A Personality Study of Asthmatic and Cardiac Children

Abstract

Summary The following conclusions were indicated by the test results obtained for the various group comparisons: 1. As a group, asthmatic children were significantly more maladjusted or neurotic than were the children of the normal control group. Their personality was characterized by traits of anxiety, insecurity, and dependency. The test findings, therefore, supported our first hypothesis that the child who suffers from chronic asthma exhibits a personality pattern that differs from that of a normal, healthy child. The conclusion that asthmatic children are more maladjusted than normal children agrees with the findings of most of the previous investigators who have used psychological tests in their attempts to study the personality of asthmatic children. Thus, Riess21 found asthmatic children to be emotionally unstable as indicated by the Pintner Personality Inventory; Schatia27 discovered a high incidence of psychoneurosis in asthmatic children (and adults) on the basis of Rorschach results; Fine10 concluded that behavior and personality problems occur significantly more frequently in asthmatic boys as revealed in Rorschach, TAT and MAPS test results; Vles and Groen,30 using the Behn-Rorschach, reported that their asthmatic children were highly neurotic. The specific personality characteristics that we have found for our asthmatic group have been reported by previous investigators. Schatia's Rorschach results27 revealed a neurotic personality structure in asthmatics. Wilken-Jensen31 described the child with asthma as displaying intense anxiety on the Behn-Rorschach test. Fine's10 projective tests indicated traits of dependency and anxiety in the asthmatic child. In addition, our findings agree with the clinical observations of asthmatic children which are reported in the literature.5, 6, 9-11, 16, 17, 22, 23, 20, 28, 29 There is great consensus among clinicians in describing the personality of the asthmatic as characterized by traits of overanxiety, extreme dependence, and lack of selfconfidence. Moreover, the majority of these observations stress the high incidence of psychoneurotic difficulties or behavior problems. None of the traits which this study found characteristic of asthmatic children conflict with any of the findings reported by previous investigators. 2. Cardiac children exceeded normals in degree of neuroticism and of dependency feelings. Since the author knows of no previous psychometric studies on cardiac children, nor of published observations by psychiatric or clinical psychologists, the present findings cannot be compared with those of other investigators. Clinical observations of the personality traits of adult cardiac patients are harmonious with our general findings of neuroticism for the cardiac child.26, 28, 32, 33 3. Significant differences in test results were not obtained between the sick children and their well siblings. This suggests a similarity in personality makeup for sick children and their siblings. These test findings suggest two possibilities, namely, that the personality pattern of the siblings of the sick children may in some measure be the result of the presence of a chronically ill child in the home, or that similar constitutional or familial factors produce or contribute to the similar personality deviations of the sick children and their siblings. A choice between interpretations or a combination of them cannot be made on the basis of our present results. In two previous investigations asthmatic children and their non-asthmatic siblings have been studied,10, 30 Fine10 concluded that asthmatics have significantly more personality problems than their non-asthmatic siblings. Vles and Groen30 found that both of these groups are neurotic. Our findings agree with those of Vles and Groen in that we found both the sick children and their siblings to be more neurotic than our normal controls. These results, therefore, conflict with those of Fine. This conflicting finding may be explained by the type of sample employed in each study. Fine's population consisted of children from cultural groups that are not wholly representative of the United States. Of the thirty families included in his study, twelve were Negro and eight were Mexicans from Southern California. Their economic status was predominantly in the lowest group; more than half of their fathers were unskilled laborers. In contrast to Fine's sample, the population in this study is somewhat above average in economic status. A comparison of the two studies may be expected to produce findings which are not in agreement because of the multiplicity of factors involved. These factors include differences in parent-child expectations, cultural attitudes, and group mores. 4. The lack of significant differences in test results between the asthmatics and cardiacs indicates that the personality picture of the asthmatic child cannot be wholly ascribed to the nature of the asthmatic disorder. The data clearly rejected the concept of differential personality patterns for asthmatic and cardiac children. They suggested, on the contrary, the existence of personality traits common to both illnesses, and conceivably common to protracted illnesses in general. It should be noted, however, that these results cannot be considered conclusive regarding the lack of a unique personality pattern in asthmatic children since the tests used may not have been discriminating enough for this purpose. The author's finding needs further experimental scrutiny before the concept of a unique personality pattern for asthmatic children can be completely rejected. Since no information was available on the personality of the children prior to the onset of the sickness, this research could not directly study the possibility of the existence of distinctive personality traits or patterns which might predispose to asthma. Our results may suggest inferences as to possible cause and effect relationships, but this was not the primary goal. 5. The test results indicated that the well siblings differed from healthy children in essentially the same pattern as the asthmatics and cardiacs differed from the normal controls. This finding further supports the aforementioned interpretation of a similarity in personality make-up between the sick children and their well siblings. 6. No sex differences were found in test results of the sick children. 7. While the total sick population displayed a general maladjusted pattern, it was more intense in younger children. This may possibly be explained by the fact that younger children are more limited in their experience of living as sick children. Their relative lack of adaptation may make them more prone to feelings of insecurity and more easily threatened by the environment than older children who have generally been ill longer. These findings clearly suggest that children who suffer from a chronic physical illness display an emotional pattern that deviates from the normal. Such factors should be considered in the psychological appraisal and treatment of these children.

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