THE RELAYIONSHIP OF ORGANIC. flLNE5$ TO PERSON-ALEW INTEGRATIQN Thesis for {rho {beam 0% Ph. D. MICHIGAN SLATE UNIVERSUY Caridad V'Alzona Delefla E 962 I\N\\\\T\\\\\T\\\\I\\\\\\\\\\\\\§\\ii§‘ This is to certify that the 7’ thesis entitled THE RELATIONSHIP OF ORGANIC ILLNESS T0 PERSONALITY INTEGRATION presented by ”g, Caridad Alzona Delena has been accepted towards fulfillment of the requirements for Ph .0 0 degree in Education '\ /. ’ ) , / / . ”f ,/E ) (, /€/ / f 6 :// M. Alt/‘4’. \ Major professor Date 80”/ 7" (I? L LIBRARY Michigan State University THE RELATIONSHIP OF ORGANIC ILLNESS TO PERSONALITY INTEGRATION BY Caridad Alzona Delefia A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY College of Education 1962 Acknowledgments The author would like to express her gratitude to the chairman of the committee, Dr. H. W. Sundwall, and to the members of the committee, Dr. C. Hanley and Dr. J. Costar, for their constructive suggestions and helpful criticism. Special thanks are due to Dr. J. S. Feurig, Director of the Michigan State University Health Service, for his generous assistance during the data collecting phase of the thesis; to Miss Marvel June Allard and Dr. J. H. Stapleton, for helping with the interpretation of the statistics. Thanks are also due to Miss Margaret Reed who was especially helpful. The author would like to dedicate this dissertation to Dr. Federico B. Delefia, Dr. Socorro Alzona-Delefia, and Dr. Encarnacion Alzona, without whose support and encouragement this study may never have been finished. ii ABSTRACT THE RELATIONSHIP OF ORGANIC ILLNESS TO PERSONALITY INTEGRATION by Caridad Alzona Delefia It was hypothesized that physically ill individuals, as indicated by clinic visits, would differ significantly from relatively healthy individuals, as indicated by absence of clinic visits, in their responses to the General Opinion Survey (GOS), a test designed to measure degree of personality integration. A representative sample of 104 men and 100 women (on- campus single American citizens) was drawn from the Michigan State University (MSU) freshman class. Subjects were classified into Sick and Healthy (Zero Clinic Visits) Groups and compared on fifteen variables, i.e., ten GOS scores, Grade Point Average (GPA), College Qualifi- cation Test (CQT) scores, using the t—test. It was specifically hypothesized that the G05, GPA, and 'CQT means of the Sick Groups would be significantly lower than the means of the Healthy Groups. iii Caridad Alzona Delefia Out of 405 t-tests (computed by MISTIC) on the fifteen variables between the Sick and Healthy Groups, 40 were significant. It was concluded that the G08 Anxiety, Social, Child Status, Learning and Total Scales were the most important scales in significantly differentiating (.001 level) between the Sick and Healthy Groups. Chronically ill female subjects obtained significantly lower GPA than females who had not visited the clinic, but females with physical injuries only obtained significantly higher GPA than females who had not visited the clinic. It was concluded that chronic illness affected unfavorably the study habits and GPA of chronically ill female freshmen. Accident-proneness seemed to differentiate between females who had reported physical injuries and females who had not reported any injuries or illness to the clinic. Chronically ill subjects consistently scored signifi- cantly higher on the CQT total and sub-scores (Verbal, Information, Numerical) than subjects who had not visited the clinic. It was concluded that the chronically ill subjects of the study would have a better chance of suc- ceeding in college than subjects who had not reported any illness. iv Caridad Alzona Delefia Results of t—tests showed that individuals with organic illness manifested a significantly lower degree of person- ality integration on the G08 than individuals who had not visited the clinic. It was concluded that for the sample studied, there existed a significant relationship between organic illness and personality integration (as measured by the G08). TABLE OF CONTENTS Chapter Page I. Statement of the Problem . . . . . . . . . . . 1 Introduction Statement of the Problem Hypothesis Definitions Groups Compared Significance Level Importance of the Study Organization of the Thesis II. Review of the Literature on Test-Oriented Studies in the Psychosomatic Area . . . . . 7 Two Principal Approaches Objective Tests Projective Devices Projective and Objective Tests Conclusion III. Design of the Study . . . . . . . . . . . . . 19 Subjects Selection of Sample Outline of Research Design vi Chapter Page The Sick Group The Healthy Group Diagnosis of Subjects Data Card Medical Information Section Additional Diagnostic Classifications Test Score Section Group Comparisons Eliminations from Group Comparisons The General Opinion Survey Scales The Ten GOS Scales Background of the G05 Rationale Behind GOS Items Definition of General Integrative Behavior Limitations of the G08 Description of the G08 Scales IV. Results . . . . . . . . . . . . . . . . . . . . 40 Group Comparisons V. Discussion of Results and Conclusions . . . . . 55 Procedure Discussion of Results vii Chapter Page GOS t—tests Significant at the .001 Level Conclusions on CQT Scores Relevant Findings Implications for Research Summary of Significance Findings Summary of Conclusions Conclusions on the G08 Scales Conclusions on the GPA Conclusions on the COT Scores VI. Summary of the Study . . . . . . . . . . . . 92 Hypotheses Subjects Groups Compared Eliminations Comparisons Conclusions on the G08 Scales Conclusions on the GPA Conclusions on the CQT Scores General Conclusion Bibliography . . . . . . . . . . . . . . . . 97 Appendix . . . . . . . . . . . . . . . . . . 103 Table 10. ll. 12. 13. 14. 15. 16. 17. 18. 19. List of Tables Three Plus Clinic Visits vs. Zero Visits Chronic Organic vs. Zero Visits . . . Non—Chronic Organics vs. Zero Visits . All Organics vs. Zero Visits . . . . . Physical Injuries with Other Illnesses Zero Visits . . . . . . . . . . . . Physical Injuries Only vs. Zero Visits All Physical Injuries vs. Zero Visits Hospitalized vs. Zero Visits . . . . . Hospitalized vs. Non-Hospitalized . . GOS Anxiety Scale . . . . . . . . . . GOS Social Scale . . . . . . . . . . . GOS Punitive Scale . . . . . . . . . . GOS Child Status Scale . . . . . . . . GOS Theoretical—Philosophical Scale GOS Learning Scale . . . . . . . . . . GOS Feeling Orientation Scale . . . . GOS Interest Scale . . . . . . . . . . GOS Total Scale . . . . . . . . . . . GOS Negativism-Acquiescence Scale . . ix Page 44 44 45 46 46 47 47 48 48 49 50 51 51 51 52 52 52 53 53 Table 20. 21. 22. 23. 24. 10. ll. 12. 13. 14. Grade Point Average (GPA) . . . . CQT Verbal Score . . . . . . . . . . . . . . CQT Information Score . . . CQT Numerical Score . . . . . . . . . . . . CQT Total Score . . . . . . . . . . . . . (Three Plus Clinic Visits) vs. (Zero Visits) Chronic Organic vs. Zero Visits . . . . . Non-Chronic Organics vs. Zero Organics . . . All Organics vs. Zero Organics . . . . . . Physical Injuries with Other Illnesses vs. Zero Visits . . . . . . . . . . . . . . Physical Injuries Only vs. Zero Visits . . . All Physical Injuries vs. Zero Visits . . . Hospitalized vs. Zero Visits . . . . - . . . Hospitalized vs. Non—Hospitalized . . . . . Total of Significant t—tests on the G08 . . GOS Anxiety Scale . . . . . . . . . . . . . GOS Social Scale . . . . . . . . . . . . GOS Child Status Scale GOS Learning Scale . . . . . . . . . . . . Page 53 53 54 54 54 57 58 63 64 66 67 68 69 71 75 76 76 77 77 Table Page 15. GOS Interest Scale . . . . . . . . . . . . . . 78 16. GOS Total Scale . . . . . . . . . . . . . . . 78 xi Table Appendix List of Tables Means and Standard Deviations of the Three + Clinic Visits Group on Fifteen Measures Means and Standard Deviations of the Chronic Organic Group on Fifteen Measures Means and Standard Deviations of the Non- Chronic Organic Group on Fifteen Measures Means and Standard Deviations of the All Organics Group on Fifteen Measures Means and Standard Deviations of the Physical Injuries with Other Illnesses Group on Fifteen Measures Means and Standard Deviations of the Physical Injuries Only Group on Fifteen Measures Means and Standard Deviations of the All Physical Injuries Group on Fifteen Measures Means and Standard Deviations of the Hospitalized Group on Fifteen Measures xii Table 10. ll. 12. 13. 14. 15. 16. 17. 18. Means and Standard Deviations of the Non-Hospitalized Group on Fifteen Measures Means and Standard Deviations of the Zero Visits Group on Fifteen Measures The t-tests of Thirty Male 3 + Clinic Visits Group vs. Thirty—two Male Zero Visits Group The t-tests of Twenty-three Female 3 + Clinic Visits Group vs. Thirty-four Female Zero Visits Group The t-tests of Fifty—three Male and Female 3 + Clinic Visits Group vs. Sixty-six Male and Female Zero Visits Group The t-tests of Sixteen Male Chronic Organics vs. Thirty—two Male Zero Visits The t-tests of Three Female Chronic Organics vs. Thirty-four Female Zero Visits The t-tests of Nineteen Male and Female Chronic Organics vs. Sixty—six Male and Female Zero Visits The t-tests of Forty-five Male Non—Chronic Organics vs. Thirty-two Male Zero Visits The t-tests of Fifty-nine Female Non-Chronic Organics vs. Thirty-four Zero Visits xiii Table 19. 20. 21. 22. 23. 24. 25. 26. The t-tests of One Hundred Four Male and Female Non- Chronic Organics vs. Sixty-six Male and Female Zero Visits The t-tests of One Hundred Four Male and Female Non- Chronic Organics vs. Six Male and Female Zero Visits The t-tests of Sixty-one Male All Organics vs. Thirty—two Male Zero Visits The t—tests of One Hundred Twenty—three Male and Female All Organics vs. Sixty—six Male and Female Zero Visits The t-tests of Twenty-one Male Physical Injuries with Other Illnesses vs. Thirty-two Male Zero Visits The t-tests of Twelve Female Physical Injuries with Other Illnesses vs. Thirty—four Female Zero Visits The t-tests of Thirty-three Male and Female Physical Injuries with Other Illnesses vs. Sixty—six Male and Female Zero Visits The t—tests of Eleven Male Physical Injuries Only vs. Thirty-two Male Zero Visits xiv Table 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. The t-tests of Five Physical Injuries Only vs. Thirty—four Female Zero Visits The t—tests of Sixteen Male and Female Physical Injuries Only vs. Sixty-six Male and Female Zero Visits The t-tests of Thirty-two Male All Physical Injuries vs. Thirty—two Male Zero Visits The t—tests of Seventeen Female All Physical Injuries vs. Thirty-four Female Zero Visits The t-tests of Forty-nine Male and Female All Physical Injuries vs. Sixty—six Male and Female Zero Visits The t-tests of Sixteen Male Hospitalized vs. Thirty- two Male Zero Visits The t-tests of Fourteen Female Hospitalized vs. Thirty- four Zero Visits The t-tests of Thirty Male and Female Hospitalized vs. Sixty-six Male and Female Zero Visits The t—tests of Sixteen Male Hospitalized vs. Eighty— eight Male Non—Hospitalized The t-tests of Fourteen Female Hospitalized vs. Eighty- six Female Non-Hospitalized XV 'Table 37. The t—tests of Thirty Male and Female Hospitalized vs. One Hundred and Seventy—four Male and Female Non-Hospitalized xvi Chapter I Statement of the Problem Introduction The American Psychiatric Association defines the term "psychosomatic" as an "adjective to denote the constant and inseparable interaction of the psyche and the soma, most commonly used to refer to illnesses which are pri- marily physical with at least a partial emotional etiology" (1 :55). However, ”psychosomatic illness" as a diagnosis is today being replaced by the "psychosomatic approach" (7:405). The literature on the psychosomatic approach to ill— ness generally recognizes that certain physical illnesses are influenced by chronic emotional stress. It is quite difficult to draw a strict line between "psychosomatic" or "psychically produced” and "organic" or "real" illness. Generally there is an acceptance of the probability that there is a blending of these and other factors in many disease syndromes (6: 252). 9" The present tendency today is "toward assuming that any physical illness has its emotional components, and any personality disturbance its bodily ones” (7: 405). Coupled with this tendency is the movement toward interdisciplinary research with the viewpoint that illness can be understood only by considering the sociological, cultural, psychologi— cal and chemical factors together (7: 405). Some studies which attempted to probe into the rela— tionship of illness and emotional stress in the college environment are those by Frankle, Staton and Rutledge, and Mechanic and Volkhart. Frankle investigated the relationship between intro— version extroversion on the Minnesota Thinking-Social- Emotional (TSE) Inventory and the tendency toward somatic complaints. He found that emotionally introverted graduate students manifested significantly more somatic complaints than emotionally extroverted graduate students (6: 255). Staton and Rutledge found a significant and positive relationship between the frequency of somatic illness and certain emotional problems among college students (22:203). Mechanic and Volkhart found that students who per— ceived themselves to be under high stress were more frequent visitors to the school infirmary than students who perceived themselves to be under low stress (18: 56). In view of the variety of emotional stress confronting college students, it was decided to investigate the possi- bility of a relationship between organic illness and per- sonality integration in the Michigan State University (MSU) freshman class. The MSU Health Service provides students with free medical facilities and strives to preserve student health. It seemed promising to investigate possibilities of a relationship between organic illness and grade point aver- age, and between organic illness and academic aptitude as indicated by the College Qualification Test (CQT). Statement of the Problem The purpose of this study was to investigate the pos- sibility of a relationship between organic illness and personality integration. Hypothesis It was hypothesized that individuals susceptible to illness, as indicated by hospital visits, would differ significantly from physically healthy individuals, as indicated by absence of hospital visits, in their patterns of responses elicited by General Opinion Survey statements designed to indicate degree of personality integration. Definitions A high degree of personality integration is taken to be indicated by high scores on the General Opinion Survey (GOS): a low degree of integration, by low scores on the G08. Personality integration is therefore operationally defined by responses to the paper-and—pencil inventory used, the G08. The diagnosis of organic illness was made by MSU Health Service physicians. Groups Compared Subjects were classified into two main categories: the Sick Group and the Healthy Group categories. This classifi- cation was based on information obtained from their data cards which had been filled out by the director of the MSU Health Service, Dr. J. S. Feurig. The Sick Group was subdivided into eight sub—groups: 3 + Clinic Visits, Chronic Organic, Non-Chronic Organic, All Organic, Physical Injuries with Other Illnesses, Phy- sical Injuries Only, All Physical Injuries, and Hospitalized Groups. Each of these sub-groups was compared with the 6 Healthy Zero Visits Group on fifteen variables, i.e., ten GOS scores, Grade Point Average (GPA), and four College Qualification Test (CQT) scores. The Healthy (control) Group was called the Zero Visits Group and was composed of subjects who had not visited the MSU clinic for any reason during their freshman year. The total sample was also divided into Hospitalized and Non-Hospitalized Groups and compared with respect to the fifteen variables. The Non—Hospitalized Group was also considered healthy, but less healthy than the Zero Visits Group, because it included subjects who had visited the clinic but had not been hospitalized. It was specifically hypothesized that the Sick Groups would have significantly lower means on the G08, GPA, and CQT scores than the means of the Healthy Groups. Significance Level The minimal level of significance accepted in this study was the .05 level. Importance of the Study The investigator would not go so far as to agree with some enthusiastic psychosomaticists that all illnesses have a high proportion of emotional or psychosomatic factors. It is generally accepted that emotional factors are impor- tant in the etiology of many organic disorders. What is not clear, however, is in which disorders the emotional factor is minimal or secondary, and in which disorders the emotional factor is primary (11: 213). In general, illness, especially chronic illness, re- sults in losses in every area of effort. If persons who are more than ordinarily susceptible to illness could be shown to have identifying personality patterns on tests, remedial steps could be taken. Organization of the Thesis Chapter II will review some studies which utilized psychological tests in investigating illness. Chapter III will present the design of the study and the procedure used in classifying the subjects. Chapter IV will list the results of the comparison of the Sick and Healthy Groups. Chapter V will discuss the findings and implications for research and conclusions. Chapter VI will summarize the study. Chapter II Review of the Literature on Test-Oriented Studies in the Psychosomatic Area Two Principal Approaches The study of psychosomatic disorders has been approached from two principal directions. One approach is the dynamic investigation of the personality of the patients, largely represented by psychoanalytic studies, where most of the literature falls. The other approach is experimental and physiological and attempts to demonstrate and correlate visceral or somatic changes induced by specific emotional states (7: 220). Results have shown that this attempt at relating single psychological factors with about every known physiological factor is inadequate, and it is generally accepted today that multiplicity rather than specificity of causal factors is the only successful avenue to psycho- somatic problems (15: 616). The present survey will present samples of test—oriented studies in the psychosomatic area. Studies which used objective types of tests, projective tests, and both pro- jective and objective tests will be reported. Objective Tests Krasner administered the Wechsler-Bellevue Scale Scale, Form I, the Guilford-Martin Factor Inventory, the Thurstone Interest Schedule, and a questionnaire of sixty-six items designed to obtain background information and attitudes not covered by the Guilford or Thurstone inventories, to three groups of patients in a general medical hospital. The subjects were white males, veterans, native-born, between the ages of 20 and 40, and had all completed at least the eighth grade to insure adequate reading ability of the inventories. The first group consisted of 30 patients with duodenal ulcer as their only medical diagnosis. The second group consisted of 27 patients with ulcerative colitis as their only medical diagnosis. The third group consisted of 44 patients with non-psychosomatic disorders of either inguinal hernia or pilonidal cyst (which the literature does not consider to be markedly affected by emotional states) and who had no histories of psychiatric or psychosomatic disorder. The differences in height, weight, and height/weight ratio between the three groups were not significant. On the multiple-choice questionnaire, 9 of the 66 items yielded significant results. These items indicated that the ulcer patients reported "domineering, strict fathers, ran away from home one or more times, disliked school, liked their previous job, tended to go out with people older than themselves, and felt that they had many friends. Colitis patients tended to have strict and domineering fathers too, parents who did not get along with one another, never ran away from home, liked school and now have few or no friends." The ulcerative colitis group attained significantly higher scores on the intelligence test (80% had an IQ of 115 or more) than the other two groups. Personality differences were defined in terms of significant differences in scores on the Guilford-Martin Factor Inventory. When the ulcer and colitis patients were treated as one group of psychosomatic patients and then compared with the non-psychosomatic group, significant results occur in six factors. Psychosomatic patients in comparison with the non—psychosomatic group reported themselves as being "more shy, withdrawn, seclusive, with greater cycloid tendencies, 10 more socially passive, tending to lack of confidence, under—evaluation of one's self, feelings of inadequacy and inferiority, jumpy, jittery, with a tendency to be easily distracted, irritated and annoyed." No significant differences were found between the ulcer and colitis groups. The statistically significant differ- ences were found to be between each of the psychosomatic groups and the non—psychosomatic group, and between the combined (ulcer and colitis) psychosomatic group and the non-psychosomatic group (13: 190). LeShan and Worthington administered a projective device which resembles a questionnaire in that it appears to be a personnel form), the Worthington Personal History, to 152 patients with malignant tumors and 125 patients with other or no known disease. (The 12,000 protocols from validation studies of the Personal History were also surveyed and seemed to be authors to be in essential agreement with the control group findings.) The Worthington P.H. is a blank resembling a personnel form thereby having the advantage of rarely producing anxieties because of its non-threatening nature as other tests seem to have. The subjects (judging from occupational status) were nearly all upper-lower or lower-middle class. 11 Each protocol included a description of the personality structure (estimations of major cathexes, expression of hostility, social mobility, major ego defenses used, ego strength, and intelligence). The protocols of the cancer and control groups were then scanned to see whether any factor could be found which occurred frequently in one group and less commonly in the other group. When a factor seemed to fulfill this requirement, all protocols were re-examined specifically in this area and tabulations made of the number of records in which it was found. Three factors found in the protocols of patients with malignant cancer which were statistically less frequently found in the protocols of the controls were: 1. loss of an important relationship before the diagnosis of the tumor 2. inability to express hostile feelings towards other people, with strong aggressive feelings 3. tension over the death of a parent, often an event that had happened many years ago. In order to check these findings further, 28 new records were analyzed by the writers without clues in the "health" area of the blank that would reveal whether they 12 had cancer or not. The 28 records included 15 protocols of cancerous patients, and 13 of controls. The controls contained 5 with no known disease, 3 hyperthyroids, 1 each with allergy, arteriosclerosis, psoriasis, dermatitis, and obesity. The authors attempted to predict which patients had cancer and which did not, solely from the presence or absence of the three factors previously mentioned. Correct predictions (p = .0001) were made in 24 of the 28 cases. (Three noncancerous patients, 1 with arteriosclerosis, l with allergy, and l with hyperthyroidism were predicted as "cancer," and 1 patient with cancer of the skin was predicted as ”noncancer.”) The first factor, the loss of an important relationship has also been noted by Evans (1926), and Greene (1954) in previous studies. The second factor, the inability to express hostility, has also been previously reported as being statistically associated with the diagnosis of cancer by Bacon §t_§1, (1952), using an interview technique; Butler (1954) also using psychiatric interviews; and Cobb (1952), using interviews, questionnaires and projective techniques. LeShan and Worthington believe that the specific finding of tension over the death of a parent has not been 13 previously reported in this exact manner. However, LeShan and Worthington note that three other investigators (Evans, 1926; Tarlau and Smalheiser, 195 ; and Bacon e£__l,, 1952) have observed strong unresolved tensions concerning a parental figure as characteristic of cancer cases. LeShan and Worthington believe that all four papers although phrasing this area differently, are reporting on the same factor, because tension over the relationship with a parental figure leads frequently to unresolved problems of guilt and anxiety in the event of the parent's death (14: 281). Staton and Rutledge compared 31 men and 19 women students ranking at or above the 90th percentile ("Repeaters") in number of infirmary visits for one year, with 15 men and 30 women students ranking at or below the 10th percentile (Non-Repeaters) on the short group form of the MMPI. They found that the 90th percentile and the 10th percentile groups were significantly different on the Hypochondriasis (.01 level of confidence), Hypomania (.01 level), Psycho- pathic Personality (.05), and Depression (.05 level) scales of the short form MMPI. They found moderate to low but significant associations between hypochondriasis, l4 psychopathic personality, depression and frequency of somatic illness, with somewhat greater frequency among females than among males (24: 203). Projective Devices Bernstein and Chase administered the Blacky Pictures to three groups of hospitalized patients; an ulcer, psycho- somatic non-ulcer, and a non-psychosomatic group. Signi— ficant differences were found on only three of seventeen dimensions for each inter—group comparison, but no dif- ferentiation was found on the basis of oral eroticism, which the previous literature has considered important. The authors conclude that their findings cast some doubt on the validity of the Blacky Pictures for discriminating ulcer patients from other patients (4: 377). Waxenberg administered a test battery consisting of the Bender-Gestalt, House-Tree-Person test, Rorschach, Rapaport's word association test, and the TAT to psycho— somatic groups and to non-psychosomatic groups and found no significant difference between the two groups. This is in line with Krasner's finding although Krasner administered objective tests (Wechsler—Bellevue, Guilford-Martin Factor 15 Inventory, the Thurstone Interest schedule, and his own 66-item questionnaire). Waxenberg concluded that consistently negative findings such as his make it important that all "major psychosomatic formulations need to be subjected to rigorous and searching analysis by a variety of techniques” (34: 163). Opposed to Minski and Desai's finding on ulcer patients is Winter‘s finding on peptic ulcer patients. Winter administered the Rorschach and Blacky Pictures to 68 peptic ulcer cases in order to test his hypothesis about the per- sonality dynamics of ulcer patients. He concluded that the typical ulcer personality is not found in all peptic ulcer patients and that at least two different personality pat- terns are found in people with ulcers and these can be validly measured by the Blacky Scales developed in this investigation (36: 332). Projective and Objective Tests The team of Miski and Desai administered the Rorschach, Porteus Maze, and the Rosensweig Picture-Frustration tests to two groups ulcer and hysteric. The group of 25 male psychiatric peptic ulcer cases and a comparable group of 25 psychiatric cases with predominantly hysterical symptoms 16 were also appraised in terms of clinical judgments of personality traits. Rorschach test results indicated that the ulcer group was less immature, accepted their instinctual needs to a greater extent, had more anxiety, and greater caution. Porteus Maze test results showed the ulcer group to be more conforming. Clinical judgment revealed greater conscientiousness, neatness and tenseness among the ulcer patients. The Rosensweig Picture-Frustration results were not statistically significant (20: 113). Reznikoff administered the TAT, a Sentence Completion test, a personal history questionnaire and interviews to 25 women with breast cancer and 25 women with "benign" growths (but thought by them to be malignant at the time of the testing), and 25 normals. Specific disturbances in feminine identification with accompanying negative atti- tudes toward pregnancy were found in the group with breast cancer (23: 96). In another study, Reznikoff reported on the results of the individual administration of the Cornell Medical Index and the Multiple-Choice Rorschach to 100 cancer detection l7 clinic patients. Information was also obtained from their medical examination forms. The data were analyzed to determine background and personality variables which served as motivating factors in visiting a cancer detection clinic. The following factors were found the most prevalent: 1. cancer in a close relative 2. a history of serious illness 3. emotional difficulties involving marked body preoccupation and apprehension (22: 454) Contradicting the findings on cancer groups of LeShan and Worthington, and Reznikoff, are the findings of Wheeler and Caldwell. Wheeler and Caldwell administered the Rorschach, Kent Scale, Draw A Person, Rosensweig Picture- Frustration tests, and a clinical interview to three groups with cancer of the breast, cancer of the cervix and normal controls. They did not find striking differences between the cancer and control groups, contrary to findings reported by the above-mentioned earlier studies. Trends however suggested the early childhood environment, parental attitudes, and sexual attitudes which the authors believe warrant further study (35: 256). 18 Conclusion Various researchers point out that there is no lack of data in the psychosomatic area but that on the whole, studies are still at the correlations level. More and more evidence is being accumulated to demonstrate that somatic distur- bances may be correlated with specific inner psychological processes such as anxiety, hostility, defense mechanisms, etc. What is lacking is evidence on how effects are mediated. It is a gross oversimplification to assume that the "autonomic nervous system is activated by emotion and somehow produces the malfunction and pathology" (16: 223). There is a lack of studies with adequate research design, control groups, and relevant statistical tests. Ideally, the investigator should measure the group and make the prediction and then wait to see the type of disease developed. This way one would have ”both the pristine evaluation and another with the complications resulting from the psychological reaction to the illness" (7: 57). With the present method of measuring the sick group, the investigator measures something other than basic personality structure because the illness itself possibly contaminates and induces changes. Chapter III Design of the Study It was hypothesized that the means of the Sick Groups would be significantly lower than the means of the Healthy Groups. The Sick Groups were compared with the Healthy Groups on their GOS (General Opinion Survey) scores, CQT (College Qualification Test) test scores and Grade Point Averages (GPA), by the t-test. Subjects Selection of Sample The sample was taken from the fall term 1959 freshman who had taken the GOS during the entrance examinations. A total of 104 males and 100 females were selected from these for this study by the following process: First, names of the 2000 freshmen were arranged in alphabetical order. Every eighth male and every eighth female was then chosen until an arbitrary number of 110 males and 110 females had been reached. Second, foreign students, off-campus and married fresh- men were eliminated from the sample of 220 students. 20 Foreign students were eliminated in order to obtain a homogeneous group. Off—campus and married freshmen were eliminated in order to insure similarity in living condi- tions; only the freshmen who lived on campus were included. These eliminations left a total of 104 males and 100 fe- males, the final sample. Outline of Research Design The population was classified according to sex and into two main categories, a Healthy Group and a Sick Group. The Sick Group was subdivided into eight sub-groups, and the Healthy Group into two sub-groups. The GOS, CQT scores and GPA of the Sick Groups were compared with the GOS, CQT and GPA of the Healthy Groups, by the t-test. The sexes were first compared separately, and then combined. The Sick Group l. 3 + Clinic Visits Group: Subjects with three or more visits to the MSU clinic were labeled 3 + Clinic Visits (or 3 + Visits). Subjects who visited the clinic for a structural defect complaint alone (Structural Defect Only) or for physical injuries alone (PI Only) were eliminated from this group. 21 2. Chronic Organic Group: Subjects were classified Chronic Organics when they were diagnosed as having a chronic or long—standing organic illness (as diagnosed by Dr. Feurig). (Structural Defects Only, Physical Injuries Only were excluded.) 3. Non-Chronic Organic Group: Subjects were classified Non-Chronic Organics when they were diagnosed as suffering from an occasional organic ill- ness; this group excluded the chronically ill. (Structural Defects Only and Physical Injuries Only were excluded from this group.) 4. All Organics Group: All subjects with an organic illness, i.e. those with a chronic organic illness (Chronic Organics) and those with a non-chronic organic illness (Non-Chronic Organics) or both were classified All Organics. (Structural Defects Only and Physical Injuries Only were excluded from this group.) 5. Physical Injuries with Other Illnesses Group: Subjects were classified PI with Other Illnesses when they had bruises, contusions, etc., plus an organic illness. (Structural Defects Only and Physical Injuries Only were excluded.) 22 6. Physical Injuries Only Group (PI Only): Subjects were classified PI Only when they came to the clinic solely for treatment of accidental lacerations, con- tusions, bruises, etc., and had no organic illness on their data card. This PI Only group may (it was assumed) have the additional variable of accident—proneness. (Structural Defects Only were excluded from this group.) 7. All Physical Injuries Group (All PI): All subjects with any physical injury, i.e., subjects who had a physical injury plus an organic illness (PI with Other Illnesses) and subjects with physical injuries alone (PI Only), were classified All PI. (SD Only were excluded.) 8. Hospitalized Group: Subjects were classified Hospitalized when they had been hospitalized for any illness at the MSU Hospital. The total population (including everyone, i.e., the Structural Defects Only, the Physical Injuries Only, and the Psychosomatics Only were included either in the Hospi- talized or in the Non—Hospitalized Group) was divided into Hospitalized and the Non-Hospitalized Groups. 23 The Healthy Group 1. Zero Visits Group: Subjects were classified Zero Visits Group when they had no record of any clinic visits during their freshman year. 2. Non-Hospitalized Group: Subjects were classified Non-Hospitalized when they had never been hospitalized at the MSU hospital during their freshman year, although they may or may not have visited the MSU clinic for out-patient treatment. Diagnosis of Subjects Data Card A data card was prepared by the investigator for each subject. The card contained a medical information section and a test score section. Medical Information Section The medical information section of the card was filled out by Dr. J. S. Feurig, Medical Director of the MSU Health Service. It contains the following items: 1. Sex 2. Number of visits to MSU clinic 24 3. Number of commitments to a room at MSU Hospital 4. Diagnosis: Illness and Classification Chronic Psychosomatic Organic 5. Referred to Mental Hygiene Clinic , Counseling Center , Psychological Clinic , for 6. Number of visits to Mental Hygiene Clinic 7. Recommended withdrawal from school due to illness____ Items 5, 6, 7 were not used in the study due to the extremely small number of referrals for psychological serv- ices. A larger sample of subjects would be needed for statistical analysis. Additional Diagnostic Classifications After Dr. Feurig had filled out the cards for each student, the investigator noted that several male and fe- male subjects had visited the clinic for treatment of lacerations, sprains, and other assorted injuries. Hence the category of Physical Injuries (PI) was added to item 4 in order to isolate those who had visited the clinic for treatment of an organic illness from those who had visited the clinic solely for treatment of physical injuries. (The investigator used the MSU clinic's classification of 25 injuries which included the following: abrasions, bites, burns, contusions, foreign bodies, fractures, or disloca— tions, head injuries, lacerations, sprains or strains.) Using this classification, subjects were categorized as Physical Injuries with other illnesses, as Physical Injuries Only, and as All Physical Injuries (i.e. any subject who had a physical injury). It was also noted that a few subjects had visited the clinic with the sole complaint of flat feet, which did not seem to fall under any clear-cut classification of either Organic Illness or Physical Injuries. These subjects who had visited the clinic solely for treatment of flat feet were classified into a new category, Structural Defects, and eliminated from the comparisons of the Sick Groups vs. the Healthy (Zero Visits) Group. This elimination was an attempt to eliminate the variable of chronic congenital defects as a possible complicating factor in the compari- sons of the Sick Groups with the Healthy Group. The Zero Visits Group is therefore assumed to consist of subjects ‘without chronic congenital defects which necessitate medi— cal treatment. However, the subjects with Structural Defects Only (flat feet) were included in the Non-Hospitalized 26 Group for one comparison, the Hospitalized vs. the Non- Hospitalized Group. The rationale for their inclusion was that the important differentiating factor being tested in this comparison was the hospitalization factor, i.e. whether the subject had or had never been hospitalized for that school year. Test Score Section The test score portion of the data card for each student was a record of ten General Opinion Survey (GOS) scores, the cumulative grade point average (GPA) for the school year 1959-60, and four College Qualification Test (CQT Verbal, CQT Information, CQT Numerical and CQT Total) scores. Each card was identified by the student’s name and identification number and was checked against the student directory to eliminate those who lived off—campus, were married, or were non-freshmen or foreign students. After Dr. Feurig filled out the cards, the students” names were removed from the cards and only identification numbers were used to locate subjects. The test score portion of the data card looked like this: GOS: GPA CQT V CAT I CQT N CQT T 27 The investigator obtained the GOS test scores from the subject's test paper which was computed by the IBM machine, and the GPA and CQT scores from the MSU Office of Evalua- tion Services. The information on the data card was then coded and put into IBM card form and programmed for the MISTIC computer. Each of the Sick Groups were compared with the Zero Visits Group on the GOS, GPA and CQT scores, by the t—test. Group Comparisons The following Sick Groups were compared with the con- trols, the Healthy Zero Visits Group: 1. (3 + Clinic Visits) vs. (Zero Visits) 2. (Chronic Organic) vs. (Zero Visits) 3. (Non—Chronic Organics) vs. (Zero Visits) 4. (All Organics) vs. (Zero Visits) 5. (Physical Injuries with Other Illnesses) vs. (Zero Visits) 6. (Physical Injuries Only) vs. (Zero Visits) 7. (All Physical Injuries) vs. (Zero Visits) 8. (Hospitalized) vs. (Zero Visits) 9. (Hospitalized) vs. (Non-Hospitalized) 28 Within each group, the sexes were compared separately, and then combined. (The Ns will be found in the Results chapter, and in the Appendix.) Eliminations from Group Comparisons Subjects with a diagnosis of Structural Defect Only (S.D. Only) and subjects with Physical Injuries Only were eliminated from certain group comparisons because they did not seem to fall clearly into the two main categories of Sick and Healthy Groups. Subjects were classified as Structural Defect Only when they were diagnosed as having the congenital defect of flat feet, and were eliminated in the comparison of the Sick Groups with the Zero Visits Group in order that the Sick Groups would consist of people who were ill from infections, viruses, etc. and not chronic congenital defects. Subjects with Physical Injuries Only (PI Only) were eliminated in the comparison of the Sick Groups with the Zero Visits Group (PI Only were used in three comparisons) also for the same reason, so that the variable of accident proneness (Physical Injuries) would not complicate the interpretation of the comparison. 29 Subjects with a diagnosis of Psychosomatic illness were originally to be compared with the Zero Visits Group but were eliminated from comparisons one to eight because there were too few (four females, two males) for a valid statis- tical analysis. The General Opinion Survey Scales The Ten GOS Scales The GOS has the following ten scales: 1. Anxiety and Self-Concept Scale (24 items) 2. Social Understanding Scale (16 items) 3. Punitiveness Scale (18 items) 4. Child Status Scale (13 items) 5. Theoretical—Philosophical Scale (22 items) 6. Concept of Learning Scale (14 items) 7. Feeling Orientation Scale (10 items) 8. Breadth of Interest Scale (10 items) 9. Total Scale: Degree of personality integration (135 items) 10. Negativism-Acquiescence Scale (135 items) Background of the GOS The General Opinion Survey (GOS) is a questionnaire that attempts to get at the individual's self—image and 30 how he feels about others, through opinions on various topics. The GOS was "designed with intent to measure general integration of personality through responses indi— cating opinions that are quite heavily attitudinal. A person is conceived of as a system of systems within more extensive physio-bio-social systems. Integration is the degree of consistency of functions or relationships within and between these systems. Personality integration is conceived of as having specificity in terms of narrowness of response area and breadth in terms of number of areas and scope of areas; it is conceived of as having generality or depth in terms of level of consistency implied by responses within and between areas and/or systems" (Sund- wall: 1960). The GOS has been nine years in develOpment. The GOS scales have been correlated with Rorschachs, ratings on students by teachers, the Minnesota Teacher Attitude In- ventory, and Rokeach“s Dogmatism Scale. The GOS consists of 135 items which fall into two main types of items, the Personal-intra-personal type of item and the Personal-inter—personal type of item. The Personal-intra-personal or self-reference type of item 31 tries to get at how the person perceives and reacts to the situation; the Personal—inter—personal type of item tries to get at how the person thinks other people react to others. Rationale behind GOS Items It is assumed that subjects who respond with socially desirable responses to the self—reference type of item (the "I" — items) are unable to give consistently socially desirable responses to the other-item type of question (items referring to others). Definition of General Integrative Behavior General integrative behavior refers to the breadth and depth of the personality and is defined here as the GOS Total Integration score. If an individual has a low GOS Total score, he is assumed to be integrative in a narrow area. If an individual has a high GOS Total score, he is assumed to be integrative in a wide area. Limitations of the GOS The GOS has the usual handicaps of the paper-and-pencil questionnaire. One of the main assumptions of paper-and— pencil tests is that the person should be favorably motivated 32 to cooperate and not mark the items in a hit—or—miss fashion or with a cynical poking—fun attitude. Other limitations are the subject's response set, the desire to maintain a facade of social desirability, non- anonymity, different interpretations of words and varied interpretations of the meaning of the test item, the sub- ject's perception of the situation and the reaction to the person administering the test. The response set of the individual to the GOS is a variable that differs from person to person and contributes to the variation in testing conditions. The GOS has attempted to communicate the test instructions clearly and specifically on the cover page, and thus attempts to reduce the individual differences in response sets. The subject's response set includes his general attitude towards all questionnaires, which may range from a mild feeling of neutrality to a violent prejudice against tests which "violate his privacy." The response set also includes the tendency to answer "true" rather than "false” when not sure about an item ( : 63). In the case of the G08, this ten- dency to answer ”true" rather than "false” is overlaid with the tendency of the subject to agree with socially desirable items. 33 The GOS attempts to overcome this tendency to respond in line with what is socially desirable by having "self- item" ("1" items) types of questions and "other-item" types of questions (items referring to others), and by mixed wordings of the items by using "I" and "You” and general- viewpoint statements. Sample of the "I" type of item: "I often regret things I have done'I (item 6). Sample of a "You" item: "If you cannot recall something, it really isn't learned” (item 82). A general-viewpoint item: "All facts are useful" (item 1). The non-anonymity may contribute more to the already present tendency to respond in a socially desirable manner to items in which they are especially strongly ego-involved, especially with the test being administered by an authority figure, but non-anonymity probably has eliminated deliberate falsification or exaggeration of responses. Description of the GOS Scales There are nine GOS scales which were designed to indi- cate the individual's degree of personality integration. The higher scores on GOS Scales l to 9 indicate a high degree of integration of personality, and the lower scores indicate a low degree of integration of personality or a 34 low degree of consistency of general values. GOS Anxiety Scale 1 This scale was intended "to measure the individual's degree of anxiety and involves both covert and overt mani- festations of anxiety. It was originally designed to sam- ple an area of responses with direct self-reference for the purpose of obtaining an indication in this general area of degree of integration in personality. When it was found that general responses in this area differed in direction to quite an extent, with responses in areas without direct self-reference, the scale was examined for possible meaning. The direct personal reference appears to add emotional con— tent to the response and the situations or conditions which formed the substance of the statements which are for the most part those that would involve anxiety. In comparing these statements with Taylor's Anxiety Scale and other simi— lar scales, the GOS Anxiety Scale was found to be quite similar" (Sundwall). The anxiety scale was designed "to indicate the indi- vidual's degree of anxiety. It involves both covert and overt manifestations of anxiety” (Sundwall). Sample items: 35 "I often regret things I have done.” "I would like to be more important than I am." "I find life very boring at times." GOS Social Scale 2 This scale was intended "to indicate the individual's degree of understanding of interpersonal relations. This is not a measure of empathy, but rather one of the indi- vidual's ability to assess social situations objectively" (Sundwall). Sample items: "People of one race should feel free to marry people of another race." "No one could be happy in some occupations." "Too many foreigners are coming into this country." GOS 3: Punitive Scale This scale was designed "to indicate the individual's orientation toward extrinsic motives. It identifies the individual who sees punishment as having greater value than non—punishment in the solution of problems" (Sundwall). Sample items: "A person who tells a lie should be punished." "Ignoring people is a bad way to show disapproval." "Extra work is a good form of punishment." 36 GOS 4: Child Status Scale This scale was designed "to measure the individual's attitude toward inferior groups, or groups generally ac- cepted as inferior. Children comprise the group referred to as inferior since it was assumed they would be most generally regarded as inferior. In this case, members of the 'in-group' regard themselves as inferior" (Sundwall). Sample items: "Young children should feel free to talk about sex." "Adults can learn as much talking to children as they can talking to other adults." "Nothing a child does is nonsense." GOS 5: Theoretical-Philosophica1 Scale This scale was designed "to sample the individual's general philosophical ideas for an indication of his con- sistency in general philosophical thinking" (Sundwall). Sample items: "Everyone is creative." "A democratic leader is more efficient than a dictator.’ "All people should be trusted." 37 GOS 6: Learning Scale This scale was designed "to indicate the depth and breadth of the individual's concept of learning. It in- volves the recognition of various levels of awareness and control. The individual low on this scale sees only the highly conscious learning in relation to voluntary control in behavior" (Sundwall). "It is not important to know who starts a fight." "We lose faith in others when they do something wrong." "Everyone wants to improve." GOS 7: Feeling Orientation Scale This scale was intended "to indicate the degree of recognition of the importance of the role of feeling in learning and directing behavior. Individuals high in this scale perceive feeling as valid in indicating appropriate— ness of response" (Sundwall). Sample items: "Anger if hidden causes less harm." "We must constantly struggle with ourselves in order to be good.” "We learn most from misfortunes.” 38 GOS 8: Interest Scale This scale was intended "to measure the generality of breadth of interests of the individual" (Sundwall). Sample items: "I like to talk to foreigners." "I am interested in science." "I like neighbors who borrow things." Other topics covered include abstract art and education. GOS 9: Total Scale This scale was the summation of Scales l to 8. The Total scale was designed "to indicate the degree of person- ality integration and consistency of general values of the individual" (Sundwall). Sample items: "It takes 'pull' to become successful." "Business does not control community life." "One's 'in-laws' should in all cases live by themselves." GOS 10: Negativism-Acguiescence Scale This scale was constructed "to indicate the degree of negativism or, at the opposite pole, the degree of acquies- cence manifested in the process of responding to the state- ments in the GOS. It indicates the response set or tendency of the individual to respond in agreement as ("true") or in 39 disagreement ("false") while reacting to the issues of the inventory. A large number of disagreement responses indi- cates a high degree of negativism and a low degree of acquiescence. A large number of agreement responses indi- cates a high degree of acquiescence and a low degree of negativism. It is assumed that individuals showing a high degree of personality integration would score average (68- 70) on this scale. 40 Chapter IV Results The subjects for each of the Sick groups were sorted by the IBM sorter-machine. Each of the Sick groups was com- pared with the Healthy Groups on their GOS scores, GPA and CQT scores by the t-test. The t's, means and standard devi- ations for each group are to be found in the appendix. The t's, means and standard deviations were all computed on MISTIC. The results listed below are the t's which were significant for all comparisons. Group Comparisons The Sick Groups were compared with the Healthy Groups by t-tests on the following fifteen variables: 1. G03 Anxiety Scale 2. G08 Social Scale 3. G08 Punitive Scale 4. GOS Child Status Scale 5. GOS Theoretical-Philosophical Scale 6. GOS Learning Scale 7. G08 Feeling Orientation Scale 8. G08 Interest Scale 9. 10. ll. 12. 13. 14. 15. It 41 GOS Total Scale GOS Negativism-Acquiescence Scale GPA (Grade Point Average) CQT (College Qualification Test) Verbal score CQT Information score CQT Numerical score CQT Total score was hypothesized that the means of the Sick Groups would be significantly lower than the means of the Healthy Groups on the fifteen variables listed above. Group Comparisons I. (3 + Clinic Visits) vs. (Zero Visits) 1. 30 M 3 + Clinic Visits vs. 32 M Zero Visits 2. 23 F 3 + Clinic Visits vs. 34 F Zero Visits 3. 53 M & F 3 + Clinic Visits vs. 66 M & F Zero Visits II. (Chronic Organic) vs. (Zero Visits) 4. 16 M Chronic Organic vs. 32 M Zero Visits 5. 3 F Chronic Organic vs. 34 F Zero Visits 6. 19 M & F Chronic Organic vs. 66 M & F Zero Visits III. (Non-Chronic Organic) vs. (Zero Visits) M, F: Male, Female IV. VI. VII. 42 7. 45 M Non—Chronic Organics vs. 32 M Zero Visits 8. 59 F Non-Chronic Organics vs. 34 F Zero Visits 9. 104 M & F Non—Chronic Organics vs. 66 M & F Visits (All Organics) vs. (Zero Visits) 10. 61 M All Organics vs. 32 M Zero Visits 11. 62 F All Organics vs. 34 F Zero Visits 12. 123 M & F All Organics vs. 66 M & F Zero Visits (Physical Injuries with Other Illnesses or PI with O.I.) vs. (Zero Visits) 13. 21 M PI with O.I. vs. 32 M Zero Visits 14. 12 F PI with O.I. vs. 34 F Zero Visits 15. 33 M & F PI with O.I. vs. 66 M & F Zero Visits (Physical Injuries Only) vs. (Zero Visits) 16. 11 M PI Only vs. 32 M Zero Visits 17. 5 F PI Only vs. 34 F Zero Visits 18. 16 M & F PI Only vs. 66 M & F Zero Visits (All Physical Injuries) vs. (Zero Visits) 19. 32 M All Physical Injuries vs. 32 M Zero Visits 20. 17 F All Physical Injuries vs. 34 F Zero Visits 21. 49 M & F All PI vs. 66 M & F Zero Visits 43 VIII. (Hospitalized) vs. (Zero Visits) 22. 16 M Hospitalized vs. 32 M Zero Visits 23. 14 F Hospitalized vs. 34 F Zero Visits 24. 30 M & F Hospitalized vs. 66 M & F Zero Visits IX. (Hospitalized) vs. (Non-Hospitalized) 25. 16 M Hospitalized vs. 88 M Non-Hospitalized 26. 14 F Hospitalized vs. 86 F Non-Hospitalized 27. 30 M & F Hospitalized vs. 174 M & F Non— Hospitalized The following results, tables 1 to 9, list the t-tests which were significant for all 27 group comparisons on the 15 variables. Tables 1 to 9 list the t-tests according to the groups compared, and tables 10 to 24 list the same sig- nificant t-tests according to the variables tested “in: quick reference). The minus signs in front of the t-tests indicate that the mean of the Sick Group was lower than the mean of the Healthy Group. The t—tests without a sign indicate that the mean of the Sick Group was higher than the mean of the Healthy Group. 44 Table l 3 + Clinic Visits vs. Zero Visits 30 M 3 - Clinic Visits vs. 32 M Zero Visits: Variable E. E. GOS Social Scale -2.83 .01 23 F 3 + Clinic Visits vs. 34 F Zero Visits: Variable E P. GOS Learning Scale 3.22 .01 53 M & F 3 + Clinic Visits vs. 66 M & F Zero Visits: There were no significant differences between the total groups for all comparisons. Table 2 Chronic Organic vs. Zero Visits 16 Chronic Organic M vs. 32 M Zero Visits: There were no significant differences between the male groups on the various comparisons. 3 F Chronic Organic vs. 34 F Zero Visits: Variable p_ p_ GOS Social Scale 2.85 .01 GOS Learning Scale 6.49 .001 GOS Interest Scale -2.36 .05 GPA —2.37 .05 45 19 M & F Chronic Organics vs. 66 M & F Zero Visits: Variable E E GOS Anxiety Scale —2.76 .01 GOS Social Scale —2.40 .05 GOS Theoretical-Philosophical -2.83 .01 GOS Interest Scale -4.33 .001 GOS Total Scale —3.56 .001 CQT Verbal score 2.15 .05 CQT Information score 3.39 .01 CQT Numerical score 3.46 .001 CQT Total score 3.87 .001 Table 3 Non-Chronic Organics vs. Zero Visits 45 M Non-Chronic Organics vs. 32 M Zero Visits: Variable E E GOS Social Scale -2.61 .05 GOS Child Status Scale -2.00 .05 59 F Non-Chronic Organics vs. 34 F Zero Visits: Variable p p CQT Verbal score 2.48 .05 104 M & F Non-Chronic Organics vs. 66 M & F Zero Visits: There were no significant differences on all comparisons. 46 Table 4 All Organics vs. Zero Visits 61 M All Organics vs. 32 M Zero Visits: Variable E. E. GOS Anxiety Scale -2.22 .05 GOS Social Scale -2.86 .01 GOS Total Scale -2.21 .05 62 F A11 Organics vs. 34 F Zero Visits: CQT Verbal score 2.43 .05 123 M & F All Organics vs. 66 M & F Zero Visits: There were no significant differences on any comparison made, between the total groups. Table 5 Physical Injuries with Other Illnesses vs. Zero Visits 21 M PI with 0. Illnesses vs. 32 M Zero Visits: Variable E B GOS Social Scale -2.19 .05 12 F PI with 0. Illnesses vs. 34 F Zero Visits: Variable E. .E GOS Learning Scale 2.32 .05 23 M & F PI with 0. Illnesses vs. 66 M & F Zero Visits: There were no significant differences on all comparisons. 47 Table 6 Physical Injuries Only vs. Zero Visits 11 M PI Only vs. 32 M Zero Visits: There were no significant differences between the male groups on the various comparisons. 5 F PI Only vs. 34 F Zero Visits: Variable E. GOS Social Scale 4.06 GOS Learning Scale 3.92 GPA (Grade Point Average) 2.64 16 M & F PI Only vs. 66 M & F Zero Visits: Variable E. Gos Child Status -2.70 Table 7 All Physical Injuries vs. Zero Visits 32 M All Physical Injuries vs. 32 M Zero Visits: Variable §_ GOS Social Scale -2.45 17 F All Physical Injuries vs. 34 F Zero Visits: Variable E. GOS Social Scale 2.07 GOS Learning Scale 3.02 .001 .001 .05 .01 E. .05 .05 .01 47 Table 6 Physical Injuries Only vs. Zero Visits 11 M PI Only vs. 32 M Zero Visits: There were no significant differences between the groups on the various comparisons. 5 F PI Only vs. 34 F Zero Visits: Variable p_ GOS Social Scale 4.06 GOS Learning Scale 3.92 GPA (Grade Point Average) 2.64 16 M & F PI Only vs. 66 M & F Zero Visits: Variable p_ Gos Child Status -2.70 Table 7 All Physical Injuries vs. Zero Visits 32 M All Physical Injuries vs. 32 M Zero Visits: Variable .E GOS Social Scale -2.45 17 F All Physical Injuries vs. 34 F Zero Visits: Variable p_ GOS Social Scale 2.07 GOS Learning Scale 3.02 male .001 .001 .05 .Ol .05 .05 .01 48 49 M & F All Physical Injuries vs. 66 M & F Zero Visits: There were no significant differences between the total groups with the sexes combined, on any comparison. Table 8 Hospitalized vs. Zero Visits 16 M Hospitalized vs. 32 M Zero Visits: Variable E. E. GOS Social Scale -2.91 .01 14 F Hospitalized vs. 34 F Zero Visits: Variable E E GOS Child Status Scale 2.87 .01 GOS Learning Scale 2.76 .01 30 M & F Hospitalized vs. 66 M & F Zero Visits: Variable E E GOS Social Scale —2.25 .05 Table 9 Hospitalized vs. Non-Hospitalized 16 M Hospitalized vs. 88 M Non—Hospitalized There were significant differences between the males on any comparison. 49 14 F Hospitalized vs. 86 F Non-Hospitalized: Variable E. GOS Social Scale —2.39 GOS Learning Scale 2.44 30 M & F Hospitalized vs. 174 M & F Non—Hospitalized: Variable p_ GOS Anxiety Scale -20.42 GOS Social Scale -3.67 E. .05 .05 E. .001 .001 The succeeding tables (10 to 24) list the same signifi- cant differences for the same groups, according to the fifteen variables tested. The following tables, 10 to 24, list the significant t-tests for the same nine group comparisons (a total of 27 sub-group comparisons), according to the fifteen variables tested. Table 10 GOS Anxiety Scale Groups E. 19 M & F Chronic Organic vs. 66 M & F Zero Visits —2.76 61 M All Organic vs. 32 M Zero Visits -2.22 30 M & F Hospitalized vs. 174 M & F Non- Hospitalized -20.42 .01 .05 .001 50 Table 11 GOS Social Scale Groups 30 M 3 + Clinic Visits vs. 32 M Zero Visits 3 F Chronic Organic vs. 34 F Zero Visits 19 45 61 21 M & F Chronic Organic vs. 66 M & F Zero Visits M Non-Chronic Organics vs. 32 M Zero Visits M All Organics vs. 32 M Zero Visits M Physical Injuries with Other Illnesses vs. 32 M Zero Visits 5 F Physical Injuries Only vs. 34 F Zero Visits 32 17 16 30 16 30 comparison of the sick groups with the healthy groups were M All Physical Injuries vs. 32 M Zero Visits F All Physical Injuries vs. 34 F Zero Visits M Hospitalized vs. 32 M Zero Visits M & F Hospitalized vs. 66 M & F Zero Visits M Hospitalized vs. 88 M Non—Hospitalized M & F Hospitalized vs. 174 M & F Non- Hospitalized |t'1' -2.83 -2.40 —2.61 -2.86 -3.67 No other differences on the GOS Social Scale in the statistically significant. .01 .01 .05 .05 .01 .05 .001 .05 .05 .01 .05 .05 .001 51 Table 12 GOS Punitive Scale There were no statistically significant differences for all groups on the GOS Punitive Scale. Table 13 GOS Child Status Scale 9:922 1:— B 45 M Chronic Organic vs. 32 M Zero Visits -2.00 .05 16 M & F PI Only vs. 66 M & F Zero Visits -2.70 .01 14 F Hospitalized vs. 34 F Zero Visits 2.87 .01 14 F Hospitalized vs. 86 F Non-Hospitalized 4.14 .001 No other differences on the GOS Child Status Scale were statistically significant. Table 14 GOS Theoretical—Philosophical Scale Group E_ p_ 19 M & F Chronic Organic vs. 66 M & F Zero Visits Visits —2.83 .01 No other differences on the GOS Theoretical-Philosophi- cal Scale were statistically significant. 52 Table 15 GOS Learning Scale Group 23 F 3+ Clinic Visits vs. 34 F Zero Visits 3 F Chronic Organic vs. 34 F Zero Visits 12 F PI with Other Illnesses vs. 34F Zero Visits 5 F PI Only vs. 34 F Zero Visits 17 F PI All vs. 34 F Zero Visits 14 F Hospitalized vs. 34 F Zero Visits 14 F Hospitalized vs. 86 F Non-Hospitalized Table 16 GOS Feeling Orientation Scale .01 .001 .05 .001 .01 .01 .05 There were no significant differences on the GOS Feeling Orientation Scale between the Sick Groups and the Healthy Groups. Table 17 GOS Interest Scale Group 3 F Chronic Organic vs. 34 F Zero Visits 19 M & F Chronic Organic vs. 66 M & F Zero Visits lfl‘ -2.36 —4.33 .05 .001 53 Table 18 GOS Total Scale Group 19 M & F Chronic Organic vs. 66 M & F Zero Visits 61 M All Organics vs. 32 M Zero Visits Table 19 GOS Negativism-Acquiescence Scale There were no significant differences on the E R -3.56 .001 -2.21 .01 GOS Nega- tivism-Acquiescence Scale between the Sick Groups and the Healthy Groups. Table 20 Grade Point Average (GPA) Group 3 F Chronic Organic vs. 34 F Zero Visits 5 F Physical Injury Only vs. 34 F Zero Visits Table 21 CQT Verbal Score Group 19 M & F Chronic Organic vs. 66 M & F Zero Visits |rf —2.37 2.64 |rf 2.14 .01 .05 .05 54 59 F Non—Chronic Organics vs. 34 F Zero Visits 2.47 .05 62 F All Organics vs. 34 F Zero Visits 2.43 .05 Table 22 CQT Information Score Group p_ p_ 19 M & F Chronic Organic vs. 66 MékF Zero Visits 3.39 .01 Table 23 CQT Numerical Score Group p_ p_ 19 M & F Chronic Organic vs. 66 MERE Zero Visits 3.46 .001 Table 24 CQT Total Score Group p_ p_ 19 M & F Chronic Organic vs. 66 M8:F Zero Visits 3.87 .001 No other differences on the COT scores in the comparison of the Sick Groups with the Healthy Groups were statisti- cally significant. Chapter V Discussion of Results and Conclusions Procedure The t—tests of the GOS scores, GPA (Grade Point Aver- age), and CQT (College Qualification Test) scores of the Sick Groups vs. the Healthy Groups were computed. It was hypothesized that the means of the Sick Groups would be significantly lower than the means of the Healthy Groups. The t-tests of the following Sick Groups and the Healthy Groups were made: 1. 3 + Clinic Visits vs. Zero Visits 2. Chronic Organic vs. Zero Visits 3. Non-Chronic Organics vs. Zero Visits 4. All Organics vs. Zero Visits 5. Physical Injuries with Other Illnesses vs. Zero Visits 6. Physical Injuries Only vs. Zero Visits 7. All Physical Injuries vs. Zero Visits 8. Hospitalized vs. Zero Visits 9. Hospitalized vs. Non-Hospitalized Each of group (Zero 1. 10. 11. 12. 13. 14. 15. GOS GOS GOS GOS GOS GOS GOS GOS GOS GOS GPA CQT CQT CQT CQT 56 the Sick Groups was compared with the control Visits) on the following fifteen variables: Anxiety Scale Social Scale Punitive Scale Child Status Scale Theoretical-Philosophical Scale Learning Scale Feeling Orientation Scale Interest Scale Total Scale (total of GOS l to 8) Negativism-Acquiescence Scale (Grade Point Average) (College Qualification Test) Verbal score Information score Numerical score Total score It was hypothesized that the GOS, GPA and CQT means of the Sick Groups would be significantly lower than the GOS, GPA and CQT means of the Healthy groups. 57 Discussion of Results Table 1 (3 + Clinic Visits) vs. (Zero Visits) The mean of the Male 3 + Visits Group on the GOS Social Scale was significantly lower (.01 level) than the mean of the Male Zero Visits Group. It appears that male subjects who had never visited the clinic and were therefore adjudged healthy, had a higher degree of social understanding than male subjects who had visited the clinic three or more times. (This finding was in line with the hypothesis.) There were no other significant differences on any of the other fourteen variables between the Male 3 + Clinic Visits Group and the Male Zero Visits Group. The GOS Learning Scale mean of the Female 3 + Clinic Visits Group was significantly higher (.01 level) than the GOS Learning Scale mean of the Female Zero Visits Group. It appears that female subjects who had visited the clinic three or more times had a broader concept of learning and a greater degree of recognition of the effects of subconscious learn- ing than female subjects who had never visited the clinic. There were no other significant differences on any of the other fourteen variables. 58 There were no significant differences between the Male and Female 3 + Visits Group and the Male and Female Zero Visits Group. It is interesting to note that, contrary to the hypothesis, the GPA for the Male and Female 3 + Visits Group and the Male and Female Zero Visits Group was the same (2.15). Table 2 Chronic Organic vs. Zero Visits There were no significant differences between the Male Chronic Organic Group and the Male Zero Visits Group on all comparisons. There was a significant difference (.01 level) between the GOS Social Scale mean of the Female Chronic Organics and the GOS Social Scale mean of the Female Zero Visits, in which the mean of the Female Chronic Organics was signifi- cantly higher (.01 level) than the mean of the Female Zero Visits. It appears that female subjects who were chroni- cally ill had a higher degree of social understanding, a greater objectivity in perception of social inter- relationships than female subjects who had never visited the clinic. This finding was contrary to the hypothesis. 59 The GOS Learning Scale mean of the Female Chronic Or— ganic Group was significantly higher (.001 level) than the G08 Learning Scale mean of the Female Zero Visits Group. It appears that female subjects who were chronically ill had a broader concept of learning which included a higher degree of recognition of the effects of subconscious and involuntary learning than the female subjects who had never visited the clinic. This finding was contrary to the hypothesis. The GOS Interest mean of the Female Chronic Organic Group was significantly lower (.05 level) than the GOS Interest mean of the Female Zero Visits Group. It appears that female subjects who had never visited the clinic had a wider scope of interests than female subjects who were chronically ill. This finding was in the expected direction. The GPA mean of the Female Chronic Organic Group was significantly lower (.05 level) than the GPA mean of the Female Zero Visits Group. It appears that chronic illness affected the grade point averages of female subjects who were chronically ill. This was in line with the hypothesis. The GOS Anxiety Scale mean of the Male and Female Chronic Organic Group was significantly lower (.01 level) than the GOS Anxiety Scale mean of the Male and Female Zero 60 Visits Group. It appears that male and female subjects who were chronically ill had a greater amount of anxiety than male and female subjects who had never visited the clinic. (A high score on the GOS Anxiety Scale is an indication of low anxiety; a low score, high anxiety.) This was in line with the hypothesis. The GOS Social Scale mean of the Male and Female Chronic Organic Group was significantly lower (.05 level) than the GOS Social mean of the Male and Female Zero Visits Group. It appears that male and female subjects who had never visited the clinic had a higher degree of social under- standing than males and females who were chronically ill, as hypothesized. The GOS Theoretical-Philosophical mean of the Male and Female Chronic Organic Group was significantly lower (.01 level) than the Male and Female Zero Visits Group. It appears that male and female subjects who had never visited the clinic had a higher degree of development in general philosophical ideas than males and females who were chroni- cally ill, as hypothesized. The GOS Interest Scale mean of the Male and Female Chronic Organic Groups was significantly lower (.001 level) 61 than the GOS Interest Scale mean of the Male and Female Zero Visits Group. It appears that male and female sub- jects who had never visited the clinic had a wider scope of interests than male and female subjects who were chroni— cally ill. The GOS Total Scale mean of the Male and Female Chronic Organic Group was significantly lower (.001 level) than the GOS Total Scale mean of the Male and Female Zero Visits Group. It appears that male and female subjects who had never visited the clinic had a higher degree of personality integration and consistency of general values than male and female subjects who had been chronically ill. The CQT Verbal mean score of the Male and Female Chronic Organic Group was significantly higher (.05 level) than the CQT Verbal mean score of Male and Female Zero Visits Group. It appears that male and female subjects who had been chronically ill had more ability in verbal fluency than male and female subjects who had never visited the clinic. The CQT Information mean score of the Male and Female Chronic Organic Group was significantly higher (.01 level) than the CQT Information mean score of the Male and Female Zero Visits Group. It appears that male and female subjects 62 who had been chronically ill had acquired more information than male and female subjects who had never visited the clinic. The CQT Numerical mean score of the Male and Female Chronic Organic Group was significantly higher (.001 level) than the CQT Numerical mean score of the Male and Female Zero Visits Group. It appears that male and female sub— jects who had been chronically ill had a higher degree of conceptual skill in simple mathematics than male and female subjects who had never been to the clinic. The CQT Total mean score of the Male and Female Chronic Organic Group was significantly higher (.001 level) than the CQT Numerical mean score of the Male and Female Zero Visits Group. It appears that male and female subjects who had been chronically ill had a higher degree of retention and comprehension of vocabulary items, general information items, numerical items as tested by the achievement test CQT Total Scale, than male and female subjects who had never visited the clinic. It should be noted that the preceding four findings on the CQT (College Qualification Test) were unexpected find- ings, all of which were in the direction contrary to the 63 hypothesis. In each case, the chronically ill subjects scored significantly higher on all the CQT scales when the males and females were compared together as one group. It would appear that the chronically ill subjects were better read or were more compulsive students than the male and female subjects who had never visited the clinic. However it is also interesting to note that when males were com- pared with males only, there were no significant differences on any CQT comparison. Table 3 Non—Chronic Organics vs. Zero Visits The GOS Social Scale mean of the Non—Chronic Organic Males was significantly lower (.05 level) than the GOS Social Scale mean of the Male Zero Visits. It appears that male subjects who were not chronically ill had a lesser degree of social understanding than male subjects who had never visited the clinic. This finding was in line with the prediction. The GOS Child Status Scale mean of the Non-Chronic Organic Males was significantly lower (.05 level) than the GOS Child Status Scale mean of the Male Zero Visits. It 64 appears that male subjects who had never visited the clinic had a more positive regard for the abilities of children than male subjects who were not chronically ill (i.e. occasionally ill). The CQT Verbal mean score of the Female Non—Chronic Organic Group was significantly higher (.05 level) than the CQT Verbal mean score of the Female Zero Visits Group. It appears that female subjects who had been occasionally ill had a wider command of the English language and a better chance at succeeding in college in subjects requiring ver— bal fluency than female subjects who had never visited the clinic. There were no significant differences between the Male and Female Non-Chronic Organic and the Male and Female Zero Visits Groups on all comparisons. Table 4 All Organics vs. Zero Visits The GOS Anxiety Scale mean of the Male All Organic Group was significantly lower (.05 level) than the GOS Anxiety Scale mean of the Male Zero Visits Group. It ap- pears that male subjects who were occasionally ill and male subjects who were chronically ill had a greater amount of 65 anxiety than male subjects who had never visited the clinic. This was in line with the prediction. The GOS Social Scale mean of the Male All Organic Group was significantly lower (.01 level) than the Male Zero Visits Group. It appears that male subjects who were occasionally and chronically ill had a lesser degree of social under— standing on the GOS Social Scale than male subjects who had never visited the clinic. This was in line with the prediction. The GOS Total Scale of the Male All Organic Group was significantly lower (.05 level) than the Male Zero Visits Group. It appears that male subjects who were occasionally and chronically ill had a lesser degree of personality in- tegration and consistency of general values than male sub- jects who had never visited the clinic, as expected. The CQT Verbal mean of the Female All Organic Group was significantly higher (.05 level) than the COT Verbal mean of the Female Zero Visits Group. It appears that female subjects who had been occasionally and chronically ill had a better chance at succeeding at subjects requiring verbal \ fluency than female subjects who had never visited the clinic. This finding was contrary to the hypothesis. 66 There was no significant differences between the total groups on all comparisons. Table 5 Physical Injuries with Other Illnesses vs. Zero Visits The GOS Social Scale mean of Male Physical Injuries with Other Illnesses Group was significantly lower (.05 level) than the Male Zero Visits Group. It appears that the male subjects who had an organic illness plus a physical injury had a lesser degree of social understanding than male subjects who had never visited the clinic. This was in line with the hypothesis. The GOS Learning Scale mean of Female PI with O.I. Group was significantly higher (.05 level) than the GOS Learning Scale mean of the Female Zero Visits Group. It appears that female subjects who had an organic illness plus a physical injury had a broader concept of learning and a higher degree of recognition of the effects of subconscious learning than female subjects wno nad never visited the clinic. This finding was contrary to the hypothesis. There was no significant differences between the Male and Female PI with Other Illnesses Group and the Male and Female Zero Visits Group on any comparison. 67 Table 6 Physical Injuries Only vs. Zero Visits There were no significant differences between the Male PI Only and the Male Zero Visits Groups on any comparison. The GOS Social Scale mean of the Female PI Only was significantly (.001 level) higher than the GOS Social Scale mean of the Female Zero Visits Group. It appears that fe— male subjects who had visited the clinic solely for treat- ment of physical injuries had a higher degree of social understanding than female subjects who had never visited the clinic. This was a finding contrary to the hypothesis. The GPA (Grade Point Average) mean of the Female PI Only Group was significantly higher (.05 level) than the GPA mean of the Female Zero Visits Group. It appears that female subjects who had visited the clinic solely for treat- ment of physical injuries were more compulsive or conscien— tious students than female subjects who had never visited the clinic. This finding was contrary to the hypothesis. The GOS Child Status Scale mean of the Male and Female PI Only Group was significantly lower (.01 level) than the GOS Child Status mean of the Male and Female Zero Visits Group. It appears that male and female subjects who had 68 visited the clinic solely for treatment of physical injur- ies had a lesser degree of the recognition of the importance of children than the male and female subjects who had never visited the clinic. This finding was in line with the pre— diction. The point of having the PI Only group was in order to test the variable of accident-proneness as a possible differentiating factor between the groups, but accident proneness did not differentiate on any variable between the males, and only differentiated on two GOS scales and the Grade Point Average between the females, and on only one GOS scale between the total groups when the sexes were combined. Table 7 All Physical Injuries vs. Zero Visits The GOS Social Scale mean of the Male All Physical In- juries Group was significantly lower (.05 level) than the GOS Social Scale mean of the Male Zero Visits Group. It appears that male subjects who had never visited the clinic had greater social understanding than male subjects who had visited the clinic for treatment of an organic illness plus a physical injury or for a physical injury alone. This was in line with the prediction. 69 The GOS Social Scale mean of the Female All Physical Injury Group was significantly higher (.05 level) than the GOS Social Scale mean of the Female Zero Visits Group, in contrast to the Male PI All Group. It appears that female subjects who had never visited the clinic had lesser social understanding than female subjects who had visited the clinic for treatment of an organic illness plus a physical injury or for a physical injury alone. This finding was in the direction opposite to that predicted. The GOS Learning Scale mean of the Female All Physical Injury Group was significantly higher (.01 level) than the GOS Learning Scale mean of the Female Zero Visits Group. It appears that female subjects who had never visited the clinic had a narrower concept of learning and a lower degree of recognition of the effects of subconscious learning than female subjects who had visited the clinic for treatment of an organic illness plus a physical injury or for a physical injury alone. This finding was in the direction opposite to that hypothesized. There were no significant differences between the Male and Female All Physical Injuries and the Male and Female Zero Visits on all comparisons. 70 Table 8 The GOS Social Scale mean of the Male Hospitalized Group was significantly lower (.01 level) than the GOS Social Scale mean of the Male Zero Visits Group. It appears that male subjects who had been hospitalized had a lesser degree of social understanding than male subjects who had never visited the clinic, as expected. The GOS Child Status Scale mean of the Female Hospi— talized Group was significantly higher (.01 level) than the GOS Child Status Scale mean of the Female Zero Visits Group. It appears that female subjects who had been hospitalized had a higher regard for the abilities of children and found their behavior more meaningful than female subjects who had never visited the clinic. This finding was contrary to the hypothesis. The GOS Learning Scale mean of the Female Hospitalized Group was significantly higher (.01 level) than the GOS Learning Scale mean of the Female Zero Visits Group. It appears that female subjects who had been hospitalized had a broader concept of learning than female subjects who had never visited the clinic. This finding was contrary to the hypothesis. 71 The GOS Social Scale of the Male and Female Hospitalized Group was significantly lower (.05 level) than the GOS Social Scale mean of the Male and Female Zero Visits Group. It appears that male and female subjects who had been hos- pitalized had a lesser degree of social understanding than male and female subjects who had never visited the clinic, as expected. Table 9 Hospitalized vs. Non-Hospitalized There were no significant differences between the Male Hospitalized Group and the Male Non-Hospitalized Group on any comparison. The GOS Social Scale mean of the Female Hospitalized Group was significantly lower (.05 level) than the GOS Social Scale mean of the Female Non-Hospitalized Group. It appears that female subjects who had not been hospitalized had a lesser degree of social understanding than female subjects who had been hospitalized, as expected. The GOS Child Status Scale mean of the Female Hospi- talized Group was significantly higher (.001 level) than the GOS Child Status Scale mean of the Female Non-Hospitalized 72 Group. It appears that female subjects who had been hos- pitalized had a higher regard for the abilities of children and found their behavior more meaningful than female sub- jects who had not been hospitalized. This finding was contrary to the hypothesis. The GOS Learning Scale mean of the Female Hospitalized Group was significantly higher (.05 level) than the GOS Learning Scale mean of the Female Non-Hospitalized Group. It appears that female subjects who had been hospitalized had a broader concept of learning than female subjects who had not been hospitalized. This finding was contrary to the hypothesis. The GOS Social Scale mean of the Male and Female Hos- pitalized Group was significantly lower (.001 level) than the GOS Social Scale mean of the Male and Female Non- Hospitalized Group. It appears that male and female sub- jects who had been hospitalized had a lower degree of social understanding than male and female subjects who had not been hospitalized, as expected. It should be noted that the terms "Zero Visits" and "Healthy" indicate that for the past school year of 1959- 1960, the student had not visited the MSU clinic and was therefore assumed not to have had any seriously incapacitating illness, i.e., he was presumed to be healthy. The term "Non-Hospitalized" indicates that for the past school year the student had not been hospitalized at the MSU clinic ( he could have been hospitalized at some other hospital ). The data card had been filled out by the physician, not by the student; perhaps if the student himself had filled out the card it would have been possible to isolate those who had had absolutely no illness of any kind during the period studied. It is well-known that many students with colds or other minor complaints do not bother to go to the MSU clinic for treatment. The GOS Anxiety Scale mean of the Male and Female HOSpitalized GPOUp was significantly lower ( 901 level than the G08 Anxiety Scale mean of the Male and Female Non-Hospitalized Group, as expected. Apparently male and female subjects who had been hOSpitalized had a great deal more anxiety than subjects who had not been hospitalized. The largest t-Value found ( out of 270 t-tests ) was this t between the male and female hospitalized subjects and the male and female non- hospitalized subjects on the G08 Anxiety Scale, a t which was significant beyond the .001 level. 74 05 EzEE t m (0 Significgpp_gt the L001 Lgypl Out of a total of 270 t-tests or 27 group comparisons on ten GOS scores, 32 t-tests were signifi- cant at the .05 level and above. Out of the 32 significant t-tests on the GOS scores, 12 were significant at the .05 level, 12 at the .01 level, and 8 at the .001 level. Out of the 32 significant t-tests, 20 t-tests supported the hypothesis, i.e., the GOS meansoof the Sick Groups were significantly lower than the GOS means of the Healthy Groups. Out of the 8 t-tests significant at the .001 level, 4 t-tests supported the hypothesis, i.e., the G08 means of the Healthy Groups were significantly higher than the GOS means of the Sick Groups. The Sick Groups were significantly different from the Healthy Groups at the .001 level on the following GOS Scales: GOS Anxiety, GOS Social, GOS Child Status, GOS Learning, GOS Interest, and GOS Total Scales. Of these six scales, the G08 Anxiety Scale had the greatest t-value between the male and female hospitalized subjects and the male and female non-hOSpitalized subjects. It may therefore be concluded that the G08 Anxiety Scale was the best of the ten GOS Scales in significantly differentiating between male and female hospitalized subjects and male and female non-hospitalized subjects with regard to anxiety. Table 10 Total of Significant t-tests on the GOS Scales Total no. No. of of t-tests Sig. Sig. on GOS Scales Level t-tests 270 .05 12 270 . Ol 12 270 .001 8 The GOS Anxiety Scale mean of the male and female hospitalized subjects was significantly lower than the G08 Anxiety Scale mean of the male and female non- hospitalized subjects, as expected. This is an indication that the hospitalized subjects manifested greater anxiety on the G08 Anxiety Scale than the non-hospitalized subjects( Table 11 ). 76 Table 11 GOS Anxiety Scale imp. E E 30 M & F Hospitalized vs. 174 M & F Non- Hospitalized -20.42 .001 Table 12 GOS Social Scale G_resp E E 5 F PI Only vs. 34 F Zero Visits 4.06 .001 30 M & F Hospitalized vs. 174 M & F Non—Hospitalized -3.67 .001 The first group comparison above was contrary to the hypothesis. It appears that it was highly significant that female freshmen with physical injuries only had a higher degree of ability in assessing social situations more ob- jectively than female freshmen who had not visited the clinic. The second group comparison was in line with the hypo- thesis, as expected. 77 Table 13 GOS Child Status Scale Group 1; p 14 F Hospitalized vs. 86 F Non-Hospitalized ‘4.14 .001 It appears that it was highly significant that female freshmen who had been hospitalized had a higher regard or more positive regard for abilities of children than female freshmen who had not been hospitalized, contrary to the hypothesis. Table 14 GOS Learning Scale grasp. E E 3 F Chronic Organic vs. 34 F Zero Visits 6.49 .001 5 F Physical Injury Only vs. 34 F Zero Visits 3.92 .001 It appears highly significant that female freshmen who had been diagnosed as chronically ill had a broader concept of learning than female freshmen who had not visited the clinic, contrary to the hypothesis. It appears highly significant that female freshmen who had physical injuries only and were probably accident-prone had a broader concept of learning than female freshmen who had not visited the clinic, contrary to the hypothesis. 78 Table 15 GOS Interest Scale Group E P. 19 M & F Chronic Organic vs. 66 M & F Zero Visits -4.33 .001 It appears highly significant that subjects who had been diagnosed as chronically ill had a narrower range of interests than subjects who had not visited the clinic, as expected. Table 16 GOS Total Scale £13113 E E 19 M & F Chronic Organic vs. 66 M & F Zero Visits -3.56 .001 It appears highly significant that subjects who had been diagnosed as chronically ill had a lower degree of per- sonality integration as indicated by the GOS Total score than subjects who had not visited the MSU clinic, as expected. It may be concluded that there were highly significant differences in GOS Social, Child Status, Learning, Interest, and Total scores between subjects who had reported illnesses 79 and physical injuries and subjects who had not visited the MSU clinic. It was therefore concluded that the GOS Social, GOS Child Status, GOS Learning, and GOS Total scales are the most important of the nine GOS scales in significantly differentiating between the Sick and Healthy Groups. Conclusions on CQT Scores Contrary to the hypothesis, the Sick Groups consistently scored higher on the CQT Total and CQT sub-scores than the Zero Visits Group. Statistically significant differences were found between certain of the Sick Groups and the Zero Visits Group. Significant differences between subjects who had been diagnosed as chronically ill and subjects who had not visited the clinic were found on the CQT Total score. Subjects who had been diagnosed as chronically ill and subjects who had not visited the clinic were significantly different on the CQT Verbal, CQT Information, and CQT Nu- merical scores. In addition, significant differences be- tween occasionally ill females and females who had not visited the clinic were found; also between females who had been either chronically or occasionally ill or both, and females who had not visited the clinic. 80 It appears that subjects with physical illness had a larger fund of general information to draw from than sub- jects who had not visited the clinic, as indicated by their significantly higher CQT Information score. It may be that these chronically ill subjects were wider readers than the healthy subjects (perhaps confinement led them to read more) or else they had better retention. Being more widely read, the chronically ill subjects had a larger command of vocabu- lary as indicated by their significantly higher CQT Verbal score and could be predicted to have a better chance of succeeding in college at subjects requiring verbal ability than the healthy subjects. Chronically ill subjects also had a higher degree of conceptual skill in simple mathematics than subjects who had not visited the clinic, from which it can be predicted that they would have a better chance of succeeding at sub- jects requiring a grasp of mathematical concepts than the healthy subjects. Chronically ill subjects had a significantly higher total achievement score on the CQT Total score, from which it can be Predicted that in general, they would have a better chance at succeeding in college than the subjects who had not visited the clinic. 81 It may be concluded that subjects who took better care of themselves and had reported their illnesses to the clinic were academically brighter than subjects who had not re- ported any illnesses. This finding should be checked with a larger sample. Relevant Findings Terwilliger found that freshmen subjects who had con- sulted school therapists tended to have slightly better grades than freshmen subjects who had not consulted therapists ( 31:288). Assuming that every physical illness has its emotional components and every emotional disturbance has its physical components, a parallel may be drawn between Terwilliger's freshmen submects who had consulted school therapists be- cause of emotional disturbance, and the present investi- gator's freshmen subjects who had consulted school physi- cians for physical disturbances or physical illness. The present investigator obtained a finding contra- dictory to Terwilliger's finding on grades: the Chronic Organic female freshmen had a significantly lower Grade Point Average (GPA) than the Zero Visits freshmen, as hypothesized in the current study. Contrary to the 82 investigator's hypothesis (but similar to Terwilliger's finding above), the other significant comparison between the Sick and Healthy Groups was between the female Physical Injuries Only and the female Zero Visits, with the first group obtaining the significantly higher GPA. It appears that female subjects who had been treated for physical injuries alone were academically more capable than female subjects who had not visited the clinic. These female Physical Injuries Only may or may not have been accident- prone, a variable which could be investigated in future studies in connection with GPA. Terwilliger also found significant differences in Taylor Manifest Anxiety scores, self-satisfaction and self-esteem scores between freshmen who had and who had not consulted therapists, with the former group scoring in the maladjusted direction on the Taylor Scale and obtain- ing lower self-satisfaction and lower self-esteem scores. For comparison purposes, the GOS Anxiety Scale may be considered similar to the Taylor Anxiety Scale. The pres- ent study found results which support Terwilliger's find- ings on anxiety; significant differences between (1) Chronic Organic subjects and Zero Visits subjects and between 83 (2) All Organic males and Zero Visits males, with the Sick Groups manifesting a greater amount of anxiety in both cases. Terwilliger found his subjects who had consulted therapists for emotional disturbances to be more anxious on the Taylor Anxiety Scale, and the present investigator found the Sick Groups mentioned above to be more anxious on the GOS Anxiety Scale, than subjects who had not con- sulted the therapist and subjects who had not visited the MSU clinic. Consistent with Terwilliger's findings is Mechanic and Volkhart's finding that students who perceived themselves to be under high stress were more frequent visitors to the Health Service (i.e. made three or more visits) than those who perceived themselves to be under low stress. Roughly equating the effects of stress with the effects of anxiety, the present study found that the Sick Groups manifested a greater amount of anxiety or perceived them- selves to be under greater stress than the Zero Visits Group. Assuming that Mechanic and Volkhart's observation that students under high stress make more frequent visits to the Health Service than those under low stress applies to the students in the present study, it may then be said 84 that presumably the Sick Groups or subjects who had re- ported for treatment of illness perceived themselves as being under high stress while the Zero Visits Group or subjects who had not reported any illness perceived them- selves as being under low stress. Interestingly enough, these two anxious Sick Groups, i.e. the Chronic Organic subjects and the All Organic male subjects, were also the same groups that achieved a significantly higher CQT Verbal score (higher than the Zero Visits Group). Assuming that the adjusted human being is capable of channeling his anxiety into construc- tive work, it appears that subjects who had been diagnosed as chronically ill were better able to channel their greater amount of anxiety (as indicated by GOS Anxiety scores) into academic work more effectively (as indicated by higher CQT scores) than subjects who had not reported to the MSU clinic. Although Terwilliger's subjects who had consulted therapists had shown dissatisfaction with themselves by their lower self-satisfaction and self-esteem scores, they Were rated as well liked by others as the controls were. The subjects who consulted therapists may also be said to 85 have perceived themselves to be under greater stress (i.e. inferring this from their lower self—satisfaction and self- esteem scores, a reflection of anxiety) than subjects who had not consulted the therapist. Both Terwilliger's subjects who had consulted the ther- apists and the investigator's subjects who had consulted the school physicians therefore may be said to have per- ceived themselves under high stress, while subjects who had not consulted therapists and subjects who had not visited the MSU clinic perceived themselves under low stress. Implications for Research Future studies on illness should separate subjects with reported illness from subjects with unreported illness. Mechanic and Volkhart have shown the importance of finding the "true prevalence" of illness and "reported illness." Their data indicate that frequency of medical visits is a "function of the tendency to adopt the sick role, and only partly a function of stress experience." They found that in general, the "tendency to adopt the sick role" was a more influential variable than stress in deciding the fre- quency of medical visits. They state that "persons with a high inclination to adopt the sick role will, when confronted 86 with given symptoms, seek medical aid more quickly and more frequently than will persons with a lower inclination, provided that medical facilities are equally available" ( 19:55). In View of this finding, Mechanic and Volkhart stress the importance of developing more rigorous research methods to separate the processes leading to symptom for- mation from processes leading persons to seek medical aid ( 19:58). The present study attempted to differentiate between physically ill and physically healthy freshmen, but only actually differentiated between subjects who reported their illnesses and injuries and subjects who may or may not have suffered from minor illnesses and failed to report for treatment at the MSU clinic. Summary of Significance Findings Out of a total of 405 t-tests on fifteen variables (GOS, GPA, CQT) between the Sick and Healthy Groups, 40 were sig- nificant at the .05 level. Of the 40, 16 were significant at the .05 level, 14 at the .01 level, and 10 at the .001 level. Out of 270 t-tests on ten GOS scores, 32 were signifi- cant. Out of these 32, 12 were significant at the .05 level, 87 12 at the .01 level, and 8 at the .001 level. Out of the 32 t-tests, 20 t—tests supported the hypothesis, i.e., the GOS, GPA, and CQT means of the Sick Groups were lower than the means of the Healthy Groups. Out of 27 t-tests on the Grade Point Average (GPA) variable, 2 were significant, 1 at the .05 level and the other at the .01 level. One was in the hypothesized direction. Out of 108 t-tests on the College Qualification Test (CQT) scores, 6 were significant at the .05 level. Of the 6 t-tests, 3 were significant at the .05 level on the CQT Verbal scores; 1 was significant at the .01 level on the CQT Information score; 2 were significant at the .001 level on the CQT Numerical and CQT Total scores. All of the significant findings on the CQT were contrary to the hypo- thesis, i.e., the CQT means of the Sick Groups were higher than the CQT means of the Healthy Groups. In general, findings tended to support the main hypo— thesis, with the Sick Groups manifesting a lesser degree‘ of personality integration on the G08 than the Healthy Groups. 88 Summary of Conclusions Conclusions on the GOS Scales Subjects diagnosed as (l) chronically ill and (2) chronically and occasionally ill manifested significantly greater anxiety as indicated by the GOS Anxiety Scale, than subjects who had not visited the MSU clinic. Subjects classified as (l) chronically ill and (2) chronically and occasionally ill and (3) subjects with three or more clinic visits and (4) hospitalized subjects manifested less social understanding and less ability to assess social situations objectively on the GOS Social Scale, than subjects who had not visited the MSU clinic. Contrary to expectation, subjects with (1) physical injuries only and subjects with (2) organic illness and physical injuries and (3) female subjects with chronic organic illness manifested a greater degree of social understanding and ability to assess social situations objectively on the GOS Social Scale, than subjects who had not visited the clinic. Groups were not significantly different in their orientation to punishment as a solution to problems on the GOS Punitive Scale. 89 Male subjects who had been diagnosed as chronically ill and subjects who had physical injuries only had a lower regard for the abilities of children on the GOS Child Status Scale, than subjects who had not visited the clinic. Contrary to expectation, female hospitalized subjects manifested a higher regard for the abilities of children on the GOS Child Status Scale, than female subjects who had not visited the clinic and had not been hospitalized. Subjects diagnosed as chronically ill manifested a lesser degree of develOpment of general philosophical ideas and a lesser degree of consistency in general philosophical thinking on the GOS Theoretical-Philosophical Scale, than subjects who had not visited the MSU clinic. Contrary to expectation, subjects with (1) three or more clinic visits and (2) chronic organic illness and (3) organic illness and physical injuries and (4) physical injuries only and (5) organic illness and physical injuries or physical injuries only and (6) hospitalized subjects manifested a broader concept of learning on the GOS Learning Scale, than subjects who had not visited the MSU clinic and subjects who had not been hospitalized. Groups were not significantly different on the G08 90 Feeling Orientation Scale in their perception of feeling as a "valid indicator in indicating appropriateness of response." Subjects diagnosed as chronically ill manifested a narrower range of interests on the G08 Interest Scale, than subjects who had not visited the MSU clinic. Subjects diagnosed as chronically and occasionally ill manifested a lesser degree of personality integration and a lower consistency of general values on the GOS Total Scale than subjects who had not visited the MSU clinic. Groups were not significantly different on the GOS Negativism-Acquiescence Scale. Apparently there was no difference between subjects who had reported illnesses and subjects who had not reported any illness in agreement— disagreement response tendency on the GOS. Conclusions on the GPA Female subjects who had been diagnosed as chronically ill obtained significantly lower Grade Point Averages (GPA) than female subjects who had not visited the clinic, as expected. Contrary to the hypothesis, female subjects who had physical injuries only obtained significantly higher GPA than female subjects who had not visited the clinic. 91 Apparently female freshmen who were accident-prone and had reported these accidents were also academically more able than female freshmen who had not reported any physical injuries. Conclusions on CQT Scores Contrary to the hypothesis, the physically ill subjects consistently scored higher on all the CQT scores (CQT Total and sub-scores) than subjects who had not visited the clinic. Subjects who had been diagnosed as chronically or occasion- ally ill or both, obtained significantly higher CQT Verbal scores than subjects who had not visited the clinic. Subjects who had been diagnosed as chronically ill obtained significantly higher CQT Information, CQT Numerical and CQT Total scores than subjects who had not visited the MSU clinic. It appears that subjects who had been diagnosed as chronically ill did not use illness as an escape from academic duties. It may be concluded that the chronically ill subjects had a larger command of vocabulary, a larger fund of general information, a higher degree of conceptual skill in simple mathematics, and a better chance of succeeding in college than subjects who had not visited the MSU clinic. Chapter VI Summary of the Study Hypotheses It was hypothesized that individuals susceptible to illness, as indicated by hospital visits, would differ significantly from physically healthy individuals, as indicated by absence of hospital visits, in their patterns of responses elicited by General Opinion Survey statements designed to indicate degree of personality integration. Subjects A representative sample was drawn from the Michigan State University (MSU) freshmen. There were 104 men and 100 women, all single American citizens within the confines of the campus. Groups Compared Subjects were classified into two main categories: the Sick Group and the Healthy Group. The classification was based on the information obtained from a data card filled out for each subject by the Director of the MSU Health Service, Dr. J. S. Feurig. 93 The following Sick Groups were compared with the Healthy controls (Zero Visits and Non—Hospitalized Groups): 1. (3 + Clinic Visits) vs. (Zero Visits) 2. (Chronic Organic) vs. (Zero Visits) 3. (Non-Chronic Organic) vs. (Zero Visits) 4. (All Organic) vs. (Zero Visits) 5. (Physical Injuries with Other Illnesses) vs. (Zero Visits) 6. (Physical Injuries Only) vs. (Zero Visits) 7. (All Physical Injuries) vs. (Zero Visits) 8. (Hospitalized) vs. (Zero Visits) 9. (Hospitalized) vs. (Non-Hospitalized) Eliminations Subjects with Structural Defects Only and Physical Injuries Only were eliminated from comparisons one to five above because they did not seem to fall clearly into either the sick or healthy category. Subjects with a diagnosis of Psychosomatic Illness were also eliminated from comparisons one to seven in order that the Sick Groups would be composed only of subjects with organic illness. 94 Comparisons The sexes were compared both separately, and in a com— bination, for every group comparison. The Sick Groups were compared with the Healthy Groups by the t-test on fifteen variables. The fifteen variables tested were the General Opinion Survey scores (Anxiety, Social Understanding, Puni- tive, Child Status, Theoretical-Philosophical, Learning, Feeling Orientation, Interest, Negativism-Acquiescence, Total), the Grade Point Average (GPA), the College Qualifi— cation Test (CQT) scores (Verbal, Information, Numerical, and Total). It was specifically hypothesized that the GOS, GPA, and CQT mean scores of the Sick Groups would be signifi- cantly lower than the GOS, GPA, and CQT means of the Healthy Groups. Conclusions on the GOS Scales In general, results of t-tests tended to support the hypothesis. Out of 270 t-tests on the ten GOS scales, 32 were significant: 12 at the .05 level, 12 at the .01 level, and 8 at the .001 level. It was concluded that there were highly significant differences in the GOS personality test scores between subjects who had reported their illnesses 95 and subjects who had not reported any illnesses to the MSU clinic. Of the GOS scales, the G08 Anxiety, Social, Child Status, Status, Learning, Interest and Total scales were concluded to be the most useful in significantly differen- tiating (.001 level) between the physically ill freshmen and the freshmen who had not visited the clinic. Conclusions on the GPA Out of 27 t—tests on the Grade Point Average (GPA) veriable, 2 were significant (.05 and .01 levels). It was concluded that female subjects who had been diagnosed as chronically ill obtained lower GPA probably partly due to chronic illness, but this finding should be checked with a larger sample. An interesting finding which should be checked with a larger sample was the finding that female subjects with physical injuries only obtained significantly higher GPA than female subjects who had not visited the clinic. It was concluded that accident-proneness and its relationship to illness should be investigated. Conclusions on the CQT Scores Out of 108 t-tests on the CQT scores, 6 were significant (3 at the .05 level on the CQT Verbal score, 1 at the .01 level on the CQT Information score, 2 at the .001 level on 96 the CQT Numerical and CQT Total scores). All of the sig- nificant findings on the CQT were contrary to the hypothesis. It was concluded that subjects who had reported their ill- nesses to the clinic were better academic material and had a greater chance of succeeding in college than subjects who had not reported any illnesses to the MSU clinic. General Conclusion It may be concluded that for the sample studied, fresh— men subjects who had been diagnosed as suffering from physi- cal ailments manifested a lesser degree of personality integration as indicated by the GOS, than subjects who had not visited the MSU clinic. Apparently there exists a highly significant relation- ship between organic illness and personality integration as measured by the General Opinion Survey. Subjects suscepti- ble to illness differed significantly in their patterns of responses on the GOS from subjects who had not reported any illness. Bibliography 1. American Psychiatric Glossary. Wash., D.C.: American Psychiatric Association, 1957. 2. Bell, Alice, §p_§l, The use of projective techniques in the investigation of emotional aspects of general medical disorders: Part I. The Rorschach method. Journal of Projective Techniques, 1952, léj 428-443. t g1, The use of projective techniques 3. Bell, Alice, in the investigation of general medical disorders: Part II. Other projective techniques and suggestions for experimental design. Journal of Projective Techniques, 1953, lZJ 51-60. 4. Bernstein, Lewis, & Chase, Philip H. The discriminative ability of the Blacky Pictures with ulcer patients. J. Consult. Psychol., 1955, i2, 377-380. 5. Dunbar, F. Emotions and bodily changes: A survey of literature on psychosomatic interrelationships 1910-1953. 4th Edition. N. Y.: Columbia Univ. 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The loss of parents and psychosomatic illness. Sociology and Soc. Research, 1955, 39, 404-408. 102 34. ‘Waxenberg, S. Psychosomatic patients and other physically ill persons: a comparative study. g, Consult. Psychol., 1955, 12, 163—169. 35. Wheeler, J., & Caldwell, Betty M. Psychological evaluation of women with cancer of the breast and of the cervix. Psychosomatic Medicine, 1955, ll, 256-268. 36. Winter, W. Two personality patterns in peptic ulcer patients. J. Proj. Tech., 1955, 332-344. Appendix Table 1 Means and Standard Deviations of the Three-+ Clinic Visits Group on Fifteen Measures Measures 605 605 GOS 605 603 605 GOS 605 605' 608 GPA COT CQT COT CQT ANXIEIY SOCIAL PUNITIVE CHILD s. THEORETICAL LEARNING FEELING INTEREST TOIAL . ' NEG.-ACOUI£s. VERBAL . INEORNATION' NUMERICAL TOTAL Males (30) X 10.66 7.77 7.46 4.90 10.25 6.45 5.17 4.87 61.60 . 65.40 2.07 42.17 49.30 31.15 122.60 6.92 “1.91 5.00' 1.79 2.26 1.91 1.10 1.48 9.88 11.71 .72 11.32 9.05 9.05 22.79 Females (23) I 11.08 8.87 7.91 5.25 10.55 7.55 5.22 5.15 55.59 68.43 2.26 47.48 45.95 24.55 116.09 C?" 5.04 2.15 2.08 1.52 2.85 1.58 1.50 1.29 8.54 7.59 .59 10.99 8.58 8.97 20.91 Total (53) i ' ,1.- 10.84 4.45 8.24 2.09 7.64 2.65 5.06 1.73 10.41 2.54 6.96 1.87 5.19 1.29 4.98 1.41 63.66 9.65 66.72 10.21 2.15 .67 44.47 11.48 46.98 9.14 28.32 9.57 119.77 22.23 Table 2 Means and Standard Deviations of the Chronic Organic Group on Fifteen Measures Measures GOS ANXIETY GOS SOCIAL GOSIPUNITIVE GOS CHILD S. 608 THEORETICAL GOS LEARNING GOS FEELING GOS INTEREST GOS TOTAL GOS'NEC.-ACQUIES. COT VERBAL COT INFORMATION. CQT NUMERICAL COT TOTAL Males (16) i 6" 9.25 4.43 7.69 1.68 6.50 2.23 5.12 1.83 8.87 2.23 5.87 1.99 4.81 1.38 3.87 1.32 56.19 10.22 59.12 11.54 2.44 .66 48.75 9.98 55.44 5.50 37.44 7.33 16.12 141.62 -\ Females (3) X 10.33 10.67 8.00 4.33 10.67 8.33 5.33 4.33 68.00 71.67 1.74' 42.33 40.67 28.00 111.00 4... 1 I. 1 5.51 2.05 .82 1.70 .94 .47 .94 1.25 1.55 5.25 .55 5.85 7.41 5.15 17.58 Total (19) i 6' 9.42 4.50 8.15 2.05 5.74 2.15 5.00 1.85 9.15 2.18 5.25 2.05 4.89 1.55 5.95 1.52 58.05 10.54 59.55 10.74 2.55 .71 47.74 9.85 55.10 7.95 55.95 7.94 155.79 19.78 Table 3 Means and Standard Deviations of the Non-Chronic Measures 605 605 GOS GOS GOS GOS 608 608 GOS GOS GPA CQT CQT CQT CQT ANXIETY SOCIAL PUNITIVE CHILD S. THEORETICAL LEARNING FEELING INTEREST TOTAL . NEG.-ACQUIES. . VERBAL. INTORNATION' NUMERICAL TOTAL Males (45) X 10.71 8.07 7.47 4.58 10.55 7.02 4.91 4.80 52.58 58.18 2.05 45.20 49.09 51.50 123.89 4.04 2.23 2.89 2.07 2.77 1.65 1.35 1.64 10.68 11.56 .67 12.66 9.86 9.14 25.20 Females (59) X 11.67 9.02 8.15 5.37 10.61 7.05 5.07 5.52 66.66 68.00 2.27 47.98 43.66 25.12 116.76 (T 4.52 2.25 2.55 1.55 2.58 1.85 1.55 1.50 10.55 8.55 .59 12.85 8.09 9.55 24.95 Organic Group on Fifteen Measures Total (104) X 11.25 8.60 7.85 5.03 10.50 7.04 5.00 5.21 64.89 68.08 2.17 45.91 46.01 27.92 119.84 67 4.55 2.50 2.75 1.89 2.55 1.75 1.55 1.50 10.59 10.02 .55 12.99 9.50 9.91 25.29 Table 4 Means and Standard Deviations of the All Organics Group on Fifteen Measures Males (61) Females (62) Total (123) Measures ‘i 6‘ i 9‘ I 0 G08 ANXIETY 10.52 4.19 11.51 4.57 10.97 4.44 GOS SOCIAL 7.97 2.11 9.10 2.28 8.54 2.27 603 PUNITIVE 7.21 2.75 8.14 2.50 7.58 2.57 GOS CHILD s. 4.72 2.02 5.52 1.57 5.02 1.88 GOS THEORETICAL 9.97 2.72 10.51 2.55 10.29 2.55 GOS LEARNING 5.72 1.82 7.11 1.80 5.92 1.82 GOS FEELING 4.88 1.55 5.08 1.55 4.98 1.50 GOS INTEREST 4.55 1.51 5.47 1.51 5.02 1.55 GOS TOTAL 50.90 10.95 55.72 10.12 55.84 10.92 GOS NEG.-ACOUIES. 58.45 11.51 58.18 8.59 58.50 10.15 GPA ' i 2.14 .59 2.24 .50 2.19 .55 COT VERBAL 44.55 12.25 47.71 12.59 45.19 12.57 COT INFORMATIONv 50.75 9.55 45.51 8.09 47.10 9.45 COT NUMERICAL 55.15 9.07 25.25 9.44 V29.15 10.05 CQT TOTAL 128.54 24.44 115.48 24.55 122.45 25.28 IMeans and Standard Deviations of the Physical Injuries Table 5 with Other Illnesses Group on Fifteen Measures Measures GOS AADIIETY GOS'SOCIAL GOS PUNITIVE GOS CHILD s. GOS THEORETICAL GOS LEARNING GOS FEELING GOS INTEREST 508 TOTAL 603' NEe.-ACOUIES. GPA CQT VEEFzBAL CQT INFORMATION, CQT NUMERICAL Males (21) i CS" 10.90 3.71 8.09 1.57 7.86 2.35 4.86 2.31 10.24 2.76 6.81 1.81 5.00 1.27 5.00 1.63 63.28 9.83 66.43 11.51 2.13 '.75 42.19 12.25 50.43 9.37 30.38 8.34 123.00 25.10 Females (12) X 13.50 9.58 7.92 6.00 10.92 7.50 5.08 5.92 70.83 64.83 2.29 46.50 42.25 23.08 111.83‘ O" 5.57 2.29 2.95 2.00 2.45 1.75 1.55 1.55 10.15 7.97 .75 11.70 5.94 11.55 21.50 Total (33) I 9 11.84 3.87 8.54 2.00 7.88 2.58 5.27 2.27 10.48 2.57 7.05 1.82 5.05 1.42 5.55 1.55 55.05 10.58 55.85 10.59 '2.19 .75 45.75 12.25 47.45 9.45 27.75 10.15 118.94 24.45 Table 6 Means and Standard Deviations of the Physical Injuries Only Group on Fifteen Measures Measures GOS AIEIIETY 603. SOCIAL GOS PUNITIVE GOS CHILD s. 603 THEORETICAL GOS LEA RNING GOS FEELING GOS INTEREST GOS TOTAL 603' NEG .-ACQU IEs. GPA CQT VERBAL CQT INFORMATION. CQT NUMERICAL CQT TOTAL Males (11) X 11.18 7.09 7.18 4.09 8.64 5.91 4.45 5.09 57.54 64.27 2.30 46.00 52.27 31.64 129.91 61 4.80 3.06 2.72 1.83 ‘3.34 2.68 1.67 2.15 16.06 12.98 .74 15.86 8.38 11.08 27.98 X 12.50 10.80 7.40 4.40 11.50 7.80 5.80 4.80 70.00 59.80 2.52 48.80 48.80 25.40 121.00 Females (5) 4.67 .98 1.02 1.96 3.26 .75 .75 1.17 9.45' 6.70 .48 14.80 12.92 6.77 20.30 Total‘(l6) X (e 11.62 4.80 8.25 3.11 7.25 2.33 4.19 1.88 9.56 3.59 7.19 2.30 4.87 1.58 5.00 1.90 61.44 15.45 66.00 11.68 2.40 .69 46.87 15.59 51.19 10.15 29.06 10.64 26.15 127.12 Table 7 Means and Standard Deviations of the All Physical Injuries Group on Fifteen Measures Measures GOS ANXIETY 503 SOCIAL GOS PUNITIVE GOS CHILD s. 009 THEORETICAL 509 LE¥\.RNING eos FEELING. GOS INT 1:121:97 . 603 TOTAL GOS NEG .-ACQUIES. GPA 001 VERBAL CQT INFORMATION 091' NUMERICAL CQT TOTAL Males (32) 51 11.00 7.75 7.52 4.59 9.59 6.84 4.81 5.03 51.31 65.69. 2.19 43.50 51.06 30.81 125.37 6‘ 4.12 2.25 2.51 2.19 3.07 2.15 1.44 1.83 12.63 12.08 .75 13.72 9.09 9.39 26.33 Females (17) X 13.23 9.94 7.75 5.53 11.12 7.59 5.29 5.59 70.59 55.29 2.39 47.18 44.18 23.18 114.53 1 O“ 3.94 2.07 2.53 2.12 2.74 1.54 1.48 1.54 9.95 .95 .70 12.73 9.59 10.20 21.56 Total (49) X 11.37 4.20 8.51 2.42 7.57 2.52 4.92 2.21 10.18 3.03 7.10 1.99 4.98 1.48 ‘5.22 1.75 54.53 12.57 55.90 10.83 ,2.25 .74 44.77 13.50 48.57 9.83 28.15 10.34 121.51 25.31 Means and Standard Deviations of the Hospitalized Group on Fifteen Measures Measures GOS ABEKIETY GOS SOCIAL cos PU N ITIVE GOS CHILD s. GOS THEORETICAL 30$ LEA RNING .eos FEELING GOS INTEREST ‘ GOS TOTAL 303 "£43 .-ACQUIES. CH: CQT VERBAL CQT INFORMATION CQT "U H ER ICAL CQT TOTAL Table 8 Males (16) X 10.43 7.55 7.12 4.37 9.37 5.44 4.87 4.94 59.52 59.87 2.12 45.44 51.31 35.00 132.75 C“ 4.66 1.80 3.10 2.37 2.09 1.73 .93 1.52 10.60 10.06 .61 13.17 8.66 7.19 22.90 Females (14) X 11.71 8.07 8.57 5.35 10.71 7.78 5.07 5.35 57.93 57.28 2.21 45.14 42.00 23.14 110.28 (7 4.66 2.49 2.53 1.34 2.18 1.93 1.62 1.34 10.50 9.99 .51 11.29 7.62 8.90 18.90 Total (30) X 11.03 4.70 7.80 2.17 7.80 2.94 5.30 2.19 10.00 2.23 7.07 1.95 4.97 1.30 5.13 1.45 53.50 11.34 58.57 10.11 2.15 .57 45.83 12.34 45.97 9.42 29.47 9.98 122.27 23.92 Table 9 Means and Standard Deviations of the Non— Hospitalized Group on Fifteen Measures Measures GOS GOS GOS GOS GOS GOS 'Cos _ GOS , GOS ' GOS GPA CQT CQT CQT CQT ANXIETY SOCIAL PUNITIVE CHILD S. THEORETICAL LEARNING FEELING INTERE8T TOTAL NEG.-ACQUIES. VERBAL INFORMATION NUMER ICAL TOTAL Males (88) ' E 11.07 8.49 73.35 5.00 10.19 699.90 4.84 4.79 62.84 66.95 2.15 44.49 50.98 32.48 127.60 6‘. 4.05 2.61 2.59 2.05 3.27 1.92 1.57 1.87 12.78 11.73 .77 12.52 9.37 10.80 26.23 Females (86) 2 11.57 9.30 7.71 5.07 10.65 6.82 5.29 5.42 66.22 68.66 2.26 46.01 44.13 25.78 115.92 4.81 2.21 2.59 1.79 2.85 1.50 1.55 1.59 11.91 8.57 .55 13.25 9.15 9.94 25.50 Total (174) X 11.32 8.89 7.53 5.03 10.42 6.86 5.06 5.10 64.51 67.80 2.20 45.24 47.59 29.17 121.83 C? 4.45 2.45 2.55 1.93 3.08 1.77 1.53 1.81 12.47 10.37 .71 12.91 9.88 10.91 25.57 5'” Means and Standard Deviations of the Zero Visits Measures GOS ANXIETY G08 QOCIAL GOS GOS PUNITIVE CHILD S. THEORETICAL LEARNING ‘FEELING INTEREST TOTAL ‘* NEG.-A00UIES. VERRAL INFORMATION NUMERICAL TOTAL Table 10 Group on Fifteen Measures Males (32) 56.75 68.53 10.79 2.1? .83 44.62 12.08 51.12 9.35 32.78 1012.91 27.59 Females (54), X O" 11.55 ' 5.19 8.91 2.33 '7.35 3.05 5.15 2.00 5.47 1.75 41.91' 43.52 9.49 95.95 111.79 25.07 10.82 'Total 43.23 47.25 29.49 119.45 1.71 Means and Standard Deviations of the Zero Visits Measures GOS .808 GOS 509 GOS ANXIETY QOCIAL PUNITIVE CHILD 9 THEORETICAL LEARNING INTEREST TOTAL VERPAL INFORMATION NUMERICAL TOTAL 1." . 'FEELING Table 10 Group on Fifteen Measures Males (32) N1 66.75 66.53 44.62 51.12 32.78 127.59 12.08 9.35 1012.91 27 .59 Females (54) XI 5.35 65.56 68.70 2.18 41.91' 43.69 25.95 111.79 3.32 9.49 10.89 25.07 Total >« 11.84 9.20 7.45 5.33 10.67 (A o q ‘0 5.20 5.29 55.14 57.55 2.15 43.23 47.26 29.42 119.45 (66) 1.71 1.94 18.54 10.21 .76 19.24 10.14 11.97 27.44 Table-ll The t-tests of Thirty Male 3 + Clinic Visits Group vs. Thirty—two Male Zero Visits Group ‘Measures ~ t 603 ANXIETY - 1.443510 3 cos SOCIAL - 2.834990*8- L -l 008 PUNITIVE - .170537 GOS CHILD s. - 1.155770 GOS THEORETICAL - .552340 cos LEARNING - 1.139540 GOS FEELING + .705840 605 INTEREST - .750739 . 503 TOTAL - 1.589350 GOS NEG.-ACQUIES. 4 .354512 GPA , - .238288 CQT VERBAL - .759855 COT INFORMATION - .725499 CQT NUMERICAL - .575052 CQT TOTAL ' - .734187 *: Significant at the .05 level. **: Significant at the .01 level. ***: Significant at the .001 level. Table-12 The t-tests of Twenty-three Female 3 + Clinic Visits Group vs. Thirty-four Female Zero Visits Group Measures 1 GOS ANXIETY ‘ - .417982 GOS soc IAL - .080485 603 PUNITIVE + .938759 803 CHILD S. + .268906 GOS THEORETICAL + .085801 GOS LEARNING + 3.224900 ** ' eos FEELING - .585471 GOS INTEREST ' - .595040 ' GOS TOTAL . 4. .290537 605 NEG.-ACQUIES. - .139778 GPA + .553133 CQT VERBAL 4» 2.153570 * CQT INFORMATION + .170506 CQT NUMERICAL '.7 22475 CQT TOTAL + .831257 Table_l3 The t-tests of Fifty-three Male and Female 3 + Clinic Visits Group vs. Sixty-six Male and Female Zero Visits Group I GOS Measures 2 GOS ANXIETY - .804059 GOS SOCIAL - 1.587132 GOS PUNITIVE + .254905 GOS CHILD S. - .535102 GOS THEORETICAL - .341592 005 LEARNING + .335056 GOS FEELING - .025032 GOS INTEREST - .730209 TOTAL - .848414 GOS NEG.-ACQUIES. & .325875 GPA .OOO COT VERBAL + .382742 CQT INFORMATION - .107531 CQT NUMERICAL - .392248 CQT TOTAL + .049294 Alf—- I Table 14 The t-tests of Sixteen Male Chronic OrganicsA vs. Thirty-two Male Zero Visits Measures 3 GOS ANXIETY ' - 1.095780 GOS SOCIAL - 1.711580 GOS PUNITIVE - .782107 GOS CHILD S. . - .355002 _ GOS THEORETICAL - 1.334980 GOS LEARNING - .947975 GOS FEELING _ - .118500 GOS INTEREST ' - 1.533070 ,GOS TOTAL - 1.583350 GOS NEG.-ACQUIES. + .379348 GPA + .789199 CQT VERBAL + .575903 CQT INFORMATION + 1.232180 CQT NUMERICAL + 1.000450 CQT TOTAL + 1.354440 The t-tests of Three Female Chronic Organics Table'IS 'vs. Thirty-four Female Zero Visits Measures GOS GOS GOS GOS GOS GOS GOS GOS . GOS GOS GPA CQT CQT CQT CQT ANXIETY SOCIAL PUNITIVE CHILD S. THEORETICAL LEARNING FEELING INTEREST TOTAL NEG.-ACQUIES. VERBAL INFORMATION NUMERICAL TOTAL 4. E -.811929 2.853980 ** 1.175840 1.580290 .132222 5.494900*** .380208 2.352540*-' .995058 1.372180 2.370230* .150718 1.255290 .748471 .135018 Table'lO The t-tests of Nineteen Male and Female Chronic Organics vs. Sixty-six Male and Female Zero Visits Measures t 605 ANXIETY = - 2.755150 ** Gos SOCIAL - 2.397850*‘ GOS PUNITIVE - 1.515040 GOS CHILD S. - - .875337 GOS THEORETICAL - 2.831230 H GOS LEARNING - 1.459870 GOS FEELING - ‘ - 1.072550 GOS INTEREST - 4.333610*** . GOS TOTAL - 3.555330*** GOS NEG.-ACOUIES. + .923584 GPA + 1.274420 CQT VERBAL + 2.1455908- CQT INFORMATION + 3.394540*8 CQT NUMERICAL + 3.4575504-H COT TOTAL + 3.869670*** Table'2O The t-tests of One Hundred Four Male and Female Non-Chronic Organics vs. Six Male and Female Zero Visits Measures 3 GOS ANXIETY - 2.222880*’ GOS SOCIAL - 2.857350** GOS PUNITIVE - .626883 GOS CHILD.S. ' - 1.732550 GOS THEORETICAL - 1.085590 GOS LEARNING - .735979 GOS FEELING - .089247 GOS INTEREST - 1.627080 ’ GOS TOTAL - 2.211410 GOS NEG.-ACQUIES. + .790817 GPA + .116953 CQT VERBAL + .011352 CQT INFORMATION - .181801 CQT NUMERICAL + .142926 CQT TOTAL + .164559 Table'26 The t-tests of Eleven Male Physical Injuries Only vs. Thirty—two Male Zero Visits Measures 3 ' GOS ANXIETY - .433204 GOS SOCIAL - 1.553340 GOS PUNITIVE - .293588 GOS CHILD S. - 1.595080 GOS THEORETICAL - 1.303500 GOS LEARNING - .072327 GOS FEELING - .574353 .603 INTEREST - .125843 , GOS TOTAL - 1.218710 GOS NEG.-ACQUIES. - .368637 GPA + .498531 CQT VEREAL + .185444 CQT INFORMATION + .281451 CQT NUMERICAL - .211382 CQT TOTAL +p .172747 Table-27 The t-tests of Five Physical Injuries Only. vs. Thirty-four Female Zero Visits Measures 3 GOS ANXIETY + .709030 GOS SOCIAL + 4.060830*** GOS PUNITIVE + .085555 GOS CHILD S. - 1.254120 GOS THEORETICAL + 1.015040 GOS LEARNING + 3.92355011-H GOS FEELING ' + .939003 GOS INTEREST - 1.254780 GOS TOTAL + 1.310470 GOS NEG.-ACGUIES. + .471534 GPA + 2.5370708 CQT VERBAL + 1.517530 CQT INFORMATION + 1.429290 -COT NUMERICAL - 1.143200 CQT TOTAL + 1.387010 .- '— i Table-28 The t—tests of Sixteen Male and Female Physical Injuries Only vs. Sixty—six Male and Female Zero Visits Measures 3 GOS ANXIETY - .220037 k GOS SOCIAL - 1.508170 5“ GOS PUNITIVE - .373740 GOS CHILD S. - 2.703930‘** GOS THEORETICAL - 1.454710 GOS LEARNING + .885438 GOS FEELING ' - .943839 _ GOS INTEREST - .703743 GOS TOTAL - 1.468280 GOS NEG.-ACQUIES. - .682305 GPA + 1.626940 CQT VERBAL + 1.157990 CQT INFORMATION + 1.798040 CQT NUMERICAL - .150739 CQT TOTAL + 1.339930 Table'29 The t-tests of Thirty—two Male All Physical Injuries vs. Thirty-two Male Zero Visits Measures 2 GOS ANXIETY - .9786§§ GOS SOCIAL - 2.447490% GOS PUNITIVE + .080189 ;_ GOS CHILD s. - 1.425720 GOS THEORETICAL - 1.088370 GOS LEARNING - .255093 GOS FEELING - .221044 GOS INTEREST - .335311 GOS TOTAL - 1.431280 GOS NEG.eAC0UIEs. - .240103 GPA ’ + .299731 COT VERBAL - .283043 CQT INFORMATION - .021779 CQT NUMERICAL - .528981 CQT TOTAL - .276615 .A-Fw Table'33 The t-tests of Fourteen Female Hospitalized vs. Thirty-four Zero Visits Measures 3 GOS ANXIETY + .125731 GOS SOCIAL - 1.387730 GOS PUNITIVE + 1.748610 'w, GOS CHILD S. + 2.873140 ** GOS THEORETICAL + .172809 GOS LEARNING - + 2.764790 ** GOS FEELING ' .949360 GOS INTEREST + .024633 GOS TOTAL + .763595 ' GOS NEG.-ACQUIES. - .580058 GPA + .201096 ‘CQT VERBAL + 1.097990 CQT INFORMATION - .756788 CQT NUMERICAL - 1.265200 CQT TOTAL - .273979 Table-35 The t-tests of Sixteen Male Hospitalized vs. Eighty- eight Male Non-Hospitalized Measures 3 GOS ANXIETY - .485235 GOS SOCIAL - 1.579310 7;_ GOS PUNITIVE‘ - .253058 GOS CHILD S. - .939344 GOS THEORETICAL - 1.250900 GOS LEARNING - .910484 GOS FEELING , + .100558 GOS INTEREST * + .332053 GOS TOTAL - 1.025920 GOS NEG.-ACQUIES. + .985984 GPA - .154587 CQT VERBAL + .517832 CQT INFORMATION + .130989 CQT NUMERICAL + 1.129350 CQT TOTAL ' + .755203 Table’36 The t—tests of Fourteen Female Hospitalized vs. Eighty-six Female Non—Hospitalized Measures 3 GOS ANXIETY + .144327 GOS SOCIAL -- 2.395190*- GOS PUNITIVE + 1.577130 GOS CHILD S. _ + 4.145340*** GOS THEORETICAL + .119471 GOS LEARNING + 2.445090*- GOS FEELING - .636417 GOS INTEREST - .196895 GOS TOTAL + .741492 GOS NEG.-ACQUIES. - .572937 GPA - .429485 CQT VERBAL - .347054 CQT INFORMATION - 1.249440 CQT NUMERICAL - 1.356890 CQT TOTAL - 1.278170 Table 37 The t-tests of Thirty Male and Female Hospitalized vs. One Hundred and Seventy-four Male and Female Non—Hospitalized Measures 3 GOS ANXIETY -20.419600 *** GOS SOCIAL - 3.668990 *** GOS PUNITIVE +. .725199 GOS CHILD S. + .979844 GOS THEORETICAL - 1.261020 GOS LEARNING + .848674 GOS FEELING - .484871 GOS INTEREST . + .145191 GOS TOTAL - .658233 GOS NEG.-ACQUIES. + .652200 GPA ’ - .492868 CQT VERBAL + .359866 CQT INFORMATION - .494943 CQT NUMERICAL + .222652 CQT TOTAL + .135425 1A; ROOM USE ONLY Iq‘fi ,) f _ pv .2-27195 {5.3; a ”‘47:“; '- - 4)" : 31.8%? v— « .3; HICHIGQN STATE UNIV. 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