Jacob Levine

PREMORBID SOCIAL COMPETENCE AND PARANOID-NONPARANOID STATUS IN FEMALE SCHIZOPHRENIC PATIENTS

The relation between premorbid social competence and paranoid-nonparanoid status was examined in a sample of 300 female schizophrenic patients. The subjects were drawn from the same state hospital employed in an earlier study conducted with male patients. The female paranoid patients were found to have better premorbid adjustment histories than the female nonparanoids. Tentative evidence was presented suggesting that the difference in premorbid social competence between paranoid and nonparanoid groups was greater for first and second admission patients than for patients with three or more admissions. The results were discussed in the context of their relation to previous research in this area. Differences between the female and male studies were noted, and the implications of sex differences in social competence were discussed both in terms of conventional measures of social competence and of the competence construct itself.

Age on first hospitalization of schizophrenics: A developmental approach.

Ages of first hospitalization were compared among 64 (VA) Veterans Administration hospital male, 60 state hospital male, and 60 state hospital female schizophrenic patients. Those who were diagnosed as paranoid were found to be approximately 8 years older than the nonparanoid patients on age of first admission. In both diagnostic categories men were hospitalized about 5 years earlier than women. An analysis of the relation between work status and diagnosis for the female groups revealed that working women with a diagnosis of paranoid were hospitalized approximately 10 years later than the paranoid women who remained at home and the nonparanoid women of either employment status. State hospital males were younger on first admission than VA hospital males. The ages of the two diagnostic groups in the VA were comparable, whereas in the state hospital the nonparanoid group was younger than the paranoid group by about 8 years. Possible explanations for these findings are discussed, particularly in terms of the role of the individuals developmental level in premorbid functioning, diagnosis, and course of psychiatric illness. The need to pay greater attention to the differences between schizophrenic males and females and to scrutinize more closely differences between state and VA hospital patients is emphasized.

Hallucinations vs. Delusions: A Developmental Approach

The developmental levels of three samples of paranoid and nonparanoid schizophrenic patients who manifested hallucinations, delusions, or both symptoms were compared. The patient sample consisted of 432 men and 207 women. Developmental level was assessed by the Zigler-Phillips Social Competence Index. Patients who manifested delusions were found to be at a higher developmental level than those who suffered hallucinations. The social competence of patients having both symptoms tended to fall between the levels of the single symptom groups. Females had higher competence scores than males, and paranoid patients had higher scores than nonparanoid patients. The results were-discussed in terms of the significance of developmental level as a pervasive dimension of the individual which relates to the expression of specific symptoms and other facets of psychiatric disorder.

Humor responses of high and low premorbid competence alcoholic and nonalcoholic patients

Abstract Groups of alcoholic, nonalcoholic psychiatric, and nonalcoholic medical patients, each including 10 high and 10 low social competence males, were shown cartoons having the themes of marital relations, dependency, and self-indulgence. High social competence patients recieved higher comprehension and mirth responses scores and rated the cartoons as funnier than did low social competence patients. Diagnostic status did not prove to be an important determinant of humor response. Findings involving cartoon theme indicated that the humor response is influenced by an interaction between the humor theme and the psychodynamics associated with the individuals matruity level. Alcoholics were not found to suffer circumscribed conflicts in the areas represented by the cartoon themes. The results were interpreted as support for a developmental approach to alcoholism as opposed to the psychodynamic approach. Developmental determinants of a sense of humor were discussed, and implications for future research were noted.

The developmental approach to alcoholism: A further investigation

Abstract Twenty males, age 29–61, assessed as chronic alcoholics and admitted to an inpatient alcoholic treatment program, were the subjects in this study. Relations among the severity of the alcoholism problem, the individuals developmental and/or maturity level, and dysfunction due to depression were investigated. Measures employed were Number of Previous Programs, Zigler-Phillips Social Competence Index, Rudie-McGaughran Essential-Reactive Alcoholism Scale, Beck Depression Inventory, and Overall-Patrick Alcoholic Interview. The Overall-Patrick Scale appeared to be assessing the severity of the patients alcoholism while the Rudie-McGaughran Scale assessed severity and an underlying maturity dimension. Contrary to the frequently reported relation between alcoholism and depression, no significant relation between the measure of depression and the measures of severity of alcoholism were found. Possible explanations for these findings were discussed, and an avenue for future research was suggested.

Maturity, depression, and life events in middle-aged alcoholics

Abstract Twenty-eight middle-aged hospitalized alcoholics were differentiated on the basis of their level of social competence (maturity) and their identification as either essential or reactive alcoholics types. Attempts were made to relate these differentiations to depression and life events stress. The relationship between level of social competence and type of alcoholism was confirmed. Depression and life events stress were not found to be significantly related to maturity level, although depression scores did correlate positively and significantly with several subscales of the measure of alcoholism level. These correlations and certain trends in the data were viewed as meaningful and highly suggestive primarily in terms of their implications for future research on the maturity dimension.

Humor and Psychopathology

In a book focusing mostly on emotion-related problems and psychological disorders, a chapter on humor seems a singularly happy choice, but humor, like most emotion-related behaviors, is a complex affair. While the emotion of joy may be the fundamental emotion expressed by laughter, the emotions of anger, contempt, and fear may also be couched in laughter. Levine shows how humor and laughter can both cure and kill. He demonstrates that humor and psychopathology are generally antipodal and that psychiatric patients typically perform poorly on tests of humor appreciation. He shows how people’s failure to appreciate a joke or a cartoon can furnish leads as to the nature of their problems, whether they be minor or pathological. He presents evidence for a relationship between certain types of response to humor and specific psychological disorders. He also shows how people can use humor and laughter for amusement or aggression.