Autonomic Response Specificity and Rorschach Color Responses

Transcription

1 Autonomic Response Specificity and Rorschach Color Responses JOHN I. LACEY, Ph.D.; DOROTHY E. BATEMAN, and RUTH Van LEHN 1 HE PURPOSE of this report is twofold: a) to present some data concerning intraindividual differences in the degree of activation of different physiological functions in response to stress; and b) to illustrate the significance of such patterning of response for researches that seek to establish relationships between autonomic reactions and personality. In this paper the relationship studied is between physiological response to stress and an index of "emotionality" derived from the Rorschach Inkblot Test. Cannon's researches (2, 3) have resulted in two assumptions that are implicit in many psychophysiological investigations. They are that only the sympathetic branch of the autonomic nervous system responds to unpleasant stress, and that all sympathetically innervated structures show equal increments or decrements of activity. Recent studies, however, demonstrate that the autonomic nervous system does not respond as a whole in "normal" individuals. For one physiological measure an individual may be over-reactive, for another markedly underreactive (4, 5}. Malmo and his collaborators have shown similar results with psychosomatic patients (6, 7). Their work has led them to formulate a principle of symptom specificity. "This principle states that in psychiatric patients presenting a somatic complaint, the particular physiological mechanism of that complaint is specifically susceptible to activation by stressful experience" (7). It is not known whether this principle applies only to those who have already devel- From the Samuel S. Fels Research Institute for the Study of Human Development, Yellow Springs, Ohio. Received for publication March 14, oped a psychosomatic disorder. The present study was undertaken to examine the question of response specificity in the "normal" case. We choose the term "response specificity" rather than "symptom specificity" to avoid the premature implication that the pattern of response secured in an individual not suffering from a psychosomatic complaint is predictive of the area of symptom production if psychosomatic neurosis develops. The specific hypothesis tested may be called relative response specificity: for a given set of autonomic measurements, individuals tend to respond with maximal activation in the same physiological function in a variety of stress situations. First Experiment Method Eighty-five male college students, aged 19 to 22, were subjected to four stresses in sequence: mental arithmetic, hyperventilation, difficult word association, and the cold pressor test. The first stress was administered after fifteen minutes of relaxation. The subsequent stresses were administered after recovery from the preceding stress. Heart rate, beat-to-beat variability of heart rate, and palmar conductance (indicating sweat gland activity) were continuously recorded. Details of the procedure will be presented in a later and more complete report of the physiological results. The measure of reaction used in this study was independent of the physiological level at which the stress was imposed. The details and justification for the mathematical procedure employed will be presented in a separate report. In statistical terms, the regression of stress level upon base level was removed. The

2 LACEY ET AL. end result of the procedure is a set of so-called T-scores, with a mean of 50 and a standard deviation of 10. Suppose an individual has a T-score of 40 for palmar conductance reaction. This means that the maximum level of palmar conductance which he reached during stress is one standard deviation below the average for individuals with his hase level. These measures of Autonomic Lability, as we call them, are highly correlated with absolute and percentage changes. They have the important attribute, however, that their correlations with base level are zero. This is not true of either absolute or percentage changes. In this study, four degrees of relative response specificity may appear. 1) "Maximum" response specificity, within the limits of the experiment, is shown by a subject who exhibits his maximum T-score in the same physiological variable in all four stresses. 2) "High" specificity is shown by a subject who exhibits peak response in one variable three times, and in another variable the fourth time. 3) "Low" specificity is shown by a subject who yields his peak response in one variable for two of the four stresses, and in another physiological variable for the other two stresses. 4) "Minimum" specificity is shown by the subject who exhibits peak response in all three variables over the four stresses. Results Figure 1 shows the observed number of cases demonstrating each of these four degrees of response specificity, in comparison with the frequencies expected on the hypothesis of independent and equally likely events. These chance expectancies are easily calculated using the additive and multiplicative theorems of the probability calculus. It can be seen in Figure 1 that there is a marked excess of obtained frequency over expected frequency in the category "maximum degree of response specificity." There is a slight excess for the "high" specificity category, a slight deficiency in the "low" specificity group, and a marked deficiency in the "minimum" specificity group. For purposes of testing the significance of these observed deviations from the theoretical distribution the VOL. xrv, NO. 4, <25 O20 UJ CD v 1 Legend: 2 0Chance expectancy - (Obtained frequency 257 MAXIMUM HIGH LOW MINIMUM DEGREE OF RESPONSE SPECIFICITY FlGUKB I data were recombined into two classes, as shown in Table 1. TABLE 1. FIRST EXPERIMENT: RESULTS Degree of response Expected Obtained Disfrequency specificity frequency crepancy Maximum and high Low and minimum This brings the theoretical frequency in each cell above 10, and a chi-square test may be employed legitimately. The obtained x 2 is Reference to the normal curve tabulation, entered with x a s a normal deviate, gives a confidence level of The hypothesis certainly must be rejected that there is independence from stress to stress of the physiological function in which an individual exhibits his maximum reaction. The observed frequency distribution implies that we are dealing with a group of individuals some of whom have developed fixed patterning of the three physiological variables, in which one of the functions is maximally acti-

3 258 AUTONOMIC RESPONSE SPECIFICITY vated by any stress whatsoever; some of whom Second Experiment have developed modal patterns from which they depart only occasionally; and some of Method whom are random with respect to pattern of Twenty-six of the subjects of this study autonomic arousal. were given a Rorschach Inkblot Test by the These results call into serious question the senior author, who was ignorant of the autonomic findings until after the Rorschachs typical design of many psychophysiological investigations that seek to establish covariation were scored. Scoring was in accordance with between physiological response to stress and Beck's system. For 19 subjects, the Rorschach various aspects of "emotionality." From the was given within one week after the autonomic measurements were made. For the mistaken assumptions that the sympathetic nervous system alone is responsible for response to stress, and that this branch tends to Rorschach was given ranged from 8 to 2,6. other 7 subjects, the days elapsed before the respond as a whole, has come the practice of We were specifically interested in the relationship of autonomic reactivity to the use of utilizing either a single measure of reaction as an index of the reactivity of the autonomic color on the Rorschach, which is an alleged nervous system, or of utilizing a series of indicator of "emotionality." Rorschach scoring measures but treating them one at a time. It discriminates three types of color response. is clear, however, that individuals do not exhibit quantitatively equal response in all is the dominant determinant of the percept, In the FC response, the form of the stimulus measures of autonomic function, and that this and its color is a secondary determinant. This is due in part to relatively constant intraindividual differences in the degree of activation the CF response, color is more important than is spoken of as a controlled color response. In of different somatic functions. form as a determinant, and in the pure C Can a concept of general autonomic reactivity be rescued? In many instances we do want and C responses are taken to represent uncon- response only color is a determinant. The CF to categorize individuals with respect to ease trolled use of color. In Rorschach doctrine, and amount of autonomic arousal. There are those who use color in uncontrolled ways are several possibilities. The one used in this affectively immature, capable of violent explosive outbursts of affect. These points are paper assays the autonomic reactivity of each individual by using his maximal T-score, no in general accepted in clinical practice but lack experimental verification. matter in what variable that maximum is exhibited. If Case A has a maximum T-score The Form-Color Index is: 0.5 times the of 68 in heart rate, and Case B has a maximum T-score of 68 in palmar conductance, number of CF responses minus 1.5 times number of FC responses minus 1.0 times the we can say that the maximal reaction of these the number of C responses. These weights are two individuals is the same, within the limits the usual ones given to the responses in evaluating the affective status of the individual. of the experiment. A positive Index means that the individual Using such a measure as an index of general autonomic reactivity has no physiological color; a negative Index means the reverse. used controlled color more than uncontrolled rationale at the present time. Support for its The hypothesis to be tested is that the more use must be sought in the answers to two negative the Index the greater the autonomic questions. First, does such a measure reliably reactivity to stress. discriminate between individuals; and second, The hypothesis was tested by computing does the measure relate to personality criteria rank difference correlations between the Index and measures of autonomic reaction. For more highly or more meaningfully than do single measures of reaction? The data of the 26 cases a correlation of 0.41 is required for following experiment were secured in a first significance at the 4% level, and of 0.46 for approach to the latter question. significance at the 2% level (8).

4 LACEY ET AL. 259 Results We first computed correlations between the Form-Color Index and each of the measures of autonomic reaction separately. The correlations are shown in Table 2. TABLE 2. FOBM-COLOB INDEX AND MEASURES OF AUTONOMIC REACTION: CORRELATIONS Palmar conductance.07 Heart rate -.07 Heart rate variability -.01 Stress I Stress II Stress III Stress IV these results. An individual is free to give as many responses as he wishes to the Rorschach inkblots. A subject who is expansive and productive in general produces more of everything on his record. It is always neces- These correlations vary from.07 to Only the correlation between the Form-Color Index and palmar conductance reaction to the cold pressor test (Stress IV) is significant. The median value of the 12 correlations is.23, an insignificant value. We next correlated the Index with maximum T-score in each of the four stresses. For the four stresses, the correlations were.09,.33,.30, and.34. All correlations are now positive, although none reaches acceptable significance levels. The median value is.315. This is.09 points greater than the median value of the correlations between the Form- Color Index and each of the autonomic measures tested one at a time. The final step was correlating the Form- Color Index with the maximum reaction shown in all 12 measures. This correlation was 0.47, significant at the 2% level. A further increment of.15 points in the correlations was thus obtained. One aspect of this correlation is shown in Fig. 2. The 26 cases were divided into approximately quartile groups with respect to their Form-Color Index, and the median value of the maximum T-scores for each of these quartile groups was determined. It can be seen that for the 6 cases showing Form-Color Indices between +2.5 and 0.0 the average value of the maximum T-scores was The average increases progressively to 63, 66, and 71 as the Form-Color Index becomes increasingly negative. A final point must be made in evaluating VOL. xiv, NO. 4, to to to " to-10.0 N = 6 N-T N = 6 N-7 IFC-ICF- IC FIGURE 2 sary to show in validating any Rorschach index that the results are specific to the index itself, and do not derive indirectly from the productivity of the subject. In our sample the rank difference correlations of the Form-Color Index with various aspects of productivity on the Rorschach are: 1) With total number of responses,.15; 2) With number of responses on the five colored cards,.01; 3) With number of responses on the three most highly colored cards (cards VIII, IX and X),.10; 4) With percentage of responses given to the five colored cards,.05; 5) With percentage of responses given to cards VIII, IX and X,.06. None of these correlations even approaches significance. The relation of the Form-Color Index to maximal autonomic reaction, therefore, is specific and does not depend upon differences in the productivity of the subjects. Summary and Conclusions Eighty-five male college students, between the ages of 19 and 22, were subjected to four

5 260 AUTONOMIC RESPONSE SPECIFICITY different stresses. The stresses were mental arithmetic, hyperventilation, difficult word association, and the cold pressor test. Palmar conductance, heart rate, and heart rate variability were continuously and simultaneously recorded. Twenty-six of the subjects were later given the Rorschach Inkblot Test, which was scored for the use of form and color as determinants. The results may be summarized briefly. 1) The principle of relative response specificity is strongly supported. For a given set of autonomic measurements, normal subjects tend to respond with maximal activation in the same physiological function in a variety of stress situations. The results suggest that we are dealing with a group of individuals some of whom have developed fixed patterning of the physiological variables studied, in which one of. the functions is maximally activated by any stress whatsoever. Some of them have developed modal patterns from which they depart only occasionally, and some are random with respect to pattern of autonomic arousal. 2) It is suggested that such response specificity must be taken into account in studying psychophysiological relationships. The phenomenon of-patterned autonomic arousal suggests that success in demonstrating covariation between autonomic response and personality variables may be achieved only if the reactivity of the autonomic nervous system is assayed in terms of maximal reactivity, no matter in what stress or in what physiological function this maximal reaction is exhibited. 3) This was shown to be true in a second study in which an attempt was made to validate the Rorschach Form-Color Index of "emotionality" against the criterion of autonomic response to experimentally induced stress. No convincing validity was found when the autonomic responses were correlated one at a time against the Form-Color Index. As response specificity and the sampling nature of measures of autonomic response were taken into account the correlations rose to a final value of.47, significant at the 2% level. References 1. BECK, S. J. Rorschach's Test. I. Basic processes. New York, Grune and Stratton, CANNON, W. B. Bodily Changes in Pain, Hunger, Fear and Rage. New York, Appleton, CANNON, W. B. The Wisdom of the Body. New York, Norton, LACEY, J. I. Individual differences in somatic response patterns. J. Comp. & Physiol. Psychol. 43:338, LACBY, J. I. Differential emphasis in somatic response to stress: An experimental study. Psychosom. Med. 14:71, r9;2. 6. MALMO, R. B., and SHAGASS, C. Physiologic study of symptom mechanisms in psychiatric patients under stress. Psychosom. Med. 11:25, MALMO, R. B.; SHAGASS, C; and DAVIS, F. H. Symptom specificity and bodily reactions during psychiatric interview. Psychosom. Med. 12:362, OLDS, E. G. Distributions of sums of squares of rank differences for small numbers of individuals. Ann. Math. Stat. 9:133, 1938.