Concept of process-reactive schizophrenia: A critique.

Abstract

A review of current issues, including the dichotomy vs. continuum view of the process-reactive concept; the question of organic involvement in process schizophrenia; the relationship of severity of illness to the concept; the problem of duration of hospitalization; comparability of criteria; adequacy of control groups; sociocultural diversity; and uniformity of process-reactive differences.1 This paper was prepared during the tenure of a faculty research grant from the University of California to the senior author.

Relationships among WAIS subtest scores, patient's premorbid history, and institutionalization.

“…These results give strong support to Higgins and Peterson's (1966) contention that the length of time a patient is institutionalized must be considered in research designed to study the process-reactive and other dimensions associated with schizophrenia. Since these data were age weighted, it seems more likely that time institutionalized is the major independent variable interacting with premorbid history in this study.…”

Formation of concepts of varying degrees of dominance by process and reactive schizophrenics.

“…Parsons and Klein (1970) did not report data on institutionalization. Concerning this issue, Higgins and Peterson (1966) have stressed the need for control of institutionalization, and they concluded that the interpretation of results is more difficult when hospitalization data are not reported or are not considered in data analysis. A related issue that is seldom considered is length of illness.…”

“…Streiner (1969) used the Ullmann and Giovannoni (1964) Self-Report Scale, while Parsons and Klein (1970) differentiated processreactive groups with the Kantor, Wallner, and Winder (1953) criteria. Higgins and Peterson (1966) cited evidence that different criteria may yield somewhat divergent classifications. They recommended using two or more criterion measures to identify process and reactive schizophrenics.…”

Social disability.

“…For example, the most relevant information in the schizophrenic diagnosis may derive from the process-reactive distinction. Evidence would suggest that the most fundamental factor in that distinction is general social competence (Higgens & Peterson, 1966;Rosen et al, 1969;Schwarz, 1967;Zigler & Phillips, 1962). The problem for the "process" schizophrenic (that of social disability) does not change as his condition changes from "premorbid" to "morbid," while for the reactive schizophrenic it does.…”