A PSYCHCLOGECAL STUDY 0? MOTHERS OF ASTHf-f Hie: CHEAQREN BY ' MAM’izi‘é MARGOLIS Thesis for the Degree cf Ph. D‘ MEOHIGAN SKATE. UNWERSHY MARVIN MARGOLIS 1959 ”an LIBRARY Michigan Sm: Univessity i '1 A PSYCHOLOGICAL STUDY OF "OTHERS 0F ASTHNKTIC CHILDREN by mvm moms A.THESlS Submitted to tin School of Bruduato Studies of iiichigm Stat. flnlvorslty of Agriculture and Applied Sci-nee in partial fulfillment of the requirunnnts for the degree of DOCTOR 0F 'HILOSOPHY Department of Psychology 3959 ' ACKi-ZOHLEDGMENT The writer is indebted to the members of his Guidance Committee (Professors Donald H. Johnson, Charles Henley, and Albert l. Rabin) for the valuable contributions which they have made to this study. A special debt of appreciation is owed to Professor Albert l. Rabin, chairman of the author's Guidance Committee, for the consider- able aid he rendered the writer in the design and implementation of this study. and in the analysis and interpretation of the obtained results. Or. Rabin is also thanked for the many hours of consultation so willingly provided on weekends to accommodate the writer who was living out-of-town. in general. the writer is grateful to Dr. Rabin for his instruction. encouragement. and friendship throughout the years of his professional training. The writer also wishes to express his deep gratitude to his wife, Diane Margolis, for her editorial help and personal support throughout the many months required to complete this study. Special thanks are also due to the staff of Childrens Hospital in Detroit, Michigan for cooperating with this writer in carrying through this study. Finally, appreciation must be expressed to the seventy-five mothers who served as subjects for this research project. ii TABLE OF CONTENTS AWWCOOOOOOIOOOOOOOOOOOOOOOOOOOCOOO0.00.0.0... claims in REV.“ OF M L.'EMm.OOOOOOOOOQO00.0.0.0...O. A. C. 'fltrOdUCt'Onoaaeaaaoaaaaaaaaaaaaaaaeaaaaaoaa r'ymttfld ‘ .r.“ U'.WWeaaaaaaaaaaa Research in ”mac-atlas.................. ‘ cl‘HICCI .Oficfiption of .ron‘h‘.' A‘th-.ea Quiltic A‘PC‘t‘aaaaaaaaaaaaaaaaaaaaaaaaaoaao '3ych'6 A‘PO‘t‘a-aaaaoaaaaaaaaaaoaaaaaaaoaaa ”mnlC' 0' “Maaaaeaaaaaaeeaaoaaaa The nether-Child Relationship in Aathm Research on the Paydiodyna-lca of Retina”... “6303",. “t” Add" A‘fl."€.aaaaaaaaaaaaaa Research with Aatlmatlc Children............ Research Relating to Specificity Hypotheses. Research Relating to the Mother-Child ROIOt’Ofl‘h'P 'n AsthlaoaOOOOOaaoaoaaaaaoa Statement Of 'roblunaaaaaaaaaoaaaaaaaaaaaaaa RESEARCH DESIGN AID WES...N............. A. T‘.‘ a‘ttC'Y%doaooaaoaaaaaaaacoco-acac-oaooa ‘0 Th. 'laCky "C‘U'.’ '3.taaaaoaaooaaaaaaa nm.m.' .'w.'m.aaaaaaeaaaaaaaaaa VII'd't’aaaaaoaaaaaaaaaaaaaaaaaaaaaaaaao Ad”'fl‘.tr.t‘00 3nd ‘Oor'ngaaaaaaaaaoaaoa 2. The Parent Attitude Research 'flVOfltOry ('AR')0aaaaaaaaaaaaaaaoaaaa SGor'ng and seii.‘aaoaaoaaaeaaaaaaaaaaaa “Qi'ab"Ityaaaaeaaaaaaaaaaeaoaaeaaaaaaaa Vll‘d'ty.aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa A‘QU'CGCCUC. ‘CC'Caoaaoaaaaaaaaoaaoaaaca Page ii d NWNO‘O RN— 86833 6. .0 ; WV'MtG' Ind Mt”! “W’ocoooocoooooo I. EXPCr‘mflnta‘ “'0“, (Am “9th.r.’oouooovoo a. flulthy Control Group (Surg.-0';P.D. mathOTS)0.0000000000090000000000000.. 3. Equivalent-'41: Control croup (Rheumatic “33ft “D‘h.r’)ocoooooaoouoo0000000000 Sociological Buulpflon of Populatlon...... stltCHBHt 0f HypOth...’oo00.000.00.00...a... lmlmntation of the launch Danna"... I". “TA ANALYSIS A. .‘C‘ky "Cth" T.“ ‘QSUIt‘ooooooouoouoooo- I. Analysis of "Overall Mansions] Scores“ Tate. s.mp'.c000.00.000.00...0000.00.00. Hh't. 8..'I.OOOOOOOOOOOQOOOOOOOOOOOOQOOO Negro samp'.oooo¢a000000000030...00.0000 2. Anamu of the ”Spontaneous Stories"... 3. Anaini‘ 0' .nm‘" .tmooo‘OOQooooooooo Tbtal sanfl‘.ooo.0000.00000000000000.0000 “hit. ‘IIP‘Cooooouoooooooooo000000.00... Negro samP‘OOOquoooooocoooooooooooooooo lg“. RO‘Ult'OOOOOOQOIiOOOOOOOOOOOO£0.00...DO '. TOtCI Sanpl..........o.......o.......... :- UhIt. Slaplc.........o.o................ 3- Negro saIP‘GoaoooooQOIOOOOoat-0000000..a "I .‘scmS'm ” F'NOIKGSOO0......COOCCOO.....O..OO '0 ‘m uFI”.N“OOOOOOOOOOOOOO00.00.00.000... Iv Page 33 33 E m-AL‘. . A. B. C. D. Duly" and "mmesuoooooopooooooooooocoooo B‘HCkY Resu’ts...”nu..................... 'M‘ Resu‘tsOOOOOQOOOOOOQO0.00090000.000000. ConC1U3'0nS...-............................. .I’L'W.‘OOOOODOOQOOOOCOCOOOOIO¢OOCIOOOOOIQOIOOO0.0. WWES (Tcst Battery and Suppiementary Statlsflcal Tab 16, .‘OOQOOOOOOOQOOOOOODOOOOOOOOOOOO... Page 81 8| 82 83 l IST 0' TMLES Tabla Raga i. Sol-a Sociological Charactaristlca of Exporiuontal and thl SWJ“u aouaaaoaoaaaaaaauaaaaoaoooooooaoaaoaaoaao 38 2. Sana Sociological Characteristics of Subjacts' Chlldm .... 39 3. Ordinal '03‘t‘00 0' SUbJ‘C“. “H‘ aaaaaooaaaaaoaoaaoaoaaaa 39 it. Total Non-bar of Strong Ovarail Din-analonal Scam by individual Subjacta for A. iiothara and I. ll. liothora (Tou' 5".)3 "‘50 aoooaaaaaoaooooaooaoooaooooaoaaoaaoa ‘55 5. Toial iiwdm' afbtrong Ovarall Dimsional scam by individual Subjects for A. ilothon and 8.4)... km... (10“! mi.,3 "'50 a.ooaaoaoooaaoaaoaaoaaaoaaoa ‘56 6. Ovarall Ill-analonal Seal-as for Total mm 0-75 ......... ‘58 7. ‘l'otal iii-bar of Strong Mull Ill-analonal soon: by indlvidual Subjects for A. ibthara and &. ii. lather: (Halt. 5“.)3 “‘20 aooaaaoaoaoaaoaoaaaaaaaoaoaoaaaaoaoaa 5‘ 8. 1...: am:- of‘Strong avorall Dlmalonal mm by Individual subjacta for A. ilothan ad 8.4.0.9. lunar: (“3“. h'.’: “‘20 aoaoaoaaaaoaaaoaaoaaoaoooooooooooooo s: 9. Ovarall llaamlonal Scam for hit. Nathan: n-JO ........ 53 la. Total iiudnr of Strong Dvorall Mutational Scorn by 'M'V'dfl.’ ‘Ubjfiu '9' “a ”6"". I“ ‘0 "o Nth.“ (”a m'.): “'30 a.oaoaooaaooaaoaaaaoaooaoaooaoaoaaoo 5“ 11. tom umr .{smng om." "mum! scam by individual Subjacts for A. ileum and 3.43... iiotlvara (”.970 m'." "'30 aaaaaoaooaoaaaaoaaaaaaaaaaaaaaoooaaa 55 la. Ovarali Iimnalonal Scam for liogro Indian: n45 ........ 56 I}. 'm'” 010'“! for T0“. 5".3 “'75 oaoaoaaaooaooaaooaaa 60 M. inquiry Chaim for iihlta Sula: r30 .................... 62 - o o b I ICC-Q...1CCOCOOCI¢QVOCOCOOIDVICIOIbl . i I . i A {-"“‘—‘ 0 ¢ 0 a o I l caoaooota‘doovoaaloao-voa1to . - . i ‘70-‘0QOO i I I .A I . I ‘ . I q o a o I ivovooavacvvuaDOaCbatvoutvooconlOQa-a . I Q o v v . a l- ahlooouv-Ol-b-dOQIIDG-I'IIvO-ao-‘aoo . A 90's.... - . i v - i I v, I i I . . 1 O o a i . . Coo-O...D'...III..O|‘DOOC00......Il. . . - I i ~ I . I . a a a a l 9 I , " cuooanOOOQOOGOOO‘QOOIDOOOIOO'OIODC. .. ‘ Table l5. l6. l7. l8. l9. 20. ll. 30. 3|. Page 'QQUI" W'CC5 '0' “.9" 5”“: “‘1‘5 oaeeaaeeaaaaoeeeaae 6“ Total Pathogenic Sacra: of A. ilothera. A. ll. Iotnan. m 5.433... ”other! f0? TOtBl sw‘CR "'75 oaaeaaaoeo 66 MAI Soon: of A. Mothers. Lil. Authors. and s.-o.v.a. ”“7, for TotC' “‘03 "“7Saeaaaaaaaaoaaoeaaeeaeaeeaa 67 my Of ”"1." (PM! SC... #23). "’75aaaeeaoaaaaeaa 68 Total Pathogenic Scores of Negro now... an CocoaI-ed With Wit. Nathan: "'75aaaaaaeaaooeeaaaeaaoaeaoeoaaaeaa 69 Total Pathogenic Scores of A. lathe", Lil. Iothara. .nd $.’O.'.3. Natl“?! “1 “fit, M'.: "SOeaeaoaooaoaao 70 PAM Soon: of A. Authors. li.ii. Authors. and s.-o.'.i. “thCr. for all“ M‘C: “'30aaeoaaaeaaeaaeeeoaoaaaeaaa 7' Suppression of Sex: (Pfli Scale filB) for iihita 5".3 "‘30aoaaaoaaeeeaeaaoeaeaeaaaaaaeaaaoaaeaoeeeoaaa 72 Dependency of lather (”Al Scale #23) for mu 5““: "'30aaeaaaaaeeaeeaaeooaeeoaaeaaaaaaaanoaaaeoaeaa 73 ‘I’otal Pathogenic Scores of A. Anthea. 8.8. Authors. and Safla'Je ”“1." 'H mm 3"“: Woo-eeaaoaaaoeaaae 73 ’fl' ‘W'.’ of ‘a “W“. Lil. ”thou. N ‘a'Oe'e.e nth." for ".9". ”1.: Maaeoonaeoeaoeaeaaaaooaaeaa 7" Total Number of Strong Overall Iimsional Score: by individual Subjects in Lil. Author: and 3.4.”. ””1.“ (TOtC' mi.)3 ”scooaaaaeaaeooooaooaoaoOOaeeaa 'm Overall Dinensional Soot“ for Adi. and S.-O.P.I. M610": ”Seooeaeaaaaaaoaaaaaeaeaoeaaeaeeaaaeeeaaaaaaaa ‘05 Total Met of Strong Overall ”malarial Scam by individual $ubjecta for Lil. and 8.4.LD. Elite ”WU“: mmaaaaeeeaaaeeeeoeaaaoaaaaaeeoaeaaeoeaaeaaaaa '06 Overall Olmslonal Seam for Lil. and 390.”. ”W‘ ('1'“ m‘O’3 fl‘zoaaaeaaoeaaeeeaeaeeoaaeeaeaea '07 Total an...» of Strong 6verall Iimerulonal Score: by individual Subjacta for IJi. and 8.4.PJ. iiegro 'Mfll."3 maoaeaaeoeeeaaoeaaooaooaaaaaaaeeaaeeaaaaanaena '08 Overall Dimensional Scam for Lil. and s.-o.r.a. Moth.“ ("09” W'C)‘ ”soaaaaeoaaaaaeoaaaaaaaaaeaaaae ‘09 I... ‘_-. ‘L‘ha-J’ wan—«w ~ — o a a e t e 5 D D O Q A C I : ‘ C . 0 I n I D I . O : 0 O I o e a Q Q U a . g l o e o a a a n «(o 5: av I a ll 0: 0' no o. .l 1' 0v .0 I p a a a. Table Page 31. Spontaneous Story Scores for Total Sample: n-75.......... llo 33. Spontaneous Story Scores for white Anti-Ian: n-30......... ill 3‘. Spontanewa Story Scorea for iiegro iiothera: 0-45......... lit 35. E inquiry Choices for Total Sania: n-75................... ”3 36. inquiry Choices for White Sample: n-30................... “5 37. 'HQU'I'Y ChOlCO‘ for Negro MIC: WhSeeaeeoeeeaaeaeeeoee "6 viii v - a 'e I . e o e e e e a e a . a e o a o - A . i l O a e \ a v v e a I a n e e a a e e n i ' ‘ .24- » . e n e a a n n a a a e a a v e a e e - I I. REVIEH OF THE LITERATURE A- minimal: Wile esotional factors have long been recognized as playing a role in disease. they have been largely neglected by research workers in unedi- cine rho. because of their training in the biological and physical sciences. have sought primarily to investigate physical and biochemical agents vhieh were seemed to be responsible for organic pathology. Once these physical agents were isolated and understood. atteepts were aede to control than through surgical or eedicai techniques that. again. had little connection with psychological variables. in recent years. however. within medicine itself there has been each discontent with this orientation to the investi- gation of etiological factors in disease. Critics have questioned the validity of such a near-eaciusive preoccupation with organic factors. a preoccupation that often found even more narrow expression in the isolation of particular syntoes and orgms as a focus ai' study. to the alnost coa- piate neglect of other systems in the body and their inter-relationships. These critla have suggested adoption of research perspectives \dulch would include the total organise. especially in its psychological raaificetlons. Psychiatrists have taco-e especially interested in applying to wider areas of pathology the insights and teciuquues developed fro- the treatment at the neuroses and psychoses. iiany psychiatrists now believe that there is a wide variety of major illnesses that are to a large extent precipitated. aggravated, and sustained by psychological factors. They have especially concentrated their attack on gastrointestinal disorders such as ulcers and upper respiratory diseases such as asthma. a. [sychosgg§§l§§: a briefwhigtggx. This broad spectrum of diseases has come to be known by the name "psychosomatics." As increasing numbers of diseases have been designated as psychosomatic. the term has come to be so encompassing as to lose all distinction from disease in general. in fact many serious physicians are already insisting that psychic components play an important role inlgii disease. Grinker (22). a leading student in this area. has suggested that the term‘”psychosomatics" be used to cover diseases in which psychic factors play a large, cicarrole in the illness. This distinction, it is felt, is a more useful conceptual delimitation and will therefore be used when referring to psychosomatlcs in this study. Psychosomatics is a very recent area of interest. it is only in the last two decades that it has achieved respectability and influence as a frame of reference for scientific investigation. While primarily de- veloped by psychiatrists. especially by psychoanalyticaiiy-oriented psy- chiatrlsts. there have been growlng numbers of physicians. psychologists, and other behavioral and biological scientists who have begun to work in the area of psychosomatics. Due. to the broad focus of inquiry which is implied by the term. scientists from many disciplines have been able to work together on joint projects in the area of psychosomatics. The concepts of psychosomatlcs are very new and they have met with considerable resistance within medicine. Some of this resistance can be attributed to the physician's vested interests in and preoccupation with physical variables. Some can certainly be attributed to the chaotic and vary speculative nature of much of psychosomatic theory. Encouraged by initial successes involving the application<fi=these principles to indi- vidual cases in their clinical practice. many psychiatrists have too quickly made sweeping generalizations based upon these theoretical in- sights to larger clinical populations. Some have even insisted that psychic factors are the key variables in most of disease proper. Hany have supported the "specificity" hypotheses which link specific organ malfunctioning to particular psychic conflicts. Some could accept the specificity notion but questioned the Specific dynamics. Others have de- nied these specificity notions and claimed simply that, although psychic conflicts were partly responsible for organic pathology. they could not be so neatly related to specific organic breakdown in such a one'to-one manner. instead they postulated that any psychic stress of sufficient magnitude would cause a physical breakdown at the weakest link in the body; the some conflict. they further reasoned, in one person might cause an ulcer attack and in another an asthmatic attack. in most instances these theoretical Speculations were based on single cases or small numbers of patients who have been treated by psychoanalysts. in the absence of rigorous research based upon objective studies of controlled groups of subjects. it was no wonder that there was such a proliferation of contra- dictory theories. b. fiesearch in_?sxchosomatics: it has only been in the last ten years that much research has been done in this area to test these claims and counterclaims. The newness of these research efforts is illustrated by the fact that in the area of ulcers. the "classic" psychosomatic disease. there is still very little agreement about the vast majority of the questions that have been at the center of these efforts. For example. the specificity notion is still being hotly debated, with large numbers of research reports being advanced supporting both sides of the debate. There is also little . agreement as to the most proper research techniques or designs to be employed in these studies. Consequently, there are many unrelated studies being conducted in the area.{ Often they are conceptualized and executed in so diSparate a fashion that it is difficult to compare their results. Though there is a growing sophistication apparent in methodological discussions in ulcers studies. the research in this area. theimost studied of the psychometlc diseases. is still largely in its first, rudimentary stages. The only general conclusions that can be made at this time are that the working hypotheses of many clinicians in this area are probably overesimplified and averageneralized and that research is exceedingly difficult. due to the complexity of the data. The study of other so~called psychosomatic diseases is even less de- voloped. Many workers have suggested that research efforts would best be expended at the present time in investigating the basic variables that set psychosomatic diseases apart from other diseases in both their psychological and physiological dimensions. Lacey and Von Lehn's work (33). demonstrating that a stable. differential hierarachy of autonomic responses can be found among infants. is one step in this direction. This type of research, if pursued further. may provide an answer to the question of what part constitutional predisposition to organic break- down plays in psychosomatic diseases. 0n the psychological side. Ruble (3i) has asked. "what is there which is of a peculiar. or special or different or specific nature about the regressive and dissociative processes which results in physiological disturbances." in other words. can the psychological processes which accompany the psychosomatic dis- orders be differentlated in any way fnom those that accompany non- psychosomatic organic disease. the neuroses. or the psychoses. The study of the family relationships of psychosomatic patients is one way to provide an answer to these basic questions raised by Kubie. Analogous to Lacey and Von Lehn's study on the physiological side. it is felt that these psychological variables are best studied at a time when they are likely to be most crucial, i.e.. during the infancy and childhood of psychosomatic patients. Too much work in the area of psychosomatic research involves the study of adult patients who are long removed in time from the point of first manifestation of psychosomatic symptoms. There are several studies now in progress whose aim is to investigate these early family relationships. Notable among these studies is one which Gerard helped to establish at the Medical School of the University of illinois (#5). Both the mothers and fathers of children with primarily gastointestinal complaints have been studied in this project by intensive psychological and psychiatric techniques. Preliminary findings indicate that the mothers are immature. inept at mothering, passive. and often are quite frustrating and cold and even neglectfui in their handling of their children; these same mothers also experienced during their own childhood ambivalent care from their mothers and have greater than average negative and hostile attitudes towards them. interestingly enough, while the fathers were also found to be disturbed and inadequate as parents. these workers conclude that there seems to be no great consistency between the severity of illness of child and grossness of disturbance in the father. ,The mother's role, as might be expected. seems more heavily weighted as a possible determinant of the child's conflicts and psychosomatic resolution of these conflicts. B. A Clinical Description of Bronchial Asthma: a. Lunatic Aspects: Bronchial asthma is an allergic disorder of the respiratory system. characterized clinically by paroxysms of an expiratory type of dyspnea ‘with wheezing, and anatomically by a generalized obstructive emphysema 50). it is often accompanied by nasal congestion, sneezing, coughing, and watery discharge. Attacks are most frequently precipitated by allergens, most prominent among them being the inhalants (e.g. pollen dust). .ttacks may also be caused by too hearty laughter, vigorous physical activity, exposure to cold, and inhalation of cold air, smoke or mildly irritating gases. Reapiratory infections often precede at- tacks. Asthma is a recurrent, chronic disease. Death from bronchial asthma is rare. b. fifigchic Aspects: Allergists have noticed that emotional upsets lower the threshold for asthmatic attacks. Hailowitz (2“) has noted that asthmatic attacks diminish in quantity and intensity when asthmatic children are removed from their home; conversely. they often recur when the child is returned to his home. Hallowitz reports that sat of the chronic asthma cases that come to the Denver Hospital eXperience immediate and sustained relief from their sysmptoms. An additional 35% have markedly reduced Symptomatology. Similar findings are reported by Doust and Leigh (i2) and Jessner et al (30). Jessner notes that often the very same medicine that could not bring relief to the child while he was in the home situ- ation seems to be successful in reducing the asthmatic symptoms once the child arrives at the hospital. (Some claim that this diminution in asthmatic symptoms is due to the removal of the child to a relatively pollen-free, dust-free. etc. environment. This issue awaits experimental clarification). Hany psychiatrists have noted a low incidence of asthma among mental hospital patients. These observations have been noted in a study at Worcester State Hospital by Sabbath and Luce (Si). They also report that ”those patients who retained their asthma showed less break with reality and more nearly intact personalities.” (5l. p. 566). it has been speculated that the asthmatic attack serves as a defense against the very severe conflicts of these patients. Oftentimes it is observed that when the asthma subsides. the patient manifests increased psychotic symptoms; when the asthmatic symptoms increase. the patient's contact with reality is strengthened. This position has been questioned by Leigh (35) who states that psychotic symptoms seem to be just as common among asthmatics as among non-asthmatics. The relationship of allergic sensitivity to asthmatic attacks has convinced many that asthma has a psychogenic component. Treuting and Ripley state that there are cases of asthma in which "no specific sensi- tivity to such intrinsic factors as inhalants can be demonstrated.” (59. p. 380). Gerard (20) reports that asthmatics often have attacks when in the presence of allergens, and, conversely. often have attacks when allergens are not present. Alexander and French (20) report that asthmatics who underwent psychoanalysis were often cured of their asthma; they also did not substitute any other allergic symptoms for their asthmatic symptoms. Moreover. clinical tests revealed that they were still sensitive to the allergens. Dunbar (l3) further reports that often asthmatic analytic patients would admit that they had attacks during their sleep while they were dreaming traumatic dreams. Many even had 9 attack: In her offlco «hon rolatlng theta dram to her. c. Ihe Pyohodynamlcs of Agthma: A: oarly at 1922. Vols: (”5) speculated about the psychodynanlct of attl'o. Alexander and Fronch's lbnogroph. Z1222. gong: factors In grgmhlal Aothuna (18), (whlch lnoorporatod Holss‘t orlglnol contributions. and woo based to a largo oxtont on osthootlco traatod at tho Chicago lnstltuto of nychoonalyals). ourrontly reprooanto tho loodlng and not accoptod paydloanalytlo forillatlon. Thooo urltoro aoo dopondonco on and longlng for tho author as bolng at tho vory ooro of tho ”1er non!“ of nth-a. Foar of tho lost of oatornal lovo typlcally not: off tho oath-atlc attack. Thlo far can arlao olthor fro. tho throat of an actual separatlon or froo tho patlont'o foar that tho onoauro of his oggrosalvo and sexual fantaolos would couso hlo oothor to rojoct hlo. andor and french clalo that tho four of moon of mo! lmlaoo ma tho mt froquantly lnvolvod factor In tho oathoatlc caaoo that thoy otudlod. soul and Lyon (52) atata that thoao doponooncy longlngo appoar ln drum and fantaaloo aa wlahoa for ohaltar. protactlon. holng In oncloouros. and tho lllto. bolng «proud ulth thlo Intrautorlno oyflollu lnotood of, “for mlo. ln oral ouckllng for. oo soon In tho goatmlntootlnal dloordoro. Thou «than do not fool that tho doom- oncy longlngo of tho asthoatlc patlont aro any otrongor than thoao of potlohto oufforlng wlth gastrointootlnal “action. but rothor that thoy uproot tho-oolvoo ln thlo partlcular foro. Alexandor and Fronch (l8) also roport that drum wlth lntrautorlno tho-as woro Ioro canon 10 among asthmatic patients than non-asthmatic patients. According to many research workers in this area, asthmatics deal with these primary conflicts in different ways. as is apparently the case in ulcers. Some will cling to their dependent role to avoid separation from mother. They are sick and require much mothering and nursing; thus they reassure themselves of their mother's love. Others will act out by be- ing sexually provocative and aggressive. at times to the point of com- mitting anti~social acts. in this way they attempt to master the anxiety associated with the forbidden impulses. Others become quite ambitious and striving and in this fashion deny to themselves their great depend- ency. These latter cases have been especially studied by Gerard (20) who. along with Alexander and French and others, has noted the relation- ship of crying and the desire to confess in these patients. Gerard re- ports that crying and confession of the forbidden impulses towards the mothering figure often seems to stOp the attack. The asthmatic attack then can often be understood as the respiratory equivalent of the stifled cry for the mother. which the asthmatic, forced into a pseudomaturity. cannot allow himself. All of these writers. Fenichei observes (14, page 322). emphasize the pregenital nature of the conflicts.-hleccordance with this pregenitai character, he further notes that”patients with asthma mainly present a compulsive character, with all the features of an increased anal-sadistic orientation (ambivalence, bi-sexuality, personality deviations through reaction formation, sexualization of thought and speech)." Dunbar (l3) notes that walla her asthmatic. analytic patients were coupulslva charac- ters with intense oral and anal conflicts they seemed to deveiOp few defenses such as protective rituals and phobias. Their narkad ambi- valence did not load than to separate themselves from reality. as in the case of the psychotic. instead. the estimatic attack acted to short- circuit the impulse and prevent it from ovandzelning the individual. in mun-free periods she observed that astiuatics. due to this loci: of depth in defenses. constantly caused on the verge of acting out their iwulsas and often did. There scanned to be little intarvaning batwun fantasy and actually doing what is fantasiad. the noted, therefore. that their dreams present inulsss fairly directly with little systolic elaboration or evidence of censorship. it way ba‘that these latter ' observations m a function of the restricted clientele of the analysts. ‘i‘hay nay have never treated any astiuatics who have bean more tolerant and accepting of their passivity and thus were never sufficiently " conflicted and motivated to undertake an analysis. it may uni-«or. be no accident that Dunbar. Aimndsr and rmch. and othcrs. have seen so many auditions. striving. convulsive charactars with asthna. This line of reasoning leads one also to question the assured link between the inhibition of crying and the lath-Itic attack. At any rate, that all of chess writers are able to agree on is the marked dapcndancy. basic passivity. and pro-genital orientation of theta asthmatic patients. which cost workers agree is central to the psychodynsnics of the psycho- son-tic patient in general. it should be noted that all of the Ma 12 tuitors also posit an scooMpanying somatic prodispositlon in this dissass. i.a.. an ailsrgic constitution. d. ‘ tho hild elati i n A s The anther-child rciationshlp has m in for spacial scrutiny by thsss uritors. Alexander and Fronch (l3) report that their cases vsra ehsrlctsrizod by lurked. oarly natsrnal rajoction. sarard (20) states that this astsrnal raJection'uas accompaniad by tho sattlng of hiw standards for too-early sohisvs-ont mania with strong dis- mugs-ant of oggrossivs behavior and saunal curiosity. Dunbar (l3) also notas that some cases has an early childhood charaotsrlzsdhy ' Incassiva indulgence and ovorgratlflcstion of dapondancy hoods. Sha furthor quotas an aarilar study by logsrson and hardcastla mo obssrvod that anthers of «mm children mm to ho ovsrprotsctivs. lial load it: (24) too notes that tho slothors ofa‘sthntic ohlidran scam ovsrprotootivs. They upooialiy restrict tha child‘s activitiss for fur wormrtion will bring on on astilsatlo attack. (Thor. ls so“ basis in rosiity to thoss fears). 'Thoy appear’to be very devoted and solfosacrifioing paronts. but uhdornaath this surface vanoor iia hostile. rsjscting attitudes that aro only thinly disguisod. iiallowitz altos tho intarasting obsorvntion that much of this rojaction nay ha a function of tho aucssslvo demands that an asthmatic child. hacauss of tho naturo of his iiinass. m: on a housohoid. Those writars (0.9.. l3) observe that ovsrgratlflcation of dopandoncy hoods can load to tha same result as undargratifioation of thos- noods. L... rogrosslon to. or fixation 13 at the pre-genital level. This is so because the asthmatic child is reacting to the same underlying maternal rejection which characterizes both the overlndulgent and the underindulgont mothers. Spcrling (57, 58). in her discussion of the mothers of asthmatic children. has focusedon the dynamics underlying their behavior. She feels that these mothers often carry over unresolved conflicts from their ovn childhood fend act than out upon their child. She notes that these conflicts are of an intensity often found only among the mothers of psychotic children. The astiunetic child was often found by Sperllng to represent an unconsciously hated sibling or parent to these mothers. The mothers were found in some cases to provoke the asthmatic attacks to Justify their rejection of the child. in other cases they so overidentlfied with the child that they could vicariousr iy experience their indulgence of the child as the gratification of their one: unresolved. nurturence needs. Therefore. they could not countenance the growing up of these children and discouraged ell moves towards independence. Apparently. in some cases. the very act of se- paration from the child within her. involved in the birth process. was micome to these mothers. It is for this reason that Jessner et ai (30) note that to deny mothers of asthmatic children their pregnan- en; were so very pleasant and happy. The symbiosis here is real and organic. and cannot be denied. Later on the mother's needs will come into conflict with the child's om autoruoey needs. but new there is no l’i ' conflict. it is as if they are saying that the perfect relationship is beteeen e nether and her unborn child within. Sperllng has especially called attention to the syeblotlc nature of this nther-chlld relationship and feels that the child often responds to an unconscious parental Md to get sick. she notes that one estisaetie child is sufficient to serve these needs of the nether. but if that child is cured of its esthee through ledication. and/or psychotherapy. the nether is often found to transfer this special relationship to another child and it in turn now develops sashes. Coolidgeilo) notes that the estimatie children often see- to sense that en estheetic attack is the only way that they can get the love they seek through being sick. \ Others use their symtoes is an eddltionel way: they can thus safely express their rage and anger towards their anthers and effective- ly control than. Their anthers wet now tend thee in the eiddie of the night and are thus effectively removed free the earitai bed. The anthers. leaving their husbands behind. eust Journey with their asthe eetic children to other arm there they will have mre relief free their symbols. The interdependence of symtoms. end vicissitudes of the ”titer-child relationship so. noehere better illustrated than in Coolidge's cements on cases involving estinotlc Isothers and their athletic, offsprings. Soles of these slothers were found to have sustained relief free attacks only as long as their children had estimatic attacks. Coolidge speculated that the asthma of the child served the another in l5 this eenner: The mother. because of a stress situation. finds herself beginning. once more. to be overwhelmed by fears of abandon-lent. The child reacts to the mother‘s unconscious fears and develops an attack of sneezing and wimeezing. The mother can now lavish care on the child and. by vicariously experiencing this eaternal attention. can lessen her on fears'of rejection. Jessner and associates report variations in the way asthmatic children of different sexes are treated by their mothers. Apparently these mothers are able to express lore positive feelings towards boys. They can be sore affectionate and sometimes even seductive with boys. They express their rejection more Openly with girls. dessner et al. (30) along with teeny other writers. have noted that ordinal position teens to be associated with astlne; l7 of 28 cases in this study were oldest children. in other studies. however. senses has been found to be also associated with being an only or youngest child. in nursery. it should be noted that the previously quoted writers share a large area of ogreeeent both as to the psychosomatic nature of asthma and the psychodynamics of astima. 6. «arch the r ‘ eoi of s : These previous observations have been based aleost exclusively on reports of cases treated in psychotherlPY. or on cases examined diagnose ticaliy in hospital settings. in eost cases control subjects were not i6 used. Evaluations were made on the basis of subjective criteria. Statistical. treatment of data was absent from wet reports. in recent veers. however. there have been beginnings of an attemt to examine these issues under controlled procedures. in an experimental manner. using larger groups of subjects. host of these studies leave mch to be desired in terms of the rigor and adequacy of their research designs. a. rch wi Ad l thee lc : Adult astlaaatlcs have been studied by a number of different writers (la. ‘10. ‘05. 2i. and 35) using widely differing research design. The results of these studies vary considerably from support to rejection of the psychoanalytic hypotheses. The overall trend of the five studies tends towards acceptance of the psychoanalytic fomulatlons: These studies Wiles astheatics as being sure dependent and anxious than controls. in one study (2i) they are described as exhibiting a greater need for re- comitlon. in another study (he) estimatics appear eore anblvaient in their general relatedness to wife and maternal figures. The later studies (2i) and (35) used normal controls and objective measures of evaluation. e.g.. the Cornell Radical index lieaith Questionnaire was used by Leigh ()5). .sranting for the eoeent that these reported differences are re- liable. the question mat be raised as to the naming of these differences. Could it not be that the greater anxiety. dependency and conflicts of the astheatic are prlearily a function of his physical illness. rather than prleary psychogenic factors? The designs of these studies do not allow for an answer to this question. This criticise cannot be last until 1? provision is shade for a control group consisting of subjects who are ill to the salsa extent as the astluatlcs. but with conditions that are not asst-ed to be psychosoeatlc. i.e.. an mivaientlnlll contgl b. when"; Qildrg: There have been several studies in recent years of astiuatic children (is. 26. 53. 17. lot. and hi). The trends in this group of seem seen to be in u». direction a. support of a». ”mum“ formulations. The astiuatic children were found to be are dependent. fearful. and lie-nature than the control subjects. They were relatively unable to express hostility as directly as the controls and were eore likely to direct their hostile lspulses inward. ilarris and there (17) mm estimatic children to be indistinguishable free the control sub jects on an sectional basis. Their report however is based entirely on teachers‘ subjective evaluations. it should also he noted that the reports by Miller and Iaruch (h). M. in. and hi) can also be critic- lead on this basis: while the findings are statistically significant. they are based solely on the author's evaluations. These judpants nay be correct but are not athlsslble as scientific evidence. in general. the studies dealing with children are not as eetlndologlealiy sound as the studies of astheatlc adults. a. rch eiatin to S stifle the 3 There have also been a “er of studies (‘37. 88. and 60) attent- m to test on specificity hypothesis. L... am the psychodynaelcs i8 of asthma are different than those of other psychosomatic groups. Here the results are more inconclusive due to the variety of controls and instruents used. Pollle (#7) using the M test. found differences betweentasthmatics. ulcer; non-ulcer gastrointestinal groups. and non- psychosometic sick contnols that would tend to support the specificity notions. His findings were capacially significant in the case of dis- tinguishing the asthmatics from other groups. Asthmatlcs were found to expross the wish to cling to and possess the mother and felt intensely hostile ebout interference from rivals. Pollie felt that asthmatics tended to accept their dependency; their conflicts arose from frustrat tion of their dependency needs. Asthmatic: were found to have a higher degree of conflict on the oral sadism dimension than either of the other gnoups. although this difference was statistically significant in the case of only one group. Prince (#8) also reports differences between asthmatic adult patients and ulcer patients. waxenberg (60). however. found no difference between moron with asthma end women with ulcerative colitis. d. fiesearch Relating_to the hothg[:§hild Relationshig:in Asthma: at most concern to the central issue of this study is the research reported on the dynamics of the mother-child relationship in asthma. A “er of recent studies have demonstrated differences between mothers of schizophrenics and control mothers (39. 17), differences between mothers of problem children and mothers of normal children (Sir), etc.. As yet, there have been few such studies in the area of psychosomatics. and i9 eSpecieiiy in the area of asthma. Little and Cohen (36) have studied the goal-setting behavior of the asthmatic children. and the goal-setting behavior of the mthers of these children in e level-of-aspiration experiment. Ambulatory patients or non-patient siblings of the asthmatics were used as controls. Asthmatic children tended to set higher goals for themselves than control Mjects; authors of the asthmatic Children also tended to set higher goals for their children's efforts in the task situation then did mothers of controls; Cutter (ll) reports findings on the mothers of 33 asthatlo children. contrasting them with mothers of eczematous children and the mothers of children being seen in pediatric clinics for the usual range of pediatric sylptons. Subjects tested were predominantly ilegro end of lower socio- economic and educational status. A questionnaire was used which was devised and validated by the author and based upon concepts deployed in the work of the Fels Research institute; it was scored for "warmth". ”Freedoui'. and "Control." The questionnaire consisted of 73 statements regarding parent-child interaction in concrete situations with mich the research subject «not indicate agreement or disagreoslent. Io signi- ficant differences were reported. The writer shits that "no or are nodal patterns in any one group would tend to cancel each other end oitlnetely yield averages that were similar for all three groups can- perod.” This is the outstanding difficulty in using a behavior rating scale of this type. ihthors within the some clinical group eight be 20 «looting different child-rearing techniques stunning from different constellations of defense patterns to deal with similar underlying conflicts. As the previous clinical observations have indicated. tone oothers of asthmatic children openly reject their children and show little “worntir’ to then. while others overindulge and overprotoct then and appear to be displaying excessive Warmth." Both of these oaternai types can have the same underlying conflicts. Miler and Baruch (loll) report that 983 of the anthers of allergic children in their study displayed rejecting attitudes. coward to 1‘“ in the control group. in another study reported in the same publication, they found that 57d! of 63 mothers of allergic children covered w their basic rejecting attitudes by over-protection. in neither of these publications do iiiiler and Baruch report on their methods of arriving at these conclusions. it sous that they are based on subjective ob- servations in their own private practice. While there is a trend in these studies towards support of the psyfltoanalytic formiatlons. it is clear that the research efforts in this area are too scanty to be earshalled forth as evidence of the validity of the psychoanalytic hypotheses. this review of the research in the area of astlna. especially in the area of the mther-chiid relationships. reveals the difficulties that beset such of the research in the area of psychosoeatlcs. Little allowance is nude in the research designs for equivalently-ill controls to partial out for the effect that the astluna itself may have on the 1i. personality of the estimatic. attentioes. instruaents are used that are only remotely related to the psychosoeatic constructs used by any clinical workers. Sm studies do not seen sufficiently acquainted with the sore sophisticated clinical fo-rmlatlons of the psychodyn-ics of astisaa. especially as regards the varying character structures of psychomtic patients. which may simly represent different nodes or defense eaintained to handle sleller underlying conflicts. A similar type of analysis eight be applied to the case of the mthers of psycho- sonatic patients. They oay use widely variant child-rearing nothods and yet they share with each other eany cannon areas of antionai con- flict. There have been so few studies in the area that merino of results as yet is difficult because of the wide variety of controls and instrlnonts in use. two of the research results sue to be based on subjectively evaluated interview laterials that lack the objectivity dseandod by scientific reporting. Finally. mtii large scale. longi- tudinal. eultidisciplinary studies are launched that focus the siwts of psychologists. psychiatrists. and biological scientists won this proble- in a joint effort. we will be in free answering the questions as to the relative contributions of psychological {actors to the dovel0p- cent of somatic syuotoae. b. figtmt of Problem: The present study is designed to answer at least in part some of the criticise raised regarding previously reviewed studies. The nature of 22 the nether-child relationship in psychosomatic illness is the focus of the present study. The subjects for this research were drawn from a single disease category. asthma. This is not. let it be noted. with the purpose of investigating hypotheses relating to specificity theory. however. future students who are interested in studying specificity of psychic conflict in estimawlll. because of this selection. find making comparisons between their data and the data of this study easier. in this study. however. asthma was selected as representing a more or less accepted. typical. psychosomatic disease. and also because it was de- eirobie to use a single disease category in order to core adequately allow for proper controls. The primary goal of this research was to test the notion that authors of children with a psychosomatic condition are characterized by more intense psychosexual conflicts than both the authors of children with illnesses of equivalent severity (of non- psychogenic origin) and the mothers of healthy children. Secondly. this study”was designed to provide some indications as to the nature of the psychosomai conflicts of the mothers of asthmatic children. Thirdly. the- hypothesis that eothers of estimatic children have more pathogenic attitudes toward child-rearing and fully life could be evaluated. finally. the research design allowed for relating any dis- covered personality differences to any discovered attitudes regarding child'rearing and family life in an attempt to understand their etiolog- icai significance in regard to the development of asthmatic symptoms aeong the children of these authors. A. ll. RESEARCH DESIGN AND HYPOTHESES Test Battery: l. The Blackngictures Test The choice of instruments to test propositions derived from psychoanalysis and clinical experience has come in for considerable criticism in recent years. Hany have pointed to the fact that fre- quentiy the research instruments chosen are inappropriate for the tasks for which they are selected. As has previously been indi- cated. the majority of clinicians interested in this area readily admit that there will be a wide variety of character defenses adopted by the mothers of asthmatic children. They feel that on this level it is hard to generalize about distinguishing behavior characteristics between mothers of asthmatics and mothers of non- asthmatics. They are more willing to speak of distinguishing charac- teristics in regard to level of adjustment. degree of conflict. or amount of anxiety experienced by these mothers. it is this more elusive. "clinical" material. which is related in greater degree to dynamic aspects of the personality. that they feel will reveal sig- nificant differences between mothers of asthmatics and mothers of non-asthmatics. Therefore. an instrument was sought for this study that was designed to tap these levels of personality organization. Such tests for the most part fall into the category of projective tests. and it was felt that the Blackx pictures (3). developed by 23 2h Blum. represented one of these tests that was more ideally suited for research purposes since it could be group administered and quantitatively scored, and still provide the necessary qualitative data. The Blacky lest was selected for yet another reason. This study represents a test of psychoanalytic hypotheses. it is diffi- cult to make inferences about psychosexual conflicts from Rorschach variables. TAT stories, etc.. without taking ”clinical" liberties with the data, liberties that do not seem to be too defensible in a research setting. it was therefore decided to use the £13551 Plctgges Tess. since it has been expressly designed for the testing of hypotheses derived from psychoanalytic theory. a. Psychosexual Dimensions: The Black! Pictures consist of eleven cartoon drawings which portray the adventures of a dog named Blacky. and a cast of charac' tere including "Mama." "Papa," and ”Tippie." a sibling figure of un- specified age and sex. Each of the cartoons is designed to depict either a stage of psychosexual deveIOpment or a type of object re- lationship within that stage of development. The cartoons and the related psychoanalytic dimension for female subjects are listed as follows: i. Oral Erotlcism ll. Oral Sadlsm I”. Anal Sadlsm (analyzed along following tm dlmnsions; (i) Anal expulslveness and (2) anal retentiveness) iv. Oedipai intensity V. Masturbation Guilt 25 Vi. Penis Envy Vii. identification Process Vill. Sibling Rivalry .lX. Guilt Feelings X. Ego ideal Xi. Love Object (Analyzed along following two dimensions: (l) Narcissistic love object .(2) Anaclitlc love object) b. 13mm The Blaggy lest. like all projective instruments. has an un- determined valldity. Until a larger number of.glggkx studies are undertaken. the validity of this test cannot be determined. However. in the few short years since its publication. the test has had a cer- tain amount of success that warrants further use. According to lluml. upwards of forty studies have been completed involving the use of the glagkx Ies . while the Blagkx lest was devised in i9h7. it has al- ready demonstrated its ability to differentiate known clinical groups such as of Paranoid Schizophrenics. stutterers. ulcer patients. and sexual offenders. according to Blum and Hunt (6). Book, in his recent review'of the Biacky Pigtuges Test agrees that it has "differentiating potency.“ (2). This ability to differentiate known clinical groups is certainly one criterion of validity. An especially important con- sideration for this study is the fact that in a recent dissertation 'Personal Cannunication. 26 (#7) Pollie was also able to differentiate asthmatics from other psychosomatic groups and control subjects. as was previously noted. The differences reported were in the direction expected from the observations of clinicians. Another measure of the validity of the ‘glgggy,has been its predictive usefulness in experimental studies. it has been found effective in predicting quality of interaction (9), perceptual defense and vigilance phenomena (7). relationship of defense preferences to general level of adjustment. and ex! pression of hostility and dependency. toward subjects' mothers in interviewing situation (8). c. Administration and Scorigg in the group-type administration. the cards are projected one at a time on a screen. The subjects are asked to produce stories (”spontaneous stories") to each card. Two minutes are allowed for completion of each story. After the subjects finish each spontan' eous story,.they are asked to answer a series of standard questions pertaining to that psychoanalytic dimension (Appendix i). These questions are projected in consecutive order on a screen. The questions are mostly of the multiple-choice type. Each multiple choice itemicontains one neutral alternative and usually two or three "maladj usted" answers . The gevised §ggging System for Research 952 [Eemale Form) was used to score the data (h). The writer arranged to receive super~ vision in the scoring of test data from the author of the test in order tag. insure a greater measure of reliability in scoring the 27 "spontaneous stories” and to provide for more valid comparisons with the work of other researchers using theyfilgggy technique. All‘glgggy protocols were identifiable only by code numbers, which were assigned on a random basis. Thus this writer. when scoring the "spontaneous stories." did not know'whether a particular pro- tocol belonged to an experimental or control subject. The scoring system allowed for the assignment of an "overall dimensional score" for each card; this score is a measure of overall disturbance based upon the spontaneous story produced to the Blacky card, the inquiry items selected. the Related comments. and the card prefer- ence. The overall dimensional scores together with an analysis of the inquiry choices was used to provide an estimate of the intensity and character of emotional conflicts for the subjects of this study. The inquiry data. due to its relatively greater structuring, may be assumed to tap dynamic material closer to consciousness. Thus it provides some insight into the defensive functions of the ego, especially as they relate to particular psychosexuai areas of con- flict. 2. Jflngggent Attitude Research inventory (PARL): a. Scoring and §ggles The PARI (53) was selected to measure attitudes of mothers towards child-rearing and family life. The PARI. developed by Schaefer and Bell at the National Institute of Nental Health, is an inventory consisting of thirty-two 5 - l0 item scales. The items are worded in the formrof apparent truisms. cliches. colloquialisms. 28 and conventional affect-laden phrases. The items are rated by each subject on a h-point scale: a) strongly agree b) agree c) dis- agree d) strongly disagree, The majority of the scales are "Pathogenic“ scales: less desireable child-rearlng attitudes are associated with agreement on these scales. A.ninorlty of the scales are called "Rapport Scales”: desireable child-rearlng attltudes are assoclated with agreement on these scales. A short form (Form iv) of the PARI. consisting of twenty-three 5 - item scales. was used in this study. The following twenty-three scales are included in the short form: I. Encouraging Verbalization 2. Fostering Dependency 3. Secluslon of the Mother #. Breaking the will 5. Martyrdom 6. Fear of Harulng the Baby 7. Marital Confllct 8. Strlctness 9. irritablllty l0. Excluding Outside influences ll. Deiflcation l2. Suppression of Aggression l3. Rejection of the Homemaking role lh. Equalltarlanlsm l5. Approval of Actlvlty 23 i6. Avoidance of Communication l7. inconsiderateness of the Husband i8. Suppression of Sex i9. Ascendence of the Hother 20. intrusiveness 2i. Comradeshlp and sharing 22. Acceleration of Development 23. Dependency of the "other b. ineliabiilty Coefficients of stability and internal consistency are avail- abie for the PARiI A median scale coefficient of stability of .6k is reported for Form iii of the PAPi {53). The population consisted of sixty student nurses who were highly homogeneous in tenms of age. education. and soclo~economic background. They were retested after a three month interval. A median scale consistency coefficient for Fons W of the PAM is reported of .67. These reliability co- efficients seem adequate for the purposes of gnoup date. c. [sliditx The PARi has been based on the Hark (39) and Shoben (54) inven- torles. The original item pool upon which the final items were based consisted of those items in these two studies that discriminated at the .05 level or'better between their experimental and control popula- tion. 0n the basis of these items. Mark was abie to discriminate be- tween the mothers of Schizophrenics and the mothers of control subjects. while Shoben was able to discriminate between fifty mothers of "pro. bl. dIildren“ and fifty controls. Shoben's inventory was thm 30 cross-validated on a group of twenty mothers of problem children and twenty control mothers. A validity coefficient of .763 was ob- talned. Since the MRI scales contain many of i‘lark‘s and Shoben's items. and since many of the other PARi iteins have been modeled after these items. some measure of "concurrent validity" has been assumed by the authors of the Mill scales (53). Many studies are now underway to determine the usefulness of the PAM scales. in particular. Schaefer and Bell report that a "predictive validity study" has begun at the National institute of liental iieaith. in the strictest sense this instrument must be considered as a rela- tively unvalidated technique. The fact. however. that it had been deveiOped on the basis of the most valid instnments of this type and its established reliability conmnded it to its present use in this study. d. Aeguiegccncg gcalg There is one aspect of the MRI construction that may limit its future usefulness. The Pathogenic scales it will be recalled. are scored upon a ll-peint scale running from "Strongly Agree" to “Strongly Disagree“. Scales of this type have been found subject to e. "response bias." A tendency to agree on the part of the subjects in either the experimental or control groups would constitute such e bias. Consequently. when differences between experimental and control sanples are found. they are often discovered to be partly a function of such a response bias. Therefore. higher pathogenic scale scores Ilfilt not be related enly to the content of these it“. but 3i also to some such factor as "acquiescence." Henley (25) has re- ported in one study involving l53 college students that met of the variance on the F Scale (a scale used in the California study of the "authoritarian personality"; the scale is also constructed along an Agree-Disagree dimension) seem to be a function of such a factor of “acquiescence". rather than of the content of the Authoritarlanisni scale. Jackson and ilessick have (28) found a positive correlation between F Scale scores and reversed F Scale scores. thus indicating the presence of an acquiescent response bias. ‘ To check on this possibility. is items from the F Scale of the California Authoritarianism Scale and is reversed content F Scale ltuns were interspersed systematically anong the MM items. The reversed F Scale items were prepared by Jackson and liesslck (29) in the following manner: The original F Scale item was so altered that agreement with this item indicated an apposite view to the original F Scale item. For exalzpie. one F Scale item read: "Obedience and respect for authority are the most important virtues children should learn." After its change it read: "A love of freedom and conplete independence are the most inportant virtues children should learn." henceforth these 30 item will be referred to as the "Acquiescence Scale." One Acquiescence Scale item was inserted after every three successive mu items. The total in- ventory ministered (Appendix 1.) consisted of “#5 it's (”5 PAN 32 items Ind 30 Acquiescence items). This feature of the study can be considered as a methodological investigation of the MRI scales. as well as a check on the oeanlng of the particular results of this study. B. £merimental and Control Gregg; The subjects of this study were drawn from mothers of patients who were receiving outpatient treatmt at the Ehlldren's figspital in Detroit. illichigan during the spring and sumer of l957. All mothers bringing their children to the selected clinics during specific times were asked by either their doctors or this writer to participate in the study. With very few exceptions. all- agreed to participate. They were a mixed racial group of primarily lower socio-econoeic and educa- tional status. (See pages 3640 for a more complete description). They were not a cowletely indigent group. since they were able to pay small fees for the medical treatment which they received. Hospital authori~ ties state that their average patient pays 30 percent of the regular $5.00 fee; this would apply to the mothers selected for this study. it should be noted that the .vast bulk of clinical experience with mothers of asthoatic children has been based on other socio-econooic groups. prioerily vdlite olddle-incone families. The use of the present papulr- tion, aside from considerations of expediency. can be justified on the basis that generalizations based upon clinical experience with white. higher socio-econoolc groups have not been limited to these groups. . I i l I! .i l O I v. . s... II 1 i .i i A i la J .. i . t . s I ee ‘5‘ . I c- I a .0 . . . i ll , ' a ‘ . p . i ,l s _ . n i . O».- 33 i. merioental Group LA. gathers) The experimental group consisted of twenty-five authors of osthntie children under treatment in the Allergy Clinic of 5 hiidm'g m. The diagnosis of asthoo was node by the hospi tel staff on the basis of clinical synptons as previously described (pages 5-7). The usual range in severity of astluatic symptoms found in an out- patient clinic was present. henceforward. theee anthers will be referred to es the Q. mothers. 2.”. we .2” the The first control group consisted of twenty-five mothers of children undergoing routine surgery at shildren'g mspitai or being treated in the outpatient department at ghiidran‘g for oinor cuts and burns. lilneteen of the oothers were obtained from the Surgery Clinic. more their children had undergone surgery for: hernias. tonsils. adenoids. and circuncisions. These operations «ere minor and. for the nest part. were considered to be relatively nonotramatic. The anthers were tested several days or weeks after the conclusions of their childrens' operations. It can be assumed that most of the aethers' anxiety associated with the Operations had been dissipated by this tioe. "Io rel-lining six mothers were obtained from the Outpatient Department. They had brought their children in for treatment of relatively linor cuts and burns. These mothers were also tested during the terminal stages of their childrens' treatment. Any situational anxiety attend- ant upon their childrens' accidents can be asslned to have dissipated et‘ ‘3. . o 3“ by that time. Children were excluded if they or their siblings had a history of severe allergic or chronic illness. in short. these mothers from the Surgery Clinic and the Outpatient Department (O.P.D.) can be assumed to be mothers of relatively healthy offspring. who had come to the hospital for minor. non-traumatic. routine services for their children. if the psychoanalytic formulations are correct. it is expected that these mothers would manifest lass psychosexual conflict and diSplay less damaging childaroarlng attitudes than the mothers of the asthmatic children. Henceforward. these mothers will be referred to as the S.'0.P.D. mothers. 3. ‘gquivalent-ill Controlflfiroup‘iR.H. Hothersl The second control group consisted of the mothers of children with rheumatic heart conditions being treated at the Rheumatic Heart Clinic of ghildren's flosgital. These mothers will be referred to as the R.H. mothers. Rheumatic heart children can be considered as an equivalently- lll group of patients whose condition is 59; thought to be psychosomatic. Mothers of children in this clinic were excluded if the children also had a severe allergic condition such as asthma; their siblings also had to have a history devoid of a serious allergic condition. Rheumatic heart disease is a severe. chronic condition which is fairly similar to asthma. in terms of severity and chronicity (32). it is a condition that gener- ates great concern and anxiety among parents since it can lead to death and can be very disabling. (As with the asthmatics. the mothers of the very sick Rheumatic Heart children who were bedridden or otherwise unable 35 to suite part in an outpatient treatmmtt progru were excluded from the study. These children were restricted in activity much as were the asti-Itic children. since ovoroxortion could lead to a recrudesconso of sywtoms. Their condition could be arrested or sommdlet inroved. but in most cases could not be permanently and coqletely cured. Their treatment. as in asthma. required periodic visits to the outpatient department. and they received regular medication. is was felt that it was particularly iwortant to have such a control group in a psychosomatic research project of this sort. without such a group it would be heard- ous to draw any conclusions about differences found between mothers of esti-etlcs and nonnals. hany workers concede that mothers of satin-tics are more anxious and conflicted than mothers of non-asthmatic children. but they explain this phanmonon more parsimoniously on the basis of the realistic danger that the estimatic child is in beemiso of his ill- ness. and the burdensome and continuous Mnds that such a child places on a mother's psychological resources. if there is something excessive about the anxiety and conflicts of these mothers that in some measure contributes to the illness of their child. then. on the instrument used in this study. the mothers of asthmatics should appear more conflicted than the mothers of the rheumatic heart children. However. recurrence of onto-s in rhematic heart disease is much more serious in its con- sequences than is the case in bronchial asthma. for it often leads to death. Therefore. this group of patients represents a very "conservative" control group in this research. (in reality grounds alone. the mothers of 36 children with rheumatic heart conditions have more reason to be anxious and conflicted than the mothers of esthmaticchlldren. if the mothers of estimatic children give evidence of greater psYChO'sexuei conflicts in this study. then these findings will be even stronger evidence in support of the psychoanalytic aeeulptions. This same line of reasoning can be extended to cover the hypothesis eade regarding child-rearing attitudes of mothers of astinatic children. and the necessity for an equivalently-iii non-psychosomatic control group. if such a control group mere not included. end differences were found in the hypothesized directions. then it might be argued that the differences were a function of reality considerations i.e.. the asthmatic mother. due to the illness of her child. has been cowelled to be more restrictive in order to prevent overuertlon which could lead to en astimatlc attack. etc. it mid then he exceedingly difficult to attribute her excessive restrictive- eees. even partially. to factors involving her can emotimal difficulties. 0. Biological gescgigtlon of Minion The following tables present data (obtained from the geseerch W. Appendix i) concerning the soclo-economlc. religious. and racial backgrounds of these mothers. in most areas. as can be ob- served in Table l. the mothers are surprisingly similar. They seem to be dream primarily froe upper-lower and lower-middle classes. A family income of approximately $5000.00 and a better than eleventh grade educa- tion of the mothers attests to their not being from the most depressed it; u . o it a . e I I . . . . In . _ .s s. i . ' a u | . s as s «o a . ... s CI . efl a j. in do w .0 ’ .e u ). c. I O r e C i . i rs e I V was K t l . . e... 37 antic-economic classes in Detroit. (The perseverance of these mothers who bring their children. year in and year out. for weekly or monthly treatments also reflects a level of personality organization that al- lows sacrifice for longotere satlsfactlons; this degree of ego strength is not characteristic of the lower-lower class). The stability of these families is also attested to by the fact that these are primarily intact families (mother and father living together). Perhaps the fact that the asthmatic group did not have an appreciably higher nlmlber of mothers separated free their husbands is relevant to the focus of this study. lrhiie this is an adalttedly crude index of marital stability. it does allow a gross reflection of internal familial harmony or strain. it mlggests that the astimatic group may not be radically different them the control groups in terms of familial stability. at least as measured by this index. The husbands' occupations were also typical for upper-lower and lower-middle classes. The majority held either factory Jobs. lower civil service positions. or were clerks and sales~ men. (This information also was obtained from the Research Volunteer forms). Tet. their below median family income (Mdlan family income for Detroit in l957 was over $6,000.00) prevents the group from being mibred as a middle-middle or upper-middle class group. liith the exception of race. the mothers were unselected for the variables in Table is therefore. their similarity is all the more significant. Since race is such a determining personality factor in any multl-racial culture. it was felt necessary to have an equal water of whites and 38 Negroes in each group. Later on in the analysis of the data. it will be demonstrated that this was a necessary precaution. TAOLE i SOiiE SOCIOLOGICM. WTERISTICT OF EXPERIMENTAL AND CONTROL SUBJECTS m ~ 2: WE hELiGiOii (MANOR FAMILY MliTAi. STATUS Living liegro White Protes- Catho- Years com- lncome with Sepa- tant i is pieted iiusband rated "at" l5 l0 l7 8 ".7 $392l.28 l9 6 M" l5 l0 l9 6 ll 0 that: on :2 s Mothers ' ° ""°°'°’° l5 l0 2!. l ll.S thl33.60 22 3 iiothers A A The differences reflected in Table 2 would seem to be largely a function of the nature of the illness represented. The operations that the children selected from the Surgery Clinic were undergoing. were those normally performed at a young age. Rheumatic heart disease. on the other hand. afflicts children at a later age than does asthma. iiore boys than girls have hernias. however. the reason shy there are more girls thaniboys among the rheumatic heart children is not presently clear. The large families of the rheumatic heart children afford a hint that these families may be drawn from a slightly lower class than the m-mw er No-00..-“ 9i -0. O mun-e— ”.0.“ r .--e.—-.- “A I . . e s ' ' . o __ - ‘ 0 ‘ l ’ . ‘ .I . ‘ I ' " ‘ I l C 39 TABLE 2 SOME SOCiOLOGICAL CHARACTIIISTICS OF SUIJECTS' CHILOIEI "h.“ rig-7 $733.31 2;:?:::;“ ‘ 7.u lh ii 1.9 :fi:7::::‘ ”"" no.8 9 '16 . 3.9 :g;?;:;:° 3.3 19 I i I lie V children in the other groups. ‘Thls speculation is supported by the fact of the slightly lower educational attainment of the rheumatic heart mothers (see Table i). Rheunmtic heart disease. in general. is a disease wish is intimately connected to lower scale-mic status (#9). Table 3 describes the ordinal position of the children in relation to TAIL: 3 OROIHAL POSITION OF SUBJECTS' CHILD W ~I~ A 3:: Only Child Oldest Child Youngest Child Other Asthmatic Children 1 9 3 ‘ Rheumatic Heart Children ° 7 i '7 S.eO.P.O. S h» i0 6 Children #0 their siblings. No startling differences can be noted that would dif' ferentlate the asthmatic children from the other children of both control groups. in particular. the number of asthmatic children who are the old- est should be noted; their number does not seem significantly different than those of the other groups. Hany clinicians have speculated that being the oldest child subjects a child to extra psychological difficult- ties. Students of asthmatic children have noted that they are frequently oldest children (e.g.. 30). Yet, this does not seem to be the case in this study. The low number of Rheumatic heart children who are only children or youngest children can also be attributed primarily to the nature of the Illness. since it strikes children at more advanced ages than does asthma. O. gtatement of Hyggthesest how that the research design has been detailed. the following hy- potheses can represent a more final. explicit. and Operational restate- ment of the focus of this research than was possible in an earlier section of this report. flmthesis i: liore mothers of asthmatic children are characterised by intense psychosexual conflicts than the mothers of controls. This will be manifested by stnonger "Overall Dimensional" scores on the I giagky :lctureg Test. it also was expected that additional differences in theyllgggx data relating to the specific nature of the conflicts of these mothers would hi appear in the data and provide the basis for future, more precise studies in this area. From the literature already reviewed in this paper. it was expected that these differences would show more A. mothers manifesting a greater degree of conflict in the area of unresolved de- pendency relationships with their own mothers. with considerable diffi- culty in expressing their hostility towards their mothers. Also expected were intense feelings of sibling rivalry. Since these conflicts would center about pro-genital conflicts. it was further expected that more mothers of asthmatic children would have stronger Overall Dimensional scores on the Cards i. ii. and iii of the'glgghx test (these cards center about oral and anal conflicts). flypothesis 2: The mothers of asthmatics exhibit eore psychological- ly damaging attitudes regarding child-rearing and family life than the mothers of control subjects. This will be manifested by a higher mean score on the pathogenic scales of the PARI. it was expected that thclfigfillsubscales would allow’for a more de- tailed anaiysls of group differences. in particular, it was anticipated that the mothers of asthmatics would tend to be more over-possessive in their relationships with their asthaatlc offspring. This would be reflected in over‘invoivement with the activities of their children. a self-sacrificing attitude regarding motherhood, a tendency to dis- courage the independent strivings of their children, manifested especial- ly by the suppression of their sexual and aggressive strivings. and a general fostering of dependent attitudes in their children. This would #2 be manifested by a higher mean score on the following OVERPOSSESSIVE Subscales of the PARi (Martyrdom, Soppression of Aggression. Fostering DependencY. intrusiveness. infantllizatlon, and Suppression of Sexuality). E. ‘1gglementetionof the Research Desigg: As previously noted. this study was conducted at thidren s flggglr 33g, located (szzh St. Antoine) in Detroit. Michigan. All of the instru- nents used in the study (Research Volunteer Form. 11551 and 33;) were protested on l2 subjects: four mothers from each of the three groups. This constituted the "pilot study." an the basis of this experience. some einor revisions were made in each of the three instruments to facilitate comprehension (e.g.. the word "bowel movement" was substi- tuted for "defecetd' in the ELSE—KI: etc.). Due to the insignificant character of the changes, the data collected in the pilot study was included in the final analysis of the protocols. The study itself was conducted through the spring and early summer of i957. The mothers were asked by this writer or their doctor to volunteer for the study at the time that they brought their children for treatment. Host mothers readily assented and almost all mothers who agreed appeared for their testing appointments. There seems little room for bias in this area of the study. when mothers were unable to come to the hospital for testing. they were tested at their home. Five or six mothers in each group were tested in their homes. The remainder were tested at the hospital in small groups. The average group size #3 *wes three to five subjects. The small size of the groups was simply a function of the difficulty in collecting the mothers together at one time in larger groups. The subjects were told very little about the purpose of the study. They were informed that this was a study of maternal attitudes toward child-rearing and that the study was being conducted in several clinics in the hospital. it was felt that a minimum of threat was thus involved in the study. Standardized instructions for taking both tests were used. The mothers spent two hours in completing the tests. Their high motivation seemed to be,in part, a result of the intrinsic interest of the test materials and in part, a result of their feeling of loyalty to the hospital. Many of these mothers have been obtaining low-cost medical care at the hospital for years and therefore feel very grateful for the help which hospital personnel have rendered their children. iii. ANALYSIS OF THE DATA A. piggy :ictures 1935 gesuits l. flalysis of "Overall gimensionai gcgres" a. legal Semis. The overall dimensional score is the most lmortant score in this study. for it alone affords a test of the anor question of this study: are the mothers of astissatic children eore emotionally disturbed than the mothers of control subjects. it can do this because it is a comprehensive type of score. which sums up a subject's total test performance along a given psycho. semal dimension. A "strong" overall dimensional score for e parti- cular card indicates psychosexual conflict in that area for the subject. The first analysis of the data consisted of sewing up the total strong (both "very strong' and "fairly strong") overall di- mensional scores for each mother. Each subject. «suing a maxim of psychosaxual conflict. could get a score of i3. since there are l3 psychosexuai dimensions in the Blacky test. The liedian Test (55) was used to determine whether the A. mothers would exhibit psycho- . sexual conflict in a larger meter of areas than the anthers of the control groups. This statistical procedure tests the hypothesis that the A. group would have a larger number of eothers who would have a tgsal of strong overall dimensional scores above the median for the u. .l l' _ . . - I A u I t! a L . 1‘ . a . - i . .‘ I 1-: l. l .; I -. A I v \ I , . I' 1. i . | .2 . - - i .4- I on: ’r-, anti)!“ on! {-3 t|t‘1.-"‘.”\ “‘i‘. .ii') :2. 3w... hit-A. mt 2 «n: to‘z Mikes: as: ‘\ I'll II I u I I. .- a e n I I' In: I 1+5 entire group of A. and mu. aothers (or A. and s.-o.r.n‘. mothers). Six was found to be the eedlan amber of strong overall dieenslonal scores for both A. and Lil. eothers. lion-parametric statistics were annoyed to analyze the data. since the assuwtion of a noreal distribution of scores cannot be made with 11925.! data. in the iledlan lest. the chi square aethod was used. The Yates correction was also used whenever the theoretical cell "mercies were less than 10 (56). Since predictions were Iada in a given direction. one-tailed tests of the hypothesis were utilised. TAB L! ‘I tom man or smell mutt oimsim scouts It momm 503mm roe A. was me Hi. hornets (mm. W): n-So .__—-____ M ,— v 7—— , _._‘._._‘ Scores Scores at Exccodi ng or below Total s Hedi an nail an A. Mothers 9 l6 :5 I. ii. Ni ii Ethan ” A25 Total s 23 27 50 x 2.0l; .lO > p ) .05; (one-tailed test) -. 'I l1" ii . I I ‘I ' If .; - - . . ,. ‘ . I. .. I. ' ”a. a I I I: I] h ’ I e '1 ~“~"’“‘~-~ ‘- .... mm”,..~-. L' . .‘ I I. i'.‘ a“.-- .- >_ ..._, (Jet; z...“ “vi-em.) ' "u- . _...-, ""“-a-. w .. ..«< A .‘ . l .' i ' u . __ Ma...” .-‘—-., ' 1&6 TABLE 5 TOTAL IUi‘BER O? STRONG OVERALL MENSIOML SCORES IT iiiDiViDUAL SUBJECTS FOR A. MOTHERS AND S."O.P.D. “OTHERS (TOTAL SAMPLE): 0'50 Scores Scores at Exceeding or below Total s A Hedi an #liedl an limit" , 9 '6 25 :otgei’so. 7“ i8 25 Total s * l6 310 $0 " 120-375 not statistically significant; (one-tailed test) Tables ‘0 and 5 indicate a lack of statistically significant differences. Apparently. then. A. eothers do not manifest conflict in a larger number of psychosexual areas than control mothers. at least as insured by the glackx Fifi-2 (Table ii indicates that the Ad. mthers have a larger nun-oer of strong overall dieenslon- al scores than the A. soothers. This difference aleost approaches statistical significance (.iO') p ) .05). The leaning of this n..— A AA ___. 2Statistically significant differences were found idien the liedian Test was applied to the same differences between the Rheumatic lieart ”there and Surgery-tho. anthers: A greater number of mil. lothei's had scores exceeding the median (x 3.90; .025 ) P ) .00. See Table 26 in the Appendix. These data suggest that R.ll. mothers are more psychoseuualiy disturbed than Sum-0.7.0. anthers. (Throughout. the lack data analysis. the R.ll.-Surg-0.P.ii. differences will be analyzed n an atteept to explore the role of the reactive factor in causing psychological distress in A. mothers.) .. I i I . i i ‘ I I ’ . . . I I .. ‘ 3 I u '1 e I l I ~ l l h. e I .. .. .. - . . ._ .- .~ . - .. - - -- I a I . _ .— . . a. - a o - .- \ . . _ i I I .. ml 0 I- I .. . e i I I i I 01 . .l i I I e I l i I I - I I I e . I i l 4 . .I I I I 2"“) ate. . -I -.« . ‘ - ‘ molar-it...» ...-. . ...;.'.2 .. ...i. - endosc'ImeJ-. . ;_I .l= .L...’ .1 "N ‘9 .I la a‘ 0’ It H" I) Hallie! ed! m Mac: was «cmseliie as.“ My“ yllaairsianu‘ a“ stimuli err: astound «4.151 “I. I .- em '3; only, we- in! ram 11 To nm' mum; .- ..~Ia.:7rr. “unset-up“? the “Meat .(io. ( .3 c '52:. M1,; ‘1; an." ma; ”may. a“... g. «new "filth“ .t-‘J'I J:..'£J l;€;; t; net-a are.” .xiuchA art: hi .3 er: .snedgwsdT) .auwm 5.41.1414 M53) mum» MW “3?.“ 0‘ ”b “WTTiS ,‘l,'-,'_-'-;-*I-.T.- .fl.'3 ":54 .AIt‘yiul: (765 “a guinea ei meal ruin.- . m l' 3&1 7. :‘l‘lcfifv a. mum". as v I a. . I ..T l ‘07 trend is not clear.) The results in Table 6 represent a further analysis of the overall dimensional scores for all aenbers of the experiaental and both control groups along the l3 individual test diaensions. The A. mthers were paired with each of the other two control groups. The chi square teciuquue again was used to analyze the data. in addition. the Yates correction was utiiieed Idienever the enpected frequencies were below in. The table indicates that three of the tests were significant beyond the .05 level of signi- ficance. e l r f a th i individual tests we aeda. one could be simlflcant by chance alone. Therefore. three significant tests reflect better than chance results. 3in a cosearlson of Lil. and s.-O.i'.l. anthers. one significant difference was found. (Tdile 17 in the Win). The A. ll. aothers he! stronger overall diaenslonai scores on Card Viii "Sibling Rivalry" (x 5. i8). There was also a tendency for the A.!. aotharsto stranger overall diaenslonal scores on Card i (A 2. l6; .l0) p ) .05). Card i neasures the psychosocial diaenslon of Oral Eroticisa. These findings. together with the simlficant findings reported involving the A. nthers. is consistent with the clala that - . f out ch ran appear acre psychologically conflicted than the anthers of healthy children. The fast that the anthers of astluatic children were lore conflicted than the eothers of thematic heart children sug- gests that seas of their conflicts were antecedent to their child's llness. v,| -. l - _J L. . x4 11-1 WEED-MM ...!Jis-zhm .ii,A tc mheqenoell‘ "T W .3.Aad‘i .blibaew eds n5 '{8 side?) .anuol eaw W. _ ”f. ~ . t” "N in“ no sauce lamina“ iimmw ‘ was? . _.l and and yonat—ez e ceie we seen”: .(fla .{af‘é [{flk : it t he: an eaten: ranches-rib ”new A sane lo noienmib immune an: eeweaeti . J .-i barman Chiba“ tannin“ anti this: Image: .m i mi: flit—i.) an: chin: Insular-co al .rwedaaa As. If“? , Us - - on“ own ~ ' d the mom“. “3&qu once he” and!“ em ta Mae an: m seat ., r .Imamo mung. ”I.“ died at” to unnamed: nan. sacroiliac: on.“ em slash ca Mos new norms-o emu ’7: none sens one. can!" «8 TABLE 6 OVERALL DIMENSIONAL SCORES FOR TOTAL SAMPLE: n-75 as? cant?“ .: m: Ws.~0.r.a. 3:11;. 3:1 Int." lack A A. a non- . iiothers Hothers iiothers A.&A.ii. A.sS.-0.P.0. new . e M - h e _ . How _3 - 3+ 3 0 + 0 + 0 .0 Oral ‘ grotigisn NI ll J; l} 6 l2 ,1; 5.1! l'e Oral H (BE-J. )0ng W8 l7fi 2 [6 .liL ., _0.90 __ fl (“.1 l l2 i i ll 0.00 W 9:00 W. Oedlpai‘ Intensity 22, 3 i6 j ”i ii 2.2% Vii.86t 'e "limita- sigg gum 1 l6 I; l} 310 I; .11» 0.0g . VI. Penis w ‘ *“Wz LL: m.) identifica- _t_l2t_I graces; l2 .6 , l6 fir l5 2 .28 .18 mam- - It. "“18 1 l0 1;- .78 A ma IX. Inilt _ . [egiinn 8 i7- l} uv ll l‘iW LOW .22 x. Ego ideal, l0 715 [2 i5. W8 11 @9901- 0.l0 ll. Narcissistic mg 00193 ”L 7.3} g 12 g Liana 0.00 X‘s MaCiit‘c Love object l7 8 l1 l3 ill ll 2.06eee 0.36 4‘ ’p .025“.Oi W a05‘e025 “in .i0¢.05 (trend) All 12 values represent onertalled tests. 1+9 hypothesis l. therefore. gains soae support free the results in Table 6. iiowever. since the nuaber of significant tests is so seaii. it should be emphasised that the support these data gives to the psychosoaatic interpretation of asthaa is slidit. An analysis of the content of the statistically siwiflcant tests affords hints as to the nature of the possible. aajor con- flict areas of the asthma mothers. Table 0 indicates that these anthers are aost disturbed in the area of their oedlpai relation- ships. On Card iii (“Oedlpai intensity") they have higher scores than the anthers of both the equivalently-ill and the healthy controls. ibrecuar. the differences on Card ill between the asthaa and surgery- o.p.d. anthers are greater than the difference between asthee and rheuaatic heart anthers. as is expected fnoa considerations of the reactive role of physical illness in children in generating psycho- logical conflicts in aothers. The asthoa anthers also had higher scores than the surgery-o.p.d. aothers. that were statistically significant. on Card l ("Oral lrotlcistd'). This last finding is in keeping with Boerling (57). Manor (30)‘et al.. and Coolidge (l0), do have written on the pro-genital nature of the conflicts of ., aothers of asthmatic children. The possible centrality of oedipal conflicts. however. may be a particular contribution of this study to thinking in this area. There were some trends (.lO ) p).05) in the date that ought to be noted: The R. ii. authors had hiyier overali diaensional scores than A. anthers on Card ix (“Built Feelings") and Card Xi 50 (when scored for “Narcissistic Love 003x00." The A. mother! had higher overall dimensional. scores than the R.ii. mothers on Card Al (when scored for "Anaclitic Love Object“). The fact that the A.ii. mothers appear so conflicted on Cards It and xi further underlines their disturbance and again points up the possible im- portance of the reactive factor in inducing conflict in mothers of physically-ill children. The greater disturbance on Card Xi that the A. mothers show reflect their heightened erotic interest in their fathers. an interest that is consistent with their pra- viousiy noted Oedlpal conflicts. ' b. its l . Due to the large negro-mite personality dif- ferences in our culture. it was decided to cake a separate analysis of the data along racial lines. Since this is a study of maternal mtional health and child-rearing attitudes. this is especially indicated in View of the unique role of the mother in negro family life.(l6). A non-parametric statistical test was again used to analyze 2 this data. The A test could not be used since the War of sub- Jects in each group was less than twenty; there were ten white mothers in each of the three groups. fishcr's Exact Test. conse- quently. was the statistic acployod (55). “Table 27 (See Appendix) indicates that the A.li. mothers also had significantly higher sgores than s.-o.r.s. mothers on Card Viil ("Sib- ling Alvalrr‘). The A value was S.l8. .025 ) p ) .0l. They also showed a tendency (.iO > p > .05) to be higher on Card i ("Oral troti' giw.) m m ‘e'Oe'e.e ”was Si The Hedian Test utilising Fisher's Exact Test as first used to analyse the totals of strong overall diecnsional scores for all dimensions between the A. mothers and s.-o.r.p. mothers. The results presented in Tables 7 and 8 indicate a lack of statls~ tically significant differences.5 TABLE 7 ram. men or swam ostLL "mum scones er iiiDiViWAL smart" ran A. MOTHERS no em. nouns (WIT! SAHPLE): n-20 Scores Scores at Exceeding or Below ‘l'otais W new a new A. iiothers 3 7 lo M. W ibthers 6 A “ l0 Totals 9 il 20 w iiot statistically significant .A A. L. A. 5There were also no statistically significant differences batman the Lil. and Surge-0.9.9. mothers as regards their total overall die- ensionai scores (See Table 28 in the Appendix). 52 TABLE 8 TOTAL iiUiiBER 0F STRONG OVERALL DiHENSiONAL SCORES BY iNDiVIDUAL SUB- JECTS m A. mass AND 83%,... MWEIS (WIT! ME): n-ZO Scores Scores at Exceeding or Below Totals _ Hedian iiedian _ A. . ibthers 3 7 '0 c222 a 7 2° Totals 6 “i 20 liot statistically significant Table 9. varich analyses the overall dieensienal seeres of the visits other: along the l} soarate dieansions reveals a lack of statistically significant differences.6 The previously noted trends in favor of greater conflict for the asthea anthers than LI. others on Card iv. however. Just eissed being significant by one case. For this reason. the results ‘obtained from such a snail samle can be Iaisieading. Significance sould have been achieved in this case. with. the sane percentage of eothers in both groups showing strong conflict had the sample been larger. This factor of sessile size eekes the interpretation of results obtained fro. the racial analysis of the data. hazardous. since the separate 4. ‘me am. mm lathers had stronger overall dieensionei scores than the 8.°0.P.D. vhite mothers on Cards Viii ("Sibling Rivalry“) and X ("Ego ideal"). This again suggests that the Lil. eothers were more disturbed than the S.-O.P.D. mothers. (See Table 29 in the Appendix). ..-4 ... _ l .. ulll . I‘ll-I'll. . _ a L a A A I. . . I II ail . a e . i is a i | . i I vi . i O r i i a .l i . o o . a s . l a 53 racial seeples are so snail. Therefore. all results of the racial analysis should be considerad‘as-only being suggestive and in need of repetition using larger samples. TABLE 9 OVERALL DIMENSIONAL scenes '0! HHITE MOTHERS: n-30 “a g .- a‘eee nen- ‘ Hothers flothers Mothers a Adi. S.-0.P.b. 1L“ W935... _# dh fl «r o g_4r o ‘f i. Oral [Qticig 5 5 a h 3* 7 high 3.1». ii. Oral .—...—.§§9"' _,av.: h as, 6";72;_ _ 5 2 I! AJLJL__.____!s§s_.__ ..‘e Mal Sadiflli *— ' 129-) “5......Ll 3 J. 3 lei-u 3:54.... iii. Anal Sadisn ' . Knot.) h 6 5 5 6 u_~h fl l,§, 5,}. iV. Oedipal » intensi t! 21_§_,.,.__.__§___Z____}___I.J "1.1:...— V. Nasturba- 7 tion guilt 3 z 5 5 8 #5‘1. ‘ l.§. VI. renls gnvy 0 lo 0 l0 i 2 Lg. lid. Vii. identifica- tion Process_ 8 2 ##7 3 .«2 1L I.3. I.§. Viii. Sibling Rivalry 6 h I. <}_ 2 8 ".5. N.S._ ix. Built fgglings } z 5 5 6 4 fl.§. !.§. X. £90 ideal h 6 Z l 2 8 l.i. n.1, Xi. Narcissistic Love ObjeCt _] 1 2 i 3 2 __8.§.;» "3!. hi. Anecntic have Oblectg: 6 _ A? Q I 4 8 2 tfiifi. K.§. *h.i. (hot Significant) signifies a lack of statistically significant differences. 5h c. negro sale. Tiles l0 and il present an analysis of the totals of strong overall dimensional scores for all dimensions between the A. mothers and control mothers. The differences are not statistically significant.7 TAIL! i0 _ TOTAL iii...“ 0! TTAONG OVERALL OIMNSIONAL SCORES IT iiiDiViDiiAL $03.56“ FOR A. ”THE” AND ii.ii. MOTHERS (NEGRO MI): 0-230 Scores Scores at Exceeding or below Total fl M:#fi Median W fiedian W .W A. ibthers ‘ , 9 '5 l.ii. . ibthera k 8 7 _ '5 Totals ' ill I i6 30 Not statistically significant 7 e- a Table 30. in the Appendix. indicates that there are also no statis' tically significant diffarences between Lil. and Surg.-O.P.il. mothers . (liegro) for total number of overall dimensional scores. wrest“. meg-2.2a. 2. ...: ...; mane m’fin’) a“.-. “A”; ““44 :r; “- 7“: .“ T‘Trm .2- 1; r:.§1a:f.;:..1 , i938? amp; to .49... El “1...- dd“m~o-¢e¢———— _7 «We a: we“ airs-D's: sea: antenna mu... m. «a: -: arm Athena! one u mean: arm-... aw. .. ‘ .051“! inheianwlb hunt. is 1th.. i g r 6"»:{3‘ Si'flTiA ii I 2 ' 150 Tera 55 TABLE ii Tom. men or snout ovum. slntuswnnt scouts av iiiblVlOUAL saucers ron A. MOTHERS mo s.-o.r.a. nomtns (nacho shirts): n-30 :23... Scores at Exceeding or below Total W, Median Hedian A A. ' iiothers 6 9 '5 s.-o.r‘.o. Y x huthers ‘i ll i5 Totals lo 20 30 Adi. hot statistically significant Table l2 indicates that among liegro subjects. three coweri- sons of overall dimensional scores achieved statistical signi- ficenca at the .05 level. in two cases. the coaparison involved the asthea nothers and the surgery-o.p.d. anthers; the asthee eother emerged with higher overall dinenslenal scores. reflect- ing greater psychosexual conflicts. The two cards on which the- asthea nothers scored higher were: Card i ("Oral Eroticisd') and Card W ("Oedipal intensity"). Since only one test would be significant by chance alone among the twenty-six tests involv- ing the asthma group. these findings again indicate soee support for the psychosomatic position. in the 3rd significant test. the surgery-o.p.d. mothers show wore conflict on Card ii ("Oral Sadisaf') than the astivna mothers.8 _s_‘_._ 8There were no statistically significant differences between the and surg.‘0.r.0. anthers in this analysis. (See Table 3i in the ”PMT X) e 56 TMLE i2 OVERALL DiliENSiONAL SCOAES FOR NEGRO MOTHERS: n-ll5 A‘ lack ‘ $.-0.P.D. Asthma Asthma a glean- iiothers lathers iiothers s li.li. $.r0.P.0. gion # Homer! Hotherg #d- 0 + 0 _ + 0 w .e 0"} W w groglcig fifi 6 6 2 1 l2 mg. .05__ 6's or.i gadisra _ '1 i} '3 ll 8 7 a AM. .05 ' iii. Anal Sadise ‘ a f A 193:.) Ml fim l0 6 2 W J .8 22.1% LL iii. Anal Sadisnl 7 w . _._ . (M‘Q) Wu 3 7 L 8 "’1. “9L ‘ Intmglty I; 2 ii if J L 8 wk _ .05_ 'e ”sturba- tigg guilt 6 , 1 7 8 8 7 ii.§. ii.§.__ V's '8“. ...—Jam 0 Is.___.1__.a___3___u.st2 I I e an... Vii. identifica- L tion Process ll 1. 9 is $9 6 g 31.3; ”ii-h. '6'.e s'bi'flg _ _ Livairy 8 7 H h M 8 7 3:5. 5.35 it. sun: reeling; 5 l0 8 7 j l0 ink LL ‘0 ‘w ideal 6 2 3 I2 .6 1 its. n.3, xi. Narcissistic X'e M'Ciit‘c m a0b|ect lL‘ a A6 3 6 _g m. n.;._ in general. the racial analysis continued the same trends that appeared in the analysis of the total sepia. Asthea mothers epr peered to be nore emotionally disturbed. rheumatic heart mothers were less disturbed than asthma mothers. and surgery-o.p.d. mothers 57 were the least disturbed of all three groups. The esthee mothers still demonstrated greater conflict on cards I and iV. while rhetmatic heart mothers showed greater conflict on Card Vlii. The differences on Card ill and Vi" were fairly stable in both racial groups; either the differences were statistically signi- ficant. or they uproached simificance. The statistically signi- ‘ ficant higher scores of the asthma mothers in the area of oral eroticism were found'only among the negro sessile; the statistical- ly significant higher scores of the surg..o.p.d. anthers on Card ii ("oral Sadisfl') were also found only among the negro ample. This analysis suggests that negro-white personality differences may be large enough to prevent than from being analyzed solely as one group. Perhaps the most significant finding revealed to this point is the stability of the group differences that persisted both in the analysis of the total groups and the racial groups. This tripartite method of analysis (totals. vd'litesand name) will be followed in subsequent sections of this report. ” 2. l i f " ' an " The raeeindar of the 51.55! data discussion will concern itv self with an analysis of the various parts of the test that to- gether comrlse the overall diaenslonal score. This is not to be considered as a further test of Hypothesis i. rather. it is an attewt to exaeine more closely the data in order to ascertain that the particular its-s were that contributed to the overall dimensional scores for the experimental and control groups and thus learn sore particulars of the psychosexual conflicts of these 58 mothers. The "spontaneous stories" are the first separate component of the £12551,protocois to be anal scd. There are no significant differ. ences in this analysis as can be seen by examining Table 32 in the Appendix. The same trends (.lo ) p ) .05) for asthma mothers to be high on Card l and iv and for rheumatic heart mothers to be high on Card ix and Xi still are present. Table 33 in the Appendix contains the analysis by fisher’s Exact Test of the spontaneous stories for the white sample. There are no differences that are statistically significant. Table 310 in the Appendix contains the analysis of the spone tanaous stories for the negro sample. Again. there are no statlsr tically significant differences. On Card i the asthma mothers again have higher scores. They miss significance by one case when coopared with the rheumatic heart mothers. 3. basin“ of |nguia ltm a. logo! aggplg. Table 13 presents inquiry items that disr criminated between experimental and control groups. The chi square method with the Yates correction for continuity whenever the ex- pected frequency was ten or less was again employed for the statis- tical analysis of the results for the total sample. Since pre~ dictions were not made in a specific direction. two-tailed tests were made. Two hundred and elghtyeeid'lt separate tests were made. There were six tests that were significant at the .05 level. since fifteen significant tests could arise by chance alone. these 53 differences cannot be considered to be statistically significant. Five additional tests were significant between the .l0 and .05 levels of significance. lihiie not statistically significant. these eleven tests of the inquiry date will be reviewed for the purpose of gaining further insight into the nature of the differences between the A. mothers and control mothers. it is understood that the inferences that will be dram arc speculative. An examination of Table l3 again points up the greater in- volvuent of the A.mothers in Oedipal conflicts than the Mi. mothers (iii. 3a and b). The asthma mothers seem to be more close- iy identified with their own nothers and. at the same time. tend more to see their mothers as the disciplinary figure in the house- hold than is the case with the rheumatic heart mothers (Vii. la and c; Vii. 3a and c). The A. mothers also seem to be less concerned with masturbatory conflicts than the li.ll. mothers (V. 2a). The A. mothers do not some confident about Blacky's possibilities of growing up to be like her ego ideal. as covered with the Lil. mothers.(x. 5a). 8y inference. these mothers seem to view their cum prospects in a more pessimistic light. 60 TABLE i3 iiQUiRY CHOiCES FOR TOTAL W: n-75 -- Q~-aoc.- - a”- ..— --.-—‘..D— “...-“cadr-O- M -..---~.o.-.o--s‘r ----~..-.d-_mu “--.—fie" tard Question and Answer Selected Groups x2 Sig. : #4 involved Level iV. 3. iihich one of the following A ) li.li. 3.06 .i0-.05 makes Biacky most unhappy? . . a) items keeping Papa all A ) Surg.- 3.00 .l0-.05 to herself. 0.».0. , b) The idea that llama and lid-i. ‘) A 5.i8 .05‘.02 _ Papa seem to he ignor- Surg.-O.P.0. _ _ ; iniher on gurgose. J“ f 1 A44 53i8 .05-.0; V. 2. iiew might Biecky feel about A ) RJi. 2.82 .i0-.05 this situation when she is older? a) liappy without a care in the world. m. I. ilho talks like that to Biecky- A )RJI. 2.91: Joe-.05 harm or Papa or Tippyi a) llama _A v__. cl HPPX A__ A EeHL) As 6am so;.:9.l Vii. 3. Whom is Iiacky imitating here? A ) ii.ii. 3.36 .lO-t.05 llama or Papa or Tippyi ‘ a) Home A W LHJAL MW VIII. 3. Uho does Biacky feel is pay- A ) Surgu- 10.72 .05-.02 ing more attention to Tippyi 0.P.D. b) Papa x. 5. Actually. what are Biecky's - mil.) A. lni.i3 .05-.02 chances of growing up to be like the figure in her dream? two“ a As conquered with the s.-o.r.o. mothers. the A. mothers also appear to be more conflicted in the area of oedlpal relationships (it. 3a and b). There is also evidence of greater sibling rivalry 6i feelings on the part of the A. mothers (Viil, 319). There seems to be an oedipai flavor to these rivalrous feelings inasmuch as the father is the parental figure toward whom the rivalry for effect- ion is directed.9 b. flite mothers. Again. these data were analyzed by racial groups. Due to the reduced number of subjects in each group. fisher's Exact Test was anployed for the statistical treatmmt of the data. Table ill indicates that for the white mothers. six tests were statistically significant. Two hundred and eighty-eight tests were made. therefore. these six tests could have arisen by chance I alone. (Fifteen tests could be expected to be statistically signi- ficant on a chance basis). The asthma mothers again show more oedipei-type conflicts than the rheumatic heart mothers (IV. 3a). in contrast to the asthm mothers. the rheumatic heart mothers O also seen to be more Optimistic about realizing their ego ideal (X. 5.3). The A. moths rs reflect a less belilcose attitude toward authority figures then R.H. mothers (Vii. 6d). The A. mothers also seem to have this more pessimistic view of their life prospects than do the 8.-O.P.D. mothers (X. 5a). They exhibit more conflict in m. area of oral sadism than n3. s.-o.r.o. mothers. A. mothers also display more conflict in the .v_. fivv 9‘l’he statistically significant inquiry items that involved com- parisons between the ii.ii. and $.-0.P.D. mothers can be found in Table 35 in the Appendix. in general. the ii.ii. mothers seem to exhibit ‘nre conflict in the area of sibling rivalry. The S.-0.P.D. mthers tend to prefer father as a love object. .I a I I . l l - i I i I I IJ I I ‘ _ ‘. I I .. I I I I I . I O I s l s I . l .1 I II I I i I l J i l a x I . 'I l r . i I I I . I 1 I .. I s I I I ‘ I i s. I I v I I J a I . . . I I .' . I I l I I $I’ . - 1' i a. I l d I. ‘. I I I .I I . I I . . .I I e I .I I e I .I I. ‘l , I .. I a I'. I i I . I' I s l I I I . 4 .. ii I 3 I - i 'I . . . .' .th A") stoma J.) nan: «nan 29in“. .tvefiaieiane ales-sills eesd as sea. eels mm:- .s an ' '5" 4a} .5) seeds. Jaw-Jens eh nods esseqemq all! me be as: u aches One-ave ease ans ni ”Hiram awe aid!“ yin ed! el senses n- pieeib eels Ms- .A .nedsee 1.1.9.! «ere M an as” when mu...“ muumm .ac “@th .O.1.0-..shss..ssea fiWJJeflflefi mni smefizlia; 3*. 3.3.54.9 .nsavh [elidia so In. an «I Ml .hede ave! a as secs! sesame ”I 62 TABLE lh INQUIRY CHOiCES FOR WHITE SAMPLE: n-3O Card Question and hnswer Selected Groups Sig. + involved Level I. 2. How does Mama fuel in this S.'0.P.D. .025 scene? > A. w__ a)_ Very contented- II. h. What will Blacky do next with S.-0.P.D. .OS Nana‘s collar? > A. 3) Get tired of it and leave it onfithe ground. ill. 3. which one of the following A >R.ii. .05 makes Blacky most unhappy? a) Mama keeping Papa all to herself. VII. 6. What would Blacky have an R.l-l.> A. .05 impulse to do if she were In the position of the toy dog. d1» Start fighting X. 5. Actually. what are Blacky's mil.) A. .05 chances of growing up to be like the figure In her dream? a) Very good. s.-o.r.u. .025 > A. l area of oral eroticise than the $.°0.P.D. eothers (i. la). 0 b. M. table is presents the statistically signi- ficant tests that were present in an analysis of the 5.19.95! data for the legro mothers. Again. 288 separate tests were eade and only 7 are statistically slmiflcant at the .05 level or better. Therefore. ”The I.ii.~s.-O.P.I. tests that achieved statistical significance are fluent“ In Table 36 in the Appendix. These differences suggest that the 8-‘0J... mothers are eore concerned with masturbatory guilt than the Lil. ”there. They also see- to identify more strongly with their mothers. 63 these differences could have arisen by chance alone. The differences reported in Table is suggest that the A. nothars in the negro semis exhibit less conflict in the area of oral eroticism than both groups of control mothers. especially as a function of the frustration of nurturanoa needs (ll. 3a and b). The A. leathers were also dis- tingulshed free both control groups by greater oedipal conflict (W. 3b). They also appeared to be troubled were by feelings of sibling rivalry (VIII. 3b). Their sibling rivalry had an oedipai cast to it inasmuch as they were especially provoked by the attention given to Tlppy by the father. The A. eothers also seen to identify snore closely with their mothers than the il.li. eothers (Vii. 3a)." A comparison of the two racial analyses indicates that eany of the sane conflicts or strengths seen to characterize a group regard' iess of racial character. For example. asthma mothers. whether white or liegro. seen conflicted in the area of oedipai relationships. Rheumatic heart mothers. whether negro or shite do not evince conflict of an oedipal nature. an the other hand. within each group there were my racial differences. For example. liegro asthma mothers give evidence of a strong identification with their mothers. The white asthm mothers gave no such trends. As can be seen in Tables lb and i5. there were eany such differences. To sons extent. this may be a "Table 37 in the Appendix presens these significant tests in the inquiry data that involved R.H.-Surg-0.P.D. comparisons. The R.li. mothers seeeed to manifest sore easturbatory guilt. while the Sum-0.9.0. mothers seemed to express more concern over sibling rivalry. 6h TABLE 15 INQUIRY CHOICES FOR NEGRO SAMPLE: n~h5 Card Question and Answer Selected Groups Sig. __. V “w Involved _L§xgl__ II. 3. Blacky most often acts like this when she can't get enough of which one of the following? .2) Attention R.ii. ) A. .025 b) Recreation ' A. ) Surg.- .05 4_ 0.P.D. IV. 3. Which one of the following makes Blacky most unhappy? b) The idea that Mama and R.H.;? A. .05 Papa seem to be ignoring her on purpose. Surg.-0.P.D. .0l _*u A. VII. 3. Whom is Blacky imitating here - Home or Papa or Tippy? 8) "am W AODaHe 0025 VIII. 3. Who does Blacky feel is paying more attention to Tippy: b) Papa t‘e ) ReHe e625 A. ) Surg.- 0.P.D. function of the small size of our sample. Firstly. small sample results can be easily distorted. Secondly. Fisher's Exact Test is a conservative statistical procedure. At any rate. there are suf- ficient differences to caution the researcher In his interpretation of mixed racial samples. It might be best when samples must be Small. as in this study. to base the study either on an all-white or ail-Negro population. fl! figsuits l. Lotai samle An analysis of the PARI results afforded a test of Hypothesis 2. If the mothers of estimatic children in this sawie were psycho- logically disturbed, then they would be expected to obtain higher scores on the pathogenic scales of the PAM (all 9A!!! scalesara pathogenic ms the exception of i. in. is. and 21) than would the nothars of control groups. Analysis of variance and analysis of covariance (56) were the statistics euployed. Analysis of vari- ance can be used in this instance since the nature of the LEI“. scores meets the necessary criteria of: normal distribution of scores. Independence of scores. and additive nature of scores. Analysis of covariance allowed for partiaiiing out the affects of acquiescence on the M scores. in the fl rst treatment of these data (Table i6), the mothers of the experimental and control groups no onward in tan-s of their total pathogenic scores. This score was obtained by accumlatlng the scores of each subject for i9 Pathogenic scales. Table l6 indicates that the experimental group did not differ significantly from either of the two contnol groups when their total pathogenic scores were compared. 66 ‘I’ABL! 16 m3” W VMIANBE AND CWAIIHCI OF TOTAL ”MENUS SCORES 6? A. ”THEM, 3.”. ”THEM AND SROJJ. OWNERS F0! TOTAL SAMPLE: n.75 - I--‘--‘-F~-u ...-"nun..." ..- --..-- ~.m*-mm”-”u—— w‘ —*wm*-M" Laval You] Batman HI thin I Ob. of signi- _ . #3121122! flgamg X "Y 31‘570.” “96.109 30973.31. "" «- z ; w “71067 'uoha 953002,. ... fl .0. 2.1»! 2336.51 2316.51 i3i289.|6 ... ... df 7h 2 73 .... .. 73674 ....-- # 7i .22 132.36 - ... f Imus ...... l 158.26 1823M - .... y A f ' si g. “ can... - ...... ...... ' "Gt 7 A A ~ “9' 23‘2"“ A ”215.98 593.62 30622.36 .... ... inflated “ * 42.55?— m 3236.81 111.210 «- m M m m “a-.- l h‘ _ $20 '— r T y - Acquiuccnco Scorn it ~ Total Pathogenic Scorn Tobin i7 prounts an minis of «ch of tho 23 £551 males. A significant P ratio an obtain“ only on Scale 23 (wondoncy of ”W' $¢ll .) 0 Sine. by chance alone. on. significant F ratio mid luv. bun pmnnt In hunty tests (at the .05 level). tho affirm obsnrvd batman the groups on Sea). 23 any be «st-ad . u o l - . i n . i , . O D . . . . o , . 7 _ . . . ' O u - . - o I l u . u . I . | n 67 to ba chancs differences. Thorsfora. tho mothers of astilnntic children in this sonic did not how Info paniwiogicaiiy-da-sging attitudss about child-raising than control mothers. at last as nasal-oil by tho M Scaios. “IL! i7 PM“ SCORES Of A. nouns. lJi. MM”. All. $.‘0J... MTHERS FOR TOTAL SAMPLE: 0-75 mnaiysis finaiysiiof {L 5;an fiagiysism Vnri onca Covari anco f A Vari anco Covari anco ...—Ls- . '- 13. _ . t - - J. - h 1.00 ' 14. Li; W 1.35 .1. - - - , in L17 - ‘L. A ' ° 3. f - _ - n .1; - 7: - - M 4.22... ...e. t - - m- - - w 7. w 1.30 - v ijL V - - :5. , - W jg. - - J. Vidj -' _g). LL“ i.ii w[0. - - 3;. - '- fli i . A - _ - 33: 3. 15* , Ink};— .13.: a . 1.2; w t e A t I. ratios of lass than i an indicatod by dashos (c) i F. ratio significant at .05-.01 iovoi 68 Scalo 23'uas further analyzed by tho t-test (56) to dotannino botwoon vhlch groups lay tho larger. IDI'I significant differences. These data are presented in Table l8. Tho asthma authors appear simificantly less dependent as authors than do control subjects. TABLE i8 «menu or MOTHER (PAM SCALE #23) ron TOTAL was: n-75 A ' Adj «£34 v w» gas, :2: t Between Level of a... “can Roan Adjusted Significance . Heaps A. hothors i2.32 i2.43 2.0i .05-.C25 Eli. nothors No.28 l3.93 R. Mothers i2.32 l2.li8 2.88 Beyond .005 S.-0.P.D. homers ill.32 No.5: ‘0“. “others lh.28 13.93 0.78 hot significant ‘ 0.0o 'obo Mothers ill.32 ill.5i “A...“ methodological ispiications. Perhaps tho oost interesting aspect of these data lies in their Table i7 indicates that F ratios woro altored than acquiescence was controlled by the analysis of covari- once technique. in this particular tabla no radical changes in the results occurred as a consequence of using analysis of covariance. iiovrovor. a dramatic change did follow from the uso of this statistic than the liegro sawio was cornered with the white sample on total 63 pathogenic score (Table l9). When the analysis of variance results was considered,it appeared that the iiegroes and thto had widely differing pathogenic scores: the difference wag;;lggificantgfar beypnd the .0l level of significance. One might have erroneous- ly concluded that liegro leathers had an psychologically d-eg- ing childerearing attitudes than the white mothers. However. when adjustments were made for acquiescence. the differences in total pathogenic scores dramatically vanished. TABLE 19 TOTAL PATHOGEiiiC SCORES OF NEGRO MOTHERS AS COi‘iPARED HIT" WIT! ”OTHERS: 0'75 ##4— _.__ Analysis of Analysis of'i ' A Variance g Covariance A __ F Ratio ‘ 9-95 ' Level of significance .0l Not significant v.__r 1Mdjusted for Acquiesconce This analysis reveals serious inadequacies in the PARi and similarly structured attitude inventories. l.e.. the ease with which a response bias can weight the scores obtained. This points up the necessity for redesigning this type of test. To avoid this type of response bias. ego-half of the items in each Pathogenic Scale could be rewarded so that agreement with the items reflects a non-pathogenic attitude. (At the present tine _a_l_]_ item are 70 worded so that agreement indicates a pathogenic attitude). By this COMparetlveiy simple maneuver, the factor of acquiescence could be neutralized and prevented from seriously distorting the data obtained from such instruments. The large legroewhite dif- forsnces in regard to the acquiescence variable also ro-omphasizos the necessity for caution in the selection of saMplos from public hospitals. These hospitals. as is the case with ghiidren'gyfigggir 5&1, often service a predominantly Negro clientele. These Negroes have sonic-psychological characteristics that differentiate than free their white social class peers. e.g.. acquiescence. Therefore. the racial variable must be rigorously controlled when selecting subjects from this patient population. 2. e a la The EARI data was also analyzed by racial groups; the total Pathogenic Scores of the whlte sample were first considered. Table 20 indicates that there were no significant differences be- tween the white mothers for the total Pathogenic Scores. TABLE 20 TOTAL PATHOGENIC SCORES OF A. MOTHERS. R.H. MOTHERS, AID S.'O.P.O. HOTflERS iN UHiTE SAHPLE: n‘30 Analysis of Ana'ysls of: Y Variancgj govarlanca .g_ f Ratio 2.58 i ”Level of A“ A * Significance lot significant Not significant ' ihdjustod for acquiescence 71 The date for the white seeple was also analyzed separately for each of the 23 PARi Scales (Table 2!). Two of the F ratios (Scales l8 and 23) were significant at the .05 level. Since only one I ratio would be significant by chance alone. these differences are statistically significant. however. as will be presently de~ oonstrated. these significant differences do not lend support to the hypotheses of this study. TABLE 2] RAAI SCORES Of A. MOTHERS. 8.". "OTHERS AND S.‘O.P.O. MOTHERS FOR HHITE SAMPLE: ".30 - fir-Ca ..-.» --r-Pv -4.- -..-... ...- ...“, -— .-n‘o-o-fi - - ... w‘1... - high T l.li m ’1}. LBLW 1.16% ___g. w lg; ‘ , fl . us. - g.83 4. V r 3 1g; 1;. - A- - ii. A ~ , a l6. _ 5;) m t :1 .e 4% . b.351- any i]. 1.2u 1.28 a: V - -H_. l8. m mg; 1. 2.02 2.18 fig. - - J. - , -_1 20. 1.01. W - a, 340 v 1.1: M 3:. - - 49.5- $4.1m 1.}! my. l.t+6 A ~ with. egg Tm Lg; g. A L36 Lil)... .le " t t w '2 9‘ ratios of loss than one are indicated by dashes (r) *' rl"° .OMTT'mt Ct e05-o0' IOVQT , l . a a O a I :. a I I .1. l I I o ‘¢ .l a -I 4 I. i I |i I - ‘ a 3 A I I . . . . i _ a _ - a ..a i l a i. l s ‘ . ' .. ‘ a- - . o . . - . ~ . . o . u ._ . - - .- - .- . . - - . - . . o v 0 - . n . - - O . . e.- u a - ., . ' -. . r o e - . s - _ u s . “if .53; AL..- (o, W. yd watch-mi «1. av- newh uni 3c solJes V to»: “Lib. :s :x ‘relliscle nia‘e‘t ‘0' 72 To detemine which group differences were contributing to the significant f ratios in Scales l8 and 23. t-tasts were next made between each two groups. The results in Tables 22 and 23 indicate that neither of the 3 groups exhibited consistently mre pathogenic trends. For anemia. in the Suppression of Sex Scale (Scale i8). the Surg.-0.i‘.0. and Asthma mothers appear to mifost the oost pathogenic attitudes. The thematic Heart mothers apparently have the least pathogenic attitudes in this area. Homver. in the Dependency of hother Scale (Scale 23). the Rheusatic Heart mothers exhibit the most pathogenic attitude; while the Asthma mothers ap- parently demonstrate the most constructive attitudes in this area. TABLE 22 SUPPRESSION Oi" SEX: (PAM SCALE #‘i8) FOR liliiTE SAHPLE: 0'30 r“? J a iiaw Adjusted T t Between Ichel of liean Mean Adjusted Significance ; t- _. . t as MEL A. ibthers l0.0 9.3 2.i3 ' .025-.0i Mi. ibthors 8.2 8.2 A. . lbthors l0.0 9.3 L35 .l0-.05 8.-0'.i?.D. lbtiuxs 9.2 9.8 m. ' T a lbthers 8.2 8.2 2.7l .0l-.005 enema. iiothers 9.2 9.8 I . A . . o ... . I l u v | a a. . I I . I i v v - a l g I . n I .. ~ . n X ' e u I ‘ . I n . . I. I ‘ I . e i I . h n . e - _ 4 e . n , I _ Ir. . i ! _ . - . - - . . ~ :5 a u . I I | i i e- - - - . -- -~ . e e ' e e o . -. _- - . . i I I e I .5 ." ...— ...-cue enema. 11.; ' 3.1: harassment or human (mm SCALE #23) FOR mm m: n-30 73 TABLE‘23 :=========— 214* «::~ -e‘* e e v few r~t Raw Adjusted t Between Level of Hean Mean Adjusted Significance e _e _. ‘3‘: News or W. A. “the?! "e6 i0.8 2e80 .0l-.005 ‘0”. Ethan i3.‘ i3.6 Ae ' lathers ll.6 i0.8 i.33 .l5-.l0 ...ote'eoe ”the?! i2.“ '3e' u. w W ”tho“ i3.‘ ize‘ 0.80 e35“. 30 50%. '0'; Mothers i2.“ l3.i A** c. gegro gaggle. The first analysis (Table 2h) deals with the comparison of total Pathogenic Scores between Negro mothers _of experimental and control groups. found to be statistically significant. TABLE 2“ ram. "mosaic scones or A‘. Humans. ii.ii. Homes mu s.-o.r.o. names: in «ease m: n-hs The differences were not w A if Analysis of Analysis of h j __ 1 Vagiance Covariance I Ratio , 2.33 i.i8 Level of J“ _* i W # Agignificance Not.significant ‘_flot significant 7% An analysis of each of the 23 PARI Scales (data presented in Table 25) also reflects a lack of statistically significant dif- ferences. THO of the scales had significant F ratios before ad- justment for acquiescence. These differences were no longer slgnle ficant after the adjustment was made through the analysis of con variance technique. This again underscores the large role that the acquiescence response set played in the liegro sanple selected for this study. TAB LE 25 rantscones or A. HDTHERS. n.u. norasas. AND s.-o.r.o. norutas FOR NEGRO SAMPLE: BPQS _;_‘_._ -..—... Scale *1Analysis of LiAnalysis of Scale Analysis br‘ .Analysis of h “Liege Emeriancg . _ - wValance govarlance «ei’ #_ .‘- , . 13. - . __2.fi ‘_ '-§3 . 1.99 lh. - - g1. - g ‘- 15. 2.23 fi_ 1.70 *_h.gv l.9hg, - 16. __ - __2.76 __5. b.10ag <_ 2.22 I]. 1.3; '- 5.__ l.30 - l8. - ‘ k - .22]. ~ I . - v 19. __ - - ___8. l.3§_ - 20. ‘ z.hz — ‘fingA . , -, - 4 21.jg - - g 1 _1o. . jh§5* V1.8u _g 22. 1.2a - _31: _*v ~ A. t. 23. 2.76 1.gg___. J12. 1.3g H g - F ratios of less than one are indicated by dashes (-) if ratio significant at .05-.0l level l l .a I . I \l I I .1 I I I e l I . i n I I I I I I . I I 'I I I I. '. J I i i I I I I I I I I I I I I I I e l I 1 l .I I I I .- a E I Q . . . . 1 ii .- .. I a I J I I . I I . o . u. - - — . - 0 C I . - . .. a - U — . - _. - ...e a; a sfll‘x 1:»: . '| J1 * ‘ ‘ .- :EL...-....;.....-A...._.-- :.......;.;L; - $5.1 .. .13 . EA 9x347 ~i£l “3.1.7. $5.; fl +;-. ' :4“. (-) m ya 1-9—1364th on. sun can. at.” t: gains 1 v~' .«z'.. 3e tat-itingie clan ‘1 lV. DISCUSSION OF FINDINGS An overall evaluation of the 11335! and M results indicates some support for the psychoanalytic foruulatlons of the psychodynanlcs of the anther-child relationship in asthma. in this population, mothers of astimatic children appear to be more emotionally disturbed than eothers ef non-asthmatic children. however. the reported differences are slight. in marison with the claims of clinicians (E. 6. 16‘1) regarding the etiological involvement of psychological factors. .ln particular. the snail differences in favor of the psychosomatic hypotheses raises sane doubt about the sweeping claies of many clinicians regarding the psycho- pathology of mothers of asthmatic children. Replication of this study "wdth idanticai and different experimental populations would be desirable. for emle. the study of mothers of children ulth other psychosonatlc diseases could aid in detenalnlng whether the present findings are par- ticular to asthee‘or psychosomatic disease in general. The study of authors of neurotic or psychotic children would be also necessary to fully answer the very fundamental question whether different types of Isother- child relationships help to predispose one child to a psychosomatic dis- ease and another child to a neurosis. Those the state that much of the psychological distress of the mother of the asthmatic child is motive to the child's illness can draw sons col-fort from this data. The mothers of rheunatic heart children did appear to be more psychologically disturbed than the mothers of normal children. 75 I | I ‘ s 1 I I , I I I n i 'I I ' I I I I dl .II A .. 2. i n!.l I ll; l sum-«mg... 1 t . “no no amino-i; 5. it: viz-1.12 ovz’i «more, iv ‘3“) «lb shunning: use .15 no euciii {liu‘i M venom-u; i»; I a s m an! to mull; h .MIiefi lust. it nos W bib ashlar. Isaac‘s ;.i s l» I .III' I s I! I "a 4- - n I. I I II I l I Vi ' I I l 1' I. ‘0 . ) . n o . ‘ I .l'. I is: I . al' a l l. ’1 n ,. J a . , .- l J 'I I! II I u u ‘l l I 'I . a' I l ‘ ' ’ . 0 I I J l l a l I I a I n x D ' ~ I o J l 76 However. this reactive factor did not account for all of the variance. in view of the fact that the asthiaa mothers appeared to be more emotionally disturbed than the rheunatic heart mothers. This reactive factor is too often ignored in the psychosomatic literature. it may account for a major portion of the pathology which clinicians have observed In the mothers of psychosomatic patients. This theoretical distinction could be of crucial ‘ inortance in the psychotherapeutic management of such cases. The background data obtained froa the Research Volunteer Forms is also worthy of attention. Iany have speculated about a possible link be- tween ordinal position and asthma; they have observed that asthmatics are often oldest children. it will be recalled that Jessner at al.. (30) found that seventeen out of twenty-eight asthmatics in their couple were eldest children. This Has not the case in this study. for only nine out of twenty-five cases were oldest children. Another con-on‘observation is that astl-atlc children come froia homes marked by instability in marital re- lationship. insofar as this is measured by separation of spouses. this was net borne out in this study. There were approximately as my asthnatlc children as controls living together.- with both parents in the sample studied. ' The content of the oothers' psychosexual conflicts is also of interest. The fact that the asthu mothers had higher scores on the Oral Erotlclsn dimension is consistent with psychoanalytic speculations. Iothers of estimatlc children have been described as being overly dependent and having inordinate nurturanca needs by Sperllng. (57) Jessner et al.. (30) and also by Coolidge (iii). The possibility that they are particularly disturbed 77 in the area of Oedlpal relationships. as is indicated by the present study. \dille lupliclt in all of these writings. has never been made a point of especial attention. The inquiry data hinted at the manifold rulflcatlons of the A. mothers' Oedlpal conflict. For mle. they expressed their sibling rivalry in terms of competition for father's affection rather than for mother‘s attention. The A. mothers tended to prefer their fathers as love objects. to a greater extent than did the control mothers. They also sure more closely identified with their mothers. and did not expect to realize their ego ideals. These latter two trends in the inquiry data can also be explained in terms of their heightened Oedipal conflicts. identi- fleatlon with the mother is assumed to be an integral step in a girl's attqt to resolve her Oedipal problem; an exaggerated atteupt at identifi- cation can follow fron an exacerbated Oedipal conflict. Finally. if a man renouncas her ability to achieve her ego ideals (e.g., become an attractive m. desired by man) she cannot be "accused' of being a serious rival of her mother's for her father's affections. in this fashion, misty over Oedlpai wishes ls allayed. finally, in view of the large claims of cl lniclans regarding the "asti-atogenic mther“. it might be useful to consider several different interpretations of the W in the data in m; of the psycho- ‘ emetic position. firstly. it is possible that the present findings are limited to a loser income group. Perhaps larger differences in favor of the psychosomatic hypothesis touid be found in higher soclo-economlc groups. This is especially likely since the psychoanalytic fomulations have been based primarily on work with such patients. Another possibility lies in the fact that the mother may not be as potent antlologlcai factor in asthu as is comely believed by clinicians. Psychological causation may be a 73 more general phenomenon. in one case. it may be the father she plays the primary role; in another case. it may be the siblings. in a third case. it may be a function of the interaction of the entire family and due to no primary single factor. n v i t r s e .1, g in loan ~ eren - :r- "I, h “.13.: g. en . -.';.-m -I-.r ; si» I- mi I a or .2 h - -. .1..,-d' :L W- Another WP sideration. vdslch would be less sympathetic to the psychoanalytic peels tion. is that the psychological involvement is only primary in a few cases and reactive in the large majority. if this is correct. then psycho- logical differences are leveled out when the two groups are studied as one group. . The most important implications of the present study are methodologir cal in character. in this area. more definite conclusions can be made. and the discussion need be less speculative than in the preceeding section of this chapter. The most significant findings is “related to the effect of the response bias in the MRI. Acquiescence. or the tendency to agree. had a great deal to do with the scores which subjects received on this test. in view of this finding. the usefulness of the MM and similarly structured psycho- logical tests is in question. unless corrections are made for acquiescence along the lines of the present study's efforts. This type of response bias had already been much discussed in the literature, e.g. in connection with the F Scale (29). New instrimients should be designed to eliminate this cause of error. This deficiency is remedlable by the expedient of wording items so that only one-half of the item yield a high score on the basis of 79 agreement. Unless this is done. largely spurious results can be easily . (detained. The Negro sample in this study could have been described as possessing many. very definite. psychologically damaging attitudes about cduild-rearing. if the scores had not been adjusted for acquiescence. The second major conclusion is that an equivalent'ill control group is very necessary in this type of psychosomatic research. Without such a group. the reactive factor cannot be properly assessed. Yet,a large nusjority of psychosomatic studies do not provide for such a control group. Consequently. differences that are found in such studies are attributed ju.u-—.-— ' i to primary psychological agents (rather than to reactive factors). The racial differences in the data analysis are also instructive. in that they demonstrate the necessity of establishing racially balanced ex! perimentai~controi groups in such studies. if samples must be small. it might be wiser to restrict them to one racial group; this will allow the researcher to better delineate the variables involved in the study. The fact that the Blaggx lest was able to differentiate the clinical groups. while the PARi was not. is also worthy of note. Perhaps projec- tive tests are more appropriate for research involving ”depth-type' psychological phenomena. As was previously indicated. the same underlying conflicts can accompany totally different personality types; conscious attitudes of such individuals may differ. although the underlying pathology is identical. Their performance on attitude-type questionnaires therefore will cancel each other out. and as a group. they may appear similar to controls. Of course. no combination of instruments can adequately test many psychoanalytical propositions regarding psychosomatic disease. which 80 have been derived from intensive analytic study of patients. Some of this elusive data perhaps can only be tapped by conducting research under sieiiar conditions. however time-consuming and costly the process. long-tors psychoanalytic treatment of patients with proper controls. large number of subject-patients. observers. recording apparatus. etc.. “'"‘.".‘.7il F I‘ may be the most adequate method of studying these phenomena. 'Flnsliy. there is the consideration that this study represent a further advance in the validation of the Black! 1295. Since the m Zest as able to differentiate a cl inicai group snore or less along lines _ predicted by cl iniciens. this can be interpreted as another confirmation _—' of its discriminating ability (construct validity). Admittedly. this appears to be begging the question; yet, at this stage of development of projective test validation, it represents one of the better eethods. V. SUMMARY AND CONCLUSIONS A. Qequn and Hypotheses The mother-child relationship has long been implicated as an etiological factor in the deveIOpment of asthmatic symptoms in children. There has been a dearth of experimental evidence regarding the child- . +3 : .L121. rearing attitudes and psychological status of mothers of asthmatic .h'd‘h :Q‘ children. in order to test hypotheses regarding the mother-child re- ‘ ’5.— iationship ln psychosomatic disease. twenty-five mothers of asthmatic children were studied to determine whether they were more emotionally disturbed than mothers of control groups. One control group consisted of twenty-five mothers of children with rheumatic heart disease. This was considered to be a group of children with a non-psychosomatic ill- ness equivalent in severity to asthma. The second control group con- sisted of twenty-five mothers of children undergoing minor surgery or receiving treatment for minor or transient illnesses (Surg.-O.P.D.). This latter group was considered to be the normal control group. All of the subjects were obtained in thldrenjg Hospital, a publicly-sup- sorted hospital in Detroit, Michigan that primarily serves a lower-socio- :conomic papulatlon of mixed racial character. The m and £55; Parental Attitude Research instrument) tests were administered to these pthers. it was hypothesized that the asthma mothers would manifest eater psychosexual conflict on the ME; (Hypothesis i). it s also hypothesized that the A. mothers would display more pathogenic l lei-rearing attitudes on the PARi (Hypothesis 2). 8i i. The Mach; Results An individual analysis of the overall dimensional scores indicates that the asthma mothers are more psychologically disturbed than the con- trol mothers. The asthma mothers manifest greater disturbance in the area of Oedipai conflicts (Card “0 than either of the two control re- — fl - _T groups; they also give evidence of'greater conflict in the area of oral eroticism (Card 1) than the Surg.-0.I’.D. mothers. These results indicate some support for Hypothesis l. The reactive role that the child's illness plays in aggravating the psychological conflicts of their mothers is suggested by the fact that in both Cards 1 and ill. while asthma mothers had the highest disturbance scores. the Surg.-0.P.D. mothers (Healthy controls) had the lowest scores. The rheumatic heart mothers| scores were in between. Ce PARJ Result; The EAR] results did not support the psychosomatic interpretation There were no significant differences between the total The 23 scales of the FAQ] also The refo re, Of a’mmae Pathogenic Scores of the three groups. showed a lack of statistically significant differences. incomes” 2 is unconfirmed by this data. A measure of acquiescence had been included with the EAR! scales 3 allow for a check on response bias. There were differences between 1e resui ts obtained by means of analysis of variance and covariance :dj ustsncnt made for acquiescence). The distorting potential of the quiescence response bias was especially revealed by an analysis of 82 Negro-white differences. Before adjusting for acquiescence, the Negro sample had a significantly higher total Pathogenic Score than the white sample (beyond the .0l level). After adjustment for covariance, the differences were no longer statistically significant. 0. Qonciusions The major findings of this study are both theoretical and method- ological. The'glgggx findings lend some support to the psychosomatic interpretation of the mother's role in Asthma. The acquiescence scale data indicates that a response bias exists in the.§g*i, a bias which seriously limits its usefulness as a research instrument. Signed Dr. Albert i. 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"lmf":7.2l'~ah.” fl." 0 airi- . _' Treating. Theodore F. ad Ripley. Herbert 8. “Life Situations. Emotions and Bronchial Astiuna." g. lieu. Mt. Dig. Vol. lOB. PP. 380.398: l9h80 Hamberg. Sheldon C. "Psychosomatic Patients and Other Physically lil Persons: a Comparative Study." 1. gonggit, Psxghgl. Vol. l9. PP. l63‘l69s .9550 APPENDIX I EE§E§B§H VQEENTEER FORM TO BE FILLED CUTE} DOCTOR: Dr. Patient's Name (18*) (last) ‘Diagncsis Case Humber_. iHas Patient ever had Asthma or severe allergic disease? Yes No Has Patient ever had severe, chronic disease? Yes No Has any sibling of patient had severe allergic or chronic disease? Yes No TO BE FILLED OUT gr MOTHER (or by adult agcogpanyigg child to the Clinic): Patient's Birth date Patient’s Sex Mother's Name Tier.) (last) Telephone number Address Husband's Occupation Mbther's Education: Completedh____grades; completed_____years in College. lReligious Preference of Mother: . Annual Family Income: Approximately . Marital Status: Living with husband Separated Remarried Date of Remarriage HUmber of children in family: . The patient is an only child oldest child youngest child other . Mbther’s Race; White Negro Other PREFERRED TIME r0; MOTHER'S 133nm: (check two) Wednesday 8-10:OO A.M. Saturday 10-12:OO A.M. Friday 8-10:OO A.M. Saturday 1- 3:00 P.M. Friday' 10-12:OO A.M. Saturday 3:30-5:30 P.M. INVENTORY OF ATTITUDES OH FAMIDY LIFE AND CHILDREN Read each of the statements below and then rate them as follows: A a d strongly mildly mildly agree agree disagree strongly disagree Indicate your opinion by drawing a circle around the "A" if you strongly agree. around the "a“ if you mildly agree, around the "d" if you mildly disagree, and around the "1)" if you strongly disagree. There are no right or wrong answers so answer according to your own opinion. It is very important to the study that all questions be answered. Many of the statements will seem alike but all are necessary to show slight differences of opinion. 1. Children should be allowed to disagree with their parents if they feel their own ideas are better. 2. A good mother should shelter her child from life's little difficulties. 3. The home is the only thing that matters to a good mathere li. Obedience and respect for authority are the most important virtues children should learn. 5. Some children are Just so bad they must be taught to fear adults for their own good. 6. Children should realize how much parents have to give up for them. 7. You must always keep tight hold of baby during his bath for in a careless moment he might slip. 8. The deeper and more enduring qualities in getting along well with people are far more important than external things like manners. habits, and breeding. 9. People who think they can get along in marriage without arguments Just don't know the factso 10. A child will be grateful later on for strict training. 11. Children will get on any woman's nerves if she had to be with them all day. 12. If people would talk less and work more, everybody would be better off. 13. It's best for the child if he never gets started wondering whether his mother's views are right. 1’4. More parents should teach their children to have unquestioning loyalty to them. AGREE A a A a A a A a A a A a A a A a A a A a A a A a A a A a D ISAGRIE d D d D d D d D d D d D d. D d D d D d D d D d D d D d D .2- AGREE DISAGREE 15. A child should be taught to avoid fighting no matter what happens. A a d D 16. What this country needs most, more than willful leaders. are laws and political programs requiring all citizens to actively share responsibility. A a d D 17. One of the worst things about taking care of a home is a woman feels that she can't get out. A a d D 18. Parents should adjust to the children some rather than always expecting the children to adjust to the parents. A a d D 19. There are so many things a child has to learn in life there is no excuse for him sitting around with time on his hands. A a d D 20. The businessman and the manufacturer are much more important to society than the artist and the professor. A a d D 21. If you let children talk about their troubles they end up complaining even more. A a d D 22. Mothers would do their Job better with the children if fathers were more kind. A a d D 23. A young child should be protected from hearing about sex. A a d D 21+. Nobody ever learned anything really important through suffering. A a d D 25. If a mother doesn't go ahead and make rules for the home the children and husband will get into troubles they don't need to. A a d D 26. A mother should make it her business to know everything her children are thinking. A a d D 2?. Children would be happier and better behaved if parents would show an interest in their affairs. A a d D 28. Science has its place, but there are many impor- tant things that can never possibly be understood by the human mind. A a d D 29. Most children are toilet trained by 15 months of age. A a d D 30. There is nothing worse for a young mother than being alone while going through her first experience with a baby. A a d D 31. Children should be encouraged to tell their parents about it whenever they feel family rules are unreasonable. A a d D 32. 33. 34. 35. 36. 37. 38. 39. ’40. 1+1. he. 43 . 1+5, 1+6, 2’«7. 49. .3- Sex offenses, such as rape and attacks on children. never merit punishment; such offenders should always be treated with kindness and sym- patiw by qualified psychiatrists. A mother should do her best to avoid any dis- appointment for her child. The women who want .lots of parties seldom make good mothers. It is frequently necessary to drive the mischief out of a child before he will behave. Young people sometimes get rebellious ideas, but as they grow up they ought to get over them and settle down. A mother must expect to give up her own happiness for that of her child. All young mothers are afraid of their awkwardness in handling and holding the baby. Sometimes it's necessary for a wife to tell off her husband in order to get her rights. Every truly mature person outgrows childish feel- ings of submissive respect and of excessive love and gratitude for his parents. Strict discipline develops a fine strong character. lbthers very often feel that they can't stand their children a moment longer. A parent should never be made to look wrong in a Child's 9372!. No sane. normal, decent person could ever think of hurting a close friend or relative. The child should be taught to revere (respect and honor) his parents above all other grown-ups. A child should be taught to always come to his parents or teachers rather than fight when he is in trouble. ‘ Having to be with the children all the time gives a woman the feeling her wings have been clipped. There would be no immoral, crooked, or feeble- minded people, if we could get down to brass tasks and somehow get rid of our social problems. Parents must earn the respect of their children by the way they act. AGREE DI SAGREE d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D 50. 51. 52. 53. 5“. 55. 59. 60. 61. 65. 66. 67. JI— Children who don't try hard for success will feel that they have missed out on things later on. Parents who start a ehild talkimy about him worriee don" t rem!!! thet ”Justine; dt'ebetw to Just lave-a well- enough alone. “at the youth needs to strict discipline. rugged determinations. and the em to work and fight for family and country. Husbands could do their but better if they were less selfish. n is my ' New that young Wt we at!“ not be alloys t9 “see each 0me confiletely a”fl‘t€"Qgg Childreh ens husbands» a. better! gun the mother is. ntrong enough to settle meet at: the problems. m I person has e problem or worry. It should drop everything and concentrate upon it until the selution appears. A child should sever keep a secret from his parents. laughing at children's Jokes and telling children aches nines things genera smoothly. m wells! aaflid- learns to walk the better he's Wee in insult to m hence we W‘MWM. It isn't fair that a woman he 5to bear Just about all the burden of raising children by herself. A child has a right to his own point of view and ought to be allowed to express it. A child should be protected from Jobs which might be too tiring or hard for him. Every person should have complete faith in his independent Judgment. not in some supernatural power whose decisions he obeys without question. A woman has to choose between having a well run home and hobnobbing around with neighbors and friends. A wise parent will teach a child early Just who 1. h0..e Pew women get the gratitude they deserve for all they have done for their children. soars at a plenum d n d D e .n e n“ s b d n a n a D a n a n d n a n e n a n a n a n d n d n H 69 . 70. 71. 72. 73. 74. 75. 77. 78. 79. 80. 81. 82 , 83. an. .5- Homosexuals are hardly better than criminals and ought to be severely punished. Mothers never stop blaming themselves if their babies are injured in accidents. No matter how well a married couple love one another. there are always differences which cause irritations and lead to arguments. Children who are held to firm rules grow up to be the best adults. All attempts to divide people into the two distinct classes of the weak and the strong are doomed to failure. It's a rare mother who can be sweet and even tempered with her children all day. Children should never learn things outside the home which make the!!! doubt their parents' ideas. A child soon learns that there is no greater wisdom than that of his parents. Some people are born with an urge to Jump from high places. There is no good excuse for a child hitting another child. Most young mothers are bothered more by the feeling of being shut up in the home than by anything else. Children are too often asked to do all the com- promising and adjustment and that is not fair. The so-called science of astrology (astrologists tell your fortune by studying the position and characteristics of the stars) has never explained anything and never will, because it is not really a science. Parents should teach their children that the way to get ahead is to keep busy and not waste time. Children pester you with all their little upsets if you aren't careful from the first. When a mother doesn't do a good Job with children it's probably because the father doesn't do his part around the home. Wars and social troubles may some day be ended by an earthquake or flood that will destroy the whole world. AGREE Aa DISAGREE d D d D d D d D d D d D d D d D d D d D d D d D d D d. D d D d D d D -6- AGREE DISAGREE 85. Children who take part in sex play become sex criminals when they grow up. A a d D 86. A mother has to do the planning because she is the one who knows what's going on in the home. A a d D 8?. An alert parent should try to learn all her child's thoughts. A a d D 88. All the will power in the world will not help us when weaknesses and difficulties stand in our way. A a d D 89. Parents who are interested in hearing about their children‘s parties. dates and fun help them grow up right. A a d D 90. The earlier a child is weaned from it's emotional ties to it's parents the better it will handle it's own problems. A a d D 91. A wise woman will do anything to avoid being by herself before and after a new baby. A a d D 92. Most people don't realise how much our lives are controlled by plots hatched in secret places. A a d D 93. A child's ideas should be seriously considered in making family decisions. A a d D 9 91%. Parents should know better than to allow their children to be exposed to difficult situations. A a d D 95. Too many women forget that a mother's place is in the home. A a d D 96. Only if prewar authorities (Nazis. racists. etc.) are kept out of the German government. will true democracy be achieved in that country. A a d D 97. Children need some of the natural meanness taken out of them. A a d D 98. Children should be more considerate of their mothers since their mothers suffer so much for them. A a d D 99. that mothers are fearful that they may hurt their babies in handling them. A a d D 100. Familiarity breeds contempt (getting to know people too well leads to disliking them). A a d D 101. There are some things which Just can't be settled by a mild discussion. A a d D 102. Most children should have more discipline than they 80%. A a d D 103. 10”. 105. 106. 107. 108. 109. 110. 111. 112. 113. 114. 115. 116. 11?. 118. 119. 120. 121. .7- Raising children is a nerveuracking Job. Because human nature is improving, war and conflict will eventually be eliminated. The child should not question the thinking of his parents. Parents deserve the highest esteem (respect) and regard of their children. Children should not be encouraged to box or wrestle because it often leads to trouble or injury. nowadays when so many different kinds of people move around and mix together so much, a person has to protect himself especially carefully against catchp ing an infection or disease from them. One of the bad things about raising children is that you.aren't free enough of the time to do Just as you like. As much.as is reasonable a parent should try to treat a child as an equal. A child.who is "on the go" all the time will most likely be happy. In this scientific age there can'be no Justifica- tion for denying inyestigators the right to study sc-called personal and.private matters. If a child has upset feelings it is best to leave him alone and not make it lock so serious. If mothers could get their wishes they would most often ask that the hueband be more understanding. Sex is one of the greatest problems to be contended with in children. The true American way of life is disappearing so fast that force may be necessary to preserve it. The whole family does fine if the mother puts her shoulder to the wheel and takes charge of things. A mother has a right to know everything going on in her child's life because her child is a part of her. If parents would have fun with their children, the children would be more apt to take their advice. The wild sex life of the old Greeks and Romans makes sexual goings on in this country seem tame. A.mother should make an effort to get her child toilet trained at the earliest possible time. AGREE DISAGREE A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D A a d D 122. 123. 124. 125. 126. 127. 128. 129. 130. 131. 132. 133. 138. 135. 136. 137. 138. 139. Ito. -8— Mbst women need more time than they are given to rest up in the home after going through childbirth. ‘When a child is in trouble he ought to know he ‘won't be punished for talking about it with his parents. Children should be kept away from all hard jobs which might be discouraging. A good mother will find encugh.social life within the family. It is sometimes necessary for the parent to break the child‘s will. Motherssacrifice almost all their own fun for their children. A mother's greatest fear is that in a forgetful moment she might let something bad.happen to the baby. It's natural to have quarrels when two people who both have minds of their own get married. Children are actually happier under strict training. It's natural for a mother to "blow her top" when the children are selfish and demanding. There is nothing worse than letting a child hear criticisms of his mother. Loyalty to parents comes before everything else. most parents prefer a quiet child to a "scrappy" one. A young mother feels "held down" because there are lots of things she wants to do while she is young. There is no reason parents should have their own way all the time, any more than that children should have their own.way all the time. The sooner a child learns that a wasted minute is lost forever the better off he will be. The trouble with giving attention to children's problems is they usually Just make up a lot of stories to keep you interested. Few men realize that a mother needs some fun in life, too. There is usually something wrong with a child who asks a lot of questions about sex. DISAGREE d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D d D 141. 142. 143 . 144. 145. .9- A married woman knows that she will have to take the lead in family matters. It is a mother's duty to make sure she knows her child's innermost thoughts. When you do things together, children feel close to you and can talk easier. A child should be weaned away from the bottle or breast as soon as possible. Taking care of a small baby is something that no woman should be expected to do all by herself. AGREE DISAGREE A a d D A a d D A a d D A a d D A a d D RECORD BLANK THE BLACKY PICTURES NAM; SEX AGL—_ DATE— EXAMINER Instructions to Subject — Examiner says: I’ve got something here which I think you’ll find pretty interesting. It’s a bunch of cartoons, like you see in the funny papers, except that there are no words. I'll show them to you one at a time and the idea is for you to make up a little story about each one — just tell what is happening in the picture, why it is happening, and so on. Since this is sort of a test of how good your imagination can be, try to tell as much as possible about how the characters feel. You can have as long as you like for each story, and to make it easier to go back over them later I'll write them down. At the end of each story I will want to ask you some questions to be sure I got everything that you had in mind. There are no right or wrong answers to these questions — I’m just interested in what you imagine the answers to be. Before we start, here are the characters who appear in this comic strip [show frontispiece for about 20 seconds]. Here [pointing] is Papa, Mama, Tippy, and the son (daughter), Blacky, who is the main figure in the cartoons. I’ll leave this over here for you to look at later if you want to [place frontispiece off to one side for subject to refer to during the test if he wishes]. Cartoon I (Ora. Ero.) “All right, now for the first cartoon. Here is Blacky with Mama . . ." (Record SS here.) Inquiry? for Males Inquiry? for Females 1. Is Blacky 1. Is Bloch (a) happy?‘ ((1) hams?" (b) unhappy? (b) unhappy? (c) or doesn’t he feel one way or the other? (0) or doesn’t she feel one way or the other? 2. How does Mama feel in this scene? 2. How does Mama feel in this scene? (a) Very contented. (a) Very contented. (b) Pleased but tired.’ (b) Pleased but tired.‘ (c) Rather unhappy. (6) Rather unhappy. 3. Which would Blacky rather do? 3. Which would Blacky rather do? (a) Stay until his feeding is over and then go some- (0) Stay until her feeding is over and then go some- place else.‘ place else.“ (b) Stay as long as possible to be sure he gets enough (b) Stay as long as possible to be sure she gets enough nourishment. nourishment. l'Examiner hands subject appropriate set of Inquiry cards and tells him (her) to follow silently while examiner reads ques- tions aloud, signaling subject when to turn to next card. Tell subject he (she) is not allowed to look at cards preceding or following one being read. Ask subject to respond by letter of the one alternative which he (she) thinks fits best, not by reading statement of the alternative. Check the letter given by subject and record verbatim all comments. Printed in U.S.A. Copmht 1950. m PSYCHOLOGICAL CORPORATION. 523 Fifth Avenue. New York 88. N. Y. 58-118 AS 4. Which one of the following best describes Blacky? (3) He's a little glutton who never stops eating. (b) He’s got a hearty appetite which usually gets satisfied.‘ (0) He sometimes doesn’t get enough to replace all the energy he burns up. 5. Judging by appearances, how much longer will Blacky want to be nursed by Mama before being weaned? (a) He'll want to be on his own fairly soon.“ (b) He'll want to continue being nursed until he’s quite a bit older. (0) He feels Mama would like to turn him loose right now. 6. How will Blacky feel about eating when he grows older? (a) He will rather eat than do most anything else. (b) He will enjoy eating but will like lots of other things just as much.“ (c) He will never get enough to satisfy his appetite. Cartoon II (Ora. Sad.) “Here is Blacky with Mama's collar . . . 1. Why is Blacky doing that to Mama's collar? 2. How often does Blacky feel like acting up this way? (a) Once in a while.“ (b) Fairly often. (c) Very often. 3. Blacky most often acts like this when he can’t get enough of which one of the following? (a) Attention. (b) Milk. (0) Recreation.“ 4. What will Blacky do next with Mama’s collar? (a) Get tired of it and leave it on the ground.“ (b) Return it to Mama. (C) Anme chew it to shreds. . Which one of the following best describes Blacky? (a) She’s a little glutton who never stops eating. (b) She’s got a hearty appetite which usually gets satisfied.“ (c) She sometimes doesn’t get enough to replace all the energy she burns up. . Judging by appearances, how much longer will Blacky want to be nursed by Mama before being weaned? (a) She’ll want to be on her own fairly soon.“ (19) She'll want to continue being nursed until she’s quite a bit older. (c)ShefeelsMamawouldlilcetoturnherlooser-ight now. . How will Blacky feel about eating when she grows older? (0) She will rather eat than do most anything else. (b) She will enjoy eating but will like lots of other things fast as much.“ (0) She will never get enough to satisfy her appetite. . Why is Blacky doing that to Mama’s collar? . How often does Blacky feel like acting up this way? (a) Once in a while.“ (b) Fairly often. (0) Very often. . Blacky most often acts like this when she can't 89‘ enough of which one of the following? (a) Attention. (b) Milk. ( c) Recreation.“ . What will Blacky do next with Mama's collar? (0) Get tired of it and leave it on the ground.“ (b) Return it to Mama. (0) Angrily chew it to shreds. 5. If Mama comes on the scene, what will she do? (a) Feed Blacky again. (b) Send him off to bed without his dinner. (c) Bark.“ mt would Blacky do if Mama did come over to feed (a) He’d ignore Mama and continue chewing the collar. (b) He’d put down the collar and start eating.“ (c) He'd get even with Mama by trying to bite her instead of the collar. . If Mama comes on the scene, what will she do? (a) Feed Blacky again. (b) Send her of to bed without her dinner. (0) Bark.“ . What would Blacky do if Mama did come over to feed her? (a) She’d ignore Mama and continue chewing the collar. (b) She’d put down the collar and start eating.“ (0) She’d get even with Mama by trying to bite her instead of the collar. Cartoon III (Ana. Sad.) “Here Blacky is relieving himself (herself) . . l. 8. What was Blacky’s main reason for defecating there? (a) He wanted to spite somebody. . . . Who?1' (b) He was doing what Mama and Papa told him to. (c) He picked the spot by accident.“ ((1) He wanted to keep his own area neat and clean. Which one of the following is Blacky most concerned with here? (a) Throwing dirt over what he did so that it will be neatly covered up. (b) Relieving himself so that his system feels more comfortable.“ (c) Getting rid of his anger. Why is Blacky covering it up? (a) He wants to make as little mess as possible. (b) He doesn’t want Mama and Papa to find out. ( c) He's automatically doing what he’s been taught.“ . What was Blacky’s main reason for defecating there? (0) She wanted to spite somebody. . . . Who?‘l' (b) She was doing what Mama and Papa told her to. (0) She picked the spot by accident.“ (d) She wanted to keep her own area neat and clean. . Which one of the following is Blacky most concerned with here? (a) Throwing dirt over what she did so that it will be neatly covered up. (b) Relieving herself so that her system feels more comfortable.“ (0) Getting rid of her anger. . Why is Blacky covering it up? (a) She wants to make as little mess as possible. (b) She doesn't want Mama and Papa to find out. (0) She's automatically doing what she’s been taught.“ 'l'Wherever an inquiry or an alternative is followed by a supplementary question, this additional query is not reproduced on the Inquiry Cards but is asked by the examiner following the subject’s original reply. 4. How does Blacky feel about the training he's been getting? (a) By relieving himself in the way he's been taught, he now has an opportunity to show his family what a good dog he can be. (b) He feels Mama and Papa are expecting too much of him at this early stage. (c) He is very happy to have control of himself.“ (d) He thinks he’s got Mama and Papa right where he . How does Blacky feel about the training she’s been getting? (a) By relieving herself in the way she's been taught, she now has an opportunity to show her family what a good dog she can be. (b) She feels Mama and Papa are expecting too much of her at this early stage. (c) She is very happy to have control of herself.“ (d) She thinks she’s got Mama and Papa right where wants them. she wants them. 5. What will Mama say to Blacky? 5. What will Mama say to Blacky? 6. What will Papa say to Blacky? 6. What will Papa say to Blacky? Cartoon IV (Oed. Int.) “Here is Blacky watching Mama and Papa . . ." . How does Blacky feel about seeing Mama and Papa make love? . . . Why? . When does Blacky get this feeling? (a) Whenever he sees Mama or Papa. (b) Whenever he sees Mama and Papa together. (c) Whenever he sees Mama and Papa making love.“ . Which one of the following makes Blacky most un- happy? (a) Papa keeping Mama all to himself. (b) The idea that Mama and Papa seem to be ignoring him on purpose.“ (c) He is ashamed watching the. make love out in the Open. . What does Blacky suspect is the reason behind the scene he’s watching? (a) He suspects Mama and Papa are planning an addi- tion to the family. (b) lHe suspects Mama and Papa are very much in ove. (c) He suspects Papa is having his own way about things. ((1) He suspects Mama and Papa are purposely de- priving him of attention. . How does Blacky feel about seeing Mama and Pope makelove?...Why? . When does Blacky get this feeling? (a) Whenever she sees Mama or Papa. (b) Whenever she sees Mama and Papa together. (c) Whenever she sees Mama and Papa making love.“ . Which one of the following makes Blacky mast unhappy? (a) Mama keeping Papa all to herself. (b) The idea that Mama and Papa seernto be ignoring her on purpose.“ (0) She is ashamed watching them make love out in the Open. . What does Blacky suspect is the reason behind the scene she's watching? (a) She suspects Mama and Papa are planning an addi- tion to the family. (b) She suspects Mama and Papa are very much in love “ (0) She suspects Papa is having his own way about things. (d) She suspects Mama and Papa are purposely de- priving her of attention. . What will Papa do if he sees Blacky peeking? . What will Mama do if she sees Blacky peeking? . Which would make a happier picture? (a) Mama left on the outside watching Blacky together with Papa. . . . Why?“ (b) Papa left on the outside watching Blacky together with Mama. . . . Why? Cartoon V (Mas. Glt.) “Here Blacky is discovering sex . . . How does Blacky feel here? (a) Happy, without a care in the world.“ (b) Enjoying himself, but a little worried. (c) Mixed up and guilty. How might Blacky feel about this situation when he is older? (a) Happy, without a care in the world.“ (b) Enjoying himself, but a little worried. (c) Mixed up and guilty. ((1) 'll'ge situation won’t come up again when he is 0 er. . Whom might Blacky be thinking about here? . Does Blacky naively fear that something might happen to him? . . . What? . What will Mama say if she comes over and finds Blacky? . What will Papa say if he comes over and finds Blacky? . What will Papa do if he sees Blacky peeking? . What will Mama do if she sees Blacky peeking? . Which would make a happier picture? (a) Mama left on the outside watching Blacky together with Papa. . . . Why? (b) Papa left on the outside watching Blacky together with Mama. . . . Why?“ . How does Blacky feel here? (a) Happy, without a care in the world.“ (b) Enfoying herself, but a little worried. (a) Mixed up and guilty. . How might Blacky feel about this situation when she is older? (a) Happy, without a care in the world.“ (b) Enjoying herself, but a little worried. (0) Mixed up and guilty. (d) 71's; situation won’t come up again when she is o . Whom might Blacky be thinking about here? . Does Blacky naively fear that something might happen toher?...What? . What will Mama say if she comes over and finds Blacky? . What will Papa say if he comes over and finds Blacky? . How does Blacky feel here? (a) Terrified that he's going to be next. (b) Puzzled and upset. (c) Curious but calm.“ What does Blacky suspect might be the reason for this scene? (a) He suspects Tippy is being punished for having done something wrong. (b) He suspects Tippy is an innocent victim of some- one else's ideas.“ (c) He suspects Tippy is being improved in some way. . How does Blacky feel about his own tail? (a) He’s not particularly worried about it.“ (b) He's thinking desperately about a way to save it. (c) He thinks he might look better if it is cut 03. ((1) He]: so upset he wishes he never saw or heard of tai . Do you suppose Blacky would prefer to have his own tail cut 03 right away rather than go through the sus- pense of wondering if it will happen to him? . . . Why? . Which member of the family most likely arranged for Tippy's tail to be cut off? . What will other dogs in the neighborhood do when they see Tippy’s short tail? (a) Start worrying about their own tails. (b) Make fun of Tippy. (c) Wonder what's going on.“ (d) Admire Tippy. Cartoon VI (Cas. AOL—M; Pen. Env.—F ) “Here Blacky is watching Tippy . . ." . How does Blacky feel about her own tail? (0) She has resigned herself to the inevitable. (b) She's thinking desperately about a way to save it. (c) She thinks she might look better if it is cut of.“ . What would Blacky be most upset about if she were in Tippy’s place? (a) The fact that nobody loved her enough to prevent this from happening.“ (b) The fact that she would not have her tail any more. (0) The fact that she had allowed herself to be bad enough to deserve this. . Which member of the family most likely arranged for Tippy’s tail to be cut ofl? . How will Tippy feel afterward about having had the tail cut of}? ( a) Tippy will always be envious of dogs that have tails to wag. (b) Tippy will try to make the best of a bad situation. (0) Tippy will be proud to be diflerent from the others.“ . What will other dogs in the neighborhood do when they see Tippy’s short tail? (0) Start worrying about their own tails. (b) Make fun of Tippy. (c) Wonder what’s going on.“ (d) Admire Tippy. . How would Blacky feel about trading her tail for a pretty bow which the male dogs would all admire? Cartoon VII (Pos. Ide.) “Here is Blacky with a toy dog . . ." Who talks like that to Blacky — Mama or Papa or Tippy? Whom is Blacky most likely to obey — Mama or Papa a Tippy? . Whom is Blacky imitating here - Mama or Papa or Tippy? . Whom would Blacky rather pattern himself after — Mama or Papa or Tippy? . Blacky’s disposition, actually, is most like the disposi- tion of which one — Mama or Papa or Tippy? . What would Blacky have an impulse to do if he were in the position of the toy dog? (a) Get frightened and hide. (b) Stand there and take it.“ (c) Get mad and sulk. (d) Start fighting. .WhotalkslikethattoBlacky—MamaorPapaar Tippy? . Whom is Blacky most likely to obey — Mama or Papa or Tippy? . Whom is Blacky imitating here — Mama or Papa or Tippy? . Whom would Blacky rather pattern herself after — Mama or Papa or Tippy? . Blacky’s disposition, actually, is most like the disposi- tion of which one -— Mama or Papa or Tippy? . What would Blacky have an impulse to do if she were in the position of the toy dog? (a) Get frightened and hide. (b) Stand there and take it.“ (0) Get mad and sulk. ( d) Start fighting. Cartoon VIII (Sib. Riv.) “Here Blacky is watching the rest of the family . . ." . What does Blacky probably feel like doing now? (a) Beat Tippy up. (b) Bark happily at the group and join them.“ (0) Show up Tippy by doing something better. (d) Run away to Spite Mama and Papa. . According to Blacky, how much praise does Tippy actually deserve? (a) He feels Tippy fully deserves the praise. (b) He feels Tippy deserves some praise, but not that much.“ (c) He feels Tippy deserves to be punished instead of praised. . \Vho does Blacky feel is paying more attention to Tippy? (a) Mama. (b) Papa. (c) Both paying the same amount.“ . How often does Blacky see this? (a) Once in a while.“ (b) Fairly often. (c) Very often. . How does Blacky think Mama and Papa really feel toward him at this time? (a) He thinks they love him more than they do Tippy. (b) He thinks they love him about the same as they do Tippy.“ (c) He thinks they love him less than they do Tippy. . If Blacky is angry, whom is he most angry at - Mama or Papa or Tippy? . . . Why? Cartoon IX (Git. Fee.) “Here Blacky is very upset . . ." . What does Blacky probably feel like doing now? (a) Beat Tippy up. (b) Bark happily at the group and foin them.“ (c) Show up Tippy by doing something better. ((1) Run away to spite Mama and Papa. . According to Blacky, how much praise does Tippy actually deserve? (a) She feels Tippy fully deserves the praise. (b) She feels Tippy deserves some praise, but not that much.“ (0) She feels Tippy deserves to be punished instead of praised. . Who does Blacky feel is paying more attention to Tippy? (a) Mama. (b) Papa. (0) Both paying the same amount.“ . How often does Blacky see this? (0) Once in a while.“ (b) Fairly often. (0) Very often. . How does Blacky think Mama and Papa really feel toward her at this time? (0) She thinks they love her more than they do Tippy. (b) She thinks they love her about the same as they do Tippy.“ (0) She thinks they love her less than they do T ippy. . If Blacky is angry, whom is she most angry at -— Mama or Papa or Tippy? . . . Why? . What might have happened between the last picture and this one? . How is Blacky's conscience here? (a) His conscience is so strong he's practically para— lyzed. (b) His conscience is bothering him somewhat, but he's mostly afraid of what will be done to him.“ (c) He’s hardly bothered at all by his conscience, just afraid of what will be done to him. . Which character do the actions of the pointing figure remind Blacky of? . Who is really to blame for Blacky’s feeling this way? (a) Himself. (b) Somebody else. . . . Who? ( c) The situation couldn't be helped.“ . How guilty does Blacky feel here? (a) He feels very guilty. (b) He feels fairly guilty. (c) He hardly feels guilty at all.“ . What might Blacky do now? . Do you think Blacky will (a) have this feeling as long as he lives? (b) feel had every now and then? (0) feel bad for a little while and then go out to play?“ . What might have happened between the last picture and this one? . How is Blacky's conscience here? (a) Her conscience is so strong she’s practically parap lyzed. (b) Her conscience is bothering her somewhat, but she's mostly afraid of what will be done to her.“ (c) She’s hardly bothered at all by her conscience, fust afraid of what will be done to her. . Which character do the actions of the pointing figure remind Blacky of? . Who is really to blame for Blacky’s feeling this way? (a) Herself. (b) Somebody else. . . . Who? (0) The situation couldn't be helped.“ . How guilty does Blacky feel here? (0) She feels very guilty. (b) She feels fairly guilty. (0) She hardly feels guilty at all.“ . What might Blacky do now? . Do you think Blacky will (a) have this feeling as long as she lives? (b) feel bad every now and then? (a) feel bad for a little while and then go out to play?“ Cartoon X-(M) [Cartoon Xl-(FH'I (Poe. Eg. Id.) “Here Blacky is having a dream . . ." TCartoons are numbered consecutively in the Inquiry Cards in order not to distract the subject. However, the questions follow the order as presented here. 9 . Whom does the figure remind Blacky of? . In Blacky’s mind, how does Papa stack up against the dream figure when he compares them? . What would be the main reason for Blacky wanting to be like the figure in his dream? (a) Then he would show up Tippy. (b) Then he would be the envy of all male dogs. (0) Then he would be loved more by Mama and Papa. (d) Then he would be very pOpular with the females.“ . What does Blacky himself probably feel about his chances of growing up to be like the figure in his dream? (a) He probably feels he has a very good chance to grow up to be like that.“ (b) He probably feels he has a fair chance to grow up to be like that. (c) He probably feels he has a very poor chance to grow up to be like that. . Actually, what are Blacky's chances of growing up to be like the figure in his dream? (a) Very good.“ (b) Fair. (c) Very poor. . How often does Blacky probably have this kind of dream? (a) Very often. (b) Fairly often. (c) Once in a while.“ . Whom does the figure remind Blacky of? . In Blacky’s mind, how does Mama stack up against the dream figure when she compares them? . What would be the main reason for Blacky wanting to be like the figure in her dream? (a) Then she would show up Tippy. (b) Then she would be the envy of all female dogs. (0) Then she would be loved more by Mama and Papa. (d) Then she would be very popular with the males“ . What does Blacky herself probably feel about her chances of growing up to be like the figure in her dream? (a) She probably feels she has a very good chance to grow up to be like that.“ (b) She probably feels she has a fair chance to grow up to be like that. (c) She probably feels she has a very poor chance to grow up to be like that. . Actually, what are Blacky's chances of growing up to be like the figure in her dream? (a) Very good.“ (b) Fair. (c) Very poor. . How often does Blacky probably have this kind of dream? (a) Very Often. (b) Fairly often. (0) Once in a while.“ Cartoon XI-(M) [Cartoon X-(F)] (Ly-obj.) “Here Blacky is having another dream . . . 1. Who is the figure Blacky is dreaming about? 1. Who is the figure Blacky is dreaming about? 2. Whom does the figure remind Blacky of? 2. Whom does the figure remind Blacky of? 10 . Which of the following possibilities would attract Blacky most? (a) The possibility that the dream figure looks like him- self, which would increase his pride. (b) The possibility that the dream figure looks like Mama, which would remind him of the good old days. (0) The possibility that the dream figure looks like someone else, whom he would make happy by giving her all his love.“ . Why does Blacky feel so contented while he is dream- ing? (a) He feels everyone will admire him. (b) He feels Mama will comfort him. (0) He feels the dream figure will be delighted by his attentions.“ . In Blacky's mind, how does Mama stack up against the dream figure when he compares them? . Would Blacky rather be like the figure in his dream? . . . Why? . Which of the following possibilities would attract Blacky most? (a) The possibility that the dream figure looks like herself, which would increase her pride. (b) The possibility that the dream figure looks like Papa, which would remind her of the good old days. (0) The possibility that the dream figure looks like someone else, whom she would make happy by giving him all her love.“ . Why does Blacky feel so contented while she is dream ing? (a) She feels everyone will admire her. (b) She feels contented thinking about Papa. (0) She feels the dream figure will be delighted by her attentions.“ . In Blacky’s mind, how does Papa stack up against the dream figure when she compares them? . Would Blacky rather be like the figure in her dream? . . . Why? Cartoon Preferences Hand the subject the stack of cartoons [minus the frontispiece] in their original order and say: Now I’d like you to sort all the ictures into two piles — the ones you like over here, and the ones you dislike over there. Just glance at each picture quick y and put it into one of the two piles. [Record sorting] That’s fine. Now pick out from this pile [ int to “likes”] the one picture you like best. [Pause] Why did you ick that one? [Record choice and reason.] Now am this other pile [point to “dislikes"l pick the one cartoon you e most. [Pause] Why did you pick that one? [Record choice and reason.] Likes ‘ Dislikes Best: Worst: Family Information — Record the following information after the technique has been administered: (1) Parents living or not (approximate date of death in latter case). Mother: Father: (2) Siblings listed in chronological order, including sex, age, and approximate date of death if not alive. Sibling Sex Age 11 SUMMARY Mom AND COMMENT 8: l2 APPEND IX l I 101+ TABLE 26 TOTAL HOMER OF STRONG OVERALL DIMENSIONAL SCORES BY INDIVIDUAL SiBJECTS FOR RJ‘I. HOWERS AND S.‘0.“P.D. IETMERS (TOTAL SAMPLE): 0'50 Scores Scores at Exceeding or below Total 7 Medlenfi Hedi an v Halli}: '“ l l 25 L‘e'e.‘ *— lmhm 7 18 25 Total 2! 29 50 X1 3.90; tOZS ) p ) .0l; one-tailed test. 105 TABLE 27 OVERALL DIMENSIONAL scosrs FOR s.fl. AND L'OJJ. “OTHERS: 0-50 geeky: w in. $-03in x1 Bum LET: linsn~ lathers "others and S.-0.P.l. .1129 We .__ We - . twill—... -+- o -+- o _‘ .0 Oral ‘ . ...._..££2£lstsn e_ «liL...lJ—. 5' .12_. . _~1hJ£!!!L.. "0 07" I .- :3 !2 fl 1 l6_ F19 '5 T 0900 , ...e Anal Sadlsm . a: Jan 8 11 as 16 2.39.... III. Anal Sadlsm : is (393.1“ l} I; l} 12 g 0.007 IVs Oedlpal A Intensity 4 is A 2 _ lb n 0.2 V0 ”3!“!er tion_§uilt l; 13 10 ‘fi I; 0.}; "e MI! fipvy ._ a 23 3 23 0.00 v VII. identificee tion figgggsg ., l6 .2 l6 ,2, 0.00 _n stair; W18“ _1 lo I; a, 4% ix. Guilt Eggllgggv _ __l} lg Jl lb 0.1; ,, X. £90 [deal fi 10 l5;_ 8 l7 0.l0 XI. Narcissistic Lego Oblectw 2} 2 l2 6 w l.}§ H's Mllltlc Love thF“.. 12 i3 lh ii 0.33 0’p .025-.Ol *k‘p..05-.025 m p .to-.os (trend) I. One-tailed tests; 1% TABLE 23 TOTAL NUMBER OF STRONG OVERALL DIMENSIONAL SCORES BY INDIVIDUAL SUB- JECTS FOR 3.“. AHO $.'O.P.O. WHITE MOTHERS: 0‘20 .w—v I Scdre;w Scores at Exceeding or below Totals # Median _, - Median R. H. Mothers 6 a ‘0 s.-o'.r.s. l ' __._ Hothors 3 7 '0 Totals 9 ll 20 Not statistically significant 107 TABLE 29 OVERALL DIHENSIOML scones ran «an. m s.-o.r.s. mans Mm was): n-zo d11:5:IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII:5E::E’II| Dimen- RJI. $.-O.P.O. flcance 110" m mam. Law... A + o + o 3. Oral l ......aoucvsn Y. 4.3. s .L 2 , -m... S's Oral iadisn - 5 5 L 8 It}. III. Anal Sedlsn (£59.) A 3 2 3 "i... m. Anal Sadlsn ’ __ met.) W 5 5 6 ll It'd, 'Ve Oedlpal Intengltx . 5 5 7 J «.5, '0 “55turba‘ tlgn guilt 5 5 W; 8 li.§. VI. "fl" gm: 0 lo I 2 NJ. VII. Igentiflce- on he 7 j 7 L N4. ml. Sibling ‘ Riggiry .7 _fi_}AA. pg“; 8 .05 TX. GUIIL [gel Inga 2 5 5 It a" 5'. X. (an Idea] 7 7 f L 4;“ 8 .05 XI. Narcissistic —T .-—_-_——LE!§—921£§t Mwa‘ J 8 .mwzr ”hit—u—u— XI. ARICIILIC “me guest 5 -‘I 8 FL Hair—...... “ “.8. (lint significant) slmltles a lack of statistically significant differences. .108 TABLE 30 TOTAL NUMBER OF STRONG OVERALL DIHENSIONAL SCORES BY INDIVIDURL SUIJECTS FOR 3.". AND S.’O.P.D. NEGRO ”OTHERS: n'JO J__‘ Scores Scores at Exceeding or below Tbtai new." man ‘0 no ' authors 8 7 '5 s.-o‘.r.o. w ‘ Mothers “‘ " '5 Totals I2 I8 )0 V W W lot statistically significant 109 TABLE 3i OVERALL DIMENSIONAL SCORES FOR RJI. A” $.’O.P.D. MOTHERS (NEGRO SAMPLE): IP30 glackx . V Sig“. D m. “a“. So’oo'.9. f‘m WOW m— $221.... + o + o I. Oral Emticisn 6 9 3 12 l.$.* ll. Oral Sadi'sl 1» ii 8 7 ii.$. iii. Anal Sadisa ‘ 4m; 6 3 7 8 ms. Iii. Anal Sadlsm (553,) 8 7 7 8 NJ. iV. Oadipal V. Masturba- lit 7 8 8 7 ms. Vi. Penis in 1 I3 2 i3 ii.$. Vii. idantifica- 9 6 3 6 ms. Viii. Sibling Rivalzx ll 10 8 1 ms. ix. Guilt w 8 7 5 in ms. X. Ew lag-I 3 l2 6 9 NJ. Xi. lancissistic t No I ll 10 Ls. Xi. AnacIItic ac 6 9 6 9 ms. its. (iiot significant) simiflas a lack of statistically .simificant diffsrancas. III) TABLE 32 BFOIIAIEOUS STORY SCORES FOR TOIAL SAMPLE: n'75 .ilfl‘l" AU no". $6.00'0Do A. A. ‘_ no". ‘ mi; 53553;; mflgn Etheg gum, firmhfi, hfimfll. "WV W #t 4- 7 O 4- O -+- 0 _A 'a Oral Irotlclsn l7 8 l l 2 t . 6.6 II. Oral was. i; 22 1 i8 6 a: 1.1; 5,5. m, Iii. Anal Sadisn Am.) 6 12 z. y 5 g_o_ m, M. 3.5, III. Anal Sadis- ,IRet.) ‘ 8 417 2 I6 5 £0 Usi- !.§. fl.§. Iv. 'oedlpat Intonsggx :5 ‘ lo 19 I57 ii IQ 2:00**' 3,5, g,§, 'a m.turb8. c129 Quilt 6 13_ 7 i8 9 21 3,5, [,3, 5.3, VI. Penis ...;m V 9 fizz—944W Vii. Identifica- V tion Process 0 0 I O 2 ii. it}. V ".5. ......amms 7 I8 u w Mm... ix. Guilt ...—12mm. I WANG“ M ‘s (90 . ' ideal A E 2i «k 2:_? z 2} fl.$._ I. ' s. -XI. Narcissistic Legs Oblegt I; I} II .8 I l O ' I ' ‘Be Mlit'c haze Oblect a I§* } g; 5 I,22mn_fl;i‘_____Jldfih_.._.lbdh.__. *I.$. (lot Significant) Signifies a lack of statistically signi- ficant differences. *‘Signlficant between the .IO and .05 level. A One-tailed tests llJ. TABLE 33 SPONTANEOUS STORY SCORES FOR UNITE MOTHERS: n’30 .3... . . ... ... .. .-.-— --.~-a A. I.H. B.'O.P.O. A. B ‘0 ‘ . ‘ “one ‘ 'glpn "other: "other; IHothersgw_R.H. 3.:QIP.Q. 53-9.2.2. 4- O 4- 0"5 ‘5 '0 Oral _ . Imglciga‘ .7 8 2 h 9 li.s.w_ IIs Ol’OI iii. Anal Sadlsl ‘ . III. Anal Sadisn . iv. Oedipal nten I __ "menu; ! LL 8 o to W VI. '05" , . , . VII. identifica' . , . A“ tion Pnecass 0 IO O IO 0 IO N.$. I, . ”.5. VIII. Sibling _g Rivalryrv i 2 3 z a Q fl.§. !.§. !,§. IX. Guilt , I l I I. 690 - . . , ‘__ ideal I 2 I 2 0 IO I.S. l.$. “.3. ll. Iarcissistic e t O Xi. Anaciitic , . . . vaa Object O. 6 I 2 I 2 “.8. ”.5. ".8. ifl.8. (Not Significant) signifies a lack of statistically significant differences. spoutsuaous STORY SCORES FOR NEGRO NOTNERS: 111! mu 3!» n-h5 M turn-1 A. Rte“. sdwe’snt ‘0 ‘ A. ‘ “a". ‘ .gion flgtherg 22thegl flgtggrg 3,5, 5.-Q,fi.2‘ 5.~O.:,fl. __‘ -pu C: -1- C) 4? i) '0 Oral gnotlcign l0 5 5 lg Q 2 fl,§.* g,;. 3.5. ... Oral gadim I I“ 3 I: II II lid. gas; ”ash "'0 Ai'idi 53““ (a...) i. _ 6 I. V 6 l 3 ms. m. an; IV. Oedlpel- T _h_ 7 intensity A“ IO 5‘ 8 __ 7 6 2 §,5. N,§, fl.§. V. Hesturba- . __us tionfiguilt 5 lo 5 l0 4 ii u,§. fl,§. 7 “.5. Vi. fanls gnvx$_ O I 0 l 0 l . Vii. identifies. ___ tion Process 0 l5 0 l5 9 l5 3,5. ”.5. N.§. VIII. Sibling IX. Guilt M Feelings 0 l5 2 i} i It. !.§. 5.5. 1.5.... ‘0 t? 7_ Ideal l2 I ll. Narcissistic XI. Anaclitlc a h set lo I 5 ll 5,5, lid. 5.5. *N.S. (Not Significant) signifies a lack of statistically significant differences. 113 TABLE 35 INQUIRY CHOICES FOR TOTAL SAMPLE: n-75 L's-2m: __ “ Card Question and Answer Selected Groups X2 Sig. Level _7 Elected V. 2. How might Blacky feel ' about this situation then the is older‘i d) The situation won't come up again when 5 . she Is older. Lil.)- v‘ ‘1 fl - . 333-0330, Lilo _ .lO-.05 Vii. l. Who talks like that to Blacky-Nana or Papa or Tippy? a) m ‘Ofie’en‘e 3082 .IO‘JJS ' > R.l-i. c) Tippy R.li.> Vii. 3. who. is Blacky imitat- Ing here? lime or Papa or Tippy? ' ‘O 0 e e .e 0 .0 1.. 0' I)Nm, 8'2"“. 882 iO 6) Tippy ' n.n.> «.76 .05-.02 ...“ A_A " A fl infigalzg 9a A ' Vii. 5. Olacky's disposition. actually. is most like the disposition of which one - Hana or Papa or Tippy? 3.06 .lO-.OS b) Papa $.‘0.'_.O. . > RJI. 11%- TABLE 35W mum cnolcas ran TOTAL SANPLE: n-75 : J A s Card Question and Answer Selected Groups X2 Sig. Level . Selected VIII. 5. Now does Blacky think . hens and Pan really feel toward her at this time? c) She thinks they love her less than they do R.ii.’> _ 3.510 JCT-.05 #Tipggy v f 53.1.0.2 XI. 4. why does Blacky feel so contented mm the is dreamingi y b) she feels contented 8.-O.P.O. 1MB .05-.02 A‘thinltwiggabeutraja. A >M 115 mu 36 mum entices roe mm m: M” "r w K '—v I . Card Question and Answer talented Oroups Sig. Level Involve; V. l. lion does Blacky feel here? is) Enjoying herself but a BRO)... .05 ...__ I'ttI. ”ti e w > “an. A. Vii. l. the talks like that to Blacky- line or Ina or Tippy? .) m ’e4e'e.'e 005 - > Adi. c) Tippy ”.7. , .05 A r W VIOe J- 3. 3 MI“ “Inky I.‘ ‘Itin’ 3.4.}... e05 here - llama or Fape or > R.Ii. Tippy? 6) Hana c) Tippy Eli. > .05 |V 116 TABLE 37 INQUIRY CHOICES FOR NEGRO SAMPLE: n45 Card Question and Answer Selected Groups Sig. Level Involved V. 2. lion! night Blacky feel about this situation then she Is older? 4) The situation won't cone . . up again Hun she is R.N..>, ‘ .05 flag. a ma- Vii. 3. than is Blacky initating ' here - less or face or Tippy? a) Man- s.-o.rj.s‘. .on e A I > «.5. VIII. 1.. lion often does liaclty see this? a) Once in e um. FIJI.) . .05 b) fairly often 2535*: .Oi . g A Z 3.}. v Fir-3.3,, 7;qu 5% Gig” MAY-1‘.‘3“3350?:£