An Attempt to Promote Behavioral Change in Paired-Schizophrenics by Reinforcing Associative Behavior

This report briefly describes an attempt to pair chronic, hospitalized schizophrenic patients to determine first whether they would associate togethet as a pair (e.g., go for walks, visit, play games) and second how this paired associauon would affect their behavior. The 18 male and 18 female Ss were diagnosed schizophrenics housed on the Research Ward (Western State Hospital, Washington). Ages ranged from 19 to 55, with a mean hospitalization of 9.8 yr. Each S was initially evaluated by the ward staff as either a high or low functioner on the basis of amount of supervision required and amount of psychotic or regressed behavior manifested. In addition, each S was evaluated on the Nurses' Observation Scale for Inpatient Evaluation ( I ) , Hospital Adjustment Scale ( 2 ) , and Shipley Hartford Scale ( 3 ) . Test data and staff evaluations were used to divide the Ss into two groups: better functioning patients and those functioning at a level judged more regressed. A pair ( 1 from each group) was selected by the staff using the criterion these rwo would work togethet well until there were 18 pairs. The 18 pairs were randomly divided into three groups ( 3 female and 3 male pairs in each); Experimental I, which were evaluated daily on a 5-point association rating scale by 3 ward staff, met with 3 times per week by Es, and paid scrip on the basis of amount of association; Experimental 11, which were evaluated daily, met with weekly, and paid scrip on the basis of amount of associating; Control, whtch were evaluated daily, received no scrip, and did not meet with Es. Before the study began Experimental I pairs were told what associating together meant; that they would be evaluated by the ward staff on a 5-point scale and paid by E 5 cents for each rating of 1 they received, 1 0 cents for each 2, etc.; and that they would meet three times weekly with one of the two Es. Experimental I1 pairs were told only what associating meant, that they would be paid scrip for associating, and that they would meet once weekly with Es. At every meeting, each pair was told to continue associating and that the more things they did together the more scrip they would receive. The total duration of the study was 2 mo. All Ss were evaluated before the study began, at midpoint, and after treatment. Initially some of the patients in each experimental group did associate when paid to do so, but almost all pairs stopped associating as the study progressed. In addition, except in a few cases, there were more negative than positive changes between baseline and after treatment evaluations on the NOSIE-30, HAS, and Shipley Hartford Scale. REFERENCES 1. HONIGFELD, G., & KLETT, C. J. The Nurses' Observation Scale for Inpatient Evaluarion: a new scale for measuring improvement in chronic schizophrenia. 1. clin. Psychol., 1965, 21, 65-71. 2. MCREYNOLDS, P., & FERGUSON, J. T. Clinical manna1 for the Hospital Adjustment Scale. Palo Alto, Calif.: Consulting Psychologists Press, 1946. 3. SHIPLEY, W. C. Manual for the Shipley-Institute of Living Scale. Hartford: The Institute of Living, 1939. Accepted December 22, 1967

Affect (linguistics · Association (psychology · Developmental psychology · Psychiatry · Psychotherapist · Rating scale · Scale (ratio · Schizophrenia (object-oriented programming · Clinical Psychology · Communication · Mental Health and Psychiatry · Psychiatric care and mental health services · Psychology · Schizophrenia research and treatment