SPECIFIC BEHAVIORAL CHANGES PRODUCED BY CHLORPROMAZINE IN CHRONIC SCHIZOPHRENIA

Results of this and other studies employing objective test measurements suggest that widely observed even radical alterations in behavior are not usually accompanied by commensurate changes in the psychological test performance. The dilemma faced by those interested in objective measurement is whether psychological tests are generally insensitive to change; or whether the behavioral changes are relatively superficial, while the psychological tests measure the more stable aspects of the personality? Reports of change in the literature especially in chronic psychotic patients is so prelevant that something must happen to these patients however exaggerated the claim. It is very possible that psychologists persist in applying the wrong measuring techniques and that new methods will have to be developed. At present behavior rating scales probably provide a more sensitive index of change than most psychological tests.

It is also possible, however, that changes resulting from chlorpromazine are relatively superficial. In very few studies are claims of a remission in the psychotic process substantiated by objective evidence. In this study, for example, there appeared to be an alleviation of some of the more objective symptoms but in no case could a patient [see Fig. 1. in source PDF] Fig. 1. Example of the Hospital Management Picture Frustration Test. (Modification by Moss of the Rosenzweig Picture-Frustration Study, Adult Form. Copyright 1948, made with the author's permission. be regarded as without psychosis at the conclusion of the experiment. While medication was administered for a relatively short period, it is common clinical experience that the psychological reaction to seeming tolerance develops so that in this respect the design of the present study should maximize finding psychological alterations. A 14-month followup survey also revealed that in spite of continued tranquilizing medication of one type or another, only one of the patients (number 7, Table 1) is on convalescent leave at present and none has been discharged. Enthusiasm for psychopharmacological treatment should be tempered by a more realistic appraisal of the limitations of these agents.