Longitudinal Changes in the Social Behavior of Children Hospitalized for Schizophrenia as Adults

Childhood public school records of 23 nonmigratory, hospitalized schizophrenic adults were compared with those of 69 matched control children presumed to have become normal adults. The records were analyzed by systematically coding the teachers' annual comments, focusing on longitudinal changes in social and emotional behavior. As a group the children destined to be schizophrenic adults behaved differently in school than other children. However, there was a wide range of deviation patterns and only about one-half of the preschizophrenics appeared to be distinguishable in childhood. With regard to a theory of schizophrenia, it appears that the social deviations which culminate in hospitalization are progressive over time. Whereas few of the preschizophrenic children were behaviorally distinguishable in early childhood, deviation was clear in about one-half of them by early adolescence, a crucial period for social reality testing and the development of an adult sense of social competence. During this period the boys became more irritable, aggressive, negativistic, and defiant of authority but not more introverted. By contrast, the girls became more compliant, shy, and introverted. In the rest of the preschizophrenics, deviations must not have become salient until after they left school. It is recommended that more research attention and preventive mental health action be directed to the late childhood and adolescent periods, in order to help boys develop an amiable orientation to social experience and control over aggressive impulses and to help girls to achieve emotional independence and a confident, outgoing social attitude.