Anne S. Hardesty

Schizophrenia with Childhood Onset: A Phenomenological Study of 38 Cases

Thirty-eight hospitalized children, ages 5.7 to 11.11 years, diagnosed with schizophrenic disorder by DSM-III criteria, are characterized regarding age, sex, race, socioeconomic status, pre- and perinatal complications, electroencephalogram, intelligence quotient, and family history of major psychiatric disorder. Clinical course, including age at onset of general and psychotic psychiatric symptoms and initial diagnosis of schizophrenic disorder, presence of DSM-III symptoms, hospital course, and response to antipsychotics are reviewed.

A Comparison of Schizophrenic and Autistic Children

A comparison of schizophrenic, autistic, and conduct disordered children ages 5.2 to 12.10 years is presented. Diagnosis was made by the authors in all cases using DSM-III criteria. The children were compared on a variety of variables including pre- and perinatal complications, intellectual functioning, and behavioral profile. Findings indicate that children under 12 years of age can be diagnosed schizophrenic disorder by DSM-III criteria. All schizophrenic children had a disorder of thinking and most had hallucinations (83.3%) while delusions were somewhat less frequent (54.2%). Schizophrenic children differ from autistic children on most variables although there is some overlap.

Childhood Psychosis in Perspective: A Follow-up of 10 Children

Abstract This pilot study of 10 subjects showing manifestations of illness in infancy and diagnosed as psychotic between 2:1 to 6:8 years is a report on their revaluation 3:6 to 12 years later. Multiple behavioral assessments by independent raters and psychological testings were carried out on follow-up, revealing a shift in the distribution of symptoms and a relatively stable IQ. Those who initially had some verbal skills and were able to perform at higher intellectual levels had better future prospects. The results indicate that the form of behavioral pathology depends on the organizational-maturational level each individual has reached.

Interrelations of psychiatric diagnosis, psychological profile and ethnic background.

200 psychiatric patients, who had been classified as black, white, or Hispanic at the admitting office, were divided into broad diagnostic groups according to the psychiatrists diagnosis at termination. Chi-square analyses comparing ethnicity and diagnosis yielded no significant differences. A psychologist administered the Structured Clinical Interview in the admitting office prior to determination of precipitating events and assignment of diagnosis. When scores were compared by analysis of variance, no significant group differences were found on over-all severity of illness, but three of the 10 subareas showed significant differences. The results may reflect cultural and social influences.

A Comparison of Psychiatric and Psychological Assessments of Acute Schizophrenics

Psychiatric and psychological ratings of psycho pathology were compared by means of canonical correlation of scores on the Inpatient Multidimen sional Psychiatric Scale (IMPS) syndromes with scores on the 10 subtests of the Structured Clinical Interview (SCI). The ratings by a team of psycholo gists on the SCI and by a team of psychiatrists on the IMPS were made simultaneously, while one of the psychologists conducted the structured interview of the SCI. In this way, 72 acute schizophrenics were rated shortly after admission to a psychiatric hospital; 58 of them were re-rated approximately one month later in a replication of the original procedure. Two canonical analyses were carried out: one on the initial ratings, the second on the replication. Canonical correlations of .84 and .86 were obtained respectively for the first latent roots at each occasion. Successive significant roots yielded correlations of .78 and .68 on the initial rat ings and .76, .69, and .64 on the follow-up ratings. After all 10 latent roots had been extracted for each occasion of rating, redundancy coefficients were calculated for each instrument. The results showed that for the initial ratings 30% of each in struments variance could be explained by the other instrument; at the follow-up ratings the redun ancies were 40% for both sets of variables. The data are interpreted as evidence for the congruent validity of the SCI.

Purpose and Description

The STRUCTURED CLINICAL INTERVIEW (SCI) is a psychological technique for the detection and assessment of psychopathology. Its effective application requires an examiner who can combine the experimental with the clinical attitude. It is thus a tool for the pychologist because his training uniquely qualifies him for this role. Some supervised experience with the technique is of course necessary to assure common standards of judgment.

Instructions for Administering the Interview

The material needed for the conduct of the interview is contained in the examination booklet which consists of the interview protocol, the items on which the interviewer is to record his judgments, special introductions, interviewer responses and probes.

Scoring the SCI

Since all the items are dichotomous and so worded that a mark of “Y” (YES) by the examiner indicates a judgment of psychopathology, the scorer need only concern himself with those items marked “Y.” The scorer should first count the number of items for which the response, “Y,” is checked in the examination booklet. This total should be entered in the corresponding box in the lower right-hand corner of the Scoring Sheet. He should next find and cross out on the Scoring Sheet the number corresponding to each of the items for which “Y” is checked in the examination booklet. He should then count the crossed-out numbers in each column (Subtest) of the Scoring Sheet and enter the sum in the appropriate box at the bottom. A check is performed by adding the subtest sums across the bottom to see if they agree with the total previously entered in the lower right-hand corner. Finally, the sum for each subtest should be transferred to the Profile Sheet on the line marked “Raw Score.”

Development and Applications

In the first applications of the S.C.I. the observed items of maladaptive behavior were simply summed to provide a measure of level of pathology.