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Schizothymia and leadership: An attempt to define a contrasting model for schizophrenia
91
1. Psychopathology/Diagnosis SPECIFICITY SCALE D.E. Addington*,
OF THE CALGARY
J.M. Addington,
DEPRESSION
E. Maticka-Tyndale
Department of Psychiatry, The University of Calgary, Foothills Hospital, Calgary, Alta. RN 2T9. Canada OBJECTIVE: This study sought to determine the specificity of the Calgary Depression Scale (CDS) a depression rating scale for schizophrenics. The specificity is the degree to which the scale assesses depression rather than negative or extrapyramidal symptoms. METHOD: Subjects were 100 outpatients (OP) and 50 inpatients (IP) meeting DSM-III-R criteria for schizophrenia. Negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS); extrapyramidal symptoms were assessed with the Simpson Angus Scale and depression with the (CDS). RESULTS: the CDS showed weak but statistically significant correlations with the SA and with the PANSS negative symptom score. Confirmatory factor analysis using Lisrel 6.0 showed that the model hypothesizing specificity of depression, negative symptoms and extrapyramidal symptoms was significant, with a goodness of fit index of .89 and a root mean square residual of .07. CONCLUSION: the CDS measures depression distinct from negative and extrapyramidal symptoms in subjects with schizophrenia, when combined with the measures used in this study.
Kennedy was the “fastest talker” in public life. When the schizophrenic speaks fast, it may be a “word salad.” Typical male schizophrenics have very low sex drive while manics display hypersexuality (Kennedy’s sexual escapades were legendary). But a great leader is much more than a hypomanic, owing to his superior “ego-strength” with reference to the following egostrengthening factors: “(i) Rational self-confidence and courage, (ii) dominant and influential disposition in company, (iii) ambition and initiative, (iv) restraining power over impulses and adaptability to changing environment, (v) selective attention, (vi) ability to organize a number of acts within a limited time without the feeling overcrowding or confusion, (vii) ability to choose decisively among alternatives and (viii) effortless systematization in instantaneous reactions when facing a crisis” (Alias AG, Biol Psychiat 1974; 61-72). Nevertheless, the hypomanic disposition in itself can enhance leadership, perhaps in the way that imipramine restores some lost dominance in amygdalectomized cats (Fonberg E, Int J Neuroscience 1988; 41: 201-13). Intriguingly, amygdalar stimulation causes sexual arousal. I suggest that this ego-strength rapidly falls in men, ideally of comparable intelligence, roughly as follows: A great leader (Napoleon’s mind is an apt example) > a functional hypomanic (e.g. Ross Perot) > and average person ? a schizothymic > (residual) schizophrenic > a dreaming person.
FACTOR ANALYSIS OF THE NEGATIVE SYMPTOM ASSESSMENT L.D. Alphs*, B.N. Axelrod, R.S. Goldman, J.L. Woodard Department of Psychiatry, Wayne State University, Detroit, MI 48207. USA
SCHIZOTHYMIA AND LEADERSHIP: AN ATTEMPT TO DEFINE A CONTRASTING MODEL FOR SCHIZOPHRENIA A.G. Alias Chester Mental Health Center, Chester, IL 62233, USA Inability to process information at an adequate pace to hold, say, a sensible conversation, is believed to be a fundamental defect in schizophrenia. In contrast, numerous studies have correlated leadership with speed of information processing. Terre @Minute Hour, Geigy, 1975). who extensively studied the mental health of world leaders, wrote, “political leaders have certain...traits [that] enable them both to seek out and be cast in a leadership role. The first of these characteristics is high energy [Goodwin & Jamison (1990) have correlated leadership with hypomania.]...They are able to process large quantities of information quickly...[they] also have enormous sexual appetite...” Schoenbrun (Parade, Ott 7, pp 8-11) wrote, “I never met a great man or woman [leader] who did not possess that fine quick wit...No one could think more quickly on his feet...than John Kennedy.” According to the Guinness Book of World Records,
Recent descriptions of schizophrenic symptoms have emphasized their dichotomous division into “positive” and “negative” dimensions. However, several investigators have suggested that these domains incompletely describe symptom complexes associated with schizophrenia. The Negative Symptom Assessment (NSA) has been developed to characterize symptom dimensions generally regarded as “negative.” Items on this scale are behaviourally based, are specifically anchored on a 6-point Likert severity scale and are sensitive to changes over relatively brief periods of time. We have conducted principal components analyses of this scale on data from different samples of schizophrenic patients to establish its factor structure. Results of these studies have been similar, suggesting that the structure of the NSA is stable within populations of medicated schizophrenic patients, We now report results of confirmatory factor analyses on a new sample of 216 unmedicated schizophrenic patients, testing four different factor structure models. A theoretically based structure which includes factors for communication, emotion, sociality, motivation, cognition, and retardation was the most successful solution. These data provide further evidence that symptoms commonly included under the rubric of “negative symptoms” are heterogeneous. More work is necessary to determine whether these factors are characterized by heterogeneous natural histories or have heterogeneous responses to antipsychotic medications,
1. Psychopathology/Diagnosis SPECIFICITY SCALE D.E. Addington*,
OF THE CALGARY
J.M. Addington,
DEPRESSION
E. Maticka-Tyndale
Department of Psychiatry, The University of Calgary, Foothills Hospital, Calgary, Alta. RN 2T9. Canada OBJECTIVE: This study sought to determine the specificity of the Calgary Depression Scale (CDS) a depression rating scale for schizophrenics. The specificity is the degree to which the scale assesses depression rather than negative or extrapyramidal symptoms. METHOD: Subjects were 100 outpatients (OP) and 50 inpatients (IP) meeting DSM-III-R criteria for schizophrenia. Negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS); extrapyramidal symptoms were assessed with the Simpson Angus Scale and depression with the (CDS). RESULTS: the CDS showed weak but statistically significant correlations with the SA and with the PANSS negative symptom score. Confirmatory factor analysis using Lisrel 6.0 showed that the model hypothesizing specificity of depression, negative symptoms and extrapyramidal symptoms was significant, with a goodness of fit index of .89 and a root mean square residual of .07. CONCLUSION: the CDS measures depression distinct from negative and extrapyramidal symptoms in subjects with schizophrenia, when combined with the measures used in this study.
Kennedy was the “fastest talker” in public life. When the schizophrenic speaks fast, it may be a “word salad.” Typical male schizophrenics have very low sex drive while manics display hypersexuality (Kennedy’s sexual escapades were legendary). But a great leader is much more than a hypomanic, owing to his superior “ego-strength” with reference to the following egostrengthening factors: “(i) Rational self-confidence and courage, (ii) dominant and influential disposition in company, (iii) ambition and initiative, (iv) restraining power over impulses and adaptability to changing environment, (v) selective attention, (vi) ability to organize a number of acts within a limited time without the feeling overcrowding or confusion, (vii) ability to choose decisively among alternatives and (viii) effortless systematization in instantaneous reactions when facing a crisis” (Alias AG, Biol Psychiat 1974; 61-72). Nevertheless, the hypomanic disposition in itself can enhance leadership, perhaps in the way that imipramine restores some lost dominance in amygdalectomized cats (Fonberg E, Int J Neuroscience 1988; 41: 201-13). Intriguingly, amygdalar stimulation causes sexual arousal. I suggest that this ego-strength rapidly falls in men, ideally of comparable intelligence, roughly as follows: A great leader (Napoleon’s mind is an apt example) > a functional hypomanic (e.g. Ross Perot) > and average person ? a schizothymic > (residual) schizophrenic > a dreaming person.
FACTOR ANALYSIS OF THE NEGATIVE SYMPTOM ASSESSMENT L.D. Alphs*, B.N. Axelrod, R.S. Goldman, J.L. Woodard Department of Psychiatry, Wayne State University, Detroit, MI 48207. USA
SCHIZOTHYMIA AND LEADERSHIP: AN ATTEMPT TO DEFINE A CONTRASTING MODEL FOR SCHIZOPHRENIA A.G. Alias Chester Mental Health Center, Chester, IL 62233, USA Inability to process information at an adequate pace to hold, say, a sensible conversation, is believed to be a fundamental defect in schizophrenia. In contrast, numerous studies have correlated leadership with speed of information processing. Terre @Minute Hour, Geigy, 1975). who extensively studied the mental health of world leaders, wrote, “political leaders have certain...traits [that] enable them both to seek out and be cast in a leadership role. The first of these characteristics is high energy [Goodwin & Jamison (1990) have correlated leadership with hypomania.]...They are able to process large quantities of information quickly...[they] also have enormous sexual appetite...” Schoenbrun (Parade, Ott 7, pp 8-11) wrote, “I never met a great man or woman [leader] who did not possess that fine quick wit...No one could think more quickly on his feet...than John Kennedy.” According to the Guinness Book of World Records,
Recent descriptions of schizophrenic symptoms have emphasized their dichotomous division into “positive” and “negative” dimensions. However, several investigators have suggested that these domains incompletely describe symptom complexes associated with schizophrenia. The Negative Symptom Assessment (NSA) has been developed to characterize symptom dimensions generally regarded as “negative.” Items on this scale are behaviourally based, are specifically anchored on a 6-point Likert severity scale and are sensitive to changes over relatively brief periods of time. We have conducted principal components analyses of this scale on data from different samples of schizophrenic patients to establish its factor structure. Results of these studies have been similar, suggesting that the structure of the NSA is stable within populations of medicated schizophrenic patients, We now report results of confirmatory factor analyses on a new sample of 216 unmedicated schizophrenic patients, testing four different factor structure models. A theoretically based structure which includes factors for communication, emotion, sociality, motivation, cognition, and retardation was the most successful solution. These data provide further evidence that symptoms commonly included under the rubric of “negative symptoms” are heterogeneous. More work is necessary to determine whether these factors are characterized by heterogeneous natural histories or have heterogeneous responses to antipsychotic medications,