The effect of different conditions of reinforcement of the problem solving and ward behavior of schizophrenic patients
Page, Robert Arthur
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There are many theories which stress the role of psychological factors in the etiology of schizophrenia. This study examines the theory by Jenkins which views schizophrenia is a result of frustration beyond the tolerance of the individual. When this point is reached, maladaptive behavior occurs which leads to further frustration so that the pathological process is typically progressive. Jenkins states that this process can be reversed through the use of simple learning tasks in which the occurrence of rewards appears to facilitate such a reversal. The present experiment is an attempt to test Jenkins' theory under several conditions of reward and to relate these to changes in the ward behavior of schizophrenics. This experiment also attempts to test the position of traditional learning theories in regard to the learning ability of schizophrenics. The following hypotheses were derived from the above theoretical positions. (1) Schizophrenics will learn to solve problems according to the condition of reinforcement under which they perform. (2) Successfully learning to solve these problems will generalize to the behavior of patients on the ward. Twenty-four schizophrenics were divided into four groups. Group I received a reward on correct solution trials; Group II received a reward on every trial irrespective of response correctness; Group III received no reward; Group IV was a control group who did not perform on the tasks. Subjects chose their own reward from a group of articles which are in common use in hospitals. The subjects were rated on their ward behavior by nursing assistants on two rating scales, the Bedford Rating Scale and the Hospital Adjustment Scale, prior to the experimental procedure. The subjects were asked to solve three problems of ten levels of difficulty each. The first problem was the Block Design test from the Wechsler Adult Intelligence Scale. The second problem was the Porteus Pencil Mazes. The third problem was the Multiple Choice Task made up of a modified form of the Wisconsin Card Sorting Test, consisting of a matching test and six serial learning tests. Guidance was administered to all experimental groups when it was needed. One month after finishing the experimental procedure each patient was again rated on his ward behavior. Results generally supported the predictions. The first set of predictions stated that Group I would solve each of the tasks in less trials than Group II and Group II in less trials than Group III. Statistical analysis indicated that there was no significant difference between the groups on the Block Design and Pencil Maze Tasks but there were significant differences between the groups on the Multiple Choice Task. Further analysis revealed that these differences were between Group I and Group III and Group II and Group III. The analysis of the data when all three tasks were pooled revealed a significant difference between Group I and Group III. The second set of predictions stated that Group I would show more positive change in ward behavior than Group II; Group III more than the Control Group; and that all experimental groups would show more change than the Control Group. Statistical analysis revealed no significant differences between an experimental group and any other experimental group but significant differences between each experimental group and the control group were found. It was concluded that while the condition of reinforcement did not aid in the solution of the first two tasks, there was a cumulative effect of reinforcement as demonstrated in the performance of the third task and when the data for all tasks were pooled. It was further concluded that while the presence or absence of reinforcement did not have a differential effect upon ward behavior, participating in the experimental procedure by all groups resulted in improvement in ward behavior.
Thesis (Ph.D.)--Boston University
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