“The peculiarities of schizoid psychopathies in girls.” by GE Sukhareva
(From the sanatorium school of the psycho-neurological children's clinic in Moscow [Director: Prof. Dr. MO Gurewiisch).)
The peculiarities of schizoid psychopathies in girls.
From
Dr. GE SUKHAREVA,
scientific assistant.
This communication is an addition to our work “On schizoid psychopathies in childhood”) and can be viewed as its continuation. Our starting point here is the main conclusion of the work mentioned, namely that there is a group of psychopathies, in which some external features of the schizophrenic psyche can be observed (schizoid psychopathies). Symptomatologically, this group is closest to the group described by Kraepelin as “the cranky people”. In the work mentioned above we made this point
attention to the recent misuse of the term schizoid and suggested that this term should only be retained for a small group of psychopathies with specific symptomatology. On the basis of the material we have presented, we were able to develop some clues for differentiating this group, both from those peculiarities of the schizoid psyche, which also occur normally in puberty, and from the schizophrenias and those schizoid reactions, which arise exogenously.
When selecting our clinical material, we intentionally initially described only the cases in boys.
2) See “Schizoid psychopathies in childhood”. Monthly publication for psychiatry and neurology Vol. 60 (1925).
By devoting special work to the cases of girls, we intend to highlight those distinguishing features which the gender characteristic brings into the picture of schizoid psychopathies.
The problem of the influence of sex differences on the symptomatology and course of various clinical forms deserves much more attention than is usually given to it. The difference in the functional evolutionary and involutive characteristics of the two sexes is of great importance in psychiatry, not so much in the sense of pathogenesis as in the sense of the pathoplasty of various mental illnesses. A number of psychiatrists point out that various forms of mental illness do not occur equally often in men and women and different. Women seem to be particularly predisposed to manic-depressive madness. According to Äraepelin, women make up 70% of all cases of manic-depressive insanity. The psycho-physiological peculiarities of the sexes do not remain without influence on the course and clinical picture of psychosis. In men we are much more likely to deal with pure (depressive and manic) forms, whereas for women depression with adventurous delusions and anxiety and more complicated manic states with stupor and confusion episodes are characteristic (Äraepelin). The proportion of men suffering from schizophrenia is slightly larger. According to Äraepelin's information, out of 1054 cases of dementia praecox, 57.40% fell on men. But if you look at the distribution of the sick according to age groups, the differences in the proportions of both sexes become much more significant. The age of 20 to 25 is when the majority of schizophrenias occur begins, we find a significant predominance of men (57.9-65.80/9); Around the age of 35, the female proportion reaches the male proportion and significantly overtakes it at the ages of 45 and 55. The cases of late-onset schizophrenia mainly affect women. In Schroeder's case, there were 13 women and three men in 16 cases of late catatonia. When it comes to the frequency of individual forms, gender is even more important. Women are particularly prone to periodic forms. According to Kraepelin, two thirds of all of these cases occur in women; he explains this
of schizoid psychopathies in girls.
Fact due to the influence of menstrual periods. In the hebephrenic and catatonic forms, men predominate (630/, and 590/, according to the data of Äraepelin). In the paranoid forms we have a slight predominance of women.
In the area of constitutional psychopathic states, it has long been established that hysteria is particularly characteristic of the female sex, while neurasthenia occurs more frequently in men. We find information about the differences in psychopathic manifestations in children of both sexes in the works of Voigtländer and Gregor. The authors consider
describe a series of differences in the psyche of boys and girls who are difficult to educate. In girls, the traits of unsteadiness, untidiness and domineering dominate
and lying; In boys, on the other hand, the following characteristics come into consideration: an indifference that goes as far as emotional dullness; depressed or irritable mood, withdrawnness, rudeness, irritability. For the male half, emotional information dominates
Dullness, for the female about instability and inconstancy. The author also discusses in detail the peculiarities of antisocial behavior among men and women. The woman's crime should always be subjective and emotionally colored; an element of sentimentality can be found in the woman herself in the antisocial act. Big roles
women's emotional experiences play out; Men, on the other hand, act much more straight and objectively.
The advantage of determining the differential characteristics of both sexes in children's material is that it makes it much easier to eliminate the influence of socio-economic factors (occupation, education, environment, etc.). Therefore, we believed that a parallel between cases of schizoid psychopathy in boys and girls would warrant some interest. As a supplement to the cases of schizoid boys we have described, we present here some cases of schizoid psychopathy in girls. The age is the same as for boys: 1 to 14 years. Three of these cases
were treated in the psychoneurological children's clinic, two in the institution for difficult-to-educate girls. As in the previous work, we are only concerned here
with cases that have been followed for a long time (2 to 4 years) and appear to be diagnostically clarified.
Case x. PL, born in 1913. Heredity. Father, 45 years old, Russian. Lively, active person. Very nervous, intense. Paternal grandfather died of throat cancer; was always nervous and irritable; an energetic and funny person; Großmuiter - senile with dementia from the age of 60; previously physically and mentally healthy. One uncle suffered from hysterical attacks, a second uncle was constitutionally neurasthenic and always hypochondriacal. Mother – 43 years old, Latvian; considers himself healthy; closed, silent, reserved; Grandfather (Latvian), rural farmer, died of heart failure at the age of 1; was dark, silent and sad. Grandmother, a German, died of myelitis at the age of 65. Grandfather's family consisted of ten children. Everyone is alive. Including two tuberculosis sufferers. No mental or nervous illnesses. Characterologically, they are mostly people of a grumpy sort. -
Personal anamnesis. Pregnancy and partus - N. Physical development regular. Of the infectious diseases, she survived measles, whooping cough and pneumonia. He grew up as a healthy and calm child, but showed himself to be stubborn and stubborn from a very early age. Even at the age of two, it sometimes happened that we couldn't cope with her, for example. B, while out for a walk, suddenly stopped, didn't want to go any further, sat down on the ground on the sidewalk, and all persuasion was in vain. For up to four years she lived in Finland in good economic conditions and had sufficient care and support. At the age of four, she and other children were evacuated from Leningrad to Czechoslovakia. When she returned home from there, she was even ruder and disobedient.
become clearer. At the age of five she was admitted to a kindergarten, where she was viewed as a gifted girl with a “distinct individuality”. After a year she was transferred to another kindergarten; this institution was less organized; Here her development took a less favorable course and she was considered difficult to educate. The girl was already attracting attention because of her sadness. "She lacked the funny face of a child," said her mother, "her laughter was frightening, it was so unnatural, so unchildlike." She avoided large groups of children, but she had very deep and strong affections for individual children, which, however, often suddenly stopped suddenly. Her games with the children often ended in clashes, as she always and everywhere demanded special attention towards them. She was always suspicious, sullen; It always seemed to her that they were her
treated worse than other children; She was always complaining that people didn't love her, that her mother was being unfair to her, etc. She was often rude to her siblings, sometimes even cruel to the younger ones, and sometimes beat them. Nevertheless, she longed for them in their absence, cared for them when they were sick, and expressed great concern for them at such times.
gentleness and sensitivity. “At times when I was ill or felt upset,” said the mother, “none of my children were as tender and attentive towards me as L was.” The girl always spoke very reluctantly and little about herself. She was secretive and secretive even from her mother and father. This closedness and the contrasts in her emotional structure made her a mystery to her parents. “She's sick,” said the mother; "She is a sleeping princess," said the father. From childhood she worried her parents with her tendency to fabricate things and lie. When she was seven years old, she once got lost in the streets of the city, came home late in the evening and said that she had met her father, who was riding a horse, picked her up and brought her home (all this turned out later as invented). She often said that she had to eat particularly delicious food in kindergarten
everything was told in great detail and she herself seemed to believe in her inventions. During this time she often slept restlessly, was often very frightened at night and woke up
the aunt and let her stay awake with her. Always expressed a great love for independence and did not tolerate contradictions when she wanted something. At the age of nine she ran away from the colony (40 km
from Moscow) with the motivation: “I don't like me there, I can't live there anymore.” School lessons began at the age of nine and attended school for two years. Learned satisfactorily; Towards the end of the school year, however, she had to be helped at home because she was noticeably tired. She spent her leisure hours aimlessly,
had no interest in reading, no preference for games; She was clumsy when it came to housework, she did everything clumsily: she dropped everything and stumbled. She had little interest in her clothes, was often untidy, and had little care for her things. Didn't like to dress like everyone else ; went in winter without an overcoat or put on different stockings. In 1924, the girl began to experience motor restlessness and sometimes tremors in her hands while working. According to the doctors' advice, she was given this in the summer
Sent to the country and admitted to the healing school in the fall.
Status Physicus. According to her body length she corresponds to 15 years, body type: Asthenic with athletic features. The bent one
The posture, the disproportionately small size of the skull and the broad shoulders give the impression of being dysplastic. Oval head shape that tapers upwards. Long face, blue eyes with sparse, light eyelashes. High forehead; Upper jaw somewhat prognathic. Steep palate, irregularly placed teeth, long neck, shoulders very wide in relation to the pelvis. Long chest. Big hands and feet. Fairly pale skin, pronounced cyanosis of the hands and feet. The subcutaneous fat layer is sufficiently developed. Head hair blonde, straight. Urogenital apparatus - N. Signs of sexual maturity are present. Menses - abs. Internal organs: lungs – right prolonged exhalation; Heart - systolic murmur at apex cordis; left border lateral to the L. mamillaris. Gastrointestinal tract OK. Nervous system: The movements are sufficiently strong,
a bit slowed down and clumsy. According to Dr. Oseretzky's motor skills correspond to his age. Slack posture, slow gait, walks a bit hunchbacked. Facial expressions slack, but adequate to the experience. Cranial nerves: weak asymmetry of the facial nerves; pupils even; Reactions (light, accommodation, convergence) well preserved; psychological reaction also present. Tendon reflexes slightly increased. Mucosal reflexes: conjunctiva, cornea - N. Pathological reflexes are absent. Sense organs — N. Has been sleeping peacefully lately. Laboratory tests: Blood: Hb - 65%, erythrocytes - 4620000, leukocytes - 8000. Leukocytic formula - no deviations from the norm. Negative Aquarius in the blood.
Staius psychicus. Little accessible. Very reluctant to talk about her past. Only provides very superficial and unrelated information. When asked questions that touch on her intimate experiences, she becomes even more reserved and withdraws even more. Considers himself healthy, denies everything: mood swings, phobias, increased irritability. With longer and careful exploration, we discover that she is often in a sad mood. When asked: “Why?” she replies: “I won't say that, it's my secret.” As the conversation continues, she replies stereotypically: “Don't ask, I won't say anyway, it's my secret.” secret.'' The dissatisfied, dark tone of voice is noticeable in the way she speaks. She is anxious to leave as soon as possible, is restless and makes a lot of unnecessary movements. Poor language: finding words is very difficult for her. The stock of knowledge is also small. The
Logical operations only succeed within the limits of the concrete. Where abstractions are required, the answers are much worse. Thought processes somewhat slowed and stiff; qualitatively within the limits of the norm, quantitatively (functionally) significantly reduced - due to inability to intellectual effort. Has no interest in intellectual work; where reflection is required, it immediately gives a negativistic reaction; - "I don't know". At constant
With some encouragement and some support, she gives much better answers. When examined in the laboratory according to the Binet scale, it gave + ı year.
She didn't like staying at school, always repeating: "I'm only here for a short time, I'm leaving soon anyway." Very slowly got used to the new conditions; expressed a distrustful, skeptical attitude toward everything: “Everything is bad here, the children are bad too, things were better in the other school.” Stays apart from the children's life together, but is not apathetic. Is capable of observation; behaves as if she is studying and criticizing everything, The dominant mood is calm; No cheerful excitement or increased irritability were observed. She is reserved and even, and you always get the impression of a certain coolness. Expressed affective coloring can only be perceived wherever their sense of self is touched. Here one can even
increased sensitivity. The constant desire to be better causes in connection with their inferiority.
feeling a restless basic tone of affectivity and a suspicious, suspicious attitude towards people. She perceives people's behavior towards her very finely; She also has the ability to lively, compassionately understand other people's experiences. She is not malicious, likes to share her gifts with her friends, but all affective movements remain cold and weak on the outside. She has a feeling of camaraderie, which is expressed in her constant striving to protect those who have been offended; but here too it is a question of a strange, rigid and exaggerated feeling of justice. Seems to be very fond of her parents, especially her father, who enjoys unshakable authority over her. Any aesthetic abilities could not be noted. Performance at school was sufficient.
No drastic changes could be observed during the stay at school; became physically stronger, and recently she has also started to take a more active part in the social life of the school. The mother notices a significant improvement.
At home, the girl is much calmer, has fewer conflicts with relatives, has become tidier, and sleeps well.
Summary. The hereditary components behave as follows: on the father's side, sthenic, active natures with a number of neurotic traits; maternal
Schizoid traits predominate: cool, dark, silent
People. The girl really developed. From an early age, stubborn, stubborn, extremely “individualistic”, as well as individual neurotic traits: restless sleep, nightmares, hyper-fantastic lying. Over the years, her peculiarities become more and more striking: on the one hand - her tendency to autistic reactions: closed-mindedness,
silence, low sociability; on the other hand — the contrast of their emotional personality. Given the emotional coolness and inertia of the affective reactions, there is great sensitivity and delicacy in understanding other people's experiences. Increased impressionability when assessing the behavior of those around her. The awareness of one's own inferiority often creates a fearful emotional tone due to the heightened sense of self.
Rudiments of the paranoid symptom complex: distrustful, suspicious behavior towards other people, constant search for justice. Intellect low, but in the
Standard width. Performance satisfactory. Somatic: asthenic body type, a certain angularity of movements. Internal organs: myocarditis, tuberculous intoxication
appearances. A certain improvement during the stay in the healing school.
Diagnosis: Psychopathic personality. — Schizoid course: stationary with little improvement.
Case 2.ı. W., ı4 years old, born in 1912, girl from an uneducated working-class family.
Heredity: mother died of stomach cancer at the age of 44; was nervous, irritable and mischievous. Maternal grandfather — alcoholic, died an old man. Grandmother was physically healthy, calm and even-tempered. Maternal uncle – alcoholic, a person with severe
"Character, father - killed in battle; physically and mentally healthy. Nothing further is known about his relatives.
Personal anamnesis. Pregnancy and Birth— N. Was born a healthy child. Survived scarlet fever and measles. She grew up as a very quiet child, played little with children, and was noticed by her relatives because of her calmness. Was moody, disobedient and stubborn at times. After her father's death, the girl was placed in a children's home at the age of six, where she spent a year and was then transferred to another children's home; At the age of ten she was referred to the medical observation center with the following complaints: “Avoids the larger children's society, only socializes with two to three friends, and chooses particularly weak and quiet girls. It's normal from an intellectual point of view, but it's very difficult to capture their interest in school work.' Examination in the outpatient clinic of the medical observation center (May 1922) revealed normal intellect; She gave the impression of a very reserved girl. She calmly accepted her admission to the inpatient ward of the observation center; Here it was also very closed and not very accessible. (In the observation center she was under our observation.) She rarely attended the class work; If she was present, she refused to show her notebooks to the teacher. The dominant mood was one of indifference and slackness, at times a somewhat elevated, silly one - running around the whole house, grimacing, making faxes. She reacted to the adults' comments with even greater excitement and was negativistic; but calmed down spontaneously if left unnoticed. Didn't fit in well with the institution's rules. Rejected all suggestions to do any work, but was happy to do what was forbidden. Outwardly she was emotionally superficial and never remembered her relatives; never wanted to go home on holidays. Didn't have a single friend among her classmates; their behavior to adults
there was an indifferent, sometimes even hostile attitude towards them. No judgment could be made about her school performance because the girl had done nothing at school. Of her aesthetic abilities, she had a talent for graphics. The teacher thought she was not only technically talented, but also artistically and creatively talented. What was noticeable in her drawings was the dominance of dark colors. She remained in the institution for two years; any noticeable changes
No changes in her psyche were observed during this time. In March 1924 she was transferred to an institution for difficult-to-educate girls, where she is now under our observation.
Status physicalw. Their body length exceeds their age. Body type: regular, asthenic (unspoken). Small face, regular facial features. Minor prognatism of the maxilla. Head well proportioned in relation to torso; neck thin and long; flat chest. Right-sided, vaguely pronounced scoliosis. Fat layer sufficiently developed, muscles sleep. skin thin, elastic; rosy cheeks. Hair dark blonde, hard. Thyroid normal. The secondary sexual characteristics become noticeable. Menses - abs. Internal organs: heart and lungs - gastrointestinal nerve - tendency to constipation.
Nervous system. Movements sufficiently strong, coordinated, violent, sweeping, lots of unnecessary movements. Lively facial expressions, intense grimacing during states of excitement. cranial nerves — N; pupils —N; psychological pupillary reaction present. Slightly increased patellar reflexes. Skin and mucous membrane reflexes normal. A certain hyper
anesthesia of skin sensitivity. Red, flabby dermographism; Hands somewhat cyanotic. WR in blood negative.
Status psychicus. Little accessible during examination. Dissatisfied, gloomy look. Hides her gaze from the examiner. Gives short, monosyllabic answers; When asked questions about herself and her past, she stubbornly refuses to answer and only shares
some external facts with: "Why do you want to know that, I won't tell you anything." She is sufficiently oriented in the immediate environment. The level of general education is not high, but sufficient for a girl of her origins. Their knowledge is poor and their language is poor, which is why their answers lose a lot. Logical operations satisfactory; She has a certain tendency to schematize: when asked “What is a fork?” she answers the question: B. the following
Answer: "an object made of something, such as iron, and having several projections"; "What is a table?" — “a wooden lid with four legs”. The definitions of abstract concepts are not successful at all because they lack the necessary words. Correct perception: she correctly understood and explained all the images presented. It is interesting that for all the pictures with visual impossibilities, even though she understood the picture correctly, she stubbornly strived to prove its correctness: “It doesn't matter; things like that happen; I also like to do everything the other way around; this uncle is dressed very warmly in summer; I also do the same thing: I wear a coat in the summer, but not in the winter.”
Coordinated associations (often negativistic reactions: “Oh wow, boring, don’t want to do it anymore.” Contrasting associations occur: many negations. Memory satisfactory, predominantly mechanical type. When examined according to Prof. Rossolimo’s method, it results in high suggestibility and automatism, low attention and sufficient higher processes Good performance in the
School. She accepts suggested tasks well, but prefers mechanical-automatic work. Often expresses stubborn negativism: when you ask her to write something down, she replies: "I don't want to, I won't do it." All persuasion and all punishment are unsuccessful. If you leave her unobserved, she sits down and gradually goes to work; always refuses when she has to read something out loud. She is very shy, self-loving and self-insecure - so she gets very embarrassed and blushes when she has to answer. She tries to mask her embarrassment with laughter, grimaces, and unnecessary movements. In class she is very restless, moves back and forth on the school desk, jumps up, tugs at her notebooks. She spends her free time alone or in the company of a single friend. Gets lost in the total mass of children; is closed, secretive, and doesn't let anyone into her inner world. The mood is predominantly apathetic. The states of increased excitability and silly behavior are significantly rarer than during the stay at the medical observation center; In recent years, however, the dark, distrustful emotional tone has become much more pronounced. Everything about her is unpleasant here, everything about her is
blames. To the question: “What do you like?” she answered: “Nothing, I don’t like anything.” To the question: “What do you hate?” she answered: “Everything is bad for me and everyone here is bad .' For a while she became very friendly with a girl, became embarrassed when this friendship was discussed, but immediately dropped it when the girl returned a ribbon she had given her; She felt so insulted and was so angry that she immediately broke the bond in the girl's presence. Despite her extreme external emotional shallowness, she is very sensitive, especially
their sense of self vulnerable. She has a keen understanding of different emotional experiences. According to the teacher, she was the most sensitive and intelligent girl in her entire group. Likes to draw, but refuses to draw from a template. Works in bookbinding, does good things. Over the last year the girl has become a little softer and calmer; The loss of her mother (who had died a few months ago) was very difficult for her. According to her, she cried a lot at night when no one could see her.
gathering. Hereditary burden on the mother's side. Regular physical development. Not very sociable from an early age, unchildishly quiet. Dark and moody at times. From the age of six she lives in children's homes and is difficult to educate here because of her lack of accessibility, extreme negativism and tendency towards silly misbehavior. An emotionally flat girl: feels no longing for relatives, has no intimate friends. Is
at the same time very sensitive and very sensitive to violations of their sense of self. Intellect normal, good school
achievements, expresses a talent for drawing. Physically: asthenic physique (unspoken); motor retardation, clumsiness, many superfluous movements. During the observation, a certain improvement could be noted: the girl became softer and calmer.
Diagnosis: Psychopathic personality: “schizoid”. Course: inpatient with a slight improvement in the last few years.
Case 3. WP, born in 1909.
Heredity: father died of typhus at the age of 42; was a fin-
stereotypical, malicious person who had no interest in the family and the children. Drinked often. Lues is denied. There is no information about his relatives. Muftler, 47, works as a nurse in a hospital and gives the impression of an idiot; in character she is soft and weak-willed,
Grandfather and grandmother on the mother's side died at an advanced age - further details are missing. The mother had three pregnancies. i. The older son, 2 years old, psychopath: untidy, unsteady, rude, impudent, can't find his way anywhere; 2. our patient; 3. a four-year-old girl: calm, quiet, oligophrenic.
Personal anamnesis. Pregnancy and parturition progressed normally. Was born a healthy child. Physical development was somewhat delayed. She started talking and walking when she was two
years. Supernatant varicella, measles and whooping cough. She grew up as a weak girl and often had bronchial catarrh. The economic conditions were always very difficult. The girl's upbringing was in the hands of her mother, who couldn't cope with her. The moody, capricious and strange girl was very difficult to deal with from early childhood. Usually was
She was kind, attentive and tender towards her mother, but at times she suddenly became rude, impudent and scornful, apparently without any reason, and even hit her mother at these times. Was always very stubborn and disobedient, always did the opposite of what was necessary. If someone said to her, "Go for a walk!", the answer was: "No, I'm not going," and "Then lie down and rest" - then she quickly dressed and sat at the gate for hours. She didn't play much with the children and didn't get along well with them. At the age of nine, the girl was taken to a colony in Ukraine, where she remained for up to twelve years. After returning from there, her mother referred her to the medical observation center in Moscow (February 1922), where she was under our observation.
Status physicus Anno 1923. Corresponds to body length and weight according to their age; is weakly and dysplastically built. Body type rather asthenic. Head large, almost square in shape, face broad, forehead narrow with low-growing hair; big gray eyes; wide nose, small mouth, broad teeth. Neck short, broad, narrow shoulders. A bit humpbacked. Scapulae alatae. Flatter
chest. Rickets residues. The superficial lymph glands enlarged. Tonsils hypertrophic. Subcutaneous fetal layer poorly developed; Muscles flabby. Thyroid — normal. Genitourinary apparatus — norm. Menses abs. Internal organs: chronic acute catarrh. Vascular system: anemic venous murmurs. Heart – norm.
Nervous system. Slack posture, angular movements, clumsy gait; lots of grimaces, lots of unnecessary movements; Facial expressions adequate to the experience. cranial nerves — N; Pupils —D=S, react lively. Patellar reflexes increased. Pharyngeal reflex - abs. Sensitivity - N. Face grossly reduced - short-sighted.
Status psychicus. Intellect low, but within the norm. Knowledge base is low. School knowledge is even more inadequate. _ Logical operations within the limits of the concrete. According to the methods of Binet-Simon and Rossolimo, it shows a certain backwardness. During the examination she is negativistic and doesn't want to answer many questions at all. This negativistic attitude makes it difficult to evaluate their intellectual abilities, since it is impossible to decide what is at the expense of their intellectual inadequacy and what depends on their unwillingness to respond. She is also negative in the inpatient ward of the observation center, does not comply with the house rules, and is rude to the teaching staff. During her two-year stay with the department, she had never shown her notebooks to the teachers; When she tried to look at her work, she always gave blatant, emotional explosions, could tear up her notebook, throw something in the teacher's face, etc. Her rudeness and impudence, her negativism, manifested themselves periodically, so to speak. At times she is quieter and then works in class or in the sewing workshop. At these times she doesn't give the impression of being retarded, gives clever answers and finds her way around the environment very well. '[Nevertheless, she is incapable of intellectual tension. She always sticks to automatic work; A certain inhibition becomes noticeable, a slowness
of thinking, something rigid in their psyche, a lack of adjustment. In the turbulent times she pulls absurd pranks, plays the role of a buffoon, dresses in strange, eye-catching costumes and grimaces. At these times she is suspicious and distrustful, suspects something offensive everywhere and tries to make people around her as unpleasant as possible. These rude statements do not fit well with the tone of her emotional personality. The girl is overall very emotive, sensitive, tender and kind. This combination of tender sensitivity and rudeness makes the girl's psyche strange and difficult to understand. Her mood instability also makes a bizarre impression: usually she is friendly and tender, but sometimes she suddenly, without any reason, becomes suspicious and rude. This ambivalence is characteristic of all their affective reactions. She always experiences an “I want” and an “I don’t want” at the same time. She passionately wishes for something and at the same time impulsively resists these wishes. She meets the doctor happily; but if the last one takes a step towards her, she hides
at the moment or runs away, but afterwards she follows the doctor for a long time and complains that she wasn't given enough attention. She wanted to visit the doctor in his apartment several times, but as soon as the door opened when she rang the bell, she quickly ran away. She stays aloof from the children's environment and takes part in the group games
not, is ashamed of her clumsy movements. Has no intimate friends among the girls and is secretive. Towards the end of the second year of her stay at the observatory she became somewhat more even-tempered. In 1924 she was transferred to an institution for difficult-to-educate girls. She stayed here for almost a year. Was employed at a factory, but didn't last long there. According to the latest news, she now lives with her mother, is employed as a messenger and is coping with her work. Became a little calmer.
Summary. Hereditary burden: pathological character and alcoholism in the father, debilitation in the mother. Physical development with a certain delay. Many
Illnesses in childhood (often bronchial catarrh). Pathological character anomalies from early childhood: negativism, pronounced ambivalence of the thymopsyche, inadequate emotional reactions. All of these peculiarities become even more noticeable after inclusion in the children's
home. Here she is very difficult to access the pedagogical influence, refuses to show her work, and is sometimes rude and impudent. Intellect low, but within the standard range, excellent
spoken motor insufficiency: clumsiness and angularity of movements, synkinesia. Internal organs: chronic catarrh of the apexes of the lungs. There has been some improvement in recent years. Became calmer and more even.
Diagnosis: Psychopathic personality: “Schizoid”. Course: stationary, some improvement after puberty.
Case 4. LK, 3 years old (born January 1913).
Heredity: Father died of exhaustion at age 76 (during the famine). Was always healthy, sociable and funny. Musician: played violin. Grandfather and grandmother died of unknown causes. Both were robust and healthy. No further knowledge is available. Paternal great-grandfather — a Frenchman who moved to Russia. Musician: Composer. The father's relatives were musically talented. Mother, 47 years old, believes she has a nervous disorder and is being treated at the psycho-neurological dispensary (where the diagnosis is “schizophrenia”). Gives the impression of a strange, exalted person who is not very well adapted to life. Gives music lessons. Maternal grandfather, who died of sclerosis at the age of 63, was a funny and funny person. Sometimes I drank. Grandmother died at the age of 25 during childbirth: she was musically talented,
Actress. In the mother's family there were many neurasthenics and many musically talented people.
The mother had three pregnancies. i. — spontaneous miscarriage. 2. — Daughter from first marriage, 24 years old; is also being treated at the psycho-neurological dispensary (diagnosis: psychopathic personality). 3. — our patient.
Personal history: When the girl was born, the father was 64 years old and the mother was 33 years old. The pregnancy progressed with the mother being very physically weak. Partus on time, lasting a long time, without surgical intervention. Physical development really. Of the diseases only parotitis and often influenza. From childhood until now, restless sleep, often automatic movements during sleep (swinging movements of the trunk). From the age of three, the difficult characteristics of her character became noticeable: she was unruly, moody, and often insurmountably stubborn. Intellectual development went well. Learned to read independently at age five; She showed early musical talent: (ability to improvise). Hand in hand with this became one with each passing year
the girl's certain absent-mindedness became increasingly clear. Intelligent and sensible, she could not cope with the simplest tasks. If she was sent to the store for something, she would forget what she had to bring along the way. One observed a great slowness in her: she ate very slowly, dressed for a whole hour, put on some article of clothing and sank into thought. Before she did anything, she had to make very long resolutions, did everything late, often allowed herself to be distracted, and accomplished what she had started
not over. In character she was not malicious, but had little childlike kindness and tenderness in her nature. She enjoyed playing with children, but preferred the company of adults; She particularly enjoyed listening to fantastic stories and fairy tales. She loved noisy movement games and rarely played with dolls. She lived in good economic conditions for up to seven years. The parents behaved softly and tenderly towards the child. At the age of six, the girl was sent to a kindergarten, where she could only stay for two months because she couldn't adapt, didn't like Froebel's games and invented the games herself. The teachers found her staying in the garden useless; they considered her to be talented but very absent-minded. At the age of seven, the girl was sent to the elementary school for music. Despite her good musical abilities, she made little progress and was reluctant to deal with “theory” and with anything that required effort and perseverance
were required. The period from seven to ten years was a particularly difficult one for the girl, the economic conditions changed drastically towards the bad side (poor food, frequent moves from one city to another); At the same time, her mother divorced her father and fell in love with a mentally ill person. The girl lived with her mother and was constantly physically and mentally traumatized because her stepfather often beat her and generally treated her badly. Up to ten years
She had not had any systematic school lessons. Private tutors were invited, who noted that she had good abilities, but considered her to be a very difficult student to deal with. She grasped everything very quickly, but forgot everything just as quickly. At the age of ten, the girl moved to Moscow with her mother and was sent to a so-called experimental model school. Was included in the fourth group from the start and was moved to the fifth group after just two months. At school she was considered very bright and well developed; Here her literary abilities were discovered for the first time. She went to school for one year and was then sent to the country for the next year according to the tuberculosis doctor's instructions. Her health was restored during her stay in the country. At the beginning of 1924 the girl returned to Moscow, where she again had to live in difficult conditions with poor and inadequate nutrition. This time the girl's pathological peculiarities were even more pronounced: her absent-mindedness, passivity and tardiness made her incapable of any independent work. From an educational point of view it became even more difficult: it became increasingly coarse, bolder and more negativistic. All of this caused the mother to contact a psychiatrist, who...
referred the girl to our clinic in March 1925.
Status physicws. Exceeds in body length and weight
her age by two years. Body type approaches athletic. Dysplastic features: disproportionately large hands and feet. Head proportional to torso. Skull: brachycephalic type. Broad face, well-pronounced cheekbones, small facial features, blurred profile. Teeth: wide, irregularly seated. Neck strong, medium length, broad shoulders. Chest high, regular
cylindrical shape. Skin somewhat pale, smooth, elastic, neither dry nor excessively sweating. Pale mucous membranes. Subcutaneous fat layer sufficiently developed, evenly distributed. Muscles well developed. Wide bones. Pharyngeal tonsils slightly enlarged. Thyroid normal. Mammary glands correspond ({palpatory) to age. Secondary sexual characteristics are present. Since September 1925 menses, normal, not very painful. Internal organs: Respiratory organs: exhalation in the right tip, tendency to frequent colds; Circulation: pure heart sounds, pulsus 72.
Nervous system: Movements - strong, sufficiently coordinated, but somewhat angular and stark. Walks with large, sweeping steps. When examined according to Dr. Ozeretzky gives it + two
Years. Tremor of closed eyelids and fingers when arms are outstretched. Facial expressions not very expressive. Voice pretty rough. Maintain sensitivity. Cranial nerves - N, pupils - D = $, react somewhat sluggishly; psychological reaction present. Reflexes — Patellar — R. and Achilles — R. — lively. Snow reflexes of the upper extremities sluggish. Skin reflexes - N. Mucosal reflexes: reduced. Pathological reflexes are absent. Vegetative symptoms: white dermography, positive Aschner. Sleep – falls asleep with difficulty. Often rhythmic movements of the trunk when falling asleep (explains that this is how they fall asleep)
finished). The same movements can also be observed while sleeping. Onanism was not observed. Laboratory tests: Aquarius blood negative; the blood test reveals anemia and mild leukocytosis. Leukocytic formula – no deviations from the norm. Urinalysis: nothing pathological.
Status psychicus. Quiet, oriented, he quickly found his way around in the new environment and among the same people. Is completely critical of her condition. There is a pronounced feeling of one's own inferiority combined with anxious restlessness. During the examination she always asks: “Am I normal?” “I have such big hands - does this happen or is it?
Is it an illness?” etc. Complains about her own distraction, saying she can’t do anything because she quickly forgets everything. When a job is suggested to her, she refuses for a long time: “I can't handle it, I won't succeed.” She doesn't like going to work and is anxiously excited about it. At work she is helpless, indecisive, and expects support from outside. Was unable to complete a very simple task, but this was not due to mental weakness. Intellect good (above normal); high general development. perception good, accurate; good opinion. Immediately understands the questions asked, but often gives several alternatives instead of one answer, wavers and is undecided as to which of them is the best. Their answers are often very long, detailed, reasoning, but the idea
is always correct. Logical processes coordinated, no confusion, no blockages in thinking. There is an ability for abstract thinking. There are good distinctions between abstract concepts (difference between love and friendship? — “Love is a human feeling; friendship — is a relationship of human attitudes”; the answers appear particularly successful in the area of emotional experiences; here comes a whole A certain understanding of human feelings and relationships comes to light. Other answers, in which emotional moments are less important, do not appear so good. Memory below average. According to the Binet-Simon scale
She is a 15 year old (4 11 years).
She doesn't like to talk about her past: "I don't love
confidences," she says, "and have no respect for those who tell everything about themselves." "I'm more cold-blooded than nervous," she says of herself. "I've never had strong inclinations," "I've never touched anything “I feel particularly strong,” “I don’t have any intimate girlfriends.” However, there can be no question of affective dullness here. The girl has a certain interest in the surroundings. Enjoys being busy in class, loves music, physical exercises and games - plays with great dedication and risk. Extremely increased sensitivity of the “I complex”. She is self-centered, always wants to be better than others and gets upset when she doesn't succeed. There is also an ambivalence in the assessment of their own personality. With a high assessment of themselves and their abilities, with a striving to be better than others - a constant lack of confidence and insecurity in one's own strengths. With the
She meets school children easily, but is not intimate with anyone. Always write the same words to all the girls on their stems as a souvenir.
books: "I'm gradually starting to get used to you." In her dealings with her colleagues, she thinks she seems to be gracious or angry. She is selfish and concerned about her own advantages, but she also often makes an effort for her comrades and supports them. Likes to talk about
Principles and Justice. In all their emotional movements there is a certain violence and angularity, but little spiritual warmth. Her behavior is often harassing and intrusive. She pesters with her endless questions and requests; is very stubborn,
when she wants something. In general, she fits in well with the rules of the institution; but she is sometimes very stubborn and rude. There was no noticeable nogativism. When it comes to self-service, she is very angry and does everything very clumsily. She fulfills the tasks that are given to her inadequately
and inattentive, sometimes overlooking the main thing. She is sufficiently productive in her school work; their performance continues to improve. Special Begasbieuistnmusgikaleiscnhb:egabt
(ability to compose) and demonstrates literary skills (writes stories for the school's children's magazine). She does the gymnastics and rhythm exercises well.
Course. During her stay at the healing school she developed physically and became more robust. Menses began in September 1925. Sleep became calmer. Disappeared recently
also the oscillating movements during sleep. There are also significant ones on the psychological side. changes to be recorded. During the first month her psychasthenic features would gradually fade, she would become more confident and learn to work independently. Pursue the goals set with perseverance. Recently the opposite features of the heightened sense of self have become more and more apparent. Her tone is often rough, she often likes to brag about her physical strength and shout at them
Children who fear them a little. The basic affective tone is, as before, calm. Expressed affective discharges do not occur
Children should have better feet, be sure to do so
Summary. Heredity: Significant hereditary burden (mother mentally ill, sister psychopathic) and musical talent (many talented musicians in the family). Economic conditions: satisfactory up to seven years, later a drastic change to the worse. Regular physical development. Good mental development. She had been an intelligent, talented, musical girl. However, her great absent-mindedness, insufficiency of active impulses and slowness in work became apparent early on. The girl couldn't settle in kindergarten and loved the children's games and Froebel's activities
not, invented her own games and lived more in her own fantasy world. The teachers who worked with her considered her a gifted but educationally difficult girl because of her high level of absent-mindedness. According to her character traits, she was reserved, secretive, had no strong compulsions, and was at times rude and stubborn. During the pre-puberty period, all of these pathological peculiarities came to a head, which is why the mother had to turn to the healing school. When she took the shot, she pointed
a very pronounced psychasthenic syndrome: inability to make effort, self-insecurity combined with anxious restlessness. Intellect good, above normal. Tendency to reason and ponder unnecessarily. Significant changes towards the good side during the stay in the healing school. She learned to work independently and showed high productivity in schoolwork and in music lessons. Of the somatic peculiarities, the following can be noted: Athletic physique type with individual dysplastic features, anemia and tuberculous intoxication symptoms.
Diagnosis: Psychopathic Personality: “Schizoid”. Course: stationary. Worsens in the pre-puberty period. It is possible that the escalation was also caused by the unfavorable living conditions (frequent moves, poor food, family discord). In the healing school
significant improvement.
Case 5. NW (born 1913).
Heredity. Father, a doctor, died of typhus at the age of 67. After
During the Japanese war, when he was 45 years old, ideas of greatness developed in him - he dealt with projects that were peculiar inventions. However, he remained in the profession and worked as a chief physician in various hospitals. No further information is known about his relatives. Muftier died of dysentery at the age of 46; had a heart condition; According to her personality, she was irritable and nervous and suffered from hysterical attacks. Maternal grandmother also abrupt, uneven, hysterical. Nothing is known about the other relatives.
The mother only had one pregnancy: our patient.
Personal anamnesis. When the girl was born, the father was 55 years old and the mother was 36 years old; Nothing is known about the course of the pregnancy and delivery. Physical development was regular. Supernatant measles and pneumonia. The first
She was raised by her grandmother for three years, and later by her parents,
The economic conditions were satisfactory until the father's death (he died when the girl was six years old), but then they deteriorated significantly - the mother worked as a teacher in children's homes, the girl lived with her mother. The mother pampered the girl, but at the same time irritated her with her nervousness. She grew up as a sickly, weak girl and had great educational difficulties from early childhood. Was always undisciplined and cheeky. She loved her mother very much, but constantly tormented her, insulted her and even allowed herself to beat her mother. She was once given to her mother
Something really bad, locked himself in the room of the country apartment and left his mother waiting in the yard for hours. In the children's homes where she lived with her mother, she constantly had quarrels with the children, so that the mother's position was terminated several times. The girl's intellectual development was regular.
She learned to read at the age of six, was a clever girl and read a lot. At the age of nine she went to school and did good things. When the girl was six years old, her mother died. She was left in the care of one of her mother's friends, who took her to the doctor in August 1923.
to the Observatory.
When examined in the outpatient clinic, she showed good development: high profile according to Prof. Rossolimo's method. She was taken to the inpatient ward of the observation center and tested positive
immediately proves difficult to educate. Very negativistic, rude, cheeky. He did not comply with the institution's house rules and after a few months was transferred to the sanatorium for psychopaths. She stayed there
about a year and was then referred to the institution for difficult-to-educate girls. (This is where she was under our observation.) Here, too, the girl was unable to settle in: her rudeness, her blatant negativism and constant silliness disrupted the work of the whole class. She behaves contemptuously and maliciously towards the teaching staff. Closed, secretive. It always seems to her that the teachers insult the children and treat them unfairly.
In March 1926 she was admitted to the healing school of the psychoneurological children's clinic.
Physician status. In terms of body length it exceeds the age of 16 years, in terms of thorax circumference it corresponds to 13 years, and in terms of skull circumference it corresponds to 14 years. In terms of the ratio of the descender to the ascender, it comes somewhat closer to the eunuchoid type. Body type: Asthenic-dysplastic. Tall, thin, slightly hunched. High, irregularly shaped, almost tower-shaped skull. Long, narrow, egg-shaped face. Small facial features. Long, thin neck; narrow, inwardly rotated shoulders; long, narrow chest; right-sided scoliosis. Muscles satisfactory, subcutaneous fat layer sparsely developed. Thyroid — normal. Mammary glands can be easily palpated. Internal organs: Lung exhalation in the right tip. Heart pure tones. Pulsus - 82. Anemic venous sounds. gastrointestinal tract
— Norm. Genitourinary system—m N. Secondary sexual characteristics become noticeable. Menses - abs.
Nervous system. Movements sufficiently strong, rapid, violent, somewhat angular. Lots of unnecessary movements when she gets upset. Sometimes compulsive movements: biting nails. Chunky walk. Facial expressions correspond to the experience. Voice loud, cutting. Cranial nerves: Nn. faciales somewhat asymmetrical. For the rest— N. Pupils D =- $, reaction obtained.
"Psychological pupillary reaction present. Patellar - R. slightly increased; slight tremor of songs with eyes closed. Sensitivity preserved. Face reduced - myopia. Hearing - N. Sleep peacefully, falls asleep early. Laboratory tests: Wassermann blood negative. Leukocytic formula : slight leukocytosis Urine: nothing pathological.
Status psychicus. Little accessible. Dark, suspicious. Emotional contact with her cannot be established immediately and only with difficulty. Provides detailed auto-anamnestic information. The first memories come from the fourth year of life. She was doing well at the time, but she had an evil guard who beat her in her mother's absence. She didn't like dolls and would break them to find out what was inside; preferred movement games with boys. She is neither sick nor nervous. 'I have never been afraid of anything. I climbed into the attic and onto the roofs. I have always been stubborn and liked to spite everything.'
If you ask her about something that affects her intimate life, she looks dissatisfied and answers: "Don't question me." Doesn't like to talk about life in the children's homes. “Yes, I am defective; I got into mischief and insulted the teachers because I was bad; I was always able to control myself, but I was extremely angry; I always gave a new teacher a test: if she got upset, I continued to drive her mad - if she was calm, I stopped." She hasn't had any more intimate friends: “Sometimes I like this or that one, but I don't love them. I don't particularly love anyone, I'm mostly indifferent towards people.” Your language
is ragged, poor in vocabulary, many specific expressions from children's home jargon.
Experimental-psychological investigation: Intellect - N. Associative processes coordinated: sensory associations predominate. thinking in an orderly manner; However, she finds it difficult to define abstract concepts (due to a lack of words). Good memory. Combination processes good: she carried out all ten tests according to Rossolimo correctly. Attention: sufficient tenacity. According to Binet: + one year.
She was very happy with the transfer to the healing school, but didn't outwardly express her joy and spoke in the same dissatisfied, grumpy tone: "Everyone is so good here, I'll be thrown out very soon." The first time saw them around. Stayed apart from everyone, didn't strike up conversations with the children, didn't answer many questions. Tried to keep a low profile, didn't want to do gymnastics exercises or sing a solo in singing lessons. She spent most of her time in class, reading or
worked on class assignments. After a month or two, she felt so at home at school that she was able to take part in the school festivals. She became more intimate with the children, somewhat friendly with the teacher, softer and more approachable. Mood calm. Not a single emotional explosion during this time. Also no cheerful excitement or increased irritability. She was always even-tempered, controlled and never cried. Ambivalence is characteristic of all their affective experiences. She is dark, somewhat malicious and yet very sensitive. On stage she shows a very fine representation of emotional experiences; she has a keen sense of the beautiful in nature and in books. Intense intellectual interests, which she satisfies with the help of reading. Ego-centered and extremely self-loving. Once confessed to a teacher: “I want everything in the world to be just for me.” She really likes it when people praise her, but she gets very embarrassed when she does; often expresses the fear that she will be laughed at and mocked. “Tad Seielmnich
rather than praise.'
Sthenic, stubborn in her undertakings, everything concerned
Gonnene always leads her to the end: "If I want something, I'll do it." Because of this perseverance, she shows great productivity in her school work.
She is a talented girl in artistic terms. *Musi« calish, sings well. Scenic talent. Draws well.
gathering. Heredity: father mentally ill, from: mother's side - hysteria, regular physical and mental development. Difficult to train from early childhood, stubborn, moody, irritable. Extremely pronounced ambivalence of the affective reactions: loves the mother and
mistreats her at the same time. Outwardly emotionally flat. The most sensitive place - the complex of one's own ego, a pathologically heightened and vulnerable sense of self. From age 10 to 13, she lived in several children's institutions. Everywhere she was very difficult and difficult to influence pedagogically. The following symptoms could be observed: closedness, low accessibility, anger, suspicious behavior towards teachers, stubborn negativism, and at times a tendency to be silly. After admission to the healing school
marked change for the better: she became calmer, no negativism, no silly nature (but still remains closed and not very sociable). Great advanced training work.Extremely musical and scenic ability. Somatic peculiarities: asthenic body type with dysplastic peculiarities: eunuchoid proportions in the relationship of the lower extremities
to the trunk; angular movements. Motor restlessness, compulsive movements (biting nails).
Diagnosis: Psychopathic personality (schizoid). Verlau] stationary. All of the girl's pathological peculiarities aggravated during her stay in the children's institutions. (The latter can be viewed as a psychogenic reaction to the suddenly deteriorated living conditions in a girl with a schizoid constitution.) Rapid improvement in a favorable environment.
On the basis of the cases already cited and the further study of schizoid psychopathies in boys (which we continued in the previous year), we consider it possible to describe the symptomatology of schizoid psychopathies more precisely by dividing the observed symptoms into two groups : 1. in basic symptoms, which form the characteristic peculiarities of the psyche of schizoid psychopaths, and 2. in accessory symptoms, which often, but not always, occur.
The basic symptoms include: ı. the autistic attitude, 2. the ambivalence of the thymopsyche, 3. the peculiarities of thinking: tendency towards the abstract, formal; Automatism, 4. the symptoms of motor inadequacy: angularity, clumsiness of movements. Regarding the accessory symptoms: ı. the paranoid symptom complex - the distrustful, suspicious attitude towards the environment (the constant feeling of being hurt, the incorrect interpretation of the behavior of other people), 2. the psychasthenic syndrome: self-insecurity, feeling of one's own inferiority, tendency to compulsive states and 3 . Symptoms which could be called “catatonoid” symptoms - increased suggestibility, pronounced negativism, sometimes both at the same time, 4. Close to this last group are the psychomotor disorders - tendency to stereotypes, silly nature; automatism; impulsivity.
The symptomatology of the above schizoid cases
Psychopathies in girls repeat the basic features of the picture we have described. However, when analyzing the individual symptoms, a number of specific characteristics can be identified that appear to be linked to gender.
i. The main difference is that in the case of girls, in the picture of schizoid psychopathy, the disturbances of emotional life are always in the foreground. It is precisely these emotional defects that give schizoids the stamp of being absurd, strange and eccentric. In schizoid boys, the image of crankiness is made up of tendencies towards unnecessary abstraction, absurd brooding, stereotypies and motor inadequacy; In the case of girls, on the other hand, we have what one might call emotional crankiness, which arises from a complicated game of the strangest emotional combinations. The ambivalence of emotional life, the constant presence of contradictory emotions - has, as a consequence, such actions which
appear tasteless, contradictory and incomprehensible. Bleuler explains this ambivalence by the disruption of the unity of the dominant affect, which leads to a whole series of tendencies emerging at the same time, with no single one of them gaining the upper hand. A different feature of the girls is also the greater one
Mobility of mood, whereby this change of mood in schizoid girls differs very much from the hysterical mood lability and from the cyclothymic endogenous mood phases. This mood change appears
bizarre and contradictory (see case no. 3). The elements of psychaesthetic proportion are even more pronounced in girls than in boys. The constant combination of sensitivity and emotional dullness—the inner tension in the face of external cold—is even more glaring here
and more pronounced. The image that emerges is of isolated sensitive areas against a background of general emotional flatness. In our cases, such particularly sensitive areas, affectively colored complexes, were in the area of the “I” complex. All of these children are very self-centered, strive to be something higher, and experience any violation of their sense of self extremely painfully. The presence of ambivalence also makes its mark here: a high sense of self, a heightened self-assessment goes hand in hand with a feeling of their own inferiority, which creates a constant feeling of inner tension, which manifests itself in seemingly incomprehensible moods and silliness unloads.
We have also observed the peculiarities described in schizoid boys, but in the latter they never reach such a degree. The predominance of affective disorders in the form of schizoid psychopathies in girls perhaps finds its explanation in the specific peculiarities of the female psyche - in the greater emotional excitability and in the versatility of female affectivity.
The fact that the majority of women appear more impressionable and richer in emotional experience is a fact that no one disputes. The overall mood plays a more crucial role for women. Their feelings influence their actions and thinking to a great extent; Memory, attention and judgment are also more intensely affective in women. The flexibility of mood is also much higher in women than in men. .
2. The peculiarities of schizoid thinking are less pronounced in girls. We observed such schizoid symptoms as a pronounced automatism of thinking (cases ı, 2, 3), sometimes a less plastic, somewhat inhibited psyche and a certain autism of thinking, which expressed itself in alienation from the real world ( Weakening of the feeling of real reality). The tendency towards abstract, schematic and formal thinking, which is characteristic of schizoid boys, is, on the other hand, often observed in girls
less common (we only saw them in one case).
It is possible that this observation also does not
is due and can also be explained by the specific characteristics of the female psyche. In addition to the woman's greater emotivity, her thinking is much brighter, more emotional and more pictorial; this complicates the operations where abstraction is required. Women perceive the world in concrete images and are less capable of the abstract and schematic.
3. The symptom of autistic attitude is equally characteristic of both sexes. In three cases described it was a case of pronounced autism, in two others it was a case of low or elective sociability. All of these girls appear closed, secretive,
not accessible. Everyone was “lonely” from early childhood and speaks of it themselves. “I've never had any girlfriends, I don't like confidentiality.” (Case 4.) “I don't love anyone and I don't hate anyone, everyone is indifferent to me.” (Case 5.) “All girls are unpleasant to me, I don't love anyone. " (Case 2.) "I only have one friend, I don't love anyone other than her." (Case ı.) The stamp of ambivalence also lies on their behavior towards the environment; their emotional relationships are often broken off quite suddenly , their feelings are often inherently contradictory - they
love and hate at the same time (cases ı, 2, 3, 5).
In the children's environment they stand aside, sometimes they awaken
hostile behavior (cases ı, 3 5), sometimes they are simply inconspicuous. There is a view according to which this autistic attitude of schizoids is caused by their moto-
African inadequacy explains: the clumsiness of their movements makes them anxious and shy, forcing them to avoid contact with people. For example, write B. Oetli, that the pathological changes in motor skills (particularly in the area of expressive movements) influence the attitude of social feelings. Schizophrenic patients with motor disorders become shy of people and withdraw
gradually become more and more withdrawn and perceive the outside world as something hostile. There are many things that can be said in response to the author here: postencephalitics with motor disorders, e.g. B. do not show an autistic attitude.
In schizoid psychopathies, however, where the motor insufficiency is congenital, it could have a greater significance for social attitudes; but here too the motor disorder is not an exhaustive factor.
4. We observed the next symptom—motor insufficiency—in all of our cases. The motor disorder manifests itself in the form of a general angularity and clumsiness of movements with sufficient muscle strength and good manual dexterity. In three cases we also had motor restlessness, lots of unnecessary
movements, synkinesias. Comparing these observations with those of the previous year (in boys), it can be said that in boys the motor inadequacy is more pronounced. According to Dr. Oseretzky, the average retardation of schizoiden boys = 2 to 3 years; the girls usually gave their own age (in one case + two years). Furthermore, we observed a blatant backwardness in the boys in handicrafts, physical culture, inability to draw, write, etc., while in three of our cases we found that the girls had a good ability for gymnastics and handwork.
In the area of expressive movements, facial expressions, voice and language we do not find such pronounced disorders in girls as in schizoid boys. It may be that this superiority of girls in the area of expressive movements can also be attributed to the specific gender characteristics. (It should also be added here that the other disorders associated with motor function - various speech disorders, enuresis, left-handedness - are also recorded less frequently in girls than in boys.)
As far as the somatic peculiarities and the body structure are concerned, our findings here are closer to what we found in the boys!). According to the body type, our cases are distributed as follows: athletic - 1, asthenic - 2, asthenic-dysplastic - 2 (it must be noted that all our cases belong to the pubertal age, in which the asthenic and The dysplastic types predominate, which makes our last statements seem less than demonstrative).
As for the symptoms that we have described as accessory, in two cases we observed the psychasthenic syndrome and in three cases symptoms close to the paranoid ones: a suspicious attitude towards the environment, sullen, morose tone of voice, an incorrect interpretation of behavior their surroundings: they see insults and injustices everywhere. In addition, they have a strange, rigid sense of justice, which is combined with a tendency to see oppressed people everywhere that they have to protect - a pedantic insistence on principles. The psychomotor disorders (tendencies towards stereotypies and silly behavior, impulsivity) saw
1) It should be noted here that body types are even less clearly defined in girls than in boys.
We also do this with girls, although in a less pronounced form than with boys. Zegative symptoms were observed more frequently in girls than in boys. Negativism often with a hysteroid touch, mannered nature, a desire to be noticed. If you ignore them, the negative phenomena will disappear very quickly.
We must also note that a certain hysteroid influence is always to be found in schizoid girls; Their exuberance, moodiness and strangeness always initially give the impression of being hysterical.
The differential diagnosis of schizoid psychopathies in girls must therefore always begin with hysteria. In our cases, the following characteristics speak in favor of schizoid psychopathy and against hysteria:
1. Autistic attitude; All of these girls have been lonely, not sociable, and withdrawn since childhood, while the hysterics mostly love the company where they can produce themselves. 2. In our cases the characteristic, reactive lability and suggestibility of hysterics is missing; our girls are much more independent, much more settled
their intentions, they are difficult to influence because they lack the necessary emotional receptivity. 3. The lively, glaring affectivity characteristic of hysterics was not present in our cases. Despite all the strangeness of the emotional combinations peculiar to our schizoid girls, they are all characterized by a certain coldness; it is therefore difficult to establish emotional contact with them. 4. The last thing that speaks against hysteria is the lack of the somatic stigmas of this form of the disease (sensory disorders, seizures, etc.).
Like all cases of schizoid psychopathy, our cases must be differentiated firstly with schizophrenia and secondly with the pubertal changes in the psyche. The distinction can only be made on the basis of observation and anamnesis; We cannot get by with the psychopathological analysis of the status present here.
Schizophrenia can be ruled out in our cases because there is no progression: according to the anamnestic information, the schizoid symptoms have existed since childhood and show no tendency to worsen. The course is
In our cases it was quite favorable, which is also not characteristic of schizophrenia (in three of the cases described we have seen significant improvement over the years). The same information speaks against the possibility of wanting to see the explanation of the entire clinical picture only in the pubertal changes in the psyche. In our cases, all of these mental peculiarities existed from childhood onwards and in some cases only worsened during puberty (cases 4 and 5).
It seems no less important to distinguish our cases from schizoid reactions of exogenous origin (which arise under the influence of psychogenic factors, brain diseases, narcotics, chronic infections such as tuberculosis, etc.).
We could not exclude the influence of some exogenous factor (mental trauma, tuberculosis, etc.) in any of our cases, but in none of these cases would this exogenous factor be able to completely explain the entire picture of schizoid psychopathy. The peculiarities described all appear so early, appear so persistent and change so little throughout the child's entire life that they can be considered part of the child's constitutional peculiarities. Recently, works have appeared in which the schizoid psychopathies, as exogenies as psychological
chic reactions to tuberculous intoxication should be considered. When looking through a large amount of children's material, the inaccuracy of such a point of view immediately becomes apparent. Cases of schizoid psychopathy are quite rare in childhood, while the manifestations of tuberculous intoxication cover the vast majority of the child population. The emergence of such a point of view can be explained by terminological ambiguities: when using the term “schizoid” in the broad sense, every neurotic manifestation of the child, every tendency to introversion, already gives the right to the diagnosis of “schizoidia”.
In the literature we find no information about the peculiarities of the female psyche in different constitutional types. Äreischmer, Bleuler and others, who have worked in this area, mainly focus on the male psyche. A certain confirmation of our observations
We found this in Äraepelin: in his description of the prepsychotic personality of schizophrenics.
He notices that girls show the following pre-psychotic peculiarities (in contrast to boys): increased sensitivity, high tension, nervousness, stubbornness. Voigt also finds the same prepsychotic peculiarities in his material (103 schizophrenia cases). Schultze also writes about the increased impressionability and moodiness of women who later developed schizophrenia.
Before we give a summary of our observations, attention should be drawn to the following fact: the overall picture of schizoid psychopathies is paler in girls than in boys, the schizoid disorders
The girls' peculiarities appear less prominent. The percentage of schizoid psychopathies also appears to be lower among girls (if we are to believe our limited material) than among boys. These observations confirm Zlewler's view, who sees schizoid traits as predominantly male. In his view, women are much more syntonous;
Pronounced schizoid traits speak for a male character and are impressive for women.
These are the different peculiarities of the schizoid psychopathies that we were able to record in the girls.
In summary, the essentials can be formulated in the following sentences:
“The main features of the clinical picture of the Schizoid Posyichdopaethnia in girls coincide with that described in schizoid boys. As there, here too it is a question of insufficient uniformity and consistency of the psychological mechanisms, which results in an external similarity to schizophrenic confusion.
The differential peculiarities of the schizoid psychopathies in girls consist of the following: a) In the clinical picture, the affective disorders come to the fore: ambivalence of feelings, the inadequateness of the affective reactions, the presence of complicated and contradictory emotional combinations ( these peculiarities
find their explanation in the stronger and more flexible affectivity of the female psyche). b) The schizoid character of thinking is less pronounced in girls; They are less likely to have a tendency to abstract, schematic thinking and absurd pondering. These peculiarities can also be explained by the specific characteristics of female thinking: it is more pictorial, more practical and more affectively colored, c) the phenomena of motor inadequacy (especially
in the area of expressive movements: facial expressions, voice, language) are less pronounced in the girls. d) Negativism was observed more frequently in girls and always with a hysterical touch, e) hysterical symptoms are much more common in schizoid girls than in boys, which is why schizoid psychopathies in girls are most often associated with hysteria. be changed.