Table Of ContentCOPYRIGHTED
by
Estelle Witzling Moskowitz
1951
Sponsoring Committee: Professor Dorothy I. Mulgrave,
Professor John Rockwell, Professor Harvey Zorbaugh. Consultait:
Dr. Sidney Levy
VOICE QUALITY IN THE SCHIZOPHRENIC REACTION TYPE
Estelle Moskowitz
Submitted in partial fulfillment of the
requirements for the degree of Doctor of
Philosophy in the School of Education of
New York University i
1951
I d A ‘' j ■ r
March 13, 1951
The student hereby guarantees that no part of the
dissertation or document which he has submitted for pub
lication has been heretofore published and (or) copy
righted in the United States of America, except in the
case of passages quoted from other published sources;
that he is tne sole author and proprietor of said disser
tation or document; that the dissertation or document
contains no matter which, if published, will be libelous
or otherwise injurious, or infringe in any way the copy
right of any other party; and that he will defend, indem
nify and nold harmless New York University against all
suits and proceedings which may be brought and against
all claims which may be made against New York University
by reason of the publication of said dissertation or
document.
Table of Contents
Acknowledgments
Chapters
I The Problem
II Need for the Study
III Related Studies
IV Procedure
V Results
VI Summary, Conclusions, Recommendations
Bibliography
Appendix
I Definition of Terms
II Rating Scale
III Instructions to the Judges
IV Statements from the Minnesota
Multiohasic Personality Inventory
V Pictures from the Thematic Apper
ception Test
VI Judges’ Comparison Sheet
ACKNOWLEDGMENTS
The writer wishes to express her sincere appreciation
for the valuable guidance and counsel of her sponsor, Professor
Dorothy I. Mulgrave; for the constructive criticisms and
suggestions of her advisers, Professor Harvey Zorbaugh and
Professor John Rockwell; and for the kind consideration of
consultants Dr. Sidney Levy and Dr. J. Allison Montague.
Deep appreciation is owed to the Board of Judges,
for the time and interest devoted to listening to the
recordings and rendering judgments: Dr. Leonard Finlan,
of Brooklyn College, Dr. Ruth Manser, of New York Univer
sity, Dr. Dorothy I. Mulgrave, of New York University,
and Dr. Letitia Raubicheck, Director of Speech for the New
York City Board of Education.
The writer wishes to express her thanks to Dr. John
H. Travis, Senior Director, Dr. Nobe Stein, Clinical
Director, and Mr. Joseph Smith, psychologist, of the Man
hattan State Hospital, Ward's Island, New York City, as
well as to Dr. Stephen Jewett, Professor of Psychiatry at
the Flower Fifth Avenue-New York Medical College, who very
kindly placed the facilities of the hospitals at her dis
posal, and who offered every possible support in the pursuit
of the investigation.
Gratitude is owed to Superintendent Morris E. Siegel,
of the Vocational High School Division of the New York
City Board of Education, through whose generosity the
facilities of the evening vocational high schools were
placed at the writer's disposal. Thanks are due to Mr.
William Kraengel, in charge of Veteran's Training for the
Board of Education; to Mr. Rudolph Prager, Teacher-in-
Charge of the Veteran's Training Program at the Machine
and Metal Trades Vocational High School; to Mr. Sidney
Weinman, Teacher-in-Charge of the evening school of the
Central Commercial High School; as well as to Dr. Alex
ander Massell, principal of the Central Commercial High
School.
For his never-failing interest, inspiration, support,
and assistance, deepest gratitude is paid to the writer's
husband: Dr. Harry Moskowitz.
1
CHAPTER I.
THE PROBLEM
The purpose of this investigation was to analyze
the voice quality associated with the mechanism of re
treat from reality in individuals diagnosed as schizo
phrenic reaction type, The analysis of voice quality
was made in order to discover whether or not certain
specific qualities or combination of qualities of voice
would appear with sufficient frequency to warrant a gen
eralization about the voice quality of the schizophrenic
reaction type.
The experimental group was limited to individuals
whose diagnosis of schizophrenic reaction type had been
established clinically by a board of psychiatrists at
each of the cooperating hospitals. By clinical examin
ation is meant the subjection of the individual to phys
ical and mental tests in a hospital ward or clinic. First,
an attempt is made to rule out organic pathology by means
of these tests. The individual then is given a battery
of psychological tests and is brought before the board of
psychiatrists for further study. On the basis of these
2
tests and conferences, the individuals used in the present
study were diagnosed as schizophrenic reaction type. The
diagnosis of schizophrenia was as valid and reliable as
any clinical examination can be made under our present
procedures of diagnosis. Since the diagnosis of schizo
phrenia has never been established to the point where it
can be verified by any laboratory tests, there is no other
way at present of validating the syndrome beyond the clinical
method. The same limitations of the clinical method apply
to the data of the problem under investigation, since we
are dealing with clinical rather than laboratory research.
The study focussed upon the voice quality of the indi
viduals and not upon the language content or the articula
tory pattern of the subjects selected for this study, since
the aim was to isolate the one symptom under consideration.
Analysis of voice quality was made in terms of adjective
description, such as monotonous. shrill. weak, gloomy. (See
appendix)
For the purpose of this study, the following defini
tions were applied:
The schizophrenic reaction type represents those
faulty mental habits which respond to difficulties in the
environment by a flight (or withdrawal) from reality.^
1. Ray Dorcus and G. W. Shaffer, Textbook of Abnormal
Psychology p . 330
5
Four types of schizophrenia have been dietinguished, accord
ing to the presence or absence of definite symptom groups:
simple, hebephrenic, paranoid, and catatonic. Most cases
will be mixed in type.^ The simple schizophrenic reaction
type is marked by indifference or lack of interest. Apathy
or emotional dulling is the chief clinical symptom.'0 The
hebephrenic type accepts his failure, admits defeat and
regresses to a lower level for satisfaction. The paranoid
type is characterized by the symptoms of delusions and hallu
cinations in the foreground of the clinical picture.^ The
catatonic type represents so complete a withdrawal from the
environment that food is refused, the patient becomes mute,
and makes no attempt to change his position.5
Flight from reality implies a substitution of imaginary
satisfaction for satisfaction in reality.
Voice quality is that individuality of tone which distin
guishes one voice from another. Differences in quality result
from differences in the blend of overtones. Although for
more than a hundred years attempts have been made to
classify the various ’’qualities" of voice, no scientific
classification of the differences in quality has been
developed.
1. Op. cit., p. 31&
2. Ibid., p. 312
3. Ibid., p. 521
4. Ibid., p. 52Q
5. E. A. Strecker arid F. G. Ebaugh, Practical Clinical Psychiatry,
p . 407
4
Terms used are those which have grown out of observation
and empirical analysis, such as breathiness, monotonous.
weak voice quality.1
Ambulatory patients are those treated in the out-patient
department of a hospital. They live in their home en
vironment and come to the hospital for treatment, only.
Institutionalized patients are those who have been isolated
from society and are forced to remain within the hospital
gates.
The basic assumption underlying the study to be de
scribed was Influenced by the classification of the schizo
phrenic reaction type made by the American Psychiatric
Association. To assist in the diagnosis and the treat
ment of patients, the American Psychiatric Association
has established characteristic patterns of functioning
of different clinical groups. The schizophrenic reaction
type Is included as a clinical entity, although the nature
of the etiology of the disease is as yet unknown. Although
there are many sub-groups of the schizophrenic reaction
type, the main grouping has been established on the basis
of a common symptom: separation (or flight) from reality.^
Since' voice quality manifests mental, emotional, and phys
ical states of being, undergoing changes from birth to
death, reflecting growth and maturation changes up to
1. Giles W. Gray and Carl M. Wise, The Bases &£ Speech,
pp. 12, 13.
2. Ray Dorcus and G. W. Shaffer, Textbook of Abnormal
P..sygh9logy, p.309.
