Projective Studies 投射研究 A considerable amount of evidence has been gathered employing more experimentally based types of research investigation into the problem of paranoia(Wolowitz,1971). These studies cover a wide variety of research approaches to the problem and shed a considerable amount of light, both on the characteristics of the syndrome and on possible influences involved in its genesis. We have mentioned Aronson's (1964) study of Rorschach signs in paranoia in which he found that paranoid patients produced a higher frequency of homosexual signs than did nonparanoids, psychotics, or normals. However, Grauer(1954), using the same signs as Aronson, was unable to confirm his findings in a group of paranoid schizophrenics. Another study by McKeton et al.(1962) compared a group of hospitalized paranoid schizophrenics with neurotics and alcoholics using Rorschach signs of suppressed or repressed homosexuality, and found supporting evidence for a connection with homosexuality. Other studies of the relationship between homosexuality and paranoia have been reviewed above, and, as noted there, the conclusion as to the validity of the basically Freudian hypothesis remains very much in question and lacks convincing support. 已经收集了大量的证据，采用了更多基于实验的研究类型来调查偏执问题(Wolowitz,1971)。这些研究涵盖了解决这一问题的各种各样的研究方法，并对该综合症的特征及其成因可能产生的影响提供了大量的资料。我们已经提到了Aronson(1964)对偏执症中罗夏墨迹的研究，他发现偏执患者比非偏执者、精神病患者或正常人产生更高频率的同性恋墨迹。然而，格劳尔(1954)使用与阿伦森相同的墨迹，无法在一组偏执型精神分裂症患者身上证实他的发现。McKeton等人(1962)的另一项研究使用罗夏墨迹法对一组住院的偏执型精神分裂症患者与神经症患者和酗酒者进行了比较，发现了与同性恋有关的支持证据。关于同性恋和偏执症之间关系的其他研究已经在上面进行了回顾，并且，正如在那里所指出的，关于基本的弗洛伊德假说的有效性的结论仍然存在很大的问题，缺乏令人信服的支持。 An attempt was made by Beitner (1961) to assess identification processes in paranoid patients. He studied the differences between hospitalized paranoid-schizophrenic subjects and neurotic subjects in comparison with control groups by using a form of the semantic differential. On this measure, both the paranoid group and the anxiety-neurotic group showed defective identification with both parental figures. A confusion in sexual identification was not apparent in the paranoid group, although there was some evidence to support this in the neurotic group. Also of interest is Caine's (1960) study of hostility and guilt in melancholic and paranoid patients. He employed both overt and covert measures of attitude to study these feelings in female patients. He found that paranoid patients did not act out their hostility, as measured by the MMPI scales and sentence-building tests, to the same degree as depressive patients, but their TAT stories expressed their hostility in stories involving murder, rape, violence, etc. His findings suggested that paranoids and depressives differed not so much in the intensity of their hostility but in the manner and direction in which they expressed it. 贝特纳(1961)曾试图评估偏执患者的认同过程。他利用语义差异的形式，研究住院的偏执-精神分裂症患者和神经质患者与对照组的差异。在这项测量中，偏执组和焦虑-神经质组都表现出对父母形象的不完全认同。在偏执组中，性别认同的混淆不明显，尽管在神经质组中有一些证据支持这一点。同样有趣的是凯恩(1960)对忧郁和偏执患者的敌意和内疚的研究。他采用公开的和隐蔽的态度方法来研究女性患者的这些感受。他发现，通过MMPI量表和句子构建测试，偏执型患者并没有表现出如抑郁症患者同等程度的敌意，但他们的TAT故事通过谋杀、强奸、暴力等故事表达了他们的敌意[TAT即Thematic apperception test，主题统觉测试，大致就是让被测者看着图片编故事]。他的研究结果表明，偏执者和抑郁患者之间的差别并不在于敌意的强烈程度，而在于表达敌意的方式和方向。 Other investigators have studied person-perception and self-perception in paranoid subjects. Daston, King, and Armitage (1953) found that paranoid schizophrenics showed significantly greater distortion of the descriptions of hypothetical people presented in short stories than did a normal group. Izard (1959), basing his study on the relationship between needs, motives, and perceptions, and using photographed faces to test perceptions of paranoid subjects, found that paranoids tend to perceive such faces as tense, suspicious, hostile, and threatening, whereas normal subjects do not. The findings with regard to self-perception, on the other hand, have not been altogether consistent. Friedman(1957) found no significant difference between his paranoid subjects and the normal controls with regard to congruence of their self and ideal-self concepts. However, Rogers, studying the same aspects of personality, found that his group of paranoid-schizophrenic subjects exhibited less self-ideal self discrepancy than did a control group. Havener and Izard's(1962) study of paranoid self-rating, using the Lorr scale for rating psychiatric patients, found that paranoids tended to overrate themselves in comparison with nonparanoid schizophrenics. They concluded that this was evidence of an unrealistic self-enhancement as a defense against loss of genuinely positive self-related affect and of satisfying interpersonal relationships. 其他研究者研究了偏执受试者的他人感知和自我感知。Daston, King, and Armitage(1953)发现，偏执型精神分裂症患者对短篇小说中假想人物的描述比正常组的扭曲程度要大得多。Izard(1959)通过研究需求、动机和感知之间的关系，并使用拍摄的面孔来测试偏执受试者的感知，发现偏执者倾向于感知紧张、怀疑、敌对和威胁的面孔，而正常受试者则不会。另一方面，关于自我感知的研究结果并不完全一致。Friedman(1957)发现他的偏执受试者和正常对照组在自我和理想自我概念的一致性方面没有显著差异。然而，罗杰斯在研究人格的相同方面时发现，他的那组偏执-精神分裂症受试者表现出的自我理想自我差异要比对照组少。Havener和Izard(1962)使用洛尔量表对偏执型自我评定的研究发现，与非偏执型精神分裂症患者相比，偏执者倾向于高估自己。他们得出的结论是，这是一种不现实的自我提升的证据，这种自我提升是为了防御失去真正积极的自我相关情感和令人满意的人际关系。 Several groups have utilized the TAT effectively to study self-concepts in paranoid subjects. Friedman (1957) used an eighty-statement Q-sort to characterize the TAT hero of each subject, and then compared these with statements of the patient's ideal self-concepts. He found that the TAT heroes of normal subjects correlated more highly with their ideal self-concept than did either neurotic or paranoid TAT heroes. He also found that the paranoid's TAT hero reflected much greater degrees of feelings of inadequacy, dissatisfaction and pessimism, as well as more stressful interpersonal relationships. 一些小组已经有效地利用TAT来研究偏执受试者的自我概念。Friedman(1957)使用一个80句的Q-sort[Q-分类技术]来描述每个受试者的TAT英雄，然后将其与患者的理想自我概念进行比较。他发现，与神经质或偏执型的TAT英雄相比，正常受试者的TAT英雄与他们的理想自我概念关联更强。他还发现，偏执者的TAT英雄反映了更大程度的不足感、不满和悲观情绪，以及更紧张的人际关系。 Similarly, May(1970) studied TAT responses in paranoid and nonparanoid schizophrenics and normal controls of both sexes. Only male paranoids showed significant reactions to scenes of power and aggressive assertion—suggesting a high degree of anxiety and defensiveness over power issues. These conflicts were not found in female paranoids. This suggests that power anxiety may be sex-related. May also observes that "field-independence" as a cognitive style is characteristic both of males and paranoid schizophrenics(Witkin,H.,1965). 同样地，May(1970)研究了偏执型和非偏执型精神分裂症患者和正常对照组的TAT反应。只有男性偏执者对权力场面和咄咄逼人的主张表现出明显的反应——表明他们对权力问题高度焦虑和防御。这些冲突在女性偏执者中没有发现。这表明权力焦虑可能与性有关。May还注意到，“场独立性[两种认知风格之一，另一种是场依存性。可参考这里、这里]”作为一种认知风格是男性和偏执型精神分裂症患者的特征(Witkin,H.，1965)。 Wolowitz(1965) had hypothesized an approach-avoidance conflict in male paranoids with regard to "powerful appearing" men. In the approach aspect of the conflict, the paranoid wishes to be dependent on these powerful men and to appropriate their power through magical sexual-aggressive means. In the avoidance aspect, on the other hand, the paranoid anticipates and fears retaliation and destruction from more powerful and threatening male figures. This hypothesis substantially follows Nunberg's view that the paranoid is conflicted by his desire to magically absorb another male's power through homosexual contact, and by his fear of retaliation and destruction. Following up this hypothesis, Wolowitz and Shorkey (1966) studied the power themes of paranoid patients using the TAT. They took power concerns to mean any deficits or surpluses of personal resources which seemed to be related to masculine self-esteem, as for example, physical strength, social influence, etc. They found that paranoid schizophrenics expressed a significantly greater number of power themes in TAT stories than did subjects with a variety of other diagnoses. Wolowitz(1965)提出了一种假设，即在男性偏执者中，对于“有权势”的男性，存在一种接近-回避冲突。在冲突的接近方面，偏执者希望依赖这些强大的男人，并通过性侵犯的神奇手段来盗用他们的权力。另一方面，在回避方面，偏执者预期并害怕来自更强大和更具威胁性的男性形象的报复和破坏。这一假设实质上遵循了Nunberg的观点，即偏执者渴望通过同性接触魔法般地吸收另一个男性的力量，但害怕报复和毁灭，这两者是矛盾的。根据这一假设，Wolowitz和Shorkey(1966)研究了使用TAT的偏执患者的权力主题。他们把对权力的关注理解为个人资源的任何不足或过剩，而这些似乎与男性的自尊有关，例如，体力、社会影响等。他们发现，偏执型精神分裂症患者在TAT故事中表达的权力主题明显多于其他各种诊断的受试者。 In a later study, the same authors attempted to determine whether the power preoccupation in paranoid patients was the result of long-standing paranoid orientation or part of the cause of the disorder. To test this they studied the TAT stories of young children who had been diagnosed as paranoid-schizophrenic. They reasoned that the younger subject's paranoid condition would have had little time to affect their thinking processes, and that any indications of power motifs would more likely have a causal relationship to the disorder. They studied TAT stories from seventy young boys, ages ten to eleven, and found a similar preoccupation with power motifs. They interpreted the results as consistent with the hypothesis that power conflicts play a causative role in the etiology of paranoid disorders(Wolowitz and Shorkey,1969). 在后来的一项研究中，同样的作者试图确定偏执患者的权力专注是长期偏执倾向的结果，还是该障碍的部分原因。为了验证这一点，他们研究了被诊断为偏执型精神分裂症的儿童的TAT故事。他们推断，年轻受试者的偏执状况几乎没有时间影响他们的思维过程，任何有关权力动机的迹象都更有可能与这种障碍有原因关系。他们研究了70个年龄在10到11岁之间的小男孩的TAT故事，发现他们对权力主题也有类似的先占观念。他们将结果解释为与这种假设一致，即权力冲突在偏执型障碍病因学中起着原因的作用(Wolowitz和Shorkey,1969)。