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Title: Mental hygiene and constitution in schizophrenia : an investigation of fifty cases
Author: Galbraith, A. J.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1936
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by a series of fifty cases admitted to Ewell Mental Hospital during the last three or four years. These cases were not chosen on account of any special clinical interest, but are merely those among the Schizophrenic admissions during that period about which it was possible to obtain a fuller "life history", although even the best of these contain many regrettable omissions. These omissions, and the difficulty in general of obtaining the required information, emphasise the urgent need for some central authority equipped with psychologists, to record the personality and other facts of psychological import in the case of every child; to preserve these records until the occasion for their use might arise, such as ascertain - ing suitability for employment and, in the more unfortunate cases, for the convenience of the psychiatrist. As it is, there are only a few selected cases whose personalities have been scientifically studied from infancy onwards, and in such an investigation as this we can only hear a lay, and frequently biased, opinion and are left, in many cases, with inferences and not facts. The material for this study was obtained through the usual avenue of inter views with the patient's relatives and friends, and with the aid of reports from that very valuable assistant - the Social Worker. For convenience in tabulating results etc., I have made a rough division into "age groups ", the first three years being considered as "Infancy "; from four years to a period corresponding to puberty, usually between twelve and fourteen years, as "Childhood "; and from there to the late "teens ", the exact age depending on individual circumstances, as "Adolescence "; and the remaining period as "Adult" life. Environmental circumstances are bound to differ to a considerable extent in a qualitative fashion in these different periods of life, but at the same time certain influences, such as the parental attitude, may be present throughout, and therefore, as far as possible, the environmental factors considered in each group are the same as in the other groups with certain inevitable omissions and additions. In each case, a fixed scheme has been employed to tabulate the results of the enquiries; the scheme itself having no special characteristics, but is merely a personal variation of the type used in case records in many mental hospitals. At the end of each case thus dealt with, certain provisional conclusions, pertaining to the individual case, are noted for convenience in drawing up the collective result. The question of heredity in relation to mental disorder has already been referred to, and in a study of environmental factors as possible causative, or at any rate precipitating agencies in the breakdown of mental health, the influence of abnormality in the family stock is only considered where it might have a direct effect, in other words where continual contact with an abnormal personality might well be regarded as having an adverse effect on the individual's mental equilibrium. This attitude is, of course, in concordance with Janet's well known hypothesis. Recognising the contingency of damage to the unborn germplasm, the maternal health during pregnancy, the nature and duration of the labour and delivery, have been enquired into, and are grouped as "Eugenic" factors; but it was impossible to include a study of more distant events in the lives of the parents and earlier generations, which, according to some authors, e.g. Stockhard (5), are calculated to produce an indelible effect on the constitution of the offspring. After birth, the individual is almost inevitably exposed to psychic trauma, both in direct participation, or merely as a witness of distressing situations, to a variable degree depending on circumstances. Thus the extent to which an individual encounters adverse factors depends not only upon the adjustment which he or she is able to make to their environment, but also involves the reactions of other individuals who form an essential part of that environment. The latter component of the mental hygiene of the individual can well be expressed as the one word - "atmosphere ", and it is easily comprehensible how this psychic 'atmosphere" is certainly one of the most important factors, as it is rarely absent throughout the individual's life, being thrust upon him in the home, at school, and at work. The scheme used in this series of cases is accordingly designed to record both those classes of factors: the direct and the indirect, and is subdivided in order to distinguish those arising at home, in the school, at work, and in connection with various outside social activities. Furthermore, in each of the empirical age groups a brief description of the individual's personality, with special reference to any recognisable 'Schizoid" traits, is made. In this way the constitutional and environmental factors are tabulated side by side, to facilitate the examination of their possible interactions and relative importance in the production of. Schizophrenia. Together with the tentative results in each individual investigation, a short statement pertaining to the clinical features of the case is appended, and without resorting to any symbolic or analytical interpretations, mention is made of any obvious correlation between clinical and aetiological findings, and insight shown by the patient into the presumably adverse factors in the mental hygiene of his past existence.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available