The GSR component of the orienting response in relation to duration of schizophrenia and phenothiazine level in outpatients compared to normals

Two groups each composed of 24 female undifferentiated schizophrenic outpatients equated for phenothiazine medication were compared with a group of 24 normals on GSRs to a variety of repeated auditory stimuli. The time interval since initial hospitalization for the schizophrenics in one of the two groups averaged 2.6 years, and in the other, 11.8 years. Eight different stimulus series were used, each comprising 6 identical stimuli and a test stimulus. Four series involved pure tones, and 4 series involved words, with the 4 series of tones and the 4 series of words presented in counterbalanced order. The 4 series of tones differed in frequency with 2 of the series at a high intensity level and 2 of the series at a low intensity level. Words were similarly different, except that 'intensity' was manipulated by differences in meaning. The three groups did not differ significantly with respect to basal resistance levels, orienting responses, or habituation. The shorter duration schizophrenics did differ from the other groups in that they showed less non-specific reactivity following a word series composed of emotionally loaded words. In general, the shorter duration schizophrenics appeared less similar to the normal group than the longer duration schizophrenics, whose electrodermal activity closely approximated that of the normals. Schizophrenics with relatively higher drug levels were found significantly less reactive than those with lower levels, irrespective of duration of schizophrenia. The general effect of the drug appeared to be a reduction of electrodermal reactivity toward the normal range. The magnitude of orienting responses varied in relation to the type of stimulus comprising the series. Habituation to repeated stimuli was found consistently. Based on the experimental data, schizophrenic outpatients receiving phenothiazine medication were concluded to be similar to normals in magnitude of electrodermal orientation, in adaption to novel conditions of moderate intensity, and in general background level of electrodermal activity. The disruptions of orienting responses typically reported for hospitalized patients were not typical of similar medicated outpatients. The absence of group differences between schizophrenic outpatients and normals accentuates the value of current community mental health programs which combine drug therapy with outpatient status in the more socially stimulating environment of the real world. The findings also supplement the contention that prolonged hospitalization may contribute to reduced orienting and the development of chronicity. It appears promising that with adequate drug therapy outpatients can increasingly approach normal functioning and thereby avoid the passive, vegetative aspects previously associated with chronic schizophrenia.