Symptomatology

Abstract

A group of British research workers headed by M. Creak (1961) established criteria for diagnosing the schizophrenic syndrome in childhood without, however, wishing thereby to define the nature and the etiology of the syndrome. This syndrome, too — and I am following O’Gorman here — is more a reaction type than an illness in itself. The concept “childhood autism” seemed too narrow, because it described only a part of the syndrome, and the concept “childhood psychosis” seemed too broad, because this also covered depressions and, for example, disturbances following cranial traumas or toxic and infectious conditions. It can be seen from this — and this is also clear from Rutter’s work — that an attempt was made to break away from the sharply delineated Kanner syndrome in favour of a broader interpretation of a particular reaction type. The revised version mentioned by O’Gorman is as follows:

• 1. Gross and sustained impairment of emotional relationships with people; this includes the more usual aloofness and empty clinging (so-called symbiosis), also abnormal behaviour towards other people as persons, such as using them or parts of them impersonally; difficulty in mixing and playing with other children is often outstanding and long lasting.

• 2. Apparent unawareness of the child’s own personal identity to a degree inappropriate to his age; this may be seen in abnormal behaviour towards himself, such as posturing or exploration and scrutiny of parts of his body; repeated selfdirected aggression, sometimes resulting in actual damage, may be another aspect of his lack of integration (see also 5), also the confusion of personal pronouns (see 7).