Eliot H. Rodnick

PSYCHOPHYSIOLOGICAL AND BEHAVIORAL EFFECTS OF PHENOTHIAZINE ADMINISTRATION IN ACUTE SCHIZOPHRENICS AS A FUNCTION OF PREMORBID STATUS

DUPING the last 15 years, research on the effects of phenothiazine administration on schizophrenic patients has been primarily concerned with the issue of clinical effectiveness. Since this research has generally confirmed the clinical effectiveness of these drugs in dampening schizophrenic symptoms, there has been increasing interest in exploring the mechanisms through which these drugs achieve their effects. It is clear that the characterization of these phenothiazines as agents which solely act to calm and tranquilize excited or boisterous patients represents a gross over-simplification. I A variety of behavioral changes follow phenothiazine administration, but the mechanisms by which these changes occur are still poorly understood. To some extent, this is a pharmacological problem in which sites of action and the physiology of drug action must be explored. However, it is also a psycho-pharmacolo~cal problem in which basic parameters of human performance are studied as a function of drug administration to determine which behavioral factors are likely to be involved in the attenuation of psychotic behavior. Our current research represents an attempt to provide some evidence regarding the behavioral mechanisms underlying the action of drugs of the phenothiazine group. Various hypotheses have been offered concerning how these drugs achieve their effect. The most prominent is that of autonomic attenuation which states that the medication dampens autonomic nervous system responsivity and that this dampening permits more normal behavior to reappear. In ~t previous study on chronic schizophrenic patients, 2 it was demonstrated that when a drug group was compared with a matched placebo group there was indeed a greater attenuation of peripheral indicators of autonomic responsivity to tension-arousing films.

Intrafamilial interactive behavior, parental communication deviance, and risk for schizophrenia.

This study addresses the empirical question of whether families high in communication deviance (CD) assessed from parental projective test data show direct interaction patterns similar to those found in families with offspring diagnosed as schizophrenic. Three parameters of interactive functioning were examined— focus of communication, role structure, and nonverbal affective attitude. The data base was a 5-minute, face-to-face videotaped interaction between parents and their disturbed, nonpsychotic adolescent in 47 families. Only families with high CD parents failed to focus communication on the discussion topic and to share topic-related feelings. High CD families were more likely to exhibit role structures in which the mother was active, either alone or in combination with the father. Low CD families were characterized by father activity. High CD parents showed avoidance and rigidity in their nonverbal affective attitude to the child; low CD parents were nonavoidant and relaxed. The relationships among the measures of communication deviance, type of adolescent symptomatology, interactive measures, and risk for schizophrenia are discussed.

Interpersonal themes in the Thematic Apperception Test stories of families of disturbed adolescents.

Thematic Apperception Test (TAT) stories of 24 sets of families containing disturbed adolescents were analyzed according to: 1) perceptual cognitive structuring of cards; and 2) quality of interpersonal relationships described. The cards used had a high probability of stimulating familial themes. Four groups of adolescents (aggressive-antisocial, active family conflict, passive-negative, and withdrawn) and their parents showed distinctive patterns of response to these TAT cards. Parents of aggressive-antisocial adolescents perceived minimal involvement among family figures while parents of withdrawn adolescents perceived skewed and negative relationships. Parents of active family conflict and passive-negative adolescents were similar in perceiving familial relationships with both positive and negative involvement among the characters. The data obtained on the adolescents was complementary to the parental data for two groups (aggressive-antisocial and passive-negative) and congruent for the other two groups (active family conflict and withdrawn). Hypotheses concerning the organization and quality of relationships in these four sets of families are offered.

The stability and sensitivity of measures of thought, perception and emotional arousal

The paper presents evidence concerning the stability and sensitivity of three classes of behavioral measures: a) word association quality, b) perceptual coping style, and c) skin resistance level and reactivity across a 21-day interval. Acute schizophrenic males were administered these measures 7 and 28 days following admission to a State hospital. Half of the patients were assigned to active phenothiazine medication at 7 days and half continued on placebo.Comparison of correlations between 7- and 28-day data for drug and placebo groups revealed different patterns of stability across time and sensitivity to drug ingestion for each of these three classes of measures.