17. Chi-Square Values Testing the Rela­ tionship Between Group I Themes and Total Causality Score ...... 51

18. Chi-Square Values Testing the Rela­ tionship Between DEJ Theme and Total Causality Score ...... 52

ix LIST OF TABLES Table Page

1. Range and Mean IQ and Age Scores of the Clinic find Non-Clinic Groups ...... 27

2. Ego Defense Ratings for Each Subject During the Reliability Evaluation of the Ego Defense Rating Scale ...... 31

3. Median Test of Significance of the Difference Between the Total Number of Symptoms Rated by Mothers of Children in the Clinic and Non-Clinic Groups ...... 35 4. Spearman's Coefficient of Rank Correlation Between Total Psycho­ logical Causality Score and IQ Score for the Clinic and Non-Clinic Groups .. 36 5. Chi-Square Values Testing the Rela­ tionship Between Social Class Member­ ship and Total Causality Score for the Clinic Groups ...... 38

6. Significance of the Difference Be­ tween Total Causality Scores of the Younger and Older Subjects of the Clinic and Non-Clinic Groups Using the Kruskal-Wallis One-Way Analysis of Variance By Ranks Method ...... 38

7. Median Test Values Testing the Differ­ ence Between the Subtest Causality Scores of the Clinic and Non-Clinic Groups ...... 39

8. Percentage of Subjects Attaining Scoring Levels 3 and 4 on the Causality Questions for the Non-Clinic and Clinic Groups ...... 40

x Table Page 19. Chi-Square Values Testing the Rela­ tionship Between Subjects Producing Predominantly Group I or DEJ Themes and Total Causality Score ...... 52

20. Chi-Square Values for the Signifi­ cance Between TAT Variables and Whiteman Scale Score for the 10-11 Year Old Subjects ...... 54 21. Chi-Square Values for the Signifi­ cance Between Structural Variables of the TAT Stories and Total Causality Score ...... 58 CHAPTER I

INTRODUCTION

Preliminary Statement

If the central problem for those who study the development of the mind is that of epistemology, the nature of the mental structures by which the human forms knowledge of the world of objects, then that for those who study the abnormalities of behavior must surely be the nature of those psychic structures which give rise to the varieties of psychopathology viewed by clini­ cians. Yet despite generations of clinical observation of deviant behavior still we know little of the psychic structures which correlate with these behaviors and even less of the development of 3uch structures.

Many years ago Freud wrote (S. Freud, 1909, p. 375) If we consider a number of analyses of obsessional neurotics we shall find it im­ possible to escape the impression that the relation between love and hatred such 93 we have found in our present patient is among the most frequent, the most marked, and probably, therefore the most important characteristics of obsessional neurosis. But however tempting it may be to bring

1 2

the "choice of neurosis" into connection with instinctual life, there are reasons enough for avoiding such a course. For we must remember that in every neurosis we come upon the same suppressed instincts behind the symptoms . . . What follows is, therefore, to be regarded as no more than a provisional explanation.

Thus Freud posed the significant question of why people develop particular types of disturbance, why they develop particular ways of dealing with their difficul­ ties, when the underlying conflict is the same. In an attempt to answer this question analytic theory first relied upon classic libido theory, attempting to charac­ terize disturbances by their presumed underlying drives. Later the importance of ego defense mechanisms was recog­ nized. (A. Freud, 1936) and certain defenses came to be associated with particular levels of libidinal develop­ ment. But still the question remains: what underlies the choice of symptom?

Historical. Theoretical, and Research Antecedents of the Study

It is perhaps paradoxical that the present inter­ est of psychology in individual differences, one facet of which is the study of cognitive styles, had its precursor in the work of the philosophical psychologists of the

19th century for whom the concept of instinct provided both descriptive and explanatory utility in the study of human behavior. For Bain

The nervous system may be compared to an organ with bellows constantly charged, and ready to be let off in any direction, according to the particular keys that are touched. The stimulus of our sensations and feelings, instead of supplying the inward power, merely determines the manner and place of the discharge (in Heamshaw, 1964, p. 21) .

For Darwin (1896, pp. 66, 71) there was "no funda­ mental difference between man and the higher mammals in their mental faculties . • • most of the more complex emotions are common to the higher animals and ourselves. "

For James (1890, volume 2, pp. 383-441), human behavior was determined by more than 40 instincts which included biting, curiosity, play, and grinding the teeth.

These are the most prominent of the tendencies which are worthy of being called instinctive in the human species. It will be observed that no other mam- mal, not even the monkey, shows so large an array (pp. 440-441).

MeDougall (1916, pp. 19-20) believed that the devel­ opment of a science of human behavior was impossible devoid of the basic assumption that human nature "has everywhere and at all times a common instinctual basis."

For Freud (1915) an instinctual drive may give rise to not one but any of a great variety of behaviors in an attempt to reduce the excitation of the drive, this 4

reduction being experienced as gratification. Despite his postulation of the roots of behavior as being

organic (i.e., the drive instinct) he did not so charac­

terize complex human behavior, instead believing in the

modifiability of the external object of the drive, a study of these variations being possible through the study of individual behavior. For Freud, thought (ego

processes) provided the mediating variable between the

demand for gratification of the instinctual drives and

the overt behavior which provide their satisfaction. Restraint of motor discharge (of action) had now become necessary, and was provi­ ded by means of the processes of thought, which developed from ideation. Thought was endowed with qualities which made it possible for the mental apparatus to sup­ port increased tension during a delay in the process of discharge (Freud, 1911, p. 15). This postulation of an independent mechanism which mediates between instinctual (organic) demands and reality

considerations was also present in the work of other prominent thinkers. The biologist Myers (1945, p. 12)

believes that

what in man can be compared to instincts consists . . . far less essentially in the release of appropriate, inborn, mechanized reflexes, far less essentially in any stereotyped means of achieving cer­ tain nend3n than in the awareness . . . of these "ends," in the interests in and the desires . . . for them, in the "innate determining tendencies" evoked . . . and 5

in the use of intelligence brought to bear in their achievement . • . in man, indeed, intelligence has largely usurped the functions of specific inherited be­ havior.

The philosopher Cassirer (1944, p. 24) believes that

. . . in the human world we find a new characteristic which appears to be the distinctive mark of human life. The functional circle of man is not only quantitatively enlarged; it has also under­ gone a qualitative change . . . Between the receptor system and the effector system, which are to be found in all animal species, we find in man a third link which we may describe as the symbolic system. This new acquisition transforms the whole of human life. As compared with the other animals man lives in a broader reality; he lives, so to speak, in a new dimension of reality. There is an unmistakable difference between organic reactions and human responses. In the first case a direct and immediate answer is given to an outward stimulus; in the second case the answer is delayed. It is interrupted and retarded by a slow and complicated process of thought.

In distinguishing between the behavior of man and the less cognitively advanced phyla, the psychoanalyst

Beres (1956, pp. 169-170) placed central importance upon the presence of those ego mechanisms which intervene be­ tween the instinctual impulse toward activity and the appearance of overt behavior.

The over-all function of the ego is to mediate between the instinctual drives and external reality, and this utiliza­ tion of a mediating device is a specif­ ically human attribute. In this sense the 6

ego is unique to man and serves a group of functions which, in lower animals, are accomplished by the direct action of the "instincts” • • . This distinc­ tion . • * (between the "instinctual drive" of mam and the "instinct" of the animal) . . . is relevant to the present discussion because the instinct of the animal is biologically adapted to re­ spond to environmental stimuli, whereas the instinctual drive of man requires the intervention of the ego before it finds appropriate discharge.

Later Kapaport (1959, p. 94) observed that it was

the difficulty in correlating the instinctual drive with

observable behavior, the need to explain individual dif­

ferences in the modulation and expression of instincts, out of which the concept of structure arose.

It was observed that drives do not un­ equivocally determine behavior in gen­ eral, nor symptom formation in partic­ ular. In contrast to the drive processes whose rate of change is fast and whose course is paroxysmal, the factors which conflict with them and co-determine be­ havior appeared invariant, or at least of a slower rate of change. The observation of these relatively abiding determiners of behavior and symptom seems to have been the foundation on which the concept of structure was built.

Moreover individual differences in aspects of structure are believed present from the earliest period of life, and, because of their primacy, have far-reaching deter­ mining effect upon instinctual expression. 7 The apparatus which forms memory- traces; the threshold of tension tolerance . . . the specific dis­ charge capacities of affect and idea; and the specific connection between the drive and its satisfying ObjectP­ al! appear to be structural givens, highly variable from individual to individual. There is also reason to believe that there are constitution­ ally given individual differences in the intensity of the drive and its temporal course--‘for example, rate of tension-rise and discharge— both determining in part the tolerance for the delay of its discharge. These structures, and others . . • are the prototypes for the controls which are formed later in the course of psychic development. They enter the formation of drive-controls autonomously. Then the super-organization of drive-controls (conceptualized as the ego) emerges, these structures are embodied in it, and provide the basis of its autonomy (Rapaport, 1951, pp. 692-693). Although Rapaport*s theorizing as to the presence of consistent individual differences early in life are

based primarily upon the clinical observation of adults, many observational studies have confirmed the presence of

relatively persistent, individualized patterns of response

to stimuli in infants (Wolf, 1953; Wolff, 1959; Kagan and

Moss, 1962; Schaefer and Bayley, 1963; Thomas, et al.,

1963; Escalona, 1968). Several groups of modulating structures have come

to be investigated as the means by which a consistent pattern of individualized response follows upon instinctual demands. The earliest of these were the ego defense mechanisms, later presumed to be of central importance in the determination of the "choice of illness" (Waelder,

1951; Anthony, 1970)? more recently various consisten­ cies in cognitive functioning labeled generically as cognitive controls or styles have been studied (Klein,

1954; Witkin, 1954)• Preliminary findings from these studies lend some hope that the "unquestioned variability of a person's behavior from situation to situation"

(Allport, 1958, p. 243) will be come--ultimately— more open to question. Several of the dimensions studied have been characterized as "constricted vs. flexible" control

(Klein, 1954), "global vs. articulated" cognitive style

(Witkin, et al., 1954; Witkin, et al., 1962), "focusing"

(Schlesinger, 1954) later reinterpreted as "scanning" by

Gardner, et al., (1959), "leveling vs. sharpening"

(Holzman and Gardner, 1960), and "reflection vs. impul- sivity" (Kagan, et al., 1964). Although correlations have been found between preference for various of these controls and clinical pathology, the most extensive work has been done on the stability and pathological associations of the global- articulated (field dependent-independent) variable.

Here correlations have been found between marked field dependence and alcoholism (Bailey, et al., 1961; Witkin, et al., 1959; Karp, et al., 1963, 1965), ulcer patients (Gordon, 1953), asthmatic children (Fishbein, 1963), patients with a hysterical character structure (Zukmann, 1957), psychotics who hallucinate as compared with those who are non-hallucinatory (Taylor, 1956), and between field-independence and paranoids (Janucci, 1964; Powell,

1964), and obsessive-compulsive characters (Zukmann,

1957). Considerable relative stability has been found for this variable over a 14 year interval for children

(Witkin, 1965), and a 3 year interval for adults (Bauman,

1951); attempted experimental intervention seems not to affect the articulated-global cognitive style whether this intervention be in the form of drugs (Karp, et al.,

1965), electro-convulsive shock (Pollack, et al., 1960), or significant life changes as divorce (Bauman, 1951)•

Thus correlations have been found in experimental research between cognitive consistencies and particular psychic disorders. Yet despite these findings one may question the explanatory potential of these measures in the study of childhood psychopathology. If the course of development of psychic disturbances reflects concur­ rent changes in the ego structure, then measures which seek to explain these changes should be independent of other general developmental factors (as intelligence); evidence exists that the most studied of these cognitive consistency measures (Witkin*s global-articulated style) is not: independent of general intelligence. In his

major work Witkin (1962) found field-independence meas­

ures to be significantly related to certain WISC sub­

test scores (Picture Completion, Block Design, and Object

Assembly) and unrelated to others (Vocabulary, Informa­

tion, and Comprehension)• If other studies corroborate

this it would seem that Witkin's dimension measures

other than general intelligence. But several studies

(Crandall and Sinkeldam, 1964; Wachtel, 1968) have found

significant correlations between field independence and

the three WISC subtests labeled by Cohen's (1959) factor

analytic study of the WISC as "verbal comprehension"

(Vocabulary, Information, and Comprehension subtests).

Zigler (1963a, 1963b) feels that the fieId-dependence measures reflect little but general intelligence. More­

over there has been some criticism of Witkin's person­

ality measures and methodology (Postman, 1955; Zigler,

1963a, 1963b) and a number of studies which do not sup­

port his findings (Dana and Goocher, 1959, 1960; Vaught

and Auguston, 1967)•

With regard to the adequacy of several of the other

cognitive consistency measures. Pick and Pick (1970,

p. 807) believe that "the evidence does not clearly sup­

port . . . (Kagan's reflection-impulsivity hypothesis)

• . • that the two dispositions toward visual analysis and 1 1

reflection contribute substantially to production of

analytic concepts and perceptual recognition errors.

Particularly the measure of visual analysis shows less

than desirable reliability. Furthermore, the several

reflection measures show only moderate relationship to

one another. Finally, these measures are not highly

related to the criterion measures of analytic concepts

and perceptual recognition errors." They conclude of

the cognitive consistency measures in general that

"studies of individual differences in perceptual develop-

ment have not yet revealed any variables, either dimen­

sional or categorical, which account for much of the

subject variability in perceptual performance" (Pick and Pick, 1970, p. 809).

In light of the questions raised as to the valid­

ity of the cognitive consistency findings, it seemed

advisable that another measure be sought in our search

for an ego mediational variable which would prove to be significantly related to the "choice of illness." Our problem was as follows: was there a cognitive measure which seemed to be developmental in nature (i.e., tended to increase with an increased differentiation in ego structure) , and might have— because of its nature— some association with the course of psychic disturbance. In what Anna Freud described as "an exciting paper which 12 inevitably arouses the envy of many other authors on the subject of ego psychology" (A. Freud, 1964, p. 200) ,

Ntinberg (1930) shed some light upon a possible character­ istic of the variable which we sought. In this paper he described the synthetic characteristics of the ego: the ego's capacity to unite and bind, simplify and general­ ize, strive for causality, establish a synthesis in time by linking past and present events. The natural syn­ thesizing ability of the ego, absent only in the most severe pathology, seemed similar in nature to the child's increasing competence in the awareness of logical causal relationships, this variable having been studied by sev­ eral cognitive developmental theorists. For Piaget (1928,

1932) both moral and causal judgment develop from less logical, more specific explanations to more logical, more holistic explanations. For Werner (1948) the child's causal reasoning develops through

. . . increasing abstraction and general­ ization. The younger child does not understand explanations on the basis of general, necessary determinants in the sense that these appear in a mature con­ cept of causality. Rather, he contents himself with certain historic concrete presentations of the event, with the causal grounds for it given implicitly in the imaginative configuration, yet not abstracted in any specific form. The logical relation of cause and effect re­ mains often undifferentiated, "syncretic- ally" comprehended in the form of a nar­ rative exposition (p. 321). 13 The motivation for these changes has been hypoth­ esized by various theorists as "internal," similar in source to that which energizes the ego*s synthetic func­ tion; this motivation has been conceptualized as "equil­ ibration" by Piaget (1951), "competence motive" (White,

1959), "intrinsic motivation" (Hunt, 1965), and "will to learn" (Bruner, 1966), although all these theorists recog­ nize the need for external stimuli to foster cognitive development.

Thus a useful instrument seemed to be one which measured gradations in the ability to apprehend causal re­ lationships, preferably with regard to interpersonal exper­ iences, the latter being that which is considered to be of importance in the development of psychic conflict in virtually all theories; such an instrument should also measure a characteristic largely independent of general intelligence.

Purpose of the Study

The major purpose of the present study was to in­ vestigate the relationship between a particular cognitive variable and the type of psychological disorder evidenced by children. The independent variable being utilized, awareness of psychological causation or unconscious

(covert) motivation, has never previously been related to 14 the psychopathological disturbances of children.

Although many psychologists have investigated the child's development of the concept of physical causality

(Piaget, Smedslund, Elkind, Inhelder, to name ju3t a few) and several have studied the child's developing capacity to make inferences on the subjective states (affects) of others (Amen, 1941; Kagan and Moss, 1960; Wallach and

Kogan, 1965; Ojemann, 1967; Gilbert, 1968), very few have studied the child's developing awareness of psychological causality, of the dynamics underlying human behavior, or more simply stated, of why people act as they do. This problem has been studied in its broadest sense by White­ man (1967). Previous research had dealt with particular aspects of a child's ability to infer the motivations of another as with regard to intentionality in moral judg­ ment (Piaget, 1932; MacRae, 1954), or role-taking ability

(Flavell, 1966). Utilizing an open-ended story technique,

Whiteman (1967) found a developmental progression in ease of verbalizing the underlying mechanisms, some mechanisms

(such as displacement, projection, and rationalization) proving particularly difficult for younger (ages 5 and 6) as conpared with older subjects (ages 8 and 9)• Some mechanisms were not fully grasped by even the older sub­ jects. The level of understanding evidenced by children 15 of the same age group was not uniform but varied wide-

lyy Whiteman writes (p. 155) :

. . • the operation of more specific experiential factors is suggested by the differential ease of the items within age groups, the lack of strong or consistent correlations . . . with IQ, the importance of chronological age over and above mental age differences • • . (and the) . • . sex differences . • . Certain patternings of responses to the stories may be related to par­ ticular behavioral patterns. Thus, ease in grasping projection stories, where blame is externalized, may be related to acting out behavior.

This study comprised four aspects:

1. The lack of replication of developmental re­

search has often been decried, perhaps nowhere as force­

fully as in Yarrow, et al., (1968). Thus one aspect of this study provided for a replication of the Whiteman

(1967) study. 2. The major thrust of the investigation was con­

cerned with an attempt to determine whether there exists

a relationship between a particular cognitive variable, the awareness of psychological causality, and particular

ways of responding to intra-psychic conflict, an inves­ tigation of that problem which often has been phrased as

the "choice of illness."

3. This study investigated more broadly the nature of psychological causality than did Whiteman, investigat­ ing both the effect of social class membership on its 16 development and the interpersonal and intra-psychic perceptions associated with ranges of ability to appre­ hend psychological causality. These perceptions were obtained from responses to Thematic Apperception Test stimuli, the analysis of this data including both thematic and structural aspects.

4. Because of the great need for a measure of ego defenses in children this study included the production and validation of an ego defense rating scale, this in­ strument being looked upon as a preliminary step towards the development of such a measure.

Hypotheses

The major hypotheses under consideration were the following: 1. A child with a greater awareness of psycho­

logical causality (covert motivation in others) will

a. be less likely to develop an externalizing

disorder (a disorder symptomatized by

impulsive, destructive, abusive behavior)

and more likely to develop an internal­ izing disorder (one characterized by isola­

tion and fearfulness); 17

b. tend to use developmental ly later rather

than earlier ego defense mechanisms;

c. tend to experience more overt anxiety at

the time of referral; whereas

2. A child with a lesser awareness of psychologi­

cal causality (covert motivation in others)

will

a. be more likely to develop an externalizing

disorder and less likely to develop an

internalizing disorder;

b. tend to use developmentally earlier rather

than later ego defense mechanisms;

c. tend to experience less overt anxiety at

the time of referral for evaluation.

Rationale of the Hypotheses

The rationale behind our first hypothesis is as follows: Much recent literature (Glueck and Glueck, 1950;

Sears, et al., 1953; Whiting and Child, 1953; Sears, et al.,

1957; Bandura and Walters, 1959; Miller, et al., 1960;

Aronfreed, 1961; Burton, et al., 1961; Aronfreed, 1968) has dealt with the effects which various types of discip­ line have upon the later development of the child, most notably his conscience. These studies either state directly 18 or imply that the child who experiences predominantly psychological methods of discipline (withdrawal of love, reasoning, explanation), as compared with the child who experiences predominantly physical punishment, gains a greater capacity to evaluate both his behavior and that of others.

A mother who indicates her disapproval by rejecting or ignoring her child, or by showing that she is hurt or disap­ pointed, is stimulating unpleasant feel­ ings that are not closely tied to her physical proximity or its imminence. The arousal and termination of these feelings are less well defined by exter­ nally explicit punitive events conveyed through her immediate presence than would be the case if she were to punish the child with a direct attack. Likewise, if she reasons with the child or explains why his behavior is unacceptable, she is using a verbal and cognitive medium of exchange that can provide the child with hi3 own resources for evaluating and modifying his behavior (Aronfreed, 1961, p. 226)•

One underlying thesis in these studies seems to be that of an association between the delay of action and thought. The child's ability to give a cognitive representation to the contingencies be­ tween its behavior and delayed outcomes should produce a radical increment in the delay tolerances which are generally found in the behavior of animals. The verbal medium of socialization would provide the child with cognitive equipment that would greatly expand the length of delay time over which its behavior could be sensitive to outcomes (Aronfreed, 196 8, p. 73). 19 This association between thought and the delay

of action has been postulated in the analytic movement

since its earliest days. . . . the activity of the first system aims at the free outflow of the quanti­ ties of excitation • . • the second system, by means of the cathexes emanat­ ing from it, effects an inhibition of this outflow, a transformation into dor­ mant cathexis, probably with a rise of potential . . . After the second system has completed its work of experimental thought, it removes the inhibition and damming up of the excitations and allows them to flow off into motility (Freud, 1900, pp. 533-534).

More recently Rapaport (1951, p. 701) has written

that

Delay, by establishing countercathecting energy-distributions, becomes a potent factor in the development of the all- over organization of controls which is conceptualized as the ego. This, when fully developed, performs many functions other than that of control; among others, it integrates those arising as conse­ quences of delayr such as regulation of attention-cathexes, consciousness, and secondary-process thought as internalized experimental action. Secondary-process thought has at its disposal and can cath- ect all memories, excepting those repres­ sed; it is therefore— unlike primary- process thought, which cathects only drive- representations— a potent tool of reality- appraisal. Moreover the concept of judgment is closely linked with secondary process activity in psychoanalytic theory.

A more objective perception presupposes a certain psychological distance of the perceiving Ego from the data of percep­ tion, a judgment about the sources of the 20

experienced sensations and, more than that, a correct judgment, an ability for differential learning, whereas the primitive experiences are felt as still undifferentiated wholes which make their appearance repeatedly. The pleasure-principle, that is, the need for immediate dis­ charge, is incompatible with correct judgment, which is based on consid­ eration and postponement of the reac­ tion. The time and energy saved by this postponement are used in the function of judgment (Fenichel, 1945a, p. 39). Using these theories which postulate an inverse association between impulsive action and reasoned thought, we*hypothesize that an externalizing child, one exhibit­ ing a disorder symptomatized by impulsive, destructive,

abusive behavior, will be less likely to acquire a marked awareness of covert motivation in others than will an internalizing child.

The reasoning behind our hypotheses relating the awareness of psychological causality to the use of a par­ ticular level of ego defenses and the tendency to exper­ ience anxiety is as follows: To infer accurately the motives behind the behavior of others requires an accurate perception of the existent situation, a perception free from the massive distortions present in the use of the developmentally earliest defense mechanisms. Thus a child with a greater awareness of psychological causality would tend to use the later, less perceptually distorting 2 1 mechanisms rather than the earlier ones. And because those with acting out behavior disorders tend to dis­ charge tension immediately in aggressive or destructive behavior, they will tend to evidence less overt anxiety at the time of referral for evaluation.

Our distinction between "earlier" and "later" ego defense mechanisms is based upon the research and theo­ retical literature which has accumulated over the many years that attempts have been made to classify the ego defenses chronologically. S. Freud mused in 1926 that

It may well be that before its sharp cleavage into an ego and an id, and before the formation of a super-ego, the mental' apparatus makes use of different methods of defense from those which it employs after it has reached these stages of organization (p. 164).

Anna Freud (1936, pp. 51-53) although conceding that there must be a chronological classification in the development of the ego defense mechanisms, fears the great difficulties which the attempt to order these mech­ anisms presents.

Repression consists in the withholding or expulsion of an idea or affect from the conscious ego. It is meaningless to speak of repression where the ego is still merged with the id. Similarly we might suppose that projection and introjection were methods which depended on the differentiation of the ego from the outside world . . .According to the English school of analysis, introjection 22

and projection, which in our view should be assigned to the period after the ego has been differenti­ ated from the outside world, are the very processes by which the struc­ ture of the ego is developed and but for which differentiation would never have taken place. These differences of opinion bring home to us the fact that the chronology of psychic pro­ cesses is still one of the most obscure fields of analytic theory . . .

But despite Miss Freud's pessimism, attempts to order genetically the defense mechanisms have continued. Miller and Swanson (1960) believe that defenses may be grouped according to four, not mutually exclusive charac­ teristics (pp. 198-199): 1. simplicity-complexity: some responses may ap­

pear relatively early in life and require

little or no training, such as withdrawal; others such as projection may require a more

advanced stage of mental development;

2* degree of distortion: some defenses, such as

denial in fantasy, may obliterate the percep­ tion of large segments of reality; others, such

as displacement, may be relatively focused;

3. specificity-generality: some defenses are

appropriate with many types of conflict, others

with only particular classes of difficulties (as reversal seems most useful with moral 23

conflicts involving alternatives);

4. social effectiveness: some defenses may pro-

duce considerable social difficulty by their

use; as an American who responds to conflict

by entering a trance state (a defense more

typical of Indian culture); in contrast, an

angry child who inquires solicitously about

his mother's health gains approbation.

Using these four criteria Miller and Swanson divid­ ed the defense mechanisms they considered into two "fam­ ilies":

Members of the first family share the characteristics of simplicity, maximal distortion, generality, and the crea­ tion of social difficulties . . . The second family differs from the first on each of the four criteria. Its defen­ ses are complex, they distort less of the perceptual field, and they are ap­ plicable only to specific kinds of con­ flict (p. 200).

Later Swanson (1961, pp. 37-38) believed that he had discovered grounds for an answer to the problem of such a . . • (genetic) • . . classification . . . We have seen that it is plausible to associate certain defen­ ses with certain stages of socialization. This social account implies that . . . certain defenses should appear earlier than others. The social account . . . would have certain additional advantages over those now available. It differenti­ ates more sharply than do they among the ages at which given defenses should be . well established and it implies that those ages are not so concentrated in a span of 2 4 a few months during the first two or three years of life as to prevent observation and measurement in re­ search concerning genetic order. This social account of symmetry and genetic order also helps us to understand why the number of discriminable defenses is not greater. Precisely because the number of important stages in social­ ization is quite restricted, the number of readily discriminated defenses should be correspondingly restricted.

Theorizing on why the production of particular defenses should correlate with particular stages of socialization, Swanson (1961, pp. 35-36) writes

In the beginning the infant must be sensitized to other people, must be­ come aware of his dependence on them. It is at this point that he first learns something of the discrepancies between his own behavior and the desires of others and first begins to adapt to those desires. Anaclitic identification and identification with the aggressor seem to correspond to the awareness of dependency; repression and denial to the consequent adapta­ tions . . . The relative stability and good adjustment of . . • the latency stage . . . correspond to that period in which responsible dependency is achieved • . • This seems to be aligned with the defenses of isolation and restriction of the ego. Finally, in pre­ adolescence and early adolescence, the child is required to move more defini­ tively toward responsible independence . . . the youngster must show himself capable of . • . foresight . . . Reaction formation and denial in fantasy may cor­ respond to the defenses most required by these new social demands. Hedegard (1968) ordered eight defenses on a scale of distortion going from defenses considered less dis­ torting and more cognitively complex, to cognitively more simple defenses which distort more of the anxiety laden situation. The theoretical scale of distortion consisted of intellectualization, negation of affect, action modification, mild object displacement, reaction formation, weak projection, strong projection, and denial.

Her major hypothesis, that an individual's choice of defense would increase in distortion according to the theoretical scale as his anxiety level increased, was confirmed.

Anthony (1970, pp. 679-680) has ordered the ego defense mechanisms along a developmental scale whose theoretical basis is that of the psychoanalytic psycho- sexual theory of development. This developmental scale consists of four stages, the defenses being ranged in order of development from the most primitive to the most mature: for example, projection and denial are associated with Stage 1, isolation and displacement with Stage 2, repression and regression with Stage 3, and intellectual­ ization and estheticism with Stage 4.

Thus, using knowledge gained from these research­ ers it appears that there is some broad agreement as to the genetic ordering of at least some of the ego defense mechanisms. For the purposes of this study the "earlier ego defense mechanisms will be considered to be pro­ jection, denial and isolation, and the "later" ego defense mechanisms will be considered to be repression, reaction formation and intellectualization. CHAPTER II

PROCEDURE

A. Subjects: This study employed 76 Caucasian males of 3 age ranges (5 to 5:11, 7 to 8:11, 10 to

11:11) and two major classifications: clinic sample and a non-clinic sample. Table 1 presents the age and IQ scores of the subjects.^

Table 1 Range and Mean IQ and Age Scores of the Clinic and Non-Clinic Groups

IQ Mean Age Mean Group N Range IQ Range Age I-C 10 91-141 10 9 5-5:11 5:5.2

I—NC 12 91-128 106 5-5:10 5:4.2

2—C 15 87-141 106.1 7-8:11 7:11.4

2—NC 12 95-140 107.9 7-8:11 8:0

3-C 15 80-129 108.5 10:1-11:10 10:11.7 3-NC 12 93-120 106.6 10:0-11:10 10:10.3

Throughout this study groups IC and INC refer to the 5 year old clinic and non-clinic groups respectively; groups 2C and 2NC refer to the 7-8 year old clinic and non-clinic groups respectively; and groups 3C and 3NC refer to the 10-11 year old clinic and non-clinic groups respec­ tively. 27 28 The clinic children consisted of outpatients at the Department of Child Psychiatry (Child Evaluation

and Guidance Clinics), Washington University School of

Medicine in St. Louis, Mo., the North Area Branch of the Children's Mental Health Center in Columbus, Ohio,

and the Diocesan Child Guidance Center in Columbus,

Ohio.

Only children with neurotic or characterological pathology who had not received psychotherapy were used; excluded were those with neurological impairment, psy­ chotic or borderline pathology, or significant mental retardation (IQ less than 75)•

The 5 year old non-clinic sample consisted pri­ marily of children attending the Amerikid Day Care Center in Columbus, Ohio, while several children in the 5 year old non-clinic sample and all of the older non-clinic children were students at the Evening Street School in

Worthington, Ohio, a residential suburb of Columbus.

The non-clinic groups consisted of children who had never been referred to a child guidance clinic. Children whose school medical record revealed any type of medication or the possible presence of personal difficulty (as, sleeping problems or an eating peculiarity) were excluded as were children for whom such comments as "babyish when teased" or "moody" appeared several times in the child's school 29 record and appeared to reflect atypical personal diffi­ culty. B. Measures: The children were seen individually

for a period of 1 to 1-1/2 hours and the procedures were administered in the order described below:

1. The Whiteman Measure of Awareness of Psycho­ logical Causality: The measure consists of 7 story situa­ tions r each story exemplifying a different mechanism of ego defense: displacement, wishful dreaming, projection, regression, repression, rationalization, and denial.

Queries concerned whether the child grasped the role of certain key elements. Each answer was coded on a scale of 1 point intervals ranging from 0 to 4 for 4 stories,

from 1 to 4 for 2 stories, and from 2 to 4 for 1 story, according 'to the degree to which the motivation of the child in the story was grasped. A copy of the stories and scoring criteria are included in appendices A and B.

2. The Wechsler Intelligence Scale for Children: A short form consisting of the following 5 subtests was used: comprehension, arithmetic, vocabulary, picture arrangement, and object assembly, studies having shown that the score gained from the combination of these sub­ tests correlates with the full-scale WISC IQ score above

•90 with children of a variety of ages and conditions

(Glasser and Zimmerman, 1967)• 30 3. The Thematic Apperception Test: Six cards were presented in the following order: 1, 2, 6BM, 7BM,

7GF, 8BM. 4* Interview to Assess Ego Defenses: Each

clinic child was rated on his use of 6 ego defenses (pro­ jection, intellectualization, isolation, repression, denial, and reaction formation) as judged by his respon­

ses during a structured interview lasting approximately 15 to 30 minutes. The interview concerned his perception

of why he was brought to the clinic, his perception of the difficulties in his life and feelings about his life, his perception of and feelings about his peers, teacher,

and parents, and past memories. The Ego Defense Hating

Scale used (Appendix C) was devised by the author after

the work of Haan (1963, 1965, 196 8)• The rating of each

defense varied from a score of 1 (healthy coping) through 5 (severe distortion of reality), this consideration of

the use of ego defense mechanisms as occupying a continuum from healthy, coping behavior to defensive, pathological behavior being also that which has been followed by Haan. The definitions and descriptions used in the defense rating scale were based both upon the definitions and des­

criptions used by Haan (1968) in her series of studies on ego defenses in adults (Haan, 1963, 1965) as well as some additions and revisions made necessary by the use of 31 children as subjects. To provide some reliability in­ formation for our scale, 3 males were interviewed by the author in a manner similar to that which was used throughout the study. Another clinical psychologist

(chief clinical psychologist at a major child psychiatry facility) observed the interview through a 2 way mirror. Table 2 presents the ratings which were observed for each subject.

Table 2

Ego Defense Eatings for Each Subject During the Reliability Evaluation of the Ego Defense Rating Scale

Subject 1 Subject 2 Subject 3 Rater Rater Rater Rater Rater Rater Ego Defense_____ 1______2______1______2 1______2

Projection 5 5 2 1 3 3 Intellectual­ ization 3 3 1 3 1 1 Isolation 1 2 4 1 3 3 Repression 2 1 2 1 4 5 Denial 3 3 5 1 5 5 Reaction Formation 2 5 3 4 1 1

As can be seen from these figures an exact correspondence was achieved in 39% of the ratings; in an additional 34% of the ratings there was only a 1 rating interval disagree­ ment, and in an additional 11% of the ratings there was a correspondence within a 2 rating interval correspondence. 32 Thus it seems that the accurate rating of ego defenses in children can be achieved using a 3 interval rating scale (i.e., ego defense not used, ego defense used to a moderate degree, ego defense is one of the child's major defenses) but that when a more demanding 5 inter­ val rating scale is used, exact agreement between raters is very difficult to achieve. Because our reliability sample was so small our findings based upon the use of our ego defense rating scale cannot be said to be more than possibilities worthy of further exploration. •

The interview to assess ego defenses was not used with the non-clinic children.

5. Measure of Social Class Membership: The social class of the child was determined by the occupation of the head of his household (whether male or female) using the six-step scale for occupation employed by Zigler and

Phillips (1960), and used subsequently in a study of children's psychiatric symptoms by Shechtman (1970). The Dictionary of Occupational Titles (1949) was used to classify appropriately the parental occupation.

6. Measure of Behavioral Symptoms: Numerous clin­ ical and actuarial studies have found similar symptoms to differentiate the "internalizer” from the "externalizer."

For example, Ackerson's (1942) classical factor analytic study which distinguished between the "personality-total" and the "conduct-total" included sensitiveness, seclu- siveness, depression, nervousness and feelings of in­

feriority with the former, and truancy, destructiveness,

cruelty, disobedience, lying, and stealing with the

latter. Similarly Conners (1970) found the highest synptom ratings by parents for the patients at a child

guidance clinic to be overasserts self, problems with brothers and sisters, problems keeping friends, restless,

temper, sex, lying, and stealing for the "aggressive"

child and fears and worries, trouble with feelings, prob­ lems making friends, perfectionism with the "anxious"

child. Other studies {Miller, 1936; Hewitt and Jenkins,

1946; Gerard, 1947; Louttit, 1947; Ackerman, 1953; Cameron, 1955; Peterson, 1961; Maxwell, 1962; Jenkins,

1964; Dreger, 1964; Quay and Quay, 1965; Achenback, 1966; Jenkins, 1966) have found similar symptoms to distinguish the internal!zing-externalizing dichotomy.

Zn this study 14 problem areas which have in pre­ vious studies been found to distinguish between the two groups were used (seven representative of each group).

Each symptom was rated by the mother with a score ranging from 0 (not present) through 3 (severe problem). The behavior rating scale used was developed by the Psychology Department of the Washington University Child Guidance

Clinic over a period of two years. A copy of the scale used (part of the far larger scale used at the clinic) is included in Appendix D. A factor analysis (based upon approximately 800 cases) of a somewhat earlier ver— sion of the behavior rating scale used at the clinic (Brugger, 1971) revealed a number of factors, two of which are the "internalizer-extemalizer" dimension, the rated symptoms being similar to those found in previous studies. The symptoms considered to be "internalizing" were general fearfulness, particular fears, confidence in abilities, handling anxiety, tendencies to worry, depression-sadness, find daydreaming; while those con­ sidered to be "externalizing" were excitableness, control of anger, negativism, truthfulness, stealing, overly assertive, overly active. CHAPTER III

FINDINGS

1. Behavioral Distinction Between Clinic and

Non-Clinic Groups: Evidence that the subject selection criteria was valid is provided by Table 3: for all three ages the clinic subjects were rated by their mothers as having significantly more behavioral diffi­ culties than were the non-clinic subjects, the signifi­ cance levels ranging from the .05 to the .001 levels, the greatest difference between the groups occurring with the older children (7-8 years, 10-11 years).

Table 3

Median Test of Significance of the Difference Between the Total Number of Symptoms Rated By Mothers of Children In the Clinic and Non-Clinic Groups

Mdn. No. of Symptoms Rated Range Chi- Group C NC C NC Square 1C vs. INC 16 8 9-25 2-14 4.6a 2C vs. 2NC 18 4 6-25 0-13 10. lb 3c vs. 3NC 13 2 4-26 0.11 12.4C

Significant at the less than .05 level "significant at the less than *01 level Significant at the less than .001 level 35 36

2. Significance of the Correlation Between Psy­ chological Causality and Intelligence: Table 4 reveals that for none of the clinic or non-clinic groups was the association between total causality score and intelli­ gence significant, the rho values ranging from .04 to

.49, the highest values occurring in both groups at the intermediate (7-8 year) age range (.49) while those of the other age ranges were considerably lower (.36 and

.27 for the youngest groups, .04 and .22 for the oldest groups). Correlation coefficients were also confuted between total causality score and score on each of the 5 WISC subtests: none was significant.

Table 4

Spearman's Coefficient of Bank Correlation Between Total Psychological Causality Score and IQ Score For the Clinic and Non-Clinic Groups

Group Rho 1C .36 2C .49 3C .04 IN—C .27 2N-C .49 3N-C .22

Thus general intelligence appears to play a larger role in the perception of psychological causality in what one might call the mid-latency as compared with the 37 oedipal and late latency (or pre-adolescent) periods.

With a similar range of IQ but subject racial differen­ ces between our and Whiteman's (1967) population (White­ man’s subjects being Black and Puerto Rican) our findings on the relationship between causality and IQ are similar, his rho values ranging from .15 to .40 (all non-signifi­ cant) • He also found intelligence to play a larger role in the causality score of his older children (age 8-9) as compared with his younger children (age 5-6)• His study lacked the still older age range (10-11) which our study provided.

3. Significance of the Correlation Between Social Class and Total Psychological Causality Score: Because of the large number of subjects in the non-clinic groups whose parents were professional workers (30 out of 36) only the association between social class and total caus­ ality score for the clinic groups was computed, these groups representing a wide range of social class member­ ship. Table 5 reveals that for none of the age periods or for the subjects of all ages was the correlation be­ tween social class (as indiced by parental occupation) and total causality score significant.

4. Significance of the Difference Between Total

Causality Score of Older and Younger Subjects: Table 6 reveals that for both clinic and non-clinic groups older children tended to attain significantly higher total 38 causality scores than did younger children, the signifi­ cance values ranging from the *01 to the .001 level. Age thus appears to be a critical factor in the attainment of the capacity to be aware of psychological causality, a finding in agreement with Whiteman's (1967).

Table 5

Chi-Square Values Testing the Relationship Between Social Class Membership and Total Causality Score for the Clinic Groups

Group______Chi-Square

Age 5 .42 Age 7-8 • 40 Age 10-11 1.6 All Ages .11

Table 6

Significance of the Difference Between Total Causality Scores of the Younger and Older Subjects of the Clinic and Non-Clinic Groups Using the Kruskal-Wallis One-Way Analysis of Variance by Ranks Method

Comparison of Groups H value

1C vs. 2C 14. 9b 2C vs. 3C 10.2a

INC vs. 2NC 13.7b 2NC VS. 3NC 8.3a

Significant at the less than .01 level Significant at the less than .001 level 39 5. Causality Subtest Differences Between the

Clinic and Non-Clinic Groups: Table 7 reveals that for only one of the subtest scores, projection, was there a significant difference (at the .05 level) between the clinic and non-clinic groups, a difference such that the youngest clinic children tended to have a significantly greater ability to be aware of the use of the mechanism than did their non-clinic ageroates. These figures in­ clude a correction for continuity where appropriate.

Table 7

Median Test Values Testing the Difference Between The Subtest Causality Scores of the Clinic and Non-Clinic Groups

Causality Story Group Dis DW Pr Reg Rep Rat Den Total

1 .15 .12 4 ,58a .7 .57 0 0 3.1

2 2.0 .3 .04 .03 .12 .03 .49 1.75

3 .04 .14 .20 .03 • 16 .4 .56 2.38

Significant at the less than .05 level

There were also tendencies (all non-significant, ranging in probability value from the .08 to the .19 level) for the clinic groups of all ages to have a greater aware­ ness of causality in general than their non-clinic counter­ parts, and for the 7-8 year old clinic group to have a 40 greater awareness of displacement (£ less than .16) than the non-clinic group.

Table 8, showing the percentage of children from all of the groups who attained the highest scoring levels (3 and 4) for the individual questions, seems to indicate that the rate of change over age is different with various mechanisms for the clinic and non-clinic groups, an observation for which evidence is provided in Tables 9 and 10. The figures in Table 9 include a correction for continuity where appropriate.

Table 8

Percentage of Subjects Attaining Scoring Levels 3 and 4 on the Causality Questions for the Non-Clinic and Clinic Groups

Causality Story Group Dis Dw Pr Reg Rep Rat Den

INC 17% 25% 0% 0% 8% 0% 0% IC 10% 20% 20% 10% 30% 20% 0%

2NC 92% 75% 67% 25% 67% 25% 33% 2C 67% 53% 60% 20% 53% 20% 12% 3NC 92% 100% 83% 25% 100% 75% 92% 3C 87% 73% 87% 27% 87% 67% 67% 41

Table 9

Chi-Square Values Testing the Difference Between Sub-Test Scores of the Younger and Older Subjects In the Clinic and Non-Clinic Groups

Causality Story Group Dis Dw Pr Reg Rep Rat Den

INC vs. 9.9C 4.2a 8.4° 4.6& 6.2b .17 2.1 2NC 2NC vs. .7 .7 0 .2 .9 4.2a 6 • 0b 3NC

1C VS. 5.6b 1.6 2.6 1.4 .5 0 .8 2C 2C vs. 2.1 1.2 .3 .1 2.1 4. 9a 4.8a 3C

asignificant at the less than .05 level ^significant at the less than *02 level csignificant at the less than .01 level

Table 10

Age Period Between Which a Significant Increase In Causality Sub-Test Score Occurred -in the Non- Clinic and Clinic Groups

Causality Story Group Dis Dw Pr Reg Rep Rat Den

NC 5-8 5-8 5-8 5-8 5-8 9-11 9-11

C 5-8 * * * * 9-11 9-11

a no one age period significant 42

It: appears from these tables that the major in­ crease in awareness of the individual causality mechan­ isms occurs over a 3-4 year period for all of the mech­ anisms for the non-clinic groups but for only 3 of the mechanisms for the clinic groups; for the other 4 mechanisms (dream wishing, projection, regression, and repression) a major increase in awareness over a 3-4 year period seems not to occur, the development of awareness of these mechanisms occurring more slowly and over a longer period of time for the clinic than for the non­ clinic groups. Thus while the presence of psychic con­ flict seems not to interfere with the gaining of aware­ ness of causality as a whole (perhaps even facilitating it), it does seem to make more difficult the acquiring of awareness of particular mechanisms.

Our data thus far seems to indicate some differ­ ences between the clinic and non-clinic groups related to the causality variable. We may now ask, does this var­ iable differentiate between different types of disorders, those characterized along the internalizing-externalizing dimension? In both Tables 11 and 12 an "internalizingH subject is considered to be one who scores (compared to his age-mates) both above the median in number of inter­ nalizing symptoms and below the median in number of exter­ nalizing symptoms, while subjects considered to be "exter- nalizers* are described by the reverse criteria. Only 19 of the 40 clinic subjects could be described as either

"internalizers" or "externalizers." This figure of 48% of the subjects who could be so classified is very close to the figure found by Shechtman (1970, p. 687), 49.5%, in her sample of male child outpatients at a mental health clinic.

Table 11

Table of Chi-Square Values Testing the Relationship Between Internalizing-Externalizing Subjects and Total Causality Score

Group N Chi-Square

Age 5 4 0 Age 7-8 7 .1 Age 10-11 8 .5

All Ages 19 0

Table 12

Table of Chi-Square Values Testing the Relationship Between Internalizing-Externalizing Subjects and Causality Subtest Score

Causality Story Group Dis Dw Pr Reg Rep Rat Den

Age 5 0 0 0 1.0 0 1.0 0 Age 7-8 .1 .1 0 .1 0 0 0 Age 10-11 .5 0 0 .5 .8 0 ♦ All Ages 1.7 0 0 4.1* 0 0 0

Significant at the less than .05 level 44 Table 11 reveals no significant association be­ tween children classified as "internalizing" or "exter­ nalizing" and total causality score, while Table 12 reveals that for the total clinic group "externalizers" tend to have a significantly more sophisticated aware­ ness of the ego defense mechanism of regression than do the "internalizers."

6. Association Between Anxiety Score and Total Causality Score for the Clinic Groups: Table 13 reveals that, when dichotomized at the median, there was a non­ significant tendency (at the less than .09 level of sig­ nificance) for the high anxiety clinic subjects to have a more sophisticated awareness of causality as a whole when compared with the low anxiety subjects. The measure used of the subject's level of anxiety was his rating on symptom 5 ("Handling Anxiety") on the behavior rating scale.

Table 13

Chi-Square Values Testing the Association Between Level of Anxiety and Total Causality Score for the Clinic Group

Group Chi-Square Age 5 0 Age 7-8 .1 Age 10-11 2.3 All Ages 3.0 45 7. Findings Regarding Users of Predominantly

Early vs* Predominantly Late Ego Defenses: Subjects who

scored both above the median on early defenses and below

the median on late defenses were characterized as util­

izing predominantly early defenses while the reverse characterized users of primarily late defenses. Forty percent of the clinic sample could be described as using either predominantly early or predominantly late defen­ ses. Table 14 reveals no significant correlation between those clinic subjects dichotomized as using predominantly early vs. predominantly late defenses and those scoring above and below the median on total causality score.

Table 15 reveals no significant difference between the use of early and late ego defense mechanisms based on age for the clinic sample.

Table 14

Chi-Square Values Testing the Association Between Early Vs. Late Ego Defenses and Total Causality Score

Group N Chi-Square

Age 5 6 0 Age 7-8 3 too few cases Age 10-11 7 0 All Ages 16 .1 46

Table 15

Chi-Square Values Testing the Difference Between Users of Early Vs . Late Ego Defenses and Age For the Clinic Groups

Group Early Defenses Late Defenses

Age 5 vs. 10-11 .3 1.0 Age 5 vs. 7-8 0 0 Age 10-11 vs. 7-8 .5 .4

8. Findings Regarding Use vs. Awareness of Ego

Defense: Three of the defenses rated by our Ego Defense

Rating Scale were those for which the level of awareness was measured by the Whiteman Scale. These were projection, repression, and denial* Table 16 presents the level of sig­ nificance for the association between the use of and aware­ ness of these ego defenses by the clinic subjects (the figures are corrected for continuity)• Several correla­ tions for defenses at particular age levels could not be

I Table 16

Chi-Square Values Testing the Association Between Use and Awareness of Several Ego Defenses

Ego Defense Group Proiection Repression Denial Age 5 0 1.0 * Age 7-8 .9 2.0 * Age 10-11 ** .1 *was not computed because of a too narrow range of Whiteman Scale score 47 computed because of the large number of subjects who

achieved one score on awareness of the particular defense. Table 16 reveals that for none of the three defen­

ses for which both use and awareness ratings were avail­

able was a significant association between the two dimen­

sions found. There was, however, a tendency toward sig­

nificance (chi-square 2.0, £ less than .16) for the 7-8

year old clinic subjects who scored above the median on

the use of repression to achieve above the median score

on awareness of repression on the Whiteman Scale. 9. Findings from the Analysis of the TAT data:

Because of the absence of research relating the awareness

of psychological causality to family interactional and

intra-psychic variables, each subject was asked to respond to 6 TAT cards. In our first analysis of the resultant

456 stories, the stories of 4 subjects in each of the 6

groups (clinic age 5, 7-8, 10-11; non-clinic age 5, 7-8,

10-11) were analyzed, 2 subjects representing the highest causality scorers and 2 subjects representing the lowest causality scorers. From the results of this initial anal­ ysis it seemed as if particular familial environmental and

intra-psychic themes could be correlated with either the

capability or the failure to be aware of covert motivation

in others. A. Major TAT Themes Produced by Children Attain­ ing the Highest Scores on the Psychological Causality Measure: Three themes seemed to 48 predominate in the stories produced by these children in

response to the TAT stimuli. One major theme was that

of a child who accedes to his parents demands, this con­

formity often including the distortion or denial of his

true feelings, happiness or success for the child result­

ing from these events•

I'm going to name the boy Jack. On Christmas eve Jack got a violin. He didn't like it. He just sat looking at it. Then his father came in and said, "Jack, why don't you play the violin?", and his father said, "Jack, your grandmother gave it to you for Christmas". He like the violin so he played it every evening when he came home from school. (Clinic Subject, age 7;8, re­ sponse to card 1)

A second theme seemed to reflect the child's sens­

ing (awareness) of comfort as coming from and being with people, coupled with a liking for people; despite the pos­

sible presence of overt discord between himself and his parents he feels an underlying concern for him by his parents (particularly his mother), and trusts that help

(comfort) is available when needed.

Daughter sad • . . her baby doll fell down and daughter doesn't feel very good and mother trying to comfort her. (Non-Clinic Subject, age 10:10, response to card 7GF)

This girl she's jealous about what sister got and she's looking over there and mother tell­ ing her she got mostly the best things and not to be jealous of her. (Clinic Subject, age 11:8, response to card 7GF) 49

A third theme seemed to reflect the child's ap­ parently narcissistically based belief that he can ach­ ieve virtually whatever he wishes, whether vocational or financial success or personal glory.

Once upon a time was little woman. She wanted to live on a farm. She wished and her wish came true . . . was another lady there and a man with a horse. Man wished he could live in a house and his wish came true and lady wanted her own chalk board and her wish came true and they all loved each other very much. (Clinic Subject, age 5:7, response to card 2)

B. Major TAT Themes Produced by Children Attain­

ing the Lowest Scores on the Psychological Causality Measure: The predominant theme for these children was one of sadness, dejection. Looks like the lady's worried, and the man's worried. Somebody at hospital who might die. Lady looking sad. Man look­ ing at floor and that's all. (Non-Clinic Subject, age 10:3, response to card 6BM)

But there were several additional themes present in what appeared to be a much smaller frequency of occurrence for each: 1. The child sees himself as being unable to pro­ duce or he strives to achieve (produce) but is uncertain of success. 50 He's very puzzled. Trying to learn how to violin. it's too hard and he wants to drop it but then he thinks he'll be a great musician in an or­ chestra. He's puzzled what to do. (Clinic Subject, age 10:3, response to card 1}

2. The child sees bad things as resulting when he defies his parents wishes.

He's going against his family's will. Getting married and having baby already and baby turns out crippled and mother said he shouldn't have married that girl. Turns out baby is only tempor­ arily crippled. (Clinic Subject, age 10:3, response to card 6BM)

3. The presence of sexual ambiguity.

A woman she has— not a man— with a son. She has a baby in her hands and she feels like feeding her something like that. (Clinic Subject, age 7:1, response to card 7GF) The 576 TAT stories were coded by the author

"blindly," i.e., without knowledge of the subject's caus­ ality score. Each story was judged on the basis as to whether each of 4 themes was present: N Deference-Com­ pliance (n Defc), p Nurturance (p Nur), Gratification (Gr), and Dejection (Dej). These themes were defined according to Aron (1949) as follows: N Deference-Compliance: The hero falls in with the wishes, suggestions, exhor­ tations of a dominant object. He com­ piles, agrees, cooperates, obeys. 51 P Nurturance: Someone nourishes, en­ courages, protects, or cares for the hero. He receives sympathy, consolation, pity.

Gratification: The hero achieves a goal or gains satisfaction from striving. He succeeds in accomplishing a task he had set for himself.

De5ection: The hero experiences feelings of depression, sadness, grief.

Our TAT hypotheses were, the following:

1. Children who score highly on the causality measure tend to produce TAT themes with a greater fre­ quency of the first 3 themes (n Defc, p Nur, Gr) than those who achieve low scores.

2. Children who achieve low scores on the causal­ ity measure (compared with those who achieve high scores) tend to produce TAT themes with a greater frequency of Dej themes.

In Tables 17, 18, and 19 the themes of n Defc, p Nur, and Gr are described as Group 1 themes.

Table 17

Chi-Square Values Testing the Relationship Between Group 1 Themes and Total Causality Score

Group N Chi-Square Age 10-11 27 4.51®

Significant at the less than .05 level 52

Table 18

Chi-Square Values Testing the Relationship Between DEJ Themes and Total Causality Score

Group N Chi-Square

Age 5 22 0 Age 7-8 27 1.4 Age 10-11 27 0 All Ages 76 .8

Table 19

Chi-Square Values Testing the Relationship Between Subjects Producing Predominantly Group 1 or DEJ Themes and Total Causality Score

Group N Chi-Square Age 5 12 0 Age 7-8 16 .82 Age 10-11 12 2.94 All Ages 40 6•53a

Significant at the less than .02 level

In Tables 17, 18, and 19 the statistical analysis involved a dichotomizing of the total causality score

above and below the median. Xn the analysis of the rela­

tionship of the Group X themes to total causality score there were too few of these themes in the stories of the youngest subjects (ages 5, 7-8) for statistical analysis to be conducted. Table 17 reveals a significant associa­ 53 tion (at the less than .05 level) between the presence of the Group I themes and total causality score for the oldest group of subjects (age 10-11)• Thus evidence is provided in favor of retention of TAT hypothesis I, but only with regard to the oldest subjects.

Table 18 reveals no significant relationship be­ tween the DEJ theme and total causality score for any of the 3 age ranges or for the children of all ages con­ sidered as one group: thus TAT hypothesis 2 seems to be worthy of rejection. But Table 19 provides evidence in its favor: when all of the subjects who produced pre­ dominantly Group 1 themes (subjects scoring both above the median on Group 1 themes and below the median on frequency of Dej themes) were dichotomized against those who produce predominantly Dej themes (subjects scoring both above the median on frequency of Dej themes and be­ low the median on frequency of Group 1 themes), compared with causality scorers above and below the median, an association significant at the less than .02 level was found such that high causality scorers tend to produce Group 1 themes in response to the TAT stimuli and low causality scorers tend to produce DEJ themes in response to the TAT stimuli.

In the second analysis of the TAT data, the stories of the 10-11 year old subjects were evaluated in terms of 54 all of the variables categorized by Aron (1949, pp. 31- 40)• Most of the correlations between ratings on these variables and the total causality score, both dichoto­ mized at the median, were far from significant, but several tended toward a significance (see Table 20).

Table 20

Chi-Square Values for the Significance Between TAT Variables and Whiteman Scale Score for the 10-11 Year Old Subjects

TAT Variable Chi-Square

plus n Sex 2.0

p Dom 2.9

The TAT variables which tended toward significance are defined by Aron (1949, pp. 33, 37) as follows:

n Sex: The hero seeks the company of the op­ posite sex as a love object. (Formal marriages where the love relationship is secondary, and where the motive of achieving or maintaining the role of a married person predominates, should be marked plus n Sex.)

p Dominance (p Dorn): Someone tries to guide, direct the actions of the hero. He tries to influence the hero*s convic­ tions or actions by pleading or per­ suasion. He (the hero) is lead, managed, or restrained by another person or persons•

Table 20 reveals that a low awareness of psycholog­ ical causality has a non-significant tendency to be 55 associated with the production of TAT themes reflecting plus n Sex (chi-square 2.0, £ less them .16), and a high awareness of psychological causality has a non-signifi­ cant tendency to be associated with the production of TAT themes reflecting p Pom (chi-square 2.9, £ less than .09).

Our latter finding seems in line with the results from our first analysis of the TAT themes where it was re­ vealed that children with a more sophisticated awareness of causality tended to produce n Deference-Compliance themes, themes which reflected the hero complying with the demands of a more dominant object. Our findings regarding plus n sex are more diffi­ cult to explain. The interest of the children in marriage is certainly not atypical: Broderick (1965) found that

67% of the 10-11 year old boys he studied wanted to get married someday. Moreover, the interest in being married itself, where acquiring a love object is secondary rather than primary, is understandable from a physiological point of view since in comparatively few 10-11 year old boys has pubescence occurred (Tanner, 1962). Yet, perhaps the interest of these boys in the form of the relation­ ship rather than the relationship itself is typical of how they approach interpersonal relationships, by attending to its overt appearance rather than its covert implications, and thus our findings. 56 Our third analysis of the TAT data concerned the

structural aspects of the themes. Here we attempted to see whether the level of organization of the stories produced in response to the TAT stimuli, or the subject's tendency to respond to the specific demand which each TAT card made upon him, bore any relationship to his tendency to score highly on the Whiteman Scale. Each story was rated as to one of the following levels of organization (after Henry, 1956, p. 62):

1. Enumerative listing of the facts of the picture (that's a boy and that's a violin); 2. The description of the facts of the pic­ ture in terms of their meaning and inter­ relationships (that's a boy looking at a violin)? 3. An imaginative level in which the subject enlivens his description of the picture with his own personal point of view and elaborates his story with imagined details (that's a boy who has been told to play his violin but he doesn't want to)•

Each story was also rated in terms of whether or not it was responsive to the form demand of the particular

TAT card presented. Henry (1956, pp. 63-64) writes: I have used the expression form demand . . . to indicate a certain degree of pressure placed upon the subject by the presentation of these stimuli in a manner requiring organ­ ization and structure. These instructions do not readily permit the subject merely to identify selected aspects of the picture and ignore those aspects with which he does not care to deal or avoid the obligation of suggesting a relationship between certain of the forms presented . • . It seems to me extremely helpful in analyzing the subject's 57 habits of perceptual and conceptual organization to envision him as respond­ ing to this interaction of self and a pattern of form which sets a certain task level for him. I have used the term form demand to suggest the presence of pictures with various kinds and numbers of forms, but also to imply that the task set by the instructions places a special obligation on the subject to respond with an effort at stating the relationship be­ tween these forms which he proposes at present.

The form demand of each TAT card is presented in Henry (1956, pp. 240-241, 246—250}; for example, the form demand of Card 1 (a young boy is contemplating a violin which rests on a table in front of him) requires a "ref­ erence to the boy, the violin, and some statment of a relationship between them" (p. 240}, whereas the form demand of Card 8BM (an adolescent boy looks straight out of the picture; a rifle barrel is visible at one side, and in the background is the scene of a surgical operation, like a reverie image) is to appropriately relate the seem­ ingly unrelated forms of the boy and the background scene which do not appear to be occurring in the same reality plane.

The association between Level of Organization and Form Demand of the TAT stories and awareness of psycho­ logical causality is presented in Table 21. The figures are dichotomized at the median and corrected for continu­ ity. 58

Table 21

Chi-Square Values for the Significance Between Structural Variables of the TAT Stories and Total Causality Score

Structural Variable Group Level of Organization Form Demand

Age 5 4.9a .1 Age 7-8 .3 1.0

Significant at the less than .05 level

Because the Level of Organization and the Form

Demand were very high for most of the stories produced by the 10-11 year old subjects, the coefficients were not computed for this group. Table 21 reveals a significant association (at the less than .05 level) between the Level of Organization of the TAT stories produced by the 5 year old subjects and their total causality score such that children who produced a more structurally complex story also tended to score highly on the Whiteman Scale. CHAPTER IV

DISCUSSION OF THE FINDINGS

Because of the lack of previous research on the subject under study our work was largely exploratory in nature, a search for understanding rather than a confir­ mation of what seemed to be valid. Thus it is no sur­ prise that evidence! was provided (Table 10) for the rejec­ tion of hypotheses la and 2a (which theorized that high causality awareness is associated with the occurrence of an externalizing disorder), the rejection of hypotheses lb and 2b (Table 13 - these hypotheses theorized that high causality awareness was associated with the use of later ego defense mechanisms), and a possible acceptance of only hypotheses lc and 2c (Table 12) which theorized that high causality awareness was associated with high anxiety. Perhaps before we consider further the meaning of our findings we should inquire as to our experience with the Whiteman Scale. The difficulties which we observed in using this measure seemed to reflect both difficulties inherent in the age and behavioral disturbances of our subjects, and limitations of the scoring categories provided by Whiteman. 59 60 As a generalization we may state that our assessment dif­

ficulties were in inverse proportion to the age of our

subjects, the greatest difficulty arising with our younger (5 and 7-8 year old) clinic groups. The records

of two 5 year old children and one 8 year old child were not used, the younger because they replied "don't know" to every question, the older because his great fear of new situations precluded virtually any speech. Whiteman

(1967, p. 150) also had some difficulty with his younger

(5-6 year old) children and discarded 11 of their 47 records "because of difficulty in comprehending their answers or, more frequently, because they simply replied

"don't know" to most of the questions on the . . . inter­ view. "

Probing could be carried out with only limited success with several of the children in the 5 year old clinic sample: questioning their responses seemed to present them with a greatly frustrating situation to which they responded usually with answers at a level of sophis­ tication of their initial response, but further probing which would have been desirable to assess more clearly the developmental level of their responses could not be carried out: this would have risked alienating them and losing their cooperation in the remainder of the evalua­ tion. The causality stories were responded to with a 61 sort of "curious interest" by most of the children in the first two age levels, the oldest children tending to respond with more tolerance than interest.

On the several occasions that loose associations occurred (in both the clinic and non-clinic groups) it usually consisted of using elements from an earlier story to explain a sophisticated response to a later story, as if the child didn't have a sturdy awareness of the adjust­ ment mechanism, i.e., that he was between two develop­ mental levels of awareness. This inter-level shifting was most evident (although present only in about 10% of the total cases) in the response of both groups of children to story 6 (which illustrates the mechanism of rational­ ization and concerns why a child refused to eat spinach stating that it made him fat); for example, a clinic subject (age 5:11) responded to question 6, "cause I don't think he liked spinach." When asked if Johnny really thought that spinach made him fat he responded, "X think he did it doesn't though I know that." A non-clinic subject (age 5:10) in response to question 6 remarked, "cause he didn't want to get fat*" When asked if Johnny really thought spinach made him fat he replied, "no."

When asked why then Johnny said it the child had no response. To a lesser degree this inter-level shifting was present in the responses of several of the children to question 5 (which illustrates the mechanism of 62 repression and c o n tins why a child remembers to tell his friends about:, .e loss of his gloves but forgets to tell his mother) y , a non-clinic subject (age 10:2) remarked in r e s p o n d to question 5, "He must have thought he better not t e l l t.er cause he fd get into trouble or he was having so fun he forgot.” When asked which one it was he r e p l i jsponded to question 5, "because he thought he would cr< into trouble or when he did all that stuff he had so fun he forgot." When asked which it was he responded, i had so much fun he forgot . . . when coming home ix ^would be sad for a moment and not want to tell his mom -wanted to forget and thought he would remember it later - This inter-level shifting may explain why the lowest irx-fc< rater scoring reliability figure

(75%) which Whiten*, achieved for all of the questions was for the story Lustrating rationalization.1

In all in our study in which the child re­ sponded with a r e s p o j n a e between scoring categories he was scored as having jzm-eved the less sophisticated response. 63

Although the Whiteman Scale seemed an adequate measure o£ the awareness o£ covert motivation several qualifications should be made. The questions range in length from 40 words to over 100 words, the longest stories appearing much too long for our youngest subjects.

Although Whiteman attempted to "gain some control on memory . . . differences . . • (by recapitulating) . . . part of the stories in the questions" (1967, p. 146) this seemed not at all adequate with our five year old subjects. Perhaps these subjects would show a greater awareness of causality were some other test medium, pos­ sibly animated cartoons, used in place of the verbal stories. Also, one wonders about the accuracy of several of the scoring levels below that of the "perfect" (four point) answer; for example in question 1 (a child, disap­ pointed at not having been given ice cream, hits his

toy soldier) a response that the soldier was hit because the child "wanted to" was scored one point whereas that he was hit because the soldier was bad was scored two points. It seems more likely that both responses indi­

cate a lack of knowledge of the defense mechanism of

displacement than that the latter response indicates a

significantly greater awareness than the former. 64 The presentation of our findings is completed but several questions remain still to be answered:

1. Why were so few differences in. causality

score found between the clinic and non­

clinic groups?

2• How can the differences which were found

between the two groups be explained?

3* Should the concept of "early** and "late"

ego defenses be rejected?

4. What do our TAT findings seem to reveal

about the development of psychological

causality? Before we relate to the content of our first ques­ tion perhaps we should address its implication: that the value of research may be measured by the number of sig­ nificant findings which it discovers. Bronfenbrenner

(1951, p. 209) has written that scientific knowledge does not advance purely by the discovery of differences sig­ nificant at the 5% level; more recently Lykken (1968) stated his belief that Statistical significance is perhaps the least important attribute of a good ex­ periment; it is never a sufficient condi­ tion for claiming that a theory has been usefully corroborated . • . The value of any research can be determined, not from the statistical results, but only by skilled subjective evaluation of the coher­ ence and reasonableness of the theory . . . Editors must be bold enough to take 65 responsibility for deciding which studies are good and which are not, without resorting to letting the p value of the significance tests deter­ mine this decision*

With this disclaimer of interest in the discovery of purely "statistical" findings it does seem that our results, the lack of any great number of differences be­ tween our clinic and non-clinic subjects on the Whiteman

Scale, reflect a question worthy of some thought, thought which may be pursued in a number of directions.

1. Our research has been based upon the hypoth­ esis that there are demonstrable differences in mental structure, differences which may be analyzed (made known) by a study of the products (i.e., the concepts formed) of such structure; it was further hypothesized that these structural differences are related to a child's choice of symptom. Our first assumption was based upon the theoretical and research activity of Piaget (1950) and

Werner (1948) who postulate that underlying the develop­ ment of the child's awareness of the physical world is a trend toward more inclusive, differentiated, logical, and holistic explanations of the phenomena which he per­ ceives. Yet the nature of people is far different than that of physical objects. Asch (1952, p. 142) has written that

The paramount fact about human interactions is that they are happenings that are psy­ chologically represented in each of the participants. In our relation to an object, 66 perceiving, thinking, and feeling take place on one side, whereas in relations between persons these processes take place on both sides and in dependence upon one another. We interact with others . . .via emotions and thought that are capable of taking into account the emotions and thoughts of others.

Krech and Crutchfield (1948, p. 9) believe that

. . . person objects differ from other objects in an individual's field and are especially important in determining be­ havior because they have, among other characteristics, the properties of mobil­ ity, capriciousness, unpredictability; because they are the perceived loci of a great deal of causation; because they are perceived to have power qualities— to provide rewards and threaten punishment; because they are perceived as sensitive and reciprocally reactive.

Because of these differences between physical objects and people it may be (probably is) that the struc­ ture (system of relationships) inherent in the perception of interpersonal relationships is more complex than that involved in the perception of physical causal relation­ ships; thus perhaps there is not one system of logical relationships present in the perception of people (as with objects) but many, one being similar to the logical causal concepts developed with objects (i.e., awareness of covert motivation), another being with regard to the power qualities of others, a third being the interaction of these developed causal relationships with the self (i.e., the ability to "use" the structure), perhaps this last super­ ordinate structure being that which is related to the 67 choice of illness rather than the first. Using a projective technique, the RTT (role-taking

task), a measure in which a child is asked first to

create a story and then to retell that story from the

vantage point of other members of the story, Peffer and

Gourevitch (1960) found a positive relationship between the degree of balanced decentering on the RTT (i.e., the

ability to retain continuity while telling a story from different vantage points) and decentering on Piagetian

tasks,, the RTT measure being unrelated to intelligence (using the Wise vocabulary subtest score as the index of

intelligence)• An investigation of the relationship be­

tween RTT score and Whiteman Scale score would seem

worthwhile, as would an investigation of the ability of a child to use his awareness of covert motivation to pre­ dict future behavior both with regard to himself as a participant in an interaction, and with regard to the observation of another. Thus what may be correlated with choice of symptom may not be merely the structurally based ability to grasp the logic behind interpersonal behavior, but the capacity to use this ability with regard to the self.

2. Our use of the Whiteman measure assumes that it provides an accurate assessment of the ability of a child to be aware of covert motivation in another; yet this 68 measure consists of verbal stories and many of the cues by which we determine the motivation of another are visual. Perhaps some children have a greater awareness of covert motivation in another in "real life," i.e., when confronted with people about whom they are creating inferences, than when faced with a verbal representa­ tional situation. 3. The term "ego defense" refers to a hypotheti­ cal construct believed to have descriptive and explanatory

utility in the understanding of human behavior. As a hypothetical construct its longevity is determined by its usefulness, and while it may be of great use to the in­ vestigator of psychopathology it may be of less utility to the investigator of developmental processes. There is no reason why the developing awareness in children of causal factors in human interaction should be in terms of the use of the ego defense mechanisms; perhaps this aspect, although present, is peripheral to more important parameters by which their awareness of human interaction develops, these factors being of greater relevance to the choice of symptom than those assessed by our present measure. 4. The lack of many differences between the clinic and non-clinic groups on the Whiteman Scale seems to indicate that the abilities tapped by the Scale are 69 relatively invulnerable to invasion by psychic conflict of the neurotic and characterological dimensions, and are thus, perhaps, reflective of processes largely rep­ resentative of the conflict-free ego-sphere (Hartmann,

1939). Perhaps it is not the accuracy of perception of covert motivation with which psychic conflict of this variety interferes but rather some other factor, perhaps the use of the perceived information in terms of self- directed behavior. Earlier we referred to our (perhaps puzzling) finding that our younger clinic group had a significantly greater awareness of the mechanism of projection than their non-clinic peers. A possible explanation for this selective sensitization is that the awareness of the use

t of the mechanism of projection requires the ability to discriminate self from non-self, that which is part of one from that which is associated with another. For some reason clinic children seem to have made this distinction more quickly than non-clinic children, this precocious distinction perhaps representing their means of retaining their autonomy in the face of an overly intrusive or controlling parental situation. Both borderline and psy­ chotic children were excluded from our clinic sample: perhaps the ability of our clinic group (compared wi.th

"normal" children) to precociously distinguish the "me" 70 from the "not me" is what gives the child a sturdy

enough sense of individual identity that he is capable

of attaining a neurotic or characterological defense

against his conflict rather than regress to a more prim­

itive psychotic reaction.

If this surmise is valid it may also explain why of the 5 methanisms with which there was a significant increase in awareness between the youngest and intermed­

iate age non-clinic subjects (displacement/ dream wishing, projection, regression, and repression) in only 1 mech­

anism (displacement) was there a similar change among the clinic subjects. Because cognitive development cannot be forced at a rate more quickly than the normal rate of development of the organism intrinsic with its structure

(Xnhelder and Sinclair remarking (1969, p. 21) that

"learning is subordinate to the laws of development and development does not consist in a mere successive accum­ ulation of bits of learning, since development follows structuration laws that are both logical and biological,") perhaps the psychic conflict which produces a premature acquisition of awareness of the mechanism of projection concurrently results in a distortion of other elements of the child*s cognitive structure, a distortion which interferes with his attaining awareness of 4 of the 5 mechanisms acquired at a comparatively far more rapid rate 71 by normal children in the early years of their develop­ ment (age 5-8), the conflicted child requiring more years to acquire the cues which are "learned" by less conflicted children in a briefer period of time. Perhaps a too great concern for the "me-not me" dimension, a too great sensitization to a particular aspect of behavior, results in a lessened awareness of other aspects of behavior, the child's precocity in one area being offset by his retardation in others.

An appropriate question concerns whether there are any other reasons which predisposed the clinic children to a particularly great awareness of the ego defense of projection as compared with the other ego defenses. A possible explanation may lie in the nature of the ques­ tions themselves. The projection story is the only one of the five stories (in which the most significant in­ crease in awareness in the early years occurred) which contains speech ("I bet he wont want to share any of his game3 and toys."). Sullivan (1956, pp. 27-28) remarks that . . . projection . . . does not need to be so terribly mysterious in the begin­ nings of the process. Among the dis­ tance receptors, it just happens that the sense of hearing, which is a very instant link of contact with circumambient reality, has at least a tenuous relation to what is so essential in learning--namely, speech. And so when the types of operations based on the auditory reception of events are of this primitive level, there is a lack of certainty as to whether a given thought went 72

on in one's head, or is a remark that somebody else made, or is a thought that has in some strange fashion been put into one's head. This uncertainty is not so terribly difficult to sympathize with, for occasionally some of you may have experienced auditory hallucinations in the moments of falling asleep or waking up. And if so, you have really been very, very close to the recurrent state of an actively disturbed schizophrenic, except that you, slightly better off than he, im­ mediately felt fairly sure that this had happened "in" you. But it was very moving and impressive. It had all sorts of rather unearthly emotional tones, perhaps threat or awe, or various other emotions that we do not ordinarily associate with anything anybody says to us. If you have had such an experience, you almost certainly can recall the almost lightning-like speed with which the self gained control, and you were awake and very intent indeed on whether or not anything strange was happening— showing with what vigor the presence of these ear­ lier types of processes is excluded from our ordinary waking consciousness.

Thus the presence of speech in the projection story may have been an aspect to which the child— because of his (hypothesized) intrusive familial experiences— had become overly sensitized to, one to which he thus had to respond to reject the "pull" of his desire for a symbiotic attach­ ment, an attachment representative of "these earlier

types of processes." Our finding that "externalizing" children have a significantly greater awareness of regression than "inter­ nalizing" children may perhaps reflect the externalizer's heightened sensitivity to and concurrent discomfort when 73 faced with a nurturant situation. Perhaps as a child he was forced (intrapsychically) to renounce his desire for

closeness, for warmth, because of its unavailability in his family setting. This action may have produced a heightened sensitivity to nurturant situations such as the one reflected in the causality story exemplifying regression ("he even wanted to be held in his mother's arms just like a baby"), this over-sensitization reflect­ ing his defense against his still present desire to gain the nurturance he lacked as a child. Perhaps it is his still present anger over this childhood deprivation which produces the externalizer's aggressive-destructive-abusive activity directed against his environment. Several auth­ or's have pointed to a fixation on orality and inadequate tension tolerance (Fenichel, 1945b) or early separation from the mother (Bowlby, 1944; Kaufman, 1955) as precur­ sory conditions to an acting out disorder, these factors being congruent with our hypothesis. But other authors credit other factors as significant: as Van Amerongen (1963) who believes that parental sanctioning of the acting-out behavior plays a significant role in its devel­ opment .

There is the question as to the usefulness of the genetic classification of the ego defenses in view of our findings that there was no significant difference in the use of the "early" or "late" defenses by clinic patients

ranging in age from 5 through 11 (Table 14). Our find­

ings must be qualified since they were based upon an

assessment of only 6 out of the many defenses noted by

analytic theorists (Anthony (1970, p. 680) mentions 32

in his genetic classification)• Thus an individual in

our study who was assessed as using predominantly early

defenses may have been so doing, or may have been using

many "late" ego defenses, ego defenses which were not,

however, assessed in our study. Moreover our assessment of ego defenses was carried out upon clinic patients,

children with developmental fixations and regressions,

and our ego defense rating scale concerned whether the

specific defense was used to a small degree, used to a

moderate degree, or a major defense of the child. Thus

it may be that while the late defenses were present to a greater degree in the older than the younger clinic

patients, they were not used to a moderate or major degree

in either, thus producing the statistical results which we found.

Our finding of a significant correlation between

score on the Whiteman Scale and Level of Organization of

the TAT themes (with the 5 year old subjects) would seem

to bear some explanation both in terras of the finding and with regard to why it occurred with subjects of only that 75 age. The Level of Organization variable seems to assess the ability to move from a less mature descriptive inter­ action with the TAT stimulus, to a more mature inter­ action in which facets of the stimulus are interpreted in terms of their interrelationships, to a final level of maturity in which the subject so involves himself with the stimulus as to integrate and expand the perceived interrelationships with his personal experiences, putting his idiosyncratic stamp upon the final cognitive produc­ tion. Henry (1956, p. 63) remarks that

The first two levels suggested will be found in some subjects of below normal intelligence . , . Generally a basic imaginative level will be expected from the subject of normal intelligence who co-operates at all with the instructions.

Thus very probably our non-significant findings with the older groups are a result of the majority of their stories having been rated as reaching the third level of maturity, the product of a normal developmental trend. The correla­ tion between the Whiteman Scale and the Level of Organiza­ tion variable would seem to result from the probability that success on the Whiteman Scale reflects— partially-- the ability of an individual to involve himself with the given stimulus and move beyond an interpretation in terms of its form to an assessment of the underlying dynamics, an assessment which is possible only by utilizing one's 76 previous experiences in life, this ability being similar to that measured by our TAT structural variable.

Our finding (Table 7) of a tendency toward sig­ nificance (chi-square 3.1, £ less than .08) for the 5 year old clinic group to score more highly on the White­ man scale than the non-clinic group raises the possibil­ ity of a difference in the Level of Organization of the TAT stories of the two groups. A statistical analysis revealed no significant difference between the Level of

Organization of the stories of the 5 year old clinic and non-clinic groups. Thus success on the Whiteman Scale probably reflects more than merely that which is meas­ ured by our Level of Organization variable.

The analysis of our TAT themes provided suggestive evidence that the ability to discern covert motivation in others is correlated with the desire of a child to conform "successfully” to the demands of his parents; his belief that his parents (particularly his mother) cares for him and that comfort comes from people; and his ap­ parently narcissistically based belief that he can achieve whatever he desires to achieve in life. This correlation seems to indicate the (perhaps simplistic) thought that the most important intra-psychic and familial variable related to success on the Whiteman Scale was a mothering experience which provided both a healthy (if excessive) 77 narcissism and an active interest in and trust of people and future events, perhaps based upon the underlying concern which— despite the possible presence of familial discord— he senses his parents feel for him. Perhaps the child's need to conform over sensitizes him to nuan­ ces in the attitudes of his parents, such an attitude when generalized to others providing him with an orienta­ tion which facilitates his performance on the causality measure. CHAPTER V

CONCLUSIONS

Our study provides evidence that there are few differences between disturbed and healthy children on the ability to perceive psychological causality, covert mo­ tivation in others. Some evidence was provided correlat­ ing this ability with the production of TAT themes re­ flective of particular attitudes within the child toward interpersonal experiences and with a level of structural complexity of these themes. One future productive area for research would seem to be a comparison of the ability of disturbed and heal­ thy children to use their awareness of covert motivation to predict future behavior, both with regard to them­ selves as participants in an interactional network and with regard to the observation of another. The relation­ ship of general intelligence to the awareness of psycho­ logical causality should be explored with subjects of a wider range of intelligence: that intelligence plays a small role in its attainment within an IQ range of 80-141 does not mean that at some lower level, say 50 to 80, its association is not significant. 78 79 Finally, the desperate need for a valid measure

of ego defenses in children is still present: the

recently published instrument of Gleser and Ihilevich

(1969) provides what appears to be a useful measure of ego defenses, but only with adults 1

In the mid-point of his career, despite the optimism of those early years, Freud (1909, p. 295) wrote the following, words which serve as a credo for all research as well as this study: In these circumstances there is no alter­ native but to report the facts in the imperfect and incomplete fashion in which they are known and in which it is legiti­ mate to communicate them. The crumbs of knowledge offered in these pages, though they have been laboriously enough collected, may not in themselves prove very satisfying; but they may serve as a starting-point for the work of other investigators, and common endeavor may bring the success which is per­ haps beyond the reach of individual effort. APPENDIX A 81 THE WHITEMAN MEASURE OP AWARENESS OP PSYCHOLOGICAL CAUSALITY

1. There was once a little boy named Johnny, One day his mother promised that Johnny's favorite dessert, ice cream, would be served at supper. But Johnny's mother forgot to buy the ice cream, and so there wasn't any ice cream for dessert. Johnny didn't say anything to his mother about the ice cream. After supper Johnny went to play with his toy soldiers and did something he never did before. He spanked his toy soldiers. Why did he spank his toy soldiers?

2. One day Johnny looked at T.V. and saw a boy who had a wonderful bicycle. Johnny himself didn't have a bicycle and couldn't even ride one. That night Johnny dreamed that his father bought him a bicycle and that he was riding all over the block on it. How come he had such a dream?

3. Johnny was a good boy, but there was one thing he never liked to do. He didn't like to share his toys with the other kids. He always wanted to keep his toys to himself and not let the other kids use them. One day Johnny's mother told him that they were going to visit another family where there was another little boy who was Johnny's age. Johnny and this little boy could play together. But Johnny looked unhappy and said, "I bet he won't want to share any of his games and boys." Why did Johnny say this when he didn't even know the other little boy?

4. One day Johnny didn't feel well. He had a headache and didn't want to eat. lie began to act just like his baby brother. He talked baby talk* he wanted to suck his baby brother's milk bottle; and he even wanted to be held in his mother's arms just like a baby. Why did he act this way?

5. One day Johnny's mother bought him a new pair of gloves. She warned Johnny not to lose the gloves, be­ cause Johnny had lost the last pair. One afternoon Johnny lost his gloves coming back from school. He knew he had to tell his mother. But when he got home, he forgot to tell her. When Johnny went out to play in the afternoon, he told his friends about the lost gloves. But that night he forgot to tell his mother. The next morning at breakfast Johnny again forgot to tell his mother. Why did he keep forgetting to tell him mother about the lost gloves? 82 6. One day Johnny's mother gave him a big bowl of spinach. Johnny saidr "I'm not going to eat the spinach because it makes you very fat!" Why did Johnny say that about the spinach when he liked to eat fattening things like ice cream and candy?

7. Johnny wanted very much to go to his friend's birthday party. On the day of the party he fell sick and couldn't go. But Johnny said, "I didn't want to go to that party anyway I" Why did Johnny say that? APPENDIX B

83 84 SCORING CRITERIA FOR THE WHITEMAN SCALE

Story 1 (Displacement) 4 points

a. Attribution of spanking to ice cream deprivation in first answer, without blaming soldiers, and b. Appropriate emotional expression at ice cream deprivation, i.e., either "mad*' or "sad." This response is given spontaneously in child's first answer, or in response to question— "Why did he spank the soldiers though if he didn't have any ice cream?" and c. Some psychological explanation for spanking the soldiers rather than the mother, e.g., "She took it out on the soldiers," or "She was mad at everything." 3 points

Child relates ice cream deprivation to spanking but no psychological reason for spanking soldiers rather than mother can be elicited. 3 points

The spanking is mainly a reaction to the soldiers having been bad, or to their having done something bad, without evidence of seeing the spanking as a reaction to ice cream deprivation.

1 point

Spanking is seen as part of a game, or because the child "wanted to." Story 2 (Dream Wishing)

4 points

Says spontaneously that bicycle on T.V. aroused interest in, or thought about, or wish for the bicycle. 85 3 points

Either the desire for the bicycle or the influence of T.V. is elicited only after probing, but both elements are mentioned.

2 points

Either the desire for the bicycle or the influence of T.V. can be elicited even if probed for, but not both. 1 point

Denial that T.V. had anything to do with the dream. "Well, you know he saw this picture on T.V.— would that have anything to do with his dream or not?" "Not." 0 points

Use of circumstances as part of explanation of dream, e.g., "Because it was morning time," "Because she was sleeping."

Story 3 (Projection)

4 points

Clear statement of projection, with explicit state­ ment of thought of other as due to projection of own behavior. "Because he was jealous that he never . . . that he . . . never let other children play with his toys so that he thought the other boy wouldn’t let other people play with his toys."

3 points

Emphasis on Jane’s or Johnnie's own activity— -usually because of unwillingness to share own toys and other child is perceived as not sharing. "Because he acted the very same way, and I guess if he didn't let any­ body play with his toys, the other children wouldn't play with him at all, so he didn't know what the boy would be like.”

2 points

Stress on knowledge of other child's attributes as cause of Jane's statement rather than Jane's own 86

make-up. "Because the other girl might, uh, might not let her use her toys." "She might not let her share her things like Jane do."

1 point

Jane has emotional reaction— anger at the other girl, or at her mother, or simply doesn't like the other girl. 0 points

Shows little understanding of any motivation even under probing. "Cause he liked to," or "cause she and Jane let them play with the toys." Story 4 (Regression) 4 points

Spontaneously cites idea of sickness as cause and regressive advantage of being a baby. "He didn't feel good 1 guess . . . and he acted like a baby. X guess sometimes I act the same way. He wanted somebody to notice him, maybe nobody was talking to him or something like that."

3 points

Spontaneously cites illness, but regressive advan­ tage elicited after probing, e.g., mother would treat her nice, would notice her, would pet her, would give her things.

2 points No spontaneous elicitation of illness, but regressive advantage cited after probing. 1 point

Either illness is mentioned or some reason given for acting like a baby, e.g., He was thinking about his baby brother," but either denies or is equivocal or contradictory about the advantages.

0 points No reason or motive or advantage given or elicited beyond statement that she wanted to be a baby, or that she didn't feel well. 87 Story 5 (Repression)

4 points Expresses negative consequences of telling mother (usually fear of punishment), and is able to see that friends are not fear-arousing and therefore can be told about the gloves.

3 points Also express negative consequences of telling mother, but either stresses positive advantage of telling friends (e.g., friends would help him find the gloves), or cannot give a reason why the friends were told as contrasted with mother. 2 points Spontaneous response cites non-purposive forgetting, e.g., "Didn't think about it."

Story 6 (Rationalization)

4 points Has idea of child not wanting the spinach and not wanting to tell her mother about it, e.g., "Cause she didn't want to tell her mother she didn't like it. "

3 points The idea of an excuse is advanced, but only after probing.

2 points The main idea is that the child doesn't want the spinach, with the idea of the spinach as a fat- producer either denied or not elicited.

1 point Idea that spinach really makes you fat is in the response. 88 Story 7 (Denial) 4 points

The child really wanted to go to the party, but there is an explicit psychological reason mot­ ivating child to say that he didn't want to go to the party anyway, e.g., "Because he was mad because he couldn't go."

3 points Child is perceived as really wanting to go to party, but says he doesn't want to go because*of some barrier, e.g., illness, or his mother doesn't want him to go.

2 points

Child is perceived as wanting to go to party, but some negative feature of the party is pointed out, e.g., wouldn't get cake, or didn't want to bring a gift. 1 point There's no evidence that respondent understands that child in story really wants to go to the party. Child's statement about not wanting to go is ac­ cepted at face value, because it's a bad party, or children wouldn't play at party, etc. APPENDIX C 90

EGO DEFENSE MECHANISM RATING SCALE

Your task is to rate the child on his use of the fol­ lowing six ego defense mechanisms: repression, denial# intellectualization, reaction formation, projection# and isolation. For this task you should use information derived from an interview lasting from 15-30 minutes and concerning his perception of why he was brought to the clinic, his perception of the difficulties in his life and feelings about his life# his perception of and feel­ ings about his peers, teachers and parents, and his past memories.

The following five questions represent the type of questions which should be asked:

1. Why do you feel your mom brought you to this

clinic?

2. I understand that you have a problem with (the child's presenting symptom(s)). What do you feel is at the bottom of it?

3. Children who come to this clinic usually feel

unhappy about something. Do you feel that there's

something unhappy in your life? What?

4. Do you sometimes feel that your teacher or the

children in your class treat you differently

than other children? Can you give me an example? 91

5. Mothers can sometimes be hard to get along

with. I wonder, do you sometimes get angry

at your mom? What sort of things make you

angry?

Rating Instructions: Rate 1_ if the child does not seem to be using the defense, or uses it only to a very minor degree. Rate 3^ if the child uses the de­ fense to a moderate degree, but it does not seem to be one of his major defenses. Rate 5_ if you believe the defense is one of the child's major defenses.

Projection: A process by which an objection­ able internal tendency is unreal- istically attributed to another person or persons in the environ­ ment instead of being recognized as part of one's self. The ob­ jectionable tendency that is pro­ jected may be either an id impulse or derivative or a superego impulse or derivative.

1 2 3 4 5 Lack of suspicion of Suspicious of intentions interviewer * s motives; of interviewer; feels denies being singled unreasonably victimized out by teacher or class­ by teacher or classmates; mates; can accept res­ attributes his difficulty ponsibility for diffi­ to another person; ap­ culties; approaches proaches tasks with the tasks confidently; no expectation he's being more than "normal" fear set up for failure; per­ of revealing himself, his ceives the world as a feelings, hopes, aspira­ jungle? wary, guarded tions . child, fearful of reveal­ ing himself to another. 92

Intellectualization: Retreats from world of Impulse and affectto a world principally of words and abstractions•

Appropriate volume Child is pedantic­ of speech; child ally over-detailed uses speech appro­ and over-precise; priate to the sit­ continual talking uation and his age. as defense against affect; speaks on a more abstract level that is ap­ propriate to the situation; pseudo- mature speech.

Isolations The isolation of affect from the related idea.

3 4 5

Presence of ap­ Presence of inap­ propriate affect; propriate affect; child's speech has difficulty in "makes sense." integrating ideas meaningfully (not due to organicity on retardation); lack of affect when speaking of an upsetting event.

Repressions Unconsciously motivated forgetting.

1 2 3 4 5

Ability to speak Gaps in recall of of past events; the past; just can't fluid, connected remember or elab­ expression. orate (distinguished from denial); block­ ages in expression. 93 Denial; Denial of painful facts and feelings; focusing on the pleasant; Attitude; everything happens for the best.

Acknowledges con­ Denies conflict flict, painful or unhappiness, affect, and or knowledge or thoughts; can ack- awareness of pain* knowledge unhappy ful thoughts and past events. feelings; denies pain in past events.

Reaction Formation; A personality change in- volving unconsciously determined transforma­ tion of impulses and affects into their op­ posites resulting in an alteration of behavior which may occasionally break down so that the original impulse is in evidence. Example: a child who is excessively kind or altruistic as a defense against hostile impulses, or one who is excessively self-sufficient as a defense against underlying need3 for dependence.

Admits to all "Protests too much" kinds of impul­ against the impulse ses (as a desire (such as a child's to beat up his excessive talk about sister) or no his kindness or impulse problem concern for a parent) because of other provisions for impulses such as sublimation or substitution • APPENDIX D 95 Name: Age: Sex:

DESCRIBING YOUR CHILD AND HIS PERSONALITY

Please underline the statements that describe your child.

The different statements under each heading refer to an area of your child's personality, e.g., fearfulness. Some of the statements are of behavior that is so common as to be normal. Other statements refer to ways of behaving that are uncommon, that may be a sign that your child is having problems in this area.

Underline any statements that are descriptive of your child at this time‘s (Feel free to add further descrip-. tion if you wish, on Idie back of the page if necessary) .

If your child has no problems of any sort in this area, please underline the statement on the right side, no problems in this area.

If your child is clearly and definitely better than the average child of his age in this area of functioning, please underline the second statement on the right side (just below the statement— no problems in this area).

If your child is clearly and definitely very superior in this area of functioning for a child his age, please underline the third statement on the right side. 96

GENERAL FEARFULNESS Occasionally afraid for no ap­ Has periods of intense parent reason but responds fearfulness for no appar­ quickly to reassurance; ent reason and does not fainthearted; tends to get respond readily to reas­ frightened more easily than surance; at times gets most children his age. very apprehensive; always too ready to run; "afraid of his own shadow."

Afraid most of the time and Not generally fearful. usually can't say why; gets Faces up to own fears, panic-stricken in situations, can be brave. Grit and e.g., with lightning,far out determination are of proportion to situation; superior. fears impending doom; in a state of terror most of time. PARTICULAR FEARS Has one or two fears but is Has one or more specific seldom overcome by fear; fears that concern or when alone, fears things that worry him, and may be over are not actually dangerous; come with fear; refuse to does not like to be in the go alone into basement or dark but will go to bed if dark room; refuses to meet hall or other light on. stranger. Panics when alone; panics No problem of this kind. in face of specific fears; Actively masters fears life for child and family realistically, "doesn't is changed to avoid child's lose head" even in very fears; can't get fears out frightening situation. of his mind. CONFIDENCE IN ABILITIES

At times tends to underrate Usually feels his abilities his own abilities; tends to or skills are inadequate; lack belief in own abilities; usually hangs back or re­ needs to be pushed into doing fuses to compete; always things; gives up too easily. a follower; avoids leader­ ship even when capable; often "loses his nerve"; usually abandons a task if runs into obstacles. 97

So sure will fail that won’t Average confidence. Quite try? failing at school in confident of abilities so spite of good intelligence; that he can accept crit­ convinced not good enough in icism well, keeps with anything; apathetic; absolu­ tasks. Superior capacity tely sure is inferior to do to assess own abilities so anything; "flits" from task that his high level of to task and never really confidence is well placed. even gets started.

EXCITABLENESS

When excited he gets quite Frequently gets overexcited; fidgety at times; tends to fidgety most of the time; be restless but can sit when excited very hard for still; blushes and/or per­ him to stop tapping his feet; spires easily? gets upset has difficulty speaking over having to recite in when excited; stanners; front of class; giggling once he gets excited, he "all the time"? tends to can't shift gears, i.e., he be "high strung." gets "all caught up" in his excitement. So excitable it interferes No problems of this kind. with school work? can't Levelheaded, (can "catch or won't get up in front self" by recognizing he is of class to recite? fre­ getting too excited). Sup­ quently in aimless, inef­ erior poise while maintain­ fectual movement? because ing a high degree of en­ of excitement, speech is thusiasm. cluttered (not stutter) because of poor control of excitement.

HANDLING ANXIETY

At time jittery or tense; Noticeably anxious much of apprehensive; jumpy; easily the time; tense and keyed up startled. most of time; trembling with anxiety; sleep fitful; over­ reacts in a frightened way to sounds that others hardly notice; makes others anxious when he is with them. Severe anxiety attacks? Has no problem handling panic states; gets ter­ anxiety. Handles inner ribly upset and can't be anxiety and anxiety reassured. producing situation very well. Superb in this area.

CONTROL OF ANGER

Although he loses his Gets angry very easily; temper he can fairly quick­ may kick and hit others ly recover his "normal" when angry? angrily self; becomes irritable screams if can't have when provoked; irritably own way? loses temper complains; rude; at times frequently; throws arti­ "sasses back" when cor­ cles in anger; tends to rected; quarrelsome; ir­ be explosive; very low ritable when frustrated? at frustration tolerance times has "chip on shoul­ ("low boiling point"). der. "

Gets so angry that attacks No problem with anger con others; destroys valuable trol. Excellent control property; hurts self; must of anger without denying be restrained; becomes vio­ it, handles frustration lent; seems to be filled easily and well. Far­ with anger. sighted enough that usually anticipates and deftly handles otherwise explosive situations. DEPRESSION—SADNESS

Sad if left alone for any Feels blue most of time; length of time? moody? complains of unhappiness; mopes about; too easily discontented; complains bored; "nothing is inter­ of being lonely; loses esting"; tends to see dark interest in usual games; side of proposals; says he becomes interested in lone­ feels rejected and unloved; ly animals or people; cries recovered unusually slowly more easily than average from some real loss. child; future holds little interest, always "know it won't go right"; can't be cheered up; makes sweeping pessimistic statements and predictions that are not .really warranted. 99

Despairs of life; unhappy No problems in this area. all the time; feels is no Recognizes real loss, e.g., good; talks of morbid sub­ of pet, and mourns but jects; talks frequently of "bounces back.” Superb death; talks of how good if sensitivity but also would be to be dead; future resilience. is hopeless; acts ndoomedn and forces others to accept him in this role; speech­ less with empty stare and motionless.

DAYDREAMING

Dikes to daydream but can Often so lost in thought easily "snap out of it"; that he must be spoken to when tired or with hard several times; prefers to be tasks tends to daydream; alone roost of time; only likes to go to room to play interests seem to be TV; or read by self; at times only interest is reading watches "too much" TV; main fiction; avoids being reading is comics. noticed.

"Lives in a dream world" No problems in this area. a lot of time; lack of in­ Has a delightful imagina­ terest in world around him; tion. Very superior, very sits and stares for long creative and constructively periods of time; confuses original. fantasy with reality.

NEGATIVISM

At times minor resistance Often or usually resists to rules and regulations; rules; sullen and unrespon­ occasionally sulks or pouts; sive to the point of avoid­ slow to get work done; has ing requirements; uses to be reminded about conversation to avoid tasks; chores; puts tasks off and pro-longed dawdling; tends then forgets them. to be oppositional; resists doing chores about house. Sullenly refuses to do what No problem in this area. is required; openly does Accepts his responsibilities opposite of what is re­ and chores cheerfully, does quired; refuse to answer at without prompting. Superb all; won't talk, eat, have in this area. BM, etc. 100 TRUTHFULNESS

Tells a fib now and then; Frequently tells lie when tells a small lie to escape confronted with misbehavior, punishment; evasive at or to build self up; often times. deceives parents as to where he has been; hard to believe anything he says; has a reputation of being "sneaky."

Lies most of the time, even No problem in this area. when no apparent reason to "Faces up" to what he has do so; totally untrust­ done, honest even in small worthy . things without overdoing it. Superior self honesty in thought as well as action without being over scrupulous.

STEALING IN HOME (or from friends)

Takes a few cents now and Takes money which is seen then; takes money left out, as a substantial amount e.g., on top of dresser; if by parents; takes play­ tempted will take something mates toys and will argue of small value; about returning them; keeps playmates toys but won't return change even will return them. when parents specifi­ cally ask for it.

Steals so much and so fre­ No problem in this area. quently that whole home is More than usually trust­ upset; loses friends because worthy. Sound inner moral steals from them; nothing standards wouldn't allow seems to stop his stealing him to steal. at home. STEALING OUTSIDE OF HOME

Occasionally comes home with Parent is quite sure that toy "found" in the alley"; child is stealing; enters "someone gave it to me"; other people's homes or Occasionally can*t resist goes to stores to steal; pocketing small items at uses threats to take things store. from children. 101

In trouble with police No problem of this kind. over thefts; steals cars; Others can confidently expelled from school for trust him. Superb moral stealings; steals for standards. fun of it even when has money in his pocket.

TENDENCIES TO WORRY

At times worries too much "Worry-wart," "Fuss though one can see some budget"; can get quite reason for it; whines at agitated about his concerns; times; overly careful; feels vulnerable; filled too serious; feelings too with self doubts; feels easily hurt. life is an affliction or burden.

Worries so much that he No problems of this kind. can't sleep, interferes Excellent, well-balanced with eating, etc.; tor­ self evaluation. Superb mented by worries and in this area. doubts; feels he is trapped; extreme mental distress. OVERLY ASSERTIVE

Sometimes willful or im­ Often is bossy with pertinent to parents; parents; "sass" parents will ignore parents on frequently; insulting or occasion; tends to "lord excessively rude to par­ it over" one or both ents or others; haughty, parents or brothers or arrogant, dictatorial sisters; headstrong; with other children; quotes rules to others. demands he be the leader or he won't play.

Contemptuous of parents; No problem in this area. extreme cynical air; al­ Accepted as leader among ways sneering at others; children, forceful. Very flatly refuses to obey; resourceful with ideas may try or actually does and plans, accepts full take over one of parent's responsibility of being a role; extremely intolerant leader, superb strength of of others views. character. 102

OVERLY ACTIVE

Mildly restless; moves Very restless; can't sit around in chair; doesn't still; constantly fid­ like activities that re­ gets; sleeps "all over quire him to sit still; the bed"; seems) "driven" "always on the go." at times; very hard for him to stop tapping hands or feet; wanders ab o u t aimlessly) at times.

So restless can't stay in No problem of this kind. school all day; paces the Energies very well chan­ floor; talks excessively; neled and directed. Even can only sleep a few hours in very exciting situa­ at night; often in aimless, tions is calm and effec­ ineffectual movement. tual .

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