© 1971 The Royal College of Psychiatrists
Families with Identical Twins Discordant for Schizophrenia:
Some Relationships between Identification, Thinking Styles, Psychopathology and Dominance-Submissiveness
1 Chief, Center for Studies of Schizophrenia, Clinical Research Branch, Division of Extramural Research Programs, National Institute of Mental Health, 5454 Wisconsin Avenue, Chevy Chase, Maryland.
2 Chief, Section on Twin and Sibling Studies, Clinical Investigations, Adult Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
3 Professor and Chairman, Department of Psychiatry, University of Connecticut School of Medicine, Hartford, Connecticut.
This study extends and amplifies a set of previously reported findings in a group of 11 families with identical twins discordant for schizophrenia. Our basic interest has been in describing and explaining the very different life courses of two genetically identical individuals raised in the `same' environment. In the report, we have addressed the following three questions: What patterns are found in these families with regard to identification, `cognitive style', psychopathology and dominance-submissiveness? Can the findings help us explain why one twin develops more serious psychopathology than the other? Can our findings be related to the development of schizophrenia, rather than some other form of psychologic illness, in our index schizophrenic twins? Each family member received scores for clinical and the parallel objective test variables. The results are as follows:
(1) There was a clear pattern in these families of the schizophrenic index twin's being identified with the parent who, on the basis of clinical ratings, was psychologically less healthy. The parent in question was most often the mother. The parallel objective tests (MMPI Ego-Strength and MMPI Mf) were equivocal in their documentation of this position.
(2) The index twins were more global in their `cognitive styles' (or had a relatively amorphous thought disorder) than their non-schizophrenic co-twins, and were rated as identified with the more `global' member of the parental pair. The related objective test (Embedded Figures) supported this finding strongly.
(3) The schizophrenic members of the twin pairs were most often submissive. There were no test measures of dominance-submissiveness.
(4) The mothers in these families were rated as less healthy and, contrary to their culturally-ascribed submissive-expressive role, tended to be dominant.
A tentative formulation is suggested whereby the index twin, as the result of an initial constitutional difference from his co-twin (e.g. lower birth weight) is differentially focused on by the parent who is less healthy psychologically and has less clear cognitive processes. Because of the early establishment of a pattern of identification based in large part on parental psychopathology, the relative lack of clarity of thought, and the immutability of the pattern once established, we feel that this picture may be related to the development in the index twin of the degree of attentional and conceptual problems associated with schizophrenia. Al-though our findings are consistent with those of other workers, caution should be exercised in generalizing them to non-twin samples.
Submitted on September 26, 1969
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