Brit.J. Psjchiat.(1973), i@, 209-17 Inconsistency, Loose Construing and Schizophrenic Thought Disorder By ELSIE T. HAYNES and J. P. N. PHILLIPS Bannister INTRODUCTION et ci. (1971), Spelman ci ci. (i@7i), normals, neurotics and (in the 1962 study only) depressives. This finding has been confirmed, Williams (‘97'), Frith and Lithe (1972) and McFayden and Foulds (1972), all found that, on the whole, consistency scores tended to discriminate thought-disordered schizophrenics from other groups about as well as intensity scores. Secondly, in all those studies which reported consistency scores (i.e. all except sometimes in slightly number of subsequent McPherson and Buckley, and scores tended to be positively Bannister (1960, 1962) found that thought disordered schizophrenics hadsignificantly lower scores on a repertory grid test of the intensity of the relationships between their constructs than did non-thought disordered schizophrenics, different ways, by a studies (vide infra). On the basis of his results, Bannister put forward the theory that schizophrenic thought disorder is characterized can account by ‘¿loosened construing', for all its clinical signs, and stems from repeated invalidations it would introduce which which of construing. an effectively random these with intensity scores, usually significantly so.t Thus it might simply be that thought-disordered schizophrenics differ from other groups only in consistency, or lack of it, and that this variable is related to both consistency scores and This theory has been followed up in a number of subsequent investigations (Bannister, 1963, 1965; Bannister and Salmon, 1966). However, an alternative hypothesis which will account for the finding without the need to introduce the concept of loosened construing is that thought-disordered schizophrenics are simply more inconsistent than other subjects in their performance on the repertory grid. Such inconsistency might result from a private, idiosyncratic and possibly delusional conception of what the experimenter has asked them to do, or from difficulties of discrimination (cf. Frith and Lillie, 1972),orjustfrom a chaoticdisorga nizationof theirthinking;but, whatever its origin, Williams) correlated intensity scores on grid tests. However, the evidence of these studies (with the exception of another and more important part of that of Frith and Lillie) is not conclusive, for the consistency scores used in them are contaminated by the intensity of the relation shipsbetween constructs, being indeed com puted from the very same measures of intensity as are used to compute the intensity scores, so that it is also possible that low intensity in thought-disordered schizophrenics was the cause of the low consistency scores, instead of the otherway round. Specifically, the consistency scoreswere computed by running correlations * We have found a number of inconsistencies (which it element into the patients' responding, and thus lower the absolute magnitude of the correlations wouldbetedious toenumerate) inthetables andfigures of these studies. In most cases it has not been possible to between it has been possible the differences from the correct results have not been great, and the conclusions do not seem to be materially affected. their constructs. There is some indirect support for this alternative hypothesis in Bannister's own studies and the confirmatory studies mentioned above. Firstly, Bannister (1960*, 1962*), Bannister and Fransella (1966*), Foulds et ci. (1967), Poole (5968), McPherson and Buckley (‘970), determinewhatthecorrectresultsshouldbe, butwherever t Bannister and Mair (i968) quote also an unpublished BA. dissertation by D. V. Bridges. Unfortunately, the most extensive searches failed to obtain us a copy, and it nowseemslikelythatall onceextantcopiesof thisdisserta tion have been lost. 209 210 INCONSISTKNCY, LOOSE CONSTRUING AND between measures of intensity obtained from one grid and the corresponding measures of intensity obtained from a second grid using the same constructs.* Now, in the studies by Bannister (5960, 1962), where the second grid used different elements from the first, the measures of intensity were essentially phi correlation coefficients, and their standard errors of estimate would be inversely propor tional to their magnitudes. Thus ifthe intensities in the two grids were low they would be less stably estimated than if they were high, so that the measures of intensity would agree less well together from the first grid to the second. This factor alone could have caused a positive correlation between intensity and consistency in these two studies. The subsequent studies use the Bannister-Fransella test (Bannister and Fransella, 1966, 5967), in which the second grid is just an immediate readmiistration first one, and where the measures are Spearman rhos. According of the of intensity to Bannister and Fransella, intensity scores and consistency scores SCHIZOPHRENIC THOUGHT DISORDER appear in principle feasible to devise a test of intensity that is unaffected by inconsistency; for inconsistency, as envisaged in the alternative hypothesis, is analogous to a random noise component in the thought-disordered schizo phrenics' responses, and there seems to be no way of eliminating it directly. However, it is possible to devise a test of consistency which is unaffected by intensity : one such was used by Frith and Lillie, and anothe@ is described below. By the use of such a pure test of consistency, the inconsistency component of intensity scores can be partialled out statistically, making possible a test of the alternative hypothesis, which is the purpose of the present study. METhOD Subjects. These were: Ten diagnosed schizophrenics at Dc la Pole Hospital (eight male and two female), judged to be thought-disordered by the responsible Consultant Psychiatrist and, where he was a different also by the Physician Superintendent;t person, Ten schizophrenics (nine male and one female on this test are ‘¿mathematically independent'; nevertheless, it is clear that if the intensities are similarly judged not to be thought-disordered; low in absolute value the measures of them will cluster more closely about zero than if they are high: thus, any changes in these measures resulting from changes in the rankings of the elements will cause a greater perturbation of their rank order from the first administration to the second, and hence there will be a lower correlation between the measures of intensity for the two administrations if the intensities are low in absolute value than if they are high. Ten normal controls (five male and five female), artisan, clerical and nursing staff of the hospital. This factor also could have resulted in a positive correlation between intensity and consistency in all the studies. Since, therefore, consistency can affect in tensity scores (as mentioned in the second paragraph), and intensity can affect consistency scores (as just shown), it would be desirable to administer pure tests of both intensity and consistency to thought-disordered schizophrenics and other clinical groups, in order to determine whether it is consistency, or intensity, or both of them, which is, or are, relevant to schizophrenic thought disorder. Unfortunately, it does not * For (1972). a fuller discussion of this approach see and The threegroupswerematchedon age,but not on intelligence or sex: previous work by Bannister (i96o, 1962) and Bannister and Fransella (1967) found no evidence that these three variables were related to intensity and consistency scores on repertory grid tests; Frith and Lillie found intelligence, but not age or sex, to be highly significantly related to a pure measure of consistency; when this measure was partialled out statistically, the only highly significant relationship was between age and Bannister's measure of consistency. It did not appear desirable to attempttomatchthegroupson measured intelligence since this could result in the groups being less differentiated on thought disorder (which is likely to be related to measured intelligence). An attempt was made to match the groups on pre-morbid intelligence, asestimated by pre-morbid occupational status, but paucity of records rendered this impossible. Test material. This consisted of photographs of eight men and eight women unknown to the subjects4 t We are grateful to Dr. J. A. It. Bickford, Physician Superintendent, and to Dr. I. C. Church for these assessments. We are grateful to Professor Bannister for making Slater these photographs available. BY ELSIE T. HAYNES AND Procedure.The subject was presented with four of the photographs, and asked to arrange them P. N. Scoring. This 211 PHILLIPS comprised three stages: Stage I : Since the twenty subsets of four photo graphs each constituted a balanced incomplete in order, from the most Likeable to the least. When he had @ 3. done this, another four were presented with the same block design, every possible pair of photographs request. Thiswas continued untiltwentydifferentoccurred just once in some subset. It was therefore subsets of four had been presented and ranked, the possible, following Durbin (1951), Schucker subsets constituting a balanced incomplete design, as illustrated by the data in Table Gulliksen block and Tucker (1961) and Slater (5965), to derive from the rankings an implied table of pair I, which showstherankings producedby thefirst non-thought comparisons, as may be illustrated by the example in Table I. disordered schizophrenic. The first subset of four contains photographs 3, ‘¿5, This procedure was then repeated with the further 8 and 5, which the patient has ranked in that order. constructs Mean, Good, Unusual,Narrow-minded, Sincere, &lfish, Bannister, Unreliable and 1962>, a different Kind (taken This implies that he judges 3 to be more Likeable than 15, 8 and 5, so ones are entered in columns 15, from randomization of the basic balanced incomplete block design (given by Cochran and Cox, 5957), being used for each 8 and 5 of row 3 (and noughts in rows 15, 8 and 5 of construct. more column T@nii 3): it also implies Likeable than 8 and that he judges 15 to be 5, so ones are entered in I Table Total 12345678910111213141516I00000000000000I131410i62I 315 6Rankings 48 75 IPairComparison 0000000050010I9122II3II 111111I1591374I 110110 10110110I5410II5I 10 0100110010I32,i6611111 101 I 414i67 8I II•5 9 8 0 0 0 0 0 1100101 0 I I 0 0 I 6 8 0 0550010I ‘¿3 111510I6353II•10I 10000I9810III100000000015II14I12I 10000000 o o I65i6131100101101103 I 0 I I 0 I I 0 I I @ I 0 I I I I 6557 4 3 6•@ 8.5 15 157214911111011 128 1512 412 13 15 13 001 111111111I6 @ Rank I 8 1010 2 15 254 i61000000001000 000000000000000 12 53 5 I 9 8 3 7 4 ii 14 i6 I I 0 I I 0 I I I I I I I 2 14 10 3 ‘¿5 9 4 8 5 4 ‘¿35 II 14 10 ‘¿0 3 4 11.5 3 13@5 II 0 I 9 0 I 3 ‘¿3 0 Circular Triads d=5 I 0 I 5 I3•5 3 i6 212 INCONSISTENCY, LOOSE CONSTRUING AND SCHIZOPHRENIC THOUGHT DISORDER totals. In this example, d = 620—615 = 5, and the columns 8 and 5 of row 15 (and noughts corre circular triads areshownatthefootofthetable. spondingly): it finally implies that he judges 8 to be five The second measure of inconsistency which may be moreLikeable than5,soa oneisentered incolumn5 ofrow 8 (anda noughtcorrespondingly). Treating used is Slater's (I96o, 1961) statistic i, the minimum number of (corresponding pairs of) cells it is necessary each subset of four in the same way, the pair com to change in the pair comparison table in order to parison table is filled in completely. Stage @:From such a table there can be derived both a ranking of the photographs and also measures make it completely consistent (i.e. without circular triads whatsoever), or, equivalently, of consistency (or rather, inconsistency). There are in fact two measures of inconsistency which may be used. The first is Kendall and Babington Smith's minimum number of errors one must supposethe subject to have made. In the present sample the table can be made completely consistent, and all circular (1939; triads eliminated, by changing the entries in row 4 column @,in row 10 column 14, and in any one of Kendall, circular where @ 14, I@8) statistic d, the number triads such as, in this example, the patient has judged 14 more Likeable than io of 2, 14, 10, 2 more Likeable than and more io thethreecells row 3 column9,row 9,column15or row i column 3 (and also their correspondingmirror Likeable than 2 d is readily computed by the formula d =@:I2@@ where E image T@aii II Permutated Pair Comparison Table 6 3 15 9 12 4 13 8 5 7 10 2 II 14 I 3 ‘¿5 85 7' 64 6 13 14 10 16 9 12 2 II 7 54 10 II 32 i 6 12 12 I 0 0 12 0 0 8 14 4 i6 13 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I ‘¿â€˜â€˜â€˜III 0 I 0 0 0 II 7000000000 10 I II 14 I 3 12 5 7 i6 10 4 ‘¿3 82 6 15 10 2 13 5 I 0 0 0 0 8ooooooo 13 4 II I I 10 0 I 101 63 98 3 7 I I 400000 500000100 9 8 I 11111 14 12 I 9010 2 69 I 101 57 15 I 30 15 13 15 4, etc.), so that i = 0 0 I I I I I I I I I I I I II I I I I I I 1 7 I I I I I I I I 1 I I I I I I I I I I I I I I I I I I 0 0. 0 0 0 0 0 0 0 0 0 0 0 0 11011 I 200000000000 II 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 I 0 0 0 100000000000000 ‘¿4 i6 3. the three nearest adjoining orders which differ least from the obtained data: inconsistencies stand out as noughts in the upper right-hand half of the table of the squares of the row Rankings 9 5 column rows and columns have been permuted into one of I@2 15 cells row This may be seen more clearly in Table II, where the —¿ a@ is the sum any the i6 0 o o 0 0 0 0 0 0 0 0 0 0 0 0 i3 - 3159 3 15 910 0 1593 I 0 15 I 9 310 0 I 0 9 I 30 15 9 3 ‘¿5 10 I I 0 BY ELSIE T. HAYNES and ones in the lower left-hand half. It will be noted from the sub-tables that photographs 3, 15 and 9 may be put in that order or in the order 15, 9, 3, or in the order 9, ‘¿3, ‘¿5 (depending upon which of the three cells mentioned above is changed) without altering the number of inconsistencies, so that there are here three nearest adjoining orders. The determi nation of Slater's i is not straightforward, and was carried out by computer (Phillips, 1969, 1971). The ranking of the photographs taken from each pair comparison table was that given by the row totals (as in Table I) rather than the nearest adjoining order, because, as has just been seen, there were sometimes more than one of the latter.* (It can now be seen that the procedure of ranking subsets of four photographs at a time was a compro mise between obtaining possible pair all one hundred comparison judgements and twenty of the photo graphs, which would have provided maximal infor mation on internal consistency but have been im practicably lengthy, and ranking the whole set, which although perfectly practicable provides no information on internal consistency.) Stage @:Two measures of inconsistency obtained for each subject, by summing dover were all nine constructs (Zd) and by summing i over all nine constructs (Zi). To obtain measures of intensity for each subject, Spearman rhos were first computed for all thirty-six pairs of constructs. There were then two alternatives. Bannister (1960, 1962) used a score which, when the subject has to dichotomize the elements on each construct is equal to the absolute value of the phi correlation coefficient multiplied by half the number of elements: therefore, analogously, the sum of the absolute values of all thirty-six rhos (Z@ @I)may be taken as a measure of intensity. On the other hand Bannister and Fransella (1966, 1967), and the studies * For a further method of estimating a ranking from an inconsistentpair comparison table,see Kendall 1955. AND 3. P. N. 213 PHILLIPS subsequent to them, used the sum of the squares of Spearman rhos (Zp2), which also may be taken as a measure of intensity. RESULTS There were significant differences between the groups on intensity scores, Specifically, on both Z@iI and Zp2 the thought-disordered schizophrenics scored signi ficantly less than the non-thought-disordered schizophrenics (p controls .01), (p < < .05) the method: 197 Ryan, 1959; O'Neill the normal two groups not and Wetherill, I). These results confirm the previous findings cited in the introduction, but are not crucial for the alternative hypothesis. As regards the latter, (i) there that related are three schizophrenic only to low possibilities, thought intensity, namely disorder (ii) that is it is related both to low intensity and to low con sistency, and (iii) that it is related only to low consistency. Presumably Bannister's theory im plies that one or other ofthe first two possibilities is the case, whereas the alternative hypothesis is that it is the third which is true. According to possibility (i), the thought disordered schizophrenics should not differ from the other two groups on the pure measure of inconsistency. In fact, the differences between the gi oups on this variable were more significant than those in intensity, as may be seen from Table III: thought-disordered schizophrenics scored (on both Zd and L'i) significantly more inconsistently than either of the other two [email protected] [email protected]@057.145<0I£ Group .£@j709.1242@[email protected]()<.()fJ@ZjI59@967@837@I20<.001 and latter differing significantly from one another (Tukey's D!fferences between groups on intensity and consistencyscores p26@47I4@205•99@<.@Consistency as may be seen from Table III. 214 INCONSISTENCY, LOOSE CONSTRUING AND groups (p < 00I in both cases), which did not differ significantly from one another. Indeed, there was (just barely) no overlap between the thought-disordered schizophrenics and all the other subjects on either Ed or Zi. Thus possi bility (i) above must be rejected : schizophrenic thought disorder clearly is related to inconsis tency, and from the relative magnitude of the effect (a pure measure of inconsistency differen tiating better than a measure of intensity confounded judged by inconsistency) it might be to be the more relevant of the two variables. The view that intensity scores differentiate the groups only to the extent that they are contaminated by inconsistency receives some support from the fact that these scores were SCHIZOPHRENIC THOUGHT DISORDER the test-retest reliability ofrankings ofitems, the intensities of the relationships between concepts were as high as, or higher than, those of normals. However, unfortunately for the purpose of the present study, they do not report any assessment of their schizophrenics for thought disorder, and indeed the procedure of experimentally—as opposed to statistically—matching schizophre nics with normals on consistency is likely to have selected schizophrenics who were not thought-disordered. Thus nothing about the intensity scores of thought-disordered schizo phrenics can be concluded from this study. Koh and Shears (1970), on the other hand, reported that schizophrenics showed poor internal consistency in psychological scaling tasks ( judgement@ of line lengths and preferences for tude estimation) as compared @ significantly correlated with the pure measure ofinconsistency (p < .001) Whichever measure of intensity, E@ or Ep2, and whichever Ag am, the authors do not report measure Ed or Zi, was used, the oftheir schizophrenic.s for thought disorder; but @ overall in the here, unlike with the Miller and Chapman study, it seems likely that a good many of the of consistency, correlation was whilst the within-groups no case varied another, region of —¿o 7, correlation, which in significantly from one group to was in the region of —¿o ‘¿5. However, the crucial test between possibilities musical excepts by subjects must disordered. Most crucially category actually rating have relevant, and magni with normals. any assessment been however, thought is the study of Frith and Lillie (1972), who retrospectively (ii) and (iii) must be made by analysis of co variance of the intensity scores, with the pure measureofinconsistency ascovariate. Ifthought disorderis relatedto both inconsistency and intensity, then the intensity scores, even with inconsistency partialled out, should still differen tiate between the groups; whilst if it is related variables only to inconsistency they should not. In fact, the latter turned out to be the case: for all four tion between photographs, combinations of intensity and consistency score, the F-ratios were less than unity (indeed less immediate than 0.2), one used here was of internal consistency, their and not significant even at the 75 per examined the relationship between psychiatric ally assessed thought disorder (and a number of which do not concern us here) scores on the B-F test, including calculated pure measure and a specially of consistency, namely element consistency, which is the squared correla the first and second rankings of the summed over all six constructs in the test. Although test-retest their pure measure was of consistency, whereas the cent level: thus there is no evidence in the results were in the relevant respects identical data that schizophrenic thought disorder is with those of the present study. Intensity scores thought-disordered relatedto intensity, once the contaminationof significantly differentiated intensity scores by inconsistency is removed. patients from others pure (element) DISCUSSION thought-disordered (x2 = 5'I5, p < .05): consistency scores differentiated patients from others still more significantly (x = I4'43, p < .ooi), There are two studiesof possible relevance, and were significantly correlated with both and one of certain relevance, which must be intensity scores (r = o'68, p < .ooi) and Bannister's consistency scores (r = o 6o, p < mentioned here. Miller and Chapman (1968) .oor); intensity scores, corrected for their found that when schizophrenics were matched with normals on consistency, as measured by relationship with pure (element) consistency, Related findings BY ELSIE T. HAYNES showed no relationship with psychiatric ment of thought disorder. AND assess Inconsistency, loose construing and schizophrenic thought disorder From these results, and those of the present study it would appear to follow, firstly, that there is no evidence in the studies cited in the intro duction that schizophrenic thought disorder is characterized constructs by weak relationships ; and secondly, that 3. P. N. PHILLIPS subsume the elements (behaviour of the acquaintance) under consideration and may itself be, in some way, modified (sic). This modification could take the form of loosening the construct, that is to say, weakening its relationship with other constructs, so that it leads to varying predictions (the definition of a loose construct) . Thus loosely to construe a person as “¿loving― would not be automatically to anticipate between and any appearance 215 from his “¿sincere― and so on behaviour, since the “¿likeable― relationships which is characteristic of schizophrenic thought between the constructs normally constellated with “¿loving― have been weakened.' Bannister thus appears to regard the ‘¿continual shifting of disorder. elements Before considering how this conclusion relates to the ‘¿loosened construing' theory of schizo which according to Kelly (bc. cit.) characterizes phrenic loose construing, but as being the precursor and to the contrary probably tamination of intensity thought resulted from con scores by inconsistency, disorder, it is necessary to be a loose from one pole construct, to the contrasting as not in itself pole', constituting clear as to how the phrase is to be taken, since, cause of loosening, as will fication of the construct, namely weakening its relationships with other constructs. Further be shown, it has been given two quite which is a subsequent modi distinct meanings. more, Bannister treats loosened construing as Kelly (1955) lays down the definition, which must presumably be taken as authoritative, ‘¿Asynonymous with weak structure (e.g. ‘¿thought loose construct is one which leads to varying disordered schizophrenics had very weak con (loosened construing)' Ban predictions but retains its identity.' (Vol. I, ceptual structure p. 533). He gives numerous illustrations of this definition, e.g. ‘¿If breakfast is loosely construed, then the meal one ate at i , A.M. might at once be construed both as breakfast and as something other than breakfast, or as breakfast at one time and as somethingcontrastingwith breakfasta momentlater. This is loose construction.' (Vol. II, p. 1058). Thus Kelly's concept of loose construction seems to mean both internal inconsistency, as opera tionally defined in the present study, and test retest unreliability, as operationally defined by element consistency in the study of Frith and Lilile. Bannister's concept of loose construing seems quite different. The best statement of it occurs nister, states 1965, p. 377), ‘¿From our point whereas ofview, Kelly loose explicitly construction is not to be considered as the same as lack of structure.' (Vol. II, p. 1030). Therefore, whilst the present results, and those of Frith and Lillie, suggest that there is no evidence that schizophrenic thought disorder is characterized by ‘¿loosened construing' in Bannister's sense of weak relationships between constructs, they are perfectly consistent with, and indeed strongly support the proposition that it is characterized by ‘¿loose constructs' in Kelly's sense of inconsistently used constructs. However, it should be pointed out that it does not require the elaborate conceptual apparatus of personal construct theory to tell us that in his ig6o study (p. 1246): ‘¿For example, if the construing ofa personas “¿loving― isinvalidated thought-disordered schizophrenics are incon then the tendency may be to construe the person sistent. Pluralitas non est ponenda sine necessitate. in the contrast pole as “¿hating―, but the acquaintance may then exhibit behaviour more appropriate to the “¿loving― pole and we may Sui,mi&py i. It is suggested that the repeatedly con duly shuffle him back to be construedunder that pole. However, if invalidation occurs in firmed finding of low intensity this manner schizophrenics, which Bannister has taken as the basisfor his ‘¿loosened construction' theoryof to regard repeatedly, the construct the tendency as itself may inadequate be to between constructs) (of relationships scores in thought-disordered 216 INCONSISTENCY, LOOSE CONSTRUING AND SCHIZOPHRENIC THOUGHT DISORDER schizophrenic thought disorder, is in fact an artefact of the contamination of intensity scores by inconsistency. There is some support for this alternative hypothesis in the literature, since it has been found in eleven studies that consistency scores tend to be positively, and usually signifi candy, correlated with intensity scores, and to discriminate thought-disordered schizophrenics from other groups about evidence is not conclusive, possibility as well. However, this since there is also the that consistency overcome grid test this was difficulty, a administered form of to ten thought-disordered schizophrenics, ten non thought-disordered schizophrenics and ten normal controls, in which the subjects ranked various overlapping subsets of elements, rather than, as is conventional, the whole set, thus making possible a measure of pure internal consistency. Although intensity scores signifi candy discriminated the thought-disordered schizophrenics from the others, pure internal consistency scores (which were significantly correlated with them) did so better and when pure internal consistency was partialled out of the intensity scores, the latter no longer dis criminated the groups significantly. Effectively identical results have been obtained by Frith and Lillie. 3. It is shown construction' senses, that the phrase —¿ (Kelly) and ‘¿loosened intensity (Ban nister). 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Phillips,M.A.,Ph.D.,Dip.Psych., Psychology Department, TheUniversity, Hull,E. Yorks. (Received 8 August 1972) Inconsistency, Loose Construing and Schizophrenic Thought Disorder ELSIE T. HAYNES and J. P. N. PHILLIPS BJP 1973, 123:209-217. Access the most recent version at DOI: 10.1192/bjp.123.2.209 References Reprints/ permissions You can respond to this article at Downloaded from This article cites 0 articles, 0 of which you can access for free at: http://bjp.rcpsych.org/content/123/573/209#BIBL To obtain reprints or permission to reproduce material from this paper, please write to [email protected] /letters/submit/bjprcpsych;123/573/209 http://bjp.rcpsych.org/ on June 18, 2017 Published by The Royal College of Psychiatrists To subscribe to The British Journal of Psychiatry go to: http://bjp.rcpsych.org/site/subscriptions/
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