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Sex-Role Identity, Self-Concept, And Vocational Interests Of Adolescent Hemophiliacs
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Sex-Role Identity, Self-Concept, And Vocational Interests Of Adolescent Hemophiliacs
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This dissertation has been microfilmed exactly as received Q 8 -1 6 9 4 WEISE, Phillip, 1924- SEX-ROLE IDENTITY, SELF-CONCEPT, AND VOCATIONAL INTERESTS OF ADOLESCENT HEMOPHILIACS. U niversity of Southern California, Ph.D., 1967 Psychology, clinical University Microfilms, Inc., Ann Arbor, Michigan Phillip Weise 1968 ALL RIGHTS RESERVED SEX-ROLE IDENTITY, SELF-CONCEPT, AND VOCATIONAL INTERESTS OF ADOLESCENT HEMOPHILIACS by Phillip W eise A D issertation Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillm ent of the Requirem ents for the D egree DOCTOR OF PHILOSOPHY (Educational Psychology) August 1967 UNIVERSITY O F S O U T H E R N CALIFORNIA THE GRADUATE SC H O O L UNIVERSITY PARK LOS ANGELES, CA LIFO RN IA 9 0 0 0 7 This dissertation, written by Phillip W eise under the direction of h.is....Dissertation Com mittee, and approved by all its members, has been presented to and accepted by the Graduate School, in partial fulfillment of requirements for the degree of D O C T O R OF P H IL O S O P H Y < ? . ............... ^ Dean D ate Septem ber a ...1967......................... DISSERTATION COMMITTEE DEDICATION To m y w ife, Elaine, and my son s, Donn, Howard, and Richard, whose love, encouragement, and thoughtfulness made it all p ossib le. ACKNOWLEDGMENTS I am esp ecially grateful to Dr. Shelby L. D ietrich and her Hemophilia Dem onstration and Rehabilitation Project staff at the Orthopaedic Hospital of Los A ngeles for their professional guidance and cooperation. Appreciation is also extended to Mr. Mike W illiam son for his aid in the preparation and program m ing of data for computer analyses. The study w as supported in part by Grant RD 1367-M from the Vocational Rehabilitation Adm inistration. TABLE OF CONTENTS Page D ED IC A TIO N ................................................................................................. ii ACKNOWLEDGMENTS............................................................................... iii LIST OF TABLES ............................................................ vxi Chapter I. INTRODUCTION AND DEFINITION OF THE PROBLEM ........................................................................... 1 The Issue Statement of the Problem Definitions of T erm s Hemophilia S ex -ro le identity Vocational interest Self-concept Self-acceptance Som atopsychological Physique Intervening variables Self-connection gradient D isability Handicap Hypotheses H ypotheses relating to se x -r o le identity Hypotheses relating to self-concept Lim itations of the Study Importance of the Study Assum ptions Organization of the Study REVIEW OF THE LITERATURE.................................... Studies R elating to Psychological Problem s in Hemophilia Studies Relating to Self-Concept Studies of Som atopsychological Relationships Studies R elating to Sex-R ole Identity Studies R elating to Vocational Interests and P references and Their Relation to Self-C oncept Summary of Chapter RESEARCH METHOD AND RATIONALE FOR HYPOTHESES AND PROCEDURE . ..................... Subjects H ypotheses, Rationale, and C riterion M easures Hypotheses 1 through 7 Hypothesis 8 Hypothesis 9 Hypothesis 10 Hypothesis 11 Hypothesis 11 Hypothesis 12 Hypotheses 13 through 16 Hypothesis 17 Procedure C riterion instrum ents Strong Vocational Interest Blank M -F Occupation Rating Scale Summary of Chapter Chapter Page I IV. FINDINGS 57 [ [ Hypotheses R elating to Sex-R ole Identity j H ypotheses Relating to Self-C oncept j SUMMARY, DISCUSSION, AND CONCLUSIONS . . . 88 j Summary j Purpose of the study Procedure and test instrum ents Statistical procedures Summary of findings D iscussion Relationship between se x -r o le identity and hem ophilia T heoretical im plications Relationship between self-con cep t and hem ophilia Conclusions Two com posite view s of the adolescent hem ophiliac: hypothesized and experim entally derived BIBLIOGRAPHY 102 APPENDIX A - C orrelation M atrices for Concepts and Days of H osp italization ...................... 114 APPENDIX B - Word Meaning T est . . APPENDIX C - Occupation Rating Scale APPENDIX D - Vaughan's S c a le ............. 139 118 130 j LIST OF TABLES Table Page j j X . Comparative Data for H em ophiliacs and N 0 1 1- j H em ophiliacs, Including Intelligence Quotient, j Vaughan's Socioeconom ic Index, and ' Chronological A g e ............................................................... 44 ■ 2. "D” Score Com parisons of H em ophiliacs and Non- | H em ophiliacs on the Evaluative Factor I (H ypotheses 1 to 4 and 8 to 1 0 ) ...................................... 59 i 3. "D” Score Com parisons of H em ophiliacs and Non- H em ophiliacs on the Potency Factor (H ypotheses 1 to 4 and 8 to 1 0 ) ..................................... 60 4. "D" Score Com parisons of H em ophiliacs and Non- H em ophiliacs on the A ctivity (A) F actor (H ypotheses 1 to 4 and 8 to 1 0 ) ..................................... 61 5. "D" Score Com parisons of H em ophiliacs and Non- H em ophiliacs on the Total of A ll F actors (Hypotheses 1 to 4 and 8 to 10) 62 6. Com parison of H em ophiliac "D" S cores As Indexes of Sex-R ole Identification (Hypotheses 5 and 6) . . 65 7. Com parison of Non-H em ophiliac "D" Scores As | Indexes of Sex-R ole Identification (H ypothesis 7) . 67 8. "D” Score Comparison for H em ophiliacs on Concepts "Hemophilia" and "Taking Risks" (Hypothesis 1 1 ) .................................................... ............... 72 9. "D" Score Com parisons of Self-A cceptance Concepts and Sex-R ole Identity Concepts for H em ophiliacs (Hypothesis 1 2 ) ................................. 74 i ! Table 10. 1 1 . 12. 13. 14. 15. 16. 17. Page | "D" Score Com parisons of Self-A cceptance Concepts j and Sex-R ole Identity Concepts for Non- j Hem ophiliacs (Hypothesis 1 2 )........................ 75 "D" Score Comparisons of Hem ophiliacs with Low and High M asculine Interest L evels on ' Selected Concepts (Hypothesis 1 3 ) . . .. ................ 78 Comparison of Occupation Interest L evels of Hem ophiliacs with Low and High M asculine ! Interests (Hypotheses 14 and 1 5 ) 81 | | Comparison of Occupation Interest L ev els of Non- H em ophiliacs with Low and High M asculine Interests (Hypotheses 14 and 1 5 ).................. 82 Comparison of Occupation Interest L evels of Non- Hem ophiliacs with Low and High M asculine Interests (Hypotheses 14 and 1 5 ).................. 83 Occupation Rating Scale Scores for H em ophiliacs and Non-H em ophiliacs (Hypothesis 1 6 )...................... 84 H ospitalization Record During F ir st F ive Y ears of Life for Eighteen H e m o p h ilia c s.................. 87 Summary Tabulation of Findings for A ll Hypotheses . 91 j \ viii CHAPTER I INTRODUCTION AND DEFINITION OF THE PROBLEM The Issue The past decade has seen a sharp in crease of in terest in the development of children's and adolescents' concept of se lf (26, 34, 109). Concurrent with this heightened in terest have been the em erg ence of conflicting opinions as to the significance of many of the research studies conducted in this area (23, 35). But in spite of the i ! j controversy, there s till p ersists a basic belief that research regard- ! i ! ing the self-con cept is of considerable im portance. This is p artic- j ularly felt to be so in the investigations which have attempted to I I | clarify the p rocess of the child's identity formation. Murphy and her colleagu es, in a longitudinal study of children at the Menninger Foundation, found a direct and positive relationship existed between the child's self-con cep t and his form ation of identity (16). Their findings led them to conclude: . . . Through his coping experiences the child d iscovers and m easures him self and develops his own perception of who and what he is and in tim e may becom e. We can say that the child creates his identity through his efforts in com ing to term s with the environment in his own personal way. (16:374) i ' | By the tim e the child has reached the adolescent period of I developm ent, his self-con cept has been form ed through the many coping experiences he has encountered in the past. He has made many im portant identities. It is during this developm ental period that there is a consolidation of identities which form an important part of the adolescent's self-con cep t. Erikson stated that the p rocess of consolidating the important identities for the adolescent resu lts in i the form ation of i I . . . an assured se n se of inner continuity and social sa m e- S n ess which w ill bridge what he was as a child and who he is about to becom e, and w ill reconcile his conception of him self and his community's recognition of him. (55:66) One of the m ost important identities that em erges as the adolescent 1 works through the problem of consolidation is that of his se x -r o le I identity. This identity is related to the degree to which he regards h im self as m asculine or fem inine and is heavily influenced by the degree to which he identifies with his m other and his father (15). An adolescent's concept of him self as a person and his form ation of a se x -r o le identity may influence his perceptions of his goals and the degree of acceptability of any physical handicap he may - .... - ------- ---------—— ...... —---------------- s 3 have (34). Although there Is an increasing volume of research on the se x -r o le identity, formation of self-concept and origin of vocational in terests during the period of adolescent development, there has been relatively little effort to investigate the relationships that may exist between these constructs and physical handicaps. The investigation of such possible relationships properly belongs in the domain of ! som atopsychological research . Wright, in review ing the current trends in som atopsychological research,noted that the broad concern appears to be with the ways in which the person with a disability copes with the social and personal connotations of such a disability (34). To the extent that such research has yielded negative resu lts, she explained: l i | The failure to find basic personality differences between groups of persons with sp ecific d isabilities and nondisabled subjects | undoubtedly has theoretical im plications of such im port that, indeed, these negative resu lts are not negative at all. They I indicate that persons with physical deviations are not a homo- | geneous group psychologically, that physical disability is a surface (phenotypic) classification. They point to the n ecessity of getting below the surface, of leaving the lion-psychological realm of physique and of seeking its underlying psychological significance. The basic situation appears to be that the som atopsycho logical connection between physique and behavior is not direct but is mediated by what have com e to be called intervening variables. (34:377) In spelling out som e of the areas which w ill be given m ajor em phasis by the Behavioral Science Program of the Growth and Development D ivision, National Institute of Child Health and Human Development, I 4 Kallen pointed out the need to know m ore about the relationship between innate sex characteristics, learned se x -r o le identity, and the interactions of body build, biological, and physical abilities and social behavior (71). Statement of the Problem It is the purpose of this study to explore the relationships that may exist between sex -ro le identity, self-concept, and vocational interests in m ale adolescents who have hemophilia. Because of the enforced closeness of the m other-son relationship in this inherited lifelong d isease, it offers an excellent opportunity to study sex -ro le j identity as it relates to parental identification and self-concept. Hypothesized relationships between the intervening variables of se x -r o le identity, self-concept, and vocational interests in I adolescent hemophiliacs are explored in this study. T hese sam e j j variables are also explored in a group of non-hemophiliacs and a comparison is made of the sim ilarities and differences between the groups. It is proposed that through the stated intervening variables the connection between disability (physique) and behavior is mediated. Definitions of T erm s — 5 Hemophilia In this study this term refers to a m edically diagnosed illn ess alm ost exclu sively of m ales and m anifested prim arily by bleeding into the soft tissu e s and joints. The bleeding tendency is a result of defects in clotting brought about by a deficiency of anti" hem ophiliac globulin (factor VIII) or by deficiency of plasm a throm boplastin (factor IX). The defects are of genetic origin and are passed from carrier m other to recipient son. Two sim ila r hem or rhagic d isea ses are inherited in this sex-link ed r e c e ssiv e pattern: Hemophilia A (cla ssic a l hem ophilia with deficiency in factor VIII) and i I J Hemophilia B (C hristm as D isea se with deficiency in factor IX). Because of the marked sim ila rity in the clin ical aspects of these two | d isea ses, in this study the term "hem ophilia’1 refers to both A and B i | types (19). | The incidence of hem ophilia is quite rare, as it is estim ated to be one in 10, 000 of the m ale population. There are approxim ately four c a ses of Hemophilia A to every one ca se of Hemophilia B (8). S ex-role identity T his term is used to describe the degree to which an individual regards him self as m asculine or fem inine. For purposes of this study, the adolescent's identification with each parent is presum ed to form the b asic foundation for his se x -r o le identity (11). Operationally, this w ill be the "D" m easurem ent between the concepts "me" and "father," "m other,” " m a le,” and " fem ale,” on the Sem antic D ifferential T est. Vocational interest This term refers to an estim ate of expressed in terests based on resp onses to a large number of questions concerning lik es and d islik e s, or concerning the order or preference for groups of a ctiv ities. Operationally, this w ill be sco res obtained on the Strong Vocational Interest Blank. Self-concept In this study this term refers to the reported way the adolescent p erceives h im self and coincides with R ogers' definition of "self-concept" as . . . an organized configuration or perceptions of the se lf which are adm issible to aw areness. It is com posed of such elem ents as the perceptions of one's ch aracteristics and ab ilities; the percepts and concepts of the se lf in relation to others, and to the environm ent. (22) Operationally, self-con cep t is indicated by the responses to the "me" concept and differences between th ese resp onses and those m ade to selected concepts on the Sem antic D ifferential T est. ] Self-acceptance In this study "self-acceptance" is used to refer to the d is crepancy between the way the adolescent currently perceives him s e lf and the way he would m ost like to be. This discrepancy is a m easure of self-accep tan ce. The sm a ller the discrepancy, the greater the self-acceptance; and conversely, the larger the d iscrep ancy, the le s s e r the self-accep tan ce. Large discrepancy sc o res are considered as an indication that the person has a low estim ate of his personal worth and holds h im self in low esteem (1, 10). Operation ally, this w ill be the "D" m easurem ent between the concepts, "me" ! and "how I would m ost like to b e ." I : I 1 ! I ; i | Som atopsychological | | j | This term , for purposes of this study, is used in the sam e 1 | manner as Barker, Wright, M yerson, and Gonick who perceived it as i | | a relation dealing with . « . those variations in physique that affect the psychological situation of a person by influencing the effectiveness of his body as a tool for actions or by serving as a stim ulus to him se lf or oth ers. (43) The som atopsychological relationship involves conditions that depend upon the interaction between the person and others. i I I | Physique i 1 5 j This term is used to designate all structural ch aracteristics 8 of a person, including biochem ical, anatom ical, and physiological prop erties. Intervening variables T his study used this term in a way which is consistent with ) | the definition of Wright who defined it as ". . . the attitudes, con- i I ditions, and m echanism s which account for the psychological effects i i of physical disabilities" (34). Here it refers to self-accep tan ce, degree of acceptance of disability, self-con cep t, and se x -r o le identity. T h ese are m easu res of attitude and as such connect physique (disability) and behavior. { Self-connection gradient This term as used in this study w as best defined by Wright in the follow ing manner: . . . It is known that attributes of the se lf differ with resp ect ! to how central they are to what m ay be called the " essen ce of ! the s e l f ’ or the " essential m e ." The clo ser or weaker the connection between the attribute in question and the " essential me" d escrib es the self-con n ection gradient. (34) O perationally, this is the "D" m easurem ent between the concept "me" and all other concepts. D isability In this study this term is used to exp ress a condition of physical im pairm ent which has an objective aspect that can be described by a physician. D isability is to be distinguished from the term "handicap." j ! Handicap As distinguished from the term "disability," a "handicap" in ! this study is the cum ulative resu lt of the obstacles which disability i i i i ; | interposes between the individual and his maximum functional le v el j ( 6). H ypotheses The form ation of an appropriate se x -r o le identity is depend ent to a great extent on consistent patterns during the child’s develop m ental period. The pattern of parent-child interaction is perhaps the m ost determ inant of the direction of se x -r o le identity. The m ajor parental identification should be with the lik e-se x ed parent and this j j in turn should be reflected in the individual’s self-con cep t. i It has been noted that hem ophiliacs have a very clo se relationship with their m others during their developm ental period (49, 75). The fact that this sex-lin k ed d isea se is given by ca rrier mother to her son further in tensifies the consistent pattern of m other- | son c lo se n e ss. If the p rotectiven ess of the m other and the trauma of j j | recurrent bleeding episodes in the child cause him to be m ore I dependent and attached to his mothe r , then ide ntification may take ; io ! t place with the opposite-sexed parent. This should in turn be j reflected not only in his se x -r o le identity, but also in his self-con cept i j and his vocational in terests. Such argument leads to the hypotheses j l • J of this study, which are now presented. j j j i H ypotheses relating to I se x -r o le identity j 1. Hemophiliacs have a greater degree of identifica tion with opposite-sexed parent than do non hem ophiliacs . 2. Hemophiliacs have a greater degree of identifica tion with fem ales than do non-hem ophiliacs. 3. N on-hem ophiliacs have a greater degree of identifi cation with lik e-sex ed parent than do hem ophiliacs. 4 . N on-hem ophiliacs have a greater degree of identifi cation with m ales than do hem ophiliacs. 5. Hemophiliacs have a greater degree of identifica tion with opposite-sexed parent than they do with the lik e-sex ed parent. 6. Hemophiliacs have a greater degree of identifica tion with fem ales than with m ales. 7. Non-hem ophiliacs have a greater degree of identifi cation with both m ales and lik e-sexed parent than with fem ales and op posite-sexed parent. Hypotheses relating to self-con cept 8. H em ophiliacs have a low er self-con cep t and le ss self-accep tan ce than do non-hem ophiliacs. 9. Hem ophiliacs are m ore accepting of hemophilia as a m edical condition than are non-hem ophiliacs. 10. Hem ophiliacs are m ore accepting of the concept of taking risk s than are non-hem ophiliacs. 11. Hem ophiliacs who have the greatest acceptance of risk-taking behavior are le a st accepting of their m edical condition. 12. There is a positive relationship between se lf- acceptance and identity with lik e-sex ed parent and with m ales for both hem ophiliacs and non hem ophiliacs . 13. Hem ophiliacs with high m asculine in terests differ from those with low m asculine in terests in these ways: a. They identify m ore c lo se ly with the lik e-sex ed parent. b. They have greater acceptance of their bodies. c. They are more accepting of taking risk s. I i d. They are more accepting of hemophilia. j I 14. Hemophiliacs and non-hemophiliacs who have high j I i masculine interests have greater interests in * occupations rated as m asculine than do those individuals who have low m asculine interests. j 15. Hemophiliacs and non-hemophiliacs who have low m asculine interests have greater interests in | occupations rated as feminine than do those indi viduals who have high m asculine interests. 16. Hemophiliacs and non-hemophiliacs differ in their i rating of occupations as either m asculine or feminine. 17. Hemophiliacs who have spent the greatest number of days in the hospital between birth and five years of age, identify more closely with the opposite- sexed parent. Limitations of the Study i 1 Hemophilia is an inherited disease of the blood which affects j only about one out of 10,000 boys. This low rate of incidence makes j I ! it extrem ely difficult to obtain a sizeable sam ple for psychological j testing. For this study, only thirty-nine adolescent hemophiliacs w ere available and able to participate. Although this is a sm all i number of subjects, it nevertheless represents the largest reported group of hemophiliacs of this age.to be included in one study. The j S I helpful assistan ce of the Hemophilia Project staff of the Los Angeles I ! ! | Orthopaedic Hospital made it possible to contact the thirty-nine boys j I and their fam ilies and enlist their cooperation. | The lim ited literature on the psychosocial problems j t I associated with hemophilia is in general agreement as to the m other's tendency to be overprotective of her hemophilic son. It was not possible, however, in this study to objectively a sse ss the degree to which the mothers exercised an overprotective attitude during their son's early development. Importance of the Study I This investigation is considered to be of importance for following three reasons: 1. No carefully designed, objective study has been made of the psychological aspects of this disease. This w ill be the first study of the problem with the use of objective test instrum ents. Current litera- I i | ture on this topic contains only studies of a i the descriptive nature based on either interview or | questionnaire resp o n ses. j i 2. In a recent presentation of the problem s encountered ! j in educating the hem ophilic child Connor em phasized j j for the physicians in attendance at the National i Hemophilia Institute, the need for b asic research in j | two of the areas treated in this study, namely: i ' j j a. The attitudes of the hem ophiliac him self S toward hem ophilia and its physical and so cia l ram ification s. b. The self-con cep t of hem ophilic children. (2) 3. Findings of this study may lend new understanding to the som atopsychological aspects of this d isea se, which in turn may be helpful information for physicians and educators to use in their efforts to help the i j hem ophilic child. j ; i Assum ptions This study assu m es that self-con cep t, se x -r o le identity, self-accep tan ce, and vocational in terests can be accurately m easured by the u se of the criterion instrum ents. It is also assum ed that the j J hem ophiliacs in this study are representative of the general popula- j i l . I j tion of adolescent hem ophiliacs. ! 15 It is assum ed that the concept of masculinity'■femininity represents a continuum rather than two d iscrete points and that m asculinity and fem ininity of in terests is adequately m easured on the F-M sc a le of the Strong Vocational Interest Blank. | Organization of the Study i Chapter II presents a review of resea rch in the following five i areas which rela te to this study: (1) psychological problem s in hem ophilia, (2) self-con cep t theory of personality, (3) som atopsy- chological relationships, (4) s e x -r o le identity, and (5) vocational in terests and p referen ces and their relation to self-con cept. Chapter III explains the research method and procedure, with a full d iscu ssion of the test instrum ents and the rationale for their u se. i The resu lts and findings of the study are presented in i I ! Chapter IV. Incidental findings not d irectly related to this study are also included in this section. Chapter V is the concluding chapter and contains the sum m ary and conclusions of the study as w ell as a full d iscu ssion of the findings. CHAPTER II REVIEW OF THE LITERATURE Because of the vast quantity of research literature to be I found in related areas, care was taken to select for review the most relevant research reports. T hese selections come from the areas of : (1) psychological problems in hemophilia, (2) self-concept theory of personality, (3) som atopsychological relationships, (4) sex -ro le identity, and (5) vocational interests and preferences and their rela tion to self-concept. Studies Relating to Psychological Problems in Hemophilia Research literature is replete with reports of hematological studies and various m edical treatment methods of the hemophiliac. | Only a few, however, have attempted to report on system atic studies of the psychological factors that may be involved with this disease. These few studies which have dealt with the topic consist mainly of clinical im pressions gained through psychiatric interviews with the hemophiliac and his parents. To date the professional literature contains no carefully designed, objective study of the psychological I | asp ects of hem ophilia, therefore, only clin ica l and descriptive | studies are review ed here. j i Poinsard was the first to report the resu lts of clinical j research regarding psychological problem s of the hem ophiliac (18). ! Tw enty-five c a se s, ranging in age from 2 to 38 y ears, w ere selected j i ■ i j at the Jefferson M edical C ollege H ospital for study. Although the ; I author reported that figure drawings, the Rorschach test, and a sentence com pletion test w ere used in conjunction with the resu lts of psychiatric in terview s, the report of the findings did not indicate the sp ecific resu lts of these te sts. Instead, the report appears to reflect j j I only the im pressions gained from the in terview s. The wide difference in ages made it difficult to pin-point the uniqueness of any psychologi ca l factors to be found at any one developm ental stage. Within the i ! lim itations of the research design and method of reporting, this i I investigator arrived at the following con clusions: 1. Together with tension and anxiety, the prevailing em otional tone of the hem ophiliacs was one of either p assive dependency, or h ostility and aggression . j 2. Blame and rebellion w ere the m ost common a tti- j i i tudes toward the lim itations im posed on them by S j their d isease. Another defen se, denial, occurred j 18 | | le s s frequently, but was considered to be a m ore su ccessfu l d efen se. H em ophiliacs who accepted their illn ess as a challenge and responded in an j i i a g g ressiv e m anner m ade a better so cia l adjust- j i ment than those who responded in a p assive dependent way. j j ■ i 3. Half of the subjects studied who w ere over 11 years of age, w ere considered to be psychosexually im m ature, lacked sexual identification, and m ani fested signs of castration fea r. F ive of these ca ses experienced latent hom osexual im pu lses. i 4. Some evidence w as noted that em otional str e ss may precipitate bleeding episodes. E a rlier, A gle, in a study of the effects of em otions on ! | bleeding exacerbations in hem ophilia, concluded that there w as a I tendency for his patients to exp ress em otional problem s in a physical form either through h ysterical m echanism s or through psycho- physiological pathways (36). j I Several other investigators have ra ised the p ossib ility that j som e apparently spontaneous bleeding episodes may be related to ; i som e preceding em otional s tr e s s (38, 49, 75). I i In a later study regarding what effects psychological factors j 19 I I i i m ay have upon the course of the illn e ss, A gle again reported finding ; i i spontaneous bleeding at tim es of em otional s tr e s s (37). He conducted! this study with sixteen adult hem ophiliacs through the use of a number! i | j of psychiatric in terview s. Agle found that the psychiatric disorders j i I seen in hem ophiliacs can be as varied as there are psychiatric diag- ! I nostic en tities. However, he delineated three disorders which he ! I ' i | found to directly influence the course of the illn e ss. T hese w ere I i described as recurrent risk-taking behavior, psychophysiological resp o n ses, and passive-dependent sta tes. To account for the bleeding which follow ed apparent em o tional str e s s he hypothesized the existence of a psychophysiological m echanism , as yet undiscovered, which m ay be superim posed on the organic deficit of hem ophilia. For purposes of this study, A gle's findings of greatest relevancy w ere these: i The intense m other-child relationship often appears to force the father into the role of an uninterested outsider. Furtherm ore, the hem ophiliac has thrust upon him the im age of being different, im perfect, and stigm atized. The child often appears to fear the consequences of h is own aggressive | activity since it m ay produce the bleeding and pain. This fear is an ally to those m others who encourage the child toward a p a ssiv e, som etim es fem inine way of life. E xtrem es of over protection and fear of activity may force the hem ophiliac child to acquiesce to his m other's demands and lead a fearful, p a ssiv e life, or he may reb el. This rebellion and risk-taking represent a denial of the illn e ss . . . rather than just denial; however, there appears to be ! an actual se e king out of the m ost fe ared activity. (37:79) 20 The risk-taking behavior of hem ophiliacs was also reco g nized and commented upon in the French literature by Alby, Alby, and Caen (38). They described such behavior in the adolescent hem o philiac as "daredevil reactions" and suggested that over protection by I | the mother w as the m ost im portant factor in its production. In the i | d iscu ssion of their clinical im pressions of the psychological prob- i lem s they encountered in this d isea se they str e sse d the thought that marked m aternal overprotection m ay be the resu lt of the m other’s attempt to deal with her guilt for the genetic responsibility. Investigating the psychological aspects of both the hem o philiac and his fam ily, Browne, et a l. , studied twenty-eight I hem ophiliac children and their fam ilies (49). The children ranged in age from 1 to 16 years and w ere described as having com e from fam ilies of low er-m iddle c la ss, although no evidence to substantiate I this statem ent w as reported. | Again, as in the previous reported studies, the method of investigation con sisted o f psychiatric interview s or observations of play se ssio n s. Twenty-one of them w ere given R orschachs, however, and the authors reported that the resu lts of tests indicate that the child's m ajor psychological problem was his conflict about activity. T hese te sts a lso revealed an overall constriction of the child's fantasy life and his affective resp on siven ess. A nalysis of the 21 interview s and records regarding the frequency of bleeding episodes over a six-m onth period for each patient led these psychiatrists to conclude that em otional factors can contribute to the tim ing of spon taneous bleeding ep isod es. The sp e c ific psychic conflict they found i | was that between the child's d esire to be active and aggressive and i I i j the inhibition of this w ish. P assivity w as encouraged in the child by ! ] the m other's overprotective attitude toward him. They concur with | Alby in their findings that the m other, out of the guilt sh e feels as I I the ca rrier of the d isea se, behaves as if she m ust take on the full responsibility for the care and m anagement of the child (38). This leads to further com plications sin ce the sym biotic relationship of the mother and child estranges them from the father, who often reacts with resentm ent toward and criticism of the m other. Even though he is d is tant, the father's attitudes about activity and m asculinity are felt by the child and cause conflict and confusion about identity. (49:739) M attes on and G ross have reported the resu lts of the m ost recent longitudinal study of hem ophiliac children and their fa m ilies. This study included thirty-five children and twenty-two fam ilies (75). Once again the psychiatric interview w as the research vehicle em ployed. The children and their fam ilies w ere reported to com e | from the "middle econom ic c la ss” and w ere followed for a tw o-year I , | period at the U niversity Hospital of the W estern R eserve U niversity j [ School of M edicine. The children receiv ed their total m edical care at I 22 | t f that hospital during the course of the study. The analysis of their interview s and observations was i carried out within a framework that included attention to cognitive functions, m otor activity, em otional expression, and psychic ! j | d efen ses. Their findings are significantly different in two resp ects i i from the other previous psychiatric studies. F irst, they report that j i ' I i j the m ajority of the children, ages 2 to 18, showed a good adaptation i to hem ophilia. Only three of their patients acquiesced to the m other’s over protectiveness and as a resu lt led restricted , inactive liv e s. Furtherm ore, only five of their ca ses showed rebellion against parental anxiety and displayed recurrent risk-taking behavior. Secondly, they report that the m ajority of the m others played an essen tia l role in promoting a healthy personality and did not respond in an overprotective m anner. Of the eight m others who w ere o ver- j | jprotective, five of them had w itnessed ea rlier fatal outcom es of ! ; ! j i hem ophilia in their siblings or their own children. Like other resea rch ers, they found hem ophiliacs went through periods of spontaneous bleeding, but reported this occurs i m ostly before the age of 12. After this age, they found the hem ophiliac! to show m arked improvement in both em otional and physical health. | The resu lts of this study are difficult to a s s e s s because of i p ossib le contaminating variables that w ere operant during the study. i 23 The authors conducted psychotherapy with som e of the patients during the course of the study, and in addition they offered supportive counseling and advice to the m others. T hese factors r a ise the question as to the objectivity of the clin ical im p ression s and also | leave unanswered the favorable influence they may have had on both j the m other-son relationship and the course of the illn e ss itse lf. | Several w riters have focused on the psychosocial and voca- j tional problem s of the hem ophiliac and their conclusions sim ila rly em phasize the im portance early parent-child relationships and the developm ent of self-con cept. In a review of the m ed ica l-so cia l asp ects of this d isea se, F auvre-G illy noted that early childhood is a period of extrem e anxiety for both the m other and the young hem ophiliac (56). The m other has not yet learned how to have her son avoid the types of activity which | m ay induce hem orrhage. As a resu lt, at this developm ental period, jmany m others w ill isolate the child and frequently w ill iso la te them se lv es from other m others because they feel they have little in com m on with them . School years present another traum atic em otional period to the child because of feelings of inadequacy that a r ise as a resu lt of the hem ophiliac's frequent absences from the classroom and from his p e e r s. 24 Katz and Husek surveyed a total of 1,055 m ale hem ophiliacs in the United States by m eans of a 99-item questionnaire (108). The questionnaire was designed to e lic it inform ation on personal and ! ! so cia l ch a ra cteristics, attitudes, em ploym ent inform ation, etc. The | respondents ranged in age from 16 to 81 and constituted 70 per cent of j all persons to whom questionnaires w ere sent. T w enty-five per cent i I j of the respondents w ere in the 16 to 19-year age range. From those jwho w ere 25 years old or older they extracted a " su ccessfu l” group defined as em ployed full tim e and an "unsuccessful” group defined as having been unemployed for a period of seven months or longer. They found that over half of the "unsuccessful" group did not com plete high school; they engaged in low er paying jobs when they did work and the m ajority w ere sin gle and still lived with their parents. Although the sev erity of their d isea se w as a factor, it did not account |for the great difference between the groups. In Katz and Husek's study, the following conclusions are of particular im portance to this study: Our study supports the findings of other investigators that Parental overprotection or restrictin g the hem ophiliac child from participation in norm al physical activities can have detrim ental effects on his psychosocial developm ent. R isk-taking behavior is fairly common among hem ophil- ia cs and does not n ecessa rily resu lt in hem orrhaging. (108:108). : 25 The importance of understanding significant dim ensions of i the hem ophiliac’s self-con cep t in order to carry on a program of ! effective vocational counseling was pointed out by Taylor (95). j Hurt outlined the im portance of the father's ro le in the | ! i s psychosocial development of the hem ophiliac child (65). He reported ; that if both parents are w arm , p ositive, and reassuring, then the I s | child w ill "develop a satisfactory m asculine identification" (65:1282). j Studies Relating to Self-Concept Som e of the confusion in the literature pertaining to se lf- concept theories has been thoroughly review ed by W ylie (35). She is critical of som e of the theorists for their lack of consistency in presenting testable hypotheses and equally critical of som e of the experim enters for their inability to draw up meaningful research J I designs. Her main plea is for self-con cep t research to be designed j ! uniform ly after the stim u lu s-resp on se (S-R) m odel. In this resp ect W ylie believes the Osgood model of the sem antic differential technique holds real prom ise (17). T h eorists who have devoted much of their energies to ! development of self-con cept in the research literature include M aslow j (14), Lecky (13), Rogers (24), and Combs and Snygg (1). Because of j i the major role these men have accorded to conscious perceptions, j j cognitions, and feelin gs, their approach has been labeled as "pheno- I | i m en ological." | i The central core of self-con cep t theory is the belief that all asp ects of an individual's behavior are determ ined by the concept he has of h im self and his abilities (1). Rogers b elieves the concept of ! i | s e lf to be relatively stable and that changes which occur do so gradu- i ally and in a non-threatening environment (22). j } E m pirical studies in this field have been m ainly of two types: one of the conscious or phenomenal se lf which has been characterized by objective inventories of self-report nature; and, secondly, those of the unconscious or non-phenomenal s e lf in which the u se of projective techniques have been the main source for gather ing information. Studies em ploying the use of projective tests have frequently introduced problem s of rater reliab ility as w ell as con- » | struct validity. Several of th ese studies seem to offer prom ise. For i | exam ple, in the study by M ussen and Jones, resp onses to the Them atic Apperception T est w ere used to investigate the differences in self-con cep ts between a group of early maturing boys and a group of late m aturing boys (81). T h ese investigators interpreted negative statem ents made about the hero on the various TAT cards as r e fle c tive of negative self-con cep t. The resu lts showed the late maturing boys to have m ore negative self-con cep ts than the early maturing boys. D iller and Riklan, in a study of Parkinson’s D isea se, used the { "M" resp on se on the Rorschach test as an indicator of self-con cep t i i (53). They found the number of "M" resp onses to correlate p o si tively with negative s e lf statem ents. Parker, in a recent study of the ; relationship of self-rep o rt to inferred self-con cep t with a group of s { - - : | thirty sixth graders, made u se of both a self-rep o rt test instrum ent j ; 1 j i | as w ell as a projective test which he called a Picture Story T est (84). j J i i I He found that the self-rep o rt and the inferred self-con cept rem ained relatively consistent under varying conditions of social expectation. However, m ost important was the finding that in this research the self-rep o rt and the self-con cep t w ere found to be substantially different and that the inferred self-con cep t provided m ore re a listic insight into the child's perceptions. As W ylie has pointed out, the greatest number of studies of j the self-con cep t in the literature are of the phenomenal se lf type (35). ! These involve various self-rep o rt techniques which vary from the "Q" Sorts (30) to the S elf-A ctivity Inventory (104), to the m ore recently employed sem antic differential (17). In studies of the self-accep tan ce aspect of the self-con cep t Sheerer (90), Berger (44), Fey (57), and Turner and Vanderlippe (96) all found that there was a positive j relationship between s e lf ^acceptance and acceptance of others. Wright, in offering a clinical dem onstration of the im portance of s e lf- 28 acceptance, stated ”. . . that acceptance of one's disability is a i j prerequisite not only for group identification with other persons who i have d isab ilities but a lso with other persons who are not regarded as disabled” (34:43). Self-acceptance has a lso been term ed congruence between I ; ! real s e lf and ideal se lf and has been the focal point for many investi" j j gators who have used this m easure as an indication of im provem ent I in se lf-e ste e m as a resu lt of psychotherapy (24, 74, 86). Laxer m ore recently has used the sem antic differential to investigate the con gruence of the real and ideal s e lf of th irty-seven neurotic d ep ressive, th irty-seven paranoid, and six ty -sev en other hospitalized paitents of various psychiatric classification s (72). He found of the various j diagnostic groupings only the d ep ressives m oved from a very low to a j i relatively high Real Self rating. On the Ideal Self none of the groups j showed any significant rating change during hospital stay. T his j I investigator suggested 1 . . . that the u se of discrepancy m easure R eal-Ideal Self (D sco re) has no advantage over the Real S elf as a sin gle m ea su re, sin ce in none of the five diagnostic groups m easured w as there any significant change in Ideal Self. T his seem s to be in line with R ogers (1954) study; and it su ggests that it m ight be preferable to use the R eal Self alone and avoid som e of the criticism s by Cronbach of "Dyadic” indexes (1958). (72:217) Jourard w rote that either the congruence or the discrepancy j sc o res between the concept "me" and the^concept "how I would m ost j lik e to be" can be used operationally as a m easure of self-accep tan ce i (10). Suinn, defining self-accep tan ce in Jourard's term s, studied j i the perceptions of eighty-tw o m ale high school sen iors through the use of the "Q" Sort technique (93). He found a significant correlation between self-accep tan ce and acceptance of father as w ell as accept ance of m ale teach ers. The body-im age aspect of the self-con cep t and its m easu re- i | ment by objective m eans is pertinent to the present study. Jourard ! and his colleagues have made the m ajor contribution to the literature in this area. They used "self-cathexis" and "body-cathexis" question naires in their various studies (68 , 69 , 70). They defined the term body-cathexis as the degree of satisfaction that an individual reported about h im self. Jourard and Rem y, in a study with college students, found significant correlations between the students' self-ca th ex is and i ' body-cathexis sco res and the students’ perceptions of how their ! {m others and fathers cathected their own se lv e s and bodies (69). In a com parative study of Italian and A m erican boys, M ussen and Bouterline-Young found that body build w as much m ore important as a s e x -r o le identity attribute for Am erican boys than it was for | t Italian boys (80). They a lso found that the early maturing Italian boys j have low er self-co n cep ts but fe e l warm and affectionate toward their i parents, w hile early maturing Am erican boys a re m ost self-confident 30 and le ss rebellious toward their parents. i Goldfarb, in a study of the identity problems in transvestites j i along with other test instrum ents, used a form of the semantic differ- i ential (105)= One of his major findings was that transvestites did not j i ; I j identify as closely with their fathers as did normal m ales when the j i ■ j ! j concept "my body" was used as one of the identification m easures. ! ! ' - ! i The transvestites did identify significantly with the concept "my j | ' | m other's body." He also found that the normal m ales and the trans- j vestites differed at the . 05 level of significance on the self-concept m easure, "the kind of person I am ." It is interesting to note that he did not find a difference in parental identifications between the normal m ales and normal fem ales when the self-concept was used as the stim ulus. I This study employs a form of Dr. Goldfarb's Semantic - | | Differential T est instrument (Appendix B). i Studies of Somatopsychological Relationships Barker, et a l. , referred to the somatopsychological relation as a relation that deals with "those variations in physique that affect i the psychological situation of a person by influencing the effectiveness I | j of his body as a tool for actions or by serving as a stimulus to him self j | or others" (43:1). The som atopsychological relationship involves social-psychological factors and points to the im portance of the fact that the way an individual feels and behaves about many things j depends to a great extent upon that individual's relationship to other I individuals. ! The belief that there is a relationship between physical ! attributes and personality has a long history. Phrenology and ; Lom broso's theory of the crim inal physical type are som e of the ea rlier attempts to link physique and personality. The system atic i ! I j work of Sheldon has been the m ost prominent modern approach to this t i | problem (27, 28, 29). He proposed three types of body build, j endomorphy, m esom orphy, and ectom orphy. He rated these body I j types along the dim ensions of a seven point sc a le with reference to j five areas of the body (27). Next, he developed a system of rating j i tem peram ent that could be correlated with the som atotypes that he proposed (28). T hese efforts resulted in a lis t of sixty traits which related to three components of tem peram ent. Each trait was then ranked on a rating sc a le of one to seven. Although Sheldon's findings showed high correlations between his somatotyping and tem peram ent, scholars who had not been associated with Sheldon’s experim ental efforts have not been able to find the relationships that Sheldon reported. 32 In evaluating Sheldon’s contributions, Hall and Lindsey have concluded: . . . an overall appraisal of the many studies conducted sin ce Sheldon began his work w ill lead the reader to accept existence of a significant and interesting relation between physique and personality, but w ill leave him unconvinced that the relation is so c lo se as Sheldon seem s to im ply. (5:374) In a review of the findings of research in som atopsychology, I W right commented on the inconsistency of som atopsychological studies (34). She feels that such findings should alert future in vesti- I gators against over generalization and that it should also . . . force seriou s attention to one of the m ost important and lea st accepted principles in som atopsychology, nam ely that som atic abnormality as a physical fact is not linked in a direct j or sim ple way to psychological behavior. . . . P ossible j underlying psychological factors which might account for the j differences in behavior, m ust becom e the m ain focus of in vesti gation. (34:373) I Barker, et al. (43), and Wright (34) listed a total of thirty- j I one conditions and m echanism s that they call intervening variables, j which have been proposed by various resea rch ers in the field of som atopsychology, to account for the psychological effects of physical disability. F or purposes of this study, the following variables w ere taken from these two lis ts to be used in the sem antic differential: self-accep tan ce, se x -r o le identity, body-im age, and self-con cep t. i | Poinsard surveyed the literature dealing with the relation- I ! ships between emotional states and bleeding in hem ophiliacs, and I 33 I concluded that the m ediating m echanism m ay be biophysiological i ] i rather than som atopsychological. He stated: I ; . . . changing em otional states and changing fantasies con- ■ cerning str e s s and threats may have profound effects on the | bleeding pattern, although not on the underlying genetic | hem ophilic state. One important and m ediating m echanism probably is the excretion of ACTH in resp onse to anxiety- | arousing situations, but other biophysiological m ediating | m echanism s, such as changes in epinephrine and non- I epinephrine le v e ls, or changes in serotinin le v els, may a lso | be involved. (18:52) ! j Studies R elating to Sex-R ole Identity i ■ ■ ■ ■ ■ ■ - - ■ 5 j The fact that children w ill m ake an appropriate se x -r o le identity was in itially postulated by Freud as a significant outcom e of | the socialization p rocess: ”A little boy w ill exhibit a sp ecial in terest j 1 • ! • | in father; he would like to grow like him and be like him . . . he j ) i i s | takes his father as id e a l.” (3:88) j i ! I 1 : Studies regarding the antecedent conditions of se x -r o le identity suggest that parental warmth (25, 79) and aw areness (51) I contribute toward the developm ent of a positive parent-child identifi cation. Kagan suggested that the degree to which a child w ill adopt se x -r o le standards influences the continuity of his behavior through adulthood, a lso influences his patterns of sexual behavior as an adult I j and his academ ic perform ance as a youth (11). He referred to sexual j J identity as a degree to which an individual regards h im self as j j m asculine or fem inine and believes that the m ajor determ inants of j ! se x -r o le identity for the young child include: \ \ j a. Perceptions of sim ilarity to parents and j I b. D egree to which the child adopts the gam es and m asters ! ! the sk ills that are traditionally encouraged for his sex . j | The child who p erceiv es m ajor elem ents of sim ilarity f i to the parent of the sam e se x w ill initially regard him - I | s e lf as m asculine (or fem inine) for the parents are the original prototypes of m asculinity and fem ininity for the i young child. (11:145) i i Kagan’s b elief regarding se x -r o le identification in children | ■ ; w as confirm ed in a study by E pstein and Liverant in an experim ent designed to se e what effect verbal conditioning would have on se x -r o le identification (54). The IT Scale for Children, originated by Brown j w as used as the m easure of se x -r o le identification with a sam ple j I ' | | group of 135 boys ranging in age from 5 to 7 (48). The conditioning i i procedure involved the presentation of seven ty-five questions each, j of which could only be answ ered by the resp onses "father, ” "m other, " ! j . j I "brother, " or " sister. " Depending on the appropriate condition, j either "mother" or "father" w as rewarded by verbal approval--both by using a m ale experim enter and a fem ale experim enter. They found that the boys with high m asculine identification w ere m ore effectively reinforced by the m ale experim enter than by the fem ale I experim enter. They explained the poorer conditionability of the low j i j m asculine identifiers in term s of the greater am bivalence and conflict ! experienced by boys with an inappropriate se x -r o le identification. ■ | Brown found a greater tendency among boys to se le c t the j ! 1 j cards from the IT Scale that depicted m asculine activities and m ascu-i I I I line objects (48). He did not find the sam e consistency with g ir ls. j ■ i i • ! j One of the m ost prom ising and frequently used methods for j i i ! m easuring se x -r o le identity has been the sem antic differential. This j I ' ' ! instrum ent is thoroughly described in Osgood’s book, The M easure- ! | m ent of M eaning (17). Included in the rationale for the use of this i method has been the fact that it com bines som e of the positive fea- I i tures of the self-rep o rt inventory, as w ell as the positive features of i T ' | the projective techniques. Its flexibility has m ade it an instrum ent i i i | applicable for the m easurem ent of a wide variety of psychological i | problem s. Lazowick used it to m easure sexual identification in a group of norm al and neurotic m ale and fem ale college students (73). He found that low -anxiety students, both m ale and fem ale tend to i identify m ore with both parents than do neurotic students. It w as also i i ! found that low -anxiety m ale students identified m ore clo sely with i j their fathers than did high-anxiety m ale students. T hese findings i j give partial support to M ow rer’s contention that neurotic individuals | j show a confused and divided identification, w hile normal individuals i * i jtend to identify with parents of the sam e sex (15). i J j F itzgerald and Roberts (58) used a sem antic differential and j | the Games and A ctivities Inventory (89) as indicators of se x -r o le I j ! identification, with a group of 225 boys and g irls in grades one j 1 I j 1 through five,, T heir results indicated that psychosexual in terest, as ! ■ ! i i I | m easured by the Games and A ctivities Inventory and profile con- | | gruence on the sem antic d ifferential, w ere unrelated as indicators of j | se x -r o le identification. They a lso found that girls identify m ore with j • | their own m others than with the stereotype of fem ininity (which was I i the concept "my friend's m other"), while boys identified with their . j own father-figure rather than the stereotype of m ascu lin ity--only up j ! ! j to the fifth grade. At the fifth grade level, boys seem to identify | m ore with the stereotype of m asculinity. The authors conclude that | their findings suggest evidence fo r the validity of the sem antic differ- | ential as a m easure of se x -r o le identity. j | i Biller and Borstelmann studied the relation between se x -ro le i | ! developm ent and intelligence am ong retarded children ranging in age i i 7 to 15, using figure drawing as m eans for defining sexual preference j I (46). They found that boys and g ir ls in the educable retarded range j w ere m ore lik ely to draw a sam e se x figure and had m ore appropriate s e x -r o le preference scores than did those in the trainable retarded range. ' Recent studies agree that boys of the m iddle cla ss culture ! j a re generally com m itted to m asculine s e x -r o le identity and that boys j who have achieved such identity a re more su ccessfu l in their academic! i 37 | j perform ance than those who have not achieved it (39, 62, 77, 101). | j ) i j Studies Relating to Vocational Interests | and P references and T heir Relation | to Self-C oncept j During the past decade there has been an increased em phasis| : ( I ' j | on the relationship between vocational development and vocational j I interests as it relates to self-con cept theory. A chief proponent of i i j the self-con cept theory of vocational development is Super (94). He i maintained that in selectin g a vocation a person is exp ressin g in j occupational term s the kind of person he is and that he is attempting to im plem ent the concept he has of him self. Super considers the j adolescent period as the point of em ergence of a self-con cep t (31). He agrees with Rogers to the extent that the adolescent’s self-con cep t j develops from all of his total life experiences and that a large part of j ! ! ! this com es from his perception of significant people in his environ- I I i ! | ! ment (22). j O'Hara and Tiedeman a lso viewed the choosing of an occu pation as a developing of a vocational identity, and consider the se lf- ! concept as the central concern of such identity (83). j Several proponents of the self-con cep t theory in vocational ! j psychology have proposed that parents have an important influence on j i ! I i I their child's vocational in terest and vocational choice (4, 20, 33). j 38 | | j | The bulk of the research in this area has concerned itse lf with the j I j j relationship of parental attitudes or parental identification to the j | . 1 ! vocational in terests or the vocational occupational choice. The j i \ | resu lts of this research have been conflicting. Some investigators i ; i E i i using objective m easures have found little to support the hypothesized j i i | relationship between vocational choice or vocational in terest and j j | parental identification (50, 61, 99), w hile others have found positive ! ! i i | relationships between parental identification and vocational in terest ! j | with the u se also of objective tests (20, 41, 52, 92, 97). Much of the discrepancy in the findings of th ese studies is due to the research methodology and lack of sp ecificity in term inology i i and concepts em ployed. In spite of their points of disagreem ent, there seem s to be consensus in the studies that the m ale subjects all show stronger identification with their fath ers. Only the study by Stewart is in disagreem ent in this resp ect (92). He found that mother-: | son identification, which w as the basis of his investigation, had a d irect influence on vocational in terest patterns of boys. He found boys with rejecting in terest patterns in m asculine areas tended to accept their m others' perceptions of them as their own perception j j m ore fully than did boys who rejected fem inine a rea s. i ! j ! j ; It is in teresting to note that the studies that used the sem antic, | I | differential as a testin g instrum ent tended to confirm the relationship j between parental identification and vocational in terest patterns (41, j ! ] 52). Two notable studies by Nachmann (82) and Galinsky (59), which i i ; I w ere both based on deductions m ade from psychoanalytical theory j • i i i | upon interview data, offer support for the concept that identification i r ; with parent is an important aspect of making vocational choice. j | The m ost recent and com prehensive review of the extensive | : • i I t | literatu re regarding self-condept theory, as it applies to various ; | I asp ects of vocational in terests and occupational choice, has been w ritten by Super, Starisbevsky, M atlin, and Jordaan (33), T hese rev iew ers, in noting the discrepancies in the vocational self-con cep t literatu re, suggest that future resea rch should devote greater effort t to a clea rer definition of the term " self-co n cep t,” and of other | constructs that are to be evaluated in relationship to the self-con cep t. I Summary of Chapter I j i Relevant research reports have been sum m arized and com pared in the following areas: (1) psychological problem s in hem ophilia, (2) self-con cep t theory of personality, (3) som atopsy- ! chological relationships, (4) se x -r o le identity, and (5) vocational ! ! in terests and preferences and their relation to self-con cep t. Psychological studies of hem ophilia co n sist m ainly of clin ical j i im p ression s gained through psychiatric interview s. None of the I j 40 j I studies report the system atic use of objective tests for investigating j | the psychological problem s encountered in this d isea se. I The use of the sem antic differential technique is suggested j | as an approach which offers much prom ise in m eeting the criticism | of studies conducted in the area of self-con cep t (17). This technique | has a lso been used in studies dealing with se x -r o le identity and ! vocational psychology. In general, resu lts in th ese areas indicate i that m ales and fem ales identify with the lik e-sex ed parent and that | I such identification plays an important role in the vocational in terest patterns of adolescents. | Som atopsychological studies have yielded inconsistent i resu lts. R esearchers have tended to over gen eralize their findings or have failed to acknowledge the influence of intervening variables that m ay account for the relation between physique and behavior. ; Although som e studies show that a slightly greater number of persons j I with physical disabilities have low er adjustment sc o res on psycholog ical tests than do persons who are not disabled, in many of the studies the differences are due to experim ental artifacts. The inconsistency and d iversity of findings in som atopsycho-- logical research points to the n ecessity of finding the p ossib le under- ! lying psychological factors which might explain the differences in behavior among persons with a common disability. In order to better understand the underlying psychological significance of the disability (physique), attention must be given to the variables which connect the disability and the observed behavior of the disabled person. Such a connection is a som atopsychological link between the disability and the behavior and is called an intervening variable. Self-concept, sex-role identity, and vocational interests are the intervening variables used in this study. It is hypothesized that these variables may account for the psychological effects of the disability of hemophilia. CHAPTER III | RESEARCH METHOD AND RATIONALE FOR j ! HYPOTHESES AND PROCEDURE ! i i ! I | \ It is the purpose of th is study to investigate the som atopsy- ; j ] j chological relationship between disability (physique) and behavior by i ; : focusing on the intervening variables of self-con cep t, se x -r o le I identity, and vocational in te re sts. The purposes of the study w ere im plem ented by the availability of thirty-nine adolescent hem ophiliacs who served as the disability group and 104 non-hem ophiliac ad oles- ! cents who served as a com parison group. i 5 1 j Subjects | j Two groups of m ale adolescents ranging in age from 15 to 18 | years w ere tested . One group consisted of thirty-nine hem ophiliacs. This number represented the total number of hem ophiliacs of that age, who w ere reg istered with the Hem ophilia Foundation of Southern California from the counties of L os Angeles and Orange, at the tim e this study was conducted. The second group con sisted of 104 non- j hem ophiliacs who w ere enrolled in Pasadena High School in the spring j 43 of 1966. This group w as randomly selected from four separate gym c la s s e s . The Vaughan's sc a le was used for a sse ssin g the so cio econom ic status of each boy and in addition intelligence quotients and ages of each w ere recorded (100). Table 1 presents the distribution of the two groups on each of these m easu res. H ypotheses, Rationale, and C riterion M easures j Hypotheses 1 through 7 i j T hese all rela te to problem s in se x -r o le identity for the i hem ophiliac in contrast to the non-hem ophiliac. I i i Rationale. —The rationale underlying each of these hypothe- i i I | se s is found in the observations of pediatricians and psych iatrists who have reported about the clo sen ess of the hem ophiliac son to his m other (49, 56, 75). T h ese physicians fe el that this is one of the unique behavioral reactions related to this d isea se. Hawke com mented: Because of overprotection, many children becom e extrem ely clo se to the m other. Some of these do not adopt normal m asculine patterns of behaviour and are rather effem inate. (7:33) C riterion m ea su res. —Profile sim ila r ities between the rating of the concept "me" and the concepts "m other," "father," "fem ale," TABLE 1 COMPARATIVE DATA FOR HEMOPHILIACS AND NON HEMOPHILIACS, INCLUDING INTELLIGENCE ! QUOTIENT, VAUGHAN’S SOCIOECONOMIC I INDEX, AND CHRONOLOGICAL AGE i - — - -- — Intelligence Quotienta Vaughan’s Index Chronological Age (Y ears) H em philiac Mean 119.20 10.97 16.36 Group SD 10.97 2 .0 5 1.15 (N=39) N on- Hemophiliac Mean 112. 50 11.39 16.50 Group SD 15.15 1.82 1.03 (N=1G4) Between Groups Com parison t Value 2 .1 5 0. 64 0 .6 9 P Value .0 3 .5 2 .4 8 £ W eehsler Intelligence T ests w ere used with the Hemophil iac group and the Henmon N elson T ests of Mental A bility, Tenth Grade L evel, w ere used with the Non-Hem ophiliac group. 44 | and "male" on the Word Meaning T e st are the m easures of se x -r o le j | identity. ' j i | | Hypothesis 8 j H em ophiliacs have a low er self-con cep t and le s s s e lf- I I acceptance than do non-hem ophiliacs. I 1 ! I j | R ationale. —This is a lifelon g disabling d isea se which ! ” i i | | frequently is not observable to others. N everth eless, as Alby, et al. , i i "" ' I E ! j have noted, the hem ophiliac boy has a constant aw areness of his lim itations in his everyday activities (38). This creates a conflict between his d esire to be active and a g g ressiv e and the need to inhibit this d esire. Such conflict may resu lt in a low ering of self-con cep t and self-accep tan ce (49). j | C riterion m ea su res. —The rating of the concept "me" is the | m easure of self-con cep t, w hile the m easure of self-accep tan ce w ill be | the profile sim ila r itie s between the concept "me" and the concepts j i "how I would m ost like to be" and "my body" on the Word Meaning T est. Hypothesis 9 H em ophiliacs are m ore accepting of hem ophilia as a m edical j j condition than are non-hem ophiliacs. { I i R ationale. --R esea rch ers have noted the discrepancy between j . i 46 the hemophiliac’ s concept of his illn ess and the concept of the general j public. Goldy and Katz reported: I j Because hem ophilia is little understood by the general public, j | it is often feared that hem ophiliacs w ill bleed to death if j j externally injured. . . . Many hem ophiliacs learned early | ! in life to conceal the fact of their illn ess as they becam e j | aware of people's fears about how gingerly they would have ! | to be handled. (60:190) j | I In the sam e vein, Husek wrote I i ! ; . . . the hem ophiliac is apparently viewed as an extrem e j d evian t--fragile, crippled, lik ely to bleed to death at the I scratch of a pin. The apparent harm done to hem ophiliacs by this one-sided picture is enorm ous. (9:20) I C riterion m ea su res. --T h e rating of the concept '’hemophilia" and the profile sim ila rities of the concept "me” and the concept j "hemophilia" on the Word Meaning T est are the m easures of degree | of acceptance of the m edical condition hem ophilia. J | i I Hypothesis 10 I | Hem ophiliacs are m ore accepting of the concept of taking risks than are non-hem ophiliacs. R ationale. —Very active living requires the hem ophiliac to be taking chances and risk s which to the non-hem ophiliac may not seem as risk-taking experiences. The hem ophiliac child, through the course of his development, m atures in his ability to understand and i i | accept the need of normal risk-taking. This becom es one of his m ost 1 I valuable coping m echanism s (75). j 47 C riterion m ea su res. —On the Word M eaning T est the profile sim ila rities between the concept "me" and the concept 'Taking risks" i I | is the m easure of degree of acceptance of taking risk s. j ; Hypothesis 11 H em ophiliacs who have the greatest acceptance of risk - | taking behavior are lea st accepting of their m edical condition. ! Rationale. -"Although som e risk-taking is seen as a n eces- i ' sity of everyday living for the hem ophiliac, extrem e risk-taking behavior in this illn e ss is seen by Agle as a hem ophiliac’s means of denying the existen ce of his illn ess (37). He found in som e ca ses th is denial reached counter-phobic proportions. C riterion m ea su res. —Profile sim ila rities between the concept "me" and "hemophilia" within the hem ophiliac group only, w ill be the m easure of acceptance of hem ophilia. Self-acceptance is m easured in the sam e manner as in Hypothesis 8. H ypothesis 12 T here is a positive relationship between self-accep tan ce and identity with lik e-sex ed parent and with m ales for both hem ophiliacs and non-hem ophiliacs. R ationale. --P sych ologists consider the congruence between an individual's self-con cep t, "me” and his ideal se lf, "how I would 48 m ost like to be” as a m easurem ent of self-accep tan ce and an indica tion of good adjustm ent (1, 22, 47). R esearchers have found that • self-accep tan ce correlates significantly with the person’s ability to | accept others (44, 96), esp ecially of lik e-sex ed parent (34, 93). ! C riterion m ea su res. —Self-acceptance is m easured in the sam e manner as in H ypothesis 8, w hile degree of identity with the i 1 ! lik e-se x ed parent w ill be m easured by profile sim ila rities between the concepts "me” and "father" and " m a le." H ypotheses 13 through 16 I T h ese all are concerned with the relationship that m ay exist | . j between m asculinity or fem ininity of in terests and se x -r o le identity, as w ell as patterns of vocational in terests and perceived m asculinity or fem ininity of selec ted occupations. i R ationale. —Proponents of the self-con cep t theory in the | field of vocational psychology con sistently refer to the im portance of self-con cep t in determ ining vocational in terests and occupational choices (20, 31, 62). Henderson (107) and Steim el (91) have found som e p ositive relationships to ex ist between parental identification and m asculinity-fem ininity of in terests. Others have dem onstrated clearer relationships of self-con cep t variables to vocational in terests and vocational choice (40 , 63, 64). T h ese self-con cep t variables, | which have been demonstrated as important in a norm al population, ! j | w ere seen to be even m ore important in a hem ophiliac population, as ; I | j vocational interests and choices becom e m ore critica l due to the j i i j nature of their illn e ss. ! i C riterion m ea su res. - -Ratings on the MF Scale of the Strong I | Vocational Interest Blank w ill be the m easurem ent of the m asculinity- j \ ' I i femininity of in terests. Ratings on the Occupations Rating Scale w ill ! ' i : ‘ 1 I 1 | be the m easure of the degree to which an occupation is seen as either j m asculine or fem inine. Profile sim ila rities or congruence between the concept "me” and other appropriate concepts on the Work Meaning T est, as described in above hypotheses, are the m easu res of various i i j aspects of the self-con cept. ! i i j Hypothesis 17 I I i Hemophiliacs who spend the greatest number of days in the ; hospital between birth and five years of age identify m ore clo sely with the opposite-sexed parent. Rationale. —In a study of 200 children between the ages of 2 and 12, Prug and his asso cia tes found that the children between 2 and 5 years of age showed the m ost sev ere reaction to hospitalization j i ; ] |(85). They found that the frequency and type of disturbed behavior | 3 i | decreased with increasing age, with anxiety over separation from the j 50 | parents being the prim ary disturbance. Such anxiety m ust heighten j with the hem ophiliac if he is frequently hospitalized as a young child I and, thus, finds him self m ore dependent upon his m other who m ay j | already be feeling responsible for her child's condition. C riterion m ea su res. — Profile sim ila rities between the j I j | concepts " m e," "father," and "mother" on the Word Meaning T est j I j I w ill be m easures of parental identification. The m edical records j j i available from Orthopaedic Hospital, Children's H ospital, and j California H ospital—all of Los A ngeles—se rv e as the means of determ ining the number of days of hospitalization from birth to five years of age. Procedure The test battery was adm inistered to the hem ophiliacs in this I s 1 . i | order: (1) WISC or WAIS, (2) Goldfarb form of the Word Meaning j i I I T est (Sem antic D ifferential), (3) Occupation Rating Scale, and j |(4) Strong Vocational Interest Blank. At the com pletion of testing the j Vaughan's Socioeconom ic Scale was filled out by each person. The ! WISC or WAIS was adm inistered individually, while a ll other tests from this battery w ere adm inistered to the hem ophiliacs as a group j I at Orthopaedic H ospital. The non-hem ophiliacs w ere given the sam e test battery, with j i | the exception of the WISC or WAIS, and the sam e sequence of I 51 adm inistration was followed. Intelligence Quotients w ere obtained for each non-hem ophiliac from the school record s. This sco re was the one obtained from the Henm on-Nelson Intelligence T est admin istered to each student when he was in the tenth grade. Each student I | | was randomly selected from the first four gym periods of the day | from Pasadena High School, and testin g was com pleted in two con- l | secu tive se ssio n s. Preceding the adm inistration of the Word Meaning j T est, the following statem ent regarding hemophilia was read to each group: i Hemophilia is an inherited bleeding condition which affects | boys. The condition p ersists throughout life and is caused by j an abnormality in blood-clotting. Bleeding may occur spon- : taneously, or, m ore com m only, resu lts from injury. The severity of the bleeding tendency differs greatly in fa m ilies. In som e fam ilies it is sev ere and causes frequent attack of bleeding which may require treatm ent in a hospital. In other fam ilies it is le s s sev ere and the boys experience only occasional episodes. Hemophilia is inherited by the son from his m other. {This statem ent was read to both the hem ophiliac group and the non hem ophiliac group. The directions for the other tests w ere read aloud by the exam iner to the students as they followed and read the directions of each test to th em selves. C riterion instrum ents The Goldfarb form of the Sem antic D ifferential T est used in I this study, hereafter referred to as the Word Meaning T est, was d evised by Goldfarb (106) as a m odification of an earlier form which J i he used to study the concept of sexual identity in tran svestites (105), j T he tw elve bipolar adjective sca les are randomized from page to | page to m inim ize form ation of resp onse se ts . Each sc a le has seven 1 | points between the bipolar adjectives. T w enty-seven concepts are j i included in this test (se e Appendix B), with four, se ts of bipolar j ad jectives included in each of Osgood's three m ajor factors of evalu- j a tiv e, activity, and potency. Only the nine concepts explained below w ere used in this study. The adjectives included in the evaluative factor are w ise-foolish , tru e-fa lse, kind-cruel, and beautiful-ugly. In the activity factor are fa st-slo w , m ovin g-still, activ e-p a ssiv e, and calm -excitable. The potency factor includes the following adjec- j tiv es: strong-weak, la rg e-sm a ll, heavy-light, and hard-soft. T h ese sa m e bipolar adjectives w ere su ccessfu lly used by Webb and H arris ! in a study of the effectiven ess of an N. D. E. A. Institute for coun- i s e lo r s (103). Jenkins, et a l. (67),and Osgood, et a l. (17) found these ad jectives to have high factor loadings in the appropriate factor areas as used in this study. The subject's evaluative placem ent of the "me" concept in sem an tic space reveals information about his self-con cep t (17). The i "D” m easure between the concepts "me" and the following: "m other," j "father," "m ale," " fem ale," "how I would m ost like to be," "my i 53 body," "hem ophilia,” and "taking risks" are of prim ary considera tion in this study. In each of these com parisons the "D" sta tistic was derived by use of the following formula: Dil s / ^ i l 2 I Where "D" is the linear distance between the points in the sem antic j I space representing concepts "i" and "1" and "d.j" is the algebraic j | difference between the coordinates of "i" and "1" on the sam e dim en sion or factor, "j." Thus, the larger the "D" the greater the distances or d issim ilarity between the self-con cep t "me" and the investigated concept "m other," "father, " "m ale, " "fem ale, " "how I would m ost like to be," "my body,” "hem ophilia," and "taking risk s." C onversely, the sm aller the "D ," the greater the congruence of the two concepts. In scoring the sem antic differential, digit values from 7 to 1 are assigned to the seven categories between the bipolar adjec- jtives before the form ula above can be used. F or exam ple, consider the "D" between "me" and "mother" if the following sco res w ere recorded: _______________ F a c t o r _______________ Concept Evaluation Potency A ctivity Me 7 3 1 M other 1 3 7 [ 54 j Now M D" is found by taking the difference between the sc o res of the concepts "me" and "mother" on each factor, squaring this difference, sum m ing these squares, and taking the square root of the sum . In j ; ■ ' ' 1 | this ca se j i [7 - i f + [3 - 3]2 + [1 - 7]2 = 72 | 2 | the desired D , and the square root of this value is 8 .4 9 , the desired I i | "D" or distance. This study uses the "D" sta tistic to index the distance between concepts as judged by hem ophiliacs and non hem ophiliacs. In addition, it is a lso applied in the com parison of these two groups of subjects on how sim ila rly they p erceive the sam e concept; for exam ple, how sim ila r are the m eanings of "mother" for hem ophiliacs and non-hem ophiliacs as com pared with their m eanings of " m e." | Strong Vocational Interest Blank I ^ - ... .... . .. Form M for Men (1938) is used in this study. This is designed to a s s e s s in terests of an individual as com pared to the known resp onses of persons who have been su ccessfu l in various occupations. i In the revised 1959 edition for the M form , sco res are available for forty-eight occupations, six groups of occupations, and includes a sc a le for fem ininity-m asculinity (110). Unfortunately the 1966 j revision of the SVIB was not yet available when this study was in iti 55 ated. There is extensive literatu re 011 the validity and reliab ility of this test. Layton has sum m arized the history and u se of the SVTB (12). M -F Occupation Rating Scale | This sc a le was designed for this study and includes forty- 1 three of the fifty-one occupation titles listed on the profile sh eet of I the SVIB. Eight titles w ere not included because of clerica l erro r j ! ; which was not discovered until after the tests had been adm inistered, j i With each title, there is a six point sc a le between the bipolar adjec tives "masculine" and "fem inine." The directions ask the subject to rate each occupation from his own point of view as to whether it seem s to him to be a m ore "masculine" or "feminine" type of occupa tion. This rating sc a le was adm inistered before the SVIB was adm inistered. 1 The exact occupation titles and the sequence of presentation j | ! | are as follow s: a rtist, psychologist, architect, physician, psych ia- j i i trist, osteopath, dentist, veterinarian, chem ist, m athem atician, engineer, production m anager, farm er, carpenter, printer, math and scien ce teacher, police officer, forest ranger, arm y officer, aviator, 1 "Y" physical education d irector, personnel m anager, public adm in- ] 1 | istrator, vocational counselor, so cia l scien ce teacher, city school i i superintendent, m in ister, m usician, C .P . A. partner, senior C. P. A ., j 56 office w orker, purchasing agent, banker, m ortician, pharm acist, sa le s m anager, real estate s a le s, life insurance s a le s , advertising | person, law yer, author-journalist, and president of manufacturing concern. The ratings on these occupations are com pared to the sco res for the sam e occupations made on the SVIB. S im ilarities and d iffer- ] en ces are described in term s of self-con cep t obtained on the Word Meaning T est. Summary of Chapter This chapter has presented an overview of the resea rch method em ployed in this study. The hypotheses w ere d iscu ssed , and the underlying rationale for each hypothesis was explained. The chapter concluded with a d iscussion of the criterion m easu res and the ! procedures for using these m easu res. ) i | i 1 . 1 { * ! ! i CHAPTER X V FINDINGS This chapter presents the findings relative to the hypotheses ! | d iscussed in Chapter I. The partial correlations, "D" sc o r e s, i ! m ultiple regression coefficien ts, and significance tests w ere com - | | ; ! pitted by the IBM 360 M odel 75 computer at the Health Sciences j | Computing F acility of the U niversity of California at Los A ngeles. Hypotheses 1 through 12 w ere tested by u se of the Word Meaning T est and the Strong Vocational Interest Blank. The BMD 04V ! program for analysis of covariance was used to determ ine the s ig nificance of difference of the "D" sco res between groups for approp riate concepts for Hypotheses 1, 2, 3, 4, 8, 9, 10, and 13. The BMD X70 program use of the t te st of significant difference of mean "D" i sco res was applied to Hypotheses 5, 6, and 7, as th ese dealt with the ! i i j differences within a group. Hypothesis 12 w as analyzed by the BMD 03R program of m ultiple regression an alysis. Hypotheses 14 through 16 w ere tested by a combined use of i i the Strong Vocational Interest Blank and the Occupation Rating Scale. i The resulting data w ere treated by the BMD 02S program for chi- 58 sq u are. This sam e program of sta tistica l an alysis was a lso used for H ypothesis 11. The correlation program BMD 02D was used to analyze the hospital data and the Word M eaning T est resu lts for H ypothesis 17. | Each of the seventeen hypotheses predicts the direction of I | d ifference; thus, the on e-tailed te st of sign ifican ce has been used I throughout the study. Hypotheses R elating to S ex-R ole Identity The resu lts of tests applied to the first four hypotheses regarding se x -ro le identity are reported in T ables 2, 3, 4, and 5. T h ese hypotheses w ere tested by com paring the adjusted m ean "D" sc o r e s of identical concepts from the Word M eaning T est for the two groups of subjects. Hypothesis 1 states that hem ophiliacs have a greater degree of identification with the opposite-sexed parent than do non- ! hem ophiliacs. The "D" score obtained from the concepts "m e- I I m other" is the m easurem ent index of the identification with the o p p osite-sexed parent. Tables 2 to 5 indicate that there are no sign ifican t differences between the two groups on the evaluative, potency, activity, and total factor s c o r e s . Both hem ophiliacs and non-hem ophiliacs identify to the sam e degree with the opposite- i sex ed parent and thus the first hypothesis is rejected. TABLE 2 59 "D" SCORE COMPARISONS OF HEMOPHILIACS AND NON HEMOPHILIACS ON THE EVALUATIVE FACTOR a (Hypotheses 1 to 4 and 8 to 10) Group Concept Mean Adj. Mean S .D . F Sig. L evel Non-Hem o M eb 2 .7 2 2.72 0 .7 7 1 1 .4 6 .01 Hemo 3.21 3.21 0 .7 5 Non-Hem o M e-F em ale 0 .8 0 0 .7 7 0. 60 4 .5 7 .0 5 Hemo 0 .9 5 1.02 0 .7 5 Non-Hem o M e-M ost like to be 1 .4 4 1 .4 6 0 .6 9 1.45 n. s . Hemo 1 .3 0 1.30 0 .7 0 Non-Hem o M e-M y body 0 .5 6 0. 56 0. 60 0 .5 0 n. s. Hemo 0 .6 3 0.64 0 .4 1 Non-Hem o M e-M ale 0 .8 5 0.85 0 .6 9 1. 61 1 1. s . Hemo 0 .6 7 0.68 0 .5 9 Non-Hem o M e-M other 1 .07 1.07 0 .8 6 0 .1 3 n. s . Hemo 1 .1 0 1.12 0 .7 9 Non-Hemo M e-F ather 0 .9 7 0 .9 7 0 .8 0 0 .1 0 n. s . Hemo 0 .9 0 0.92 0.81 Non-Hem o M e-Taking risks 1 .5 0 1.51 1 .1 5 2.90 n. s. Hemo 1 .2 0 1.16 0. 87 Non-Hem o Me -Hem ophilia 2.38 2.38 1 .2 2 13.69 .01 Hemo 1.53 1.51 1 .2 2 3 - Comparison by m eans of analysis of covariance with age and I. Q. as the independent variables. bRaw score. 60 TABLE 3 "D” SCORE COMPARISONS OF HEMOPHILIACS AND NON HEMOPHILIACS ON THE POTENCY FACTOR a (H ypotheses 1 to 4 and 8 to 10) Group Concept Mean Adj. Mean S .D . F Sig. L evel Non-Hemo , , b Me 3 .5 2 3.5 2 0 .9 6 0.01 1 1. s . Hemo 3 .5 3 3.54 0. 72 Non-Hemo M e-F em ale 2 .0 5 2.04 1.22 0 .0 0 n. s . Hemo 2 .0 0 2 .0 3 0.99 Non-Hemo M e-L ike to be 1.04 1.04 0 .7 5 0 .0 0 n. s . Hemo 1.04 1.04 0. 75 Non-Hemo M e-M y body 0 .7 0 0 .7 0 0. 63 3.63 n. s . Hemo 0 .4 8 0,48 0 .4 4 Non-Hemo M e-M ale 1 .4 4 1.44 0 .9 4 2.84 n. s . Hemo 1 .1 5 1.15 0 .7 2 Non-Hemo M e-M other 1.38 1.38 1.02 0.59 n. s . Hemo 1 .23 1.23 0. 88 Non-Hemo M e-F ather 1.14 1.13 1.01 0 .2 0 n. s . Hemo 1.04 1 .0 5 0 .7 6 Non-Hemo M e-Taking risk s 1.24 1.22 1.01 3.18 n. s . Hemo 0 .8 5 0 .9 0 0 .7 4 Non-Hemo M e-H em ophilia 1.54 1.55 1.08 4.41 .0 5 Hemo 1 .1 6 1.12 0.99 cl Com parison by m eans of analysis of covariance with age and I.Q. as the independent variables. b„ Raw sco re. TABLE 4 61 "D" SCORE COMPARISONS OF HEMOPHILIACS AND NON HEMOPHILIACS ON THE ACTIVITY (A) FACTORa (Hypotheses 1 to 4 and 8 to 10) Group Concept Mean Adj. Mean S .D . F Sig. L evel Non-Hemo Meb 3 .0 6 3 .0 6 0.94 0 .1 2 n. s . Hemo 3 .1 3 3.13 1.03 Non-Hem o M e-F em ale 0 .8 9 0 .9 0 0 .8 0 0 .9 8 n. s . Hemo 0 .7 8 0 .7 5 0. 65 Non-Hemo M e-Like to be 0 .7 3 0 .7 3 0. 63 0 .1 8 n. s . Hemo 0.7 9 0.7 8 0. 64 Non-Hemo Me-M y body 0 .6 4 0.64 0. 68 0 .4 7 1 1. s . Hemo 0 .5 5 0 .5 6 0 .5 0 Non-Hemo M e-M ale 0.91 0 .9 2 0.81 0 .4 3 n. s . Hemo 0 .8 3 0 .8 2 0. 70 Non-Hemo M e-M other 0 .9 4 0 .9 5 0.71 0 .0 0 n. s . Hemo 0 .9 6 0.94 0 .9 5 Non-Hemo M e-Father 0 .9 5 0 .9 6 0 .7 7 0 .5 2 n. s . Hemo 1.10 1.07 0 .9 5 Non-Hemo M e-Taking risks 1.11 1.12 0 .9 3 1.38 n. s . Hemo 0 .9 2 0 .9 2 0 .7 9 Non-Hemo M e-Hem ophilia 1.43 1.43 1.03 0 .1 7 n. s. Hemo 1 .3 6 1.35 1.09 aComparison by m eans of analysis of covariance with age and I. Q. as the independent variables. bRaw score. 62 TABLE 5 ’D" SCORE COMPARISONS OF HEMOPHILIACS AND NON HEMOPHILIACS ON THE TOTAL OF ALL FACTORS a (Hypotheses 1 to 4 and 8 to 10) Group Concept Mean Adj. Mean S .D . F Sig. L evel Non-Hemo M eb 9 .3 0 9 .3 0 0 .8 8 3.20 n. s . Hemo 9.87 9.8 8 0 .8 3 Non-Hemo M e-F em ale 2 .6 2 2. 57 1.11 0.03 n. s . Hemo 2.54 2 .5 7 1 .0 2 Non-Hemo M e-L ike to be 2.01 2 .0 0 0 .8 4 0.82 n. s. Hemo 2.13 2.15 0 .8 4 Non-Hem o M e-M y body 1.30 1.29 0 .8 7 1.05 n. s. Hemo 1.13 1.14 0 .5 0 Non-Hemo M e-M ale 2.13 2.13 1 .0 6 3.16 n. s. Hemo 1.79 1.79 0 .7 7 Non-Hemo M e-M other 2.28 2.28 1 .0 0 0.21 n. s . Hemo 2.20 2 .2 0 1 .0 4 Non-Hemo M e-Father 2.04 2.03 1 .1 0 0.00 n. s . Hemo 2.03 2.04 1 .0 5 Non-Hemo M e-Taking risk s 2.59 2. 59 1 .2 0 6.70 .0 2 Hemo 2.03 2.03 0 .8 9 Non-Hemo M e-H em ophilia 3.44 3 .4 5 1.39 8. 66 .01 Hemo 2.67 2. 65 1 .4 3 3 - Comparison by m eans of analysis of covariance with age and I.Q . as the independent variables. bRaw sco re. 63 | | Hypothesis 2 proposes that hem ophiliacs have a greater I s degree of identification with fem ales than do non-hem ophiliacs. j ! T ables 2 to 5 reveal that only on the evaluative factor is there a s ig - ! i i nificant difference between the groups on the "D" sco re for the j I ) concepts ,rm e-fem ale. " This difference is significant at the . 05 j lev el, but not in the predicted direction. Thus, not only is the second j hypothesis rejected, but also it is seen that non-hem ophiliacs identify m ore closely with fem ales than do the hem ophiliacs on the evaluative factor. Hypothesis 3 states that non-hem ophiliacs have a greater degree of identification with lik e-sex ed parent than do hem ophiliacs. No significant differences are noted in Tables 2 to 5 between the groups on the ”D,T sco re m eans for the concepts " m e-fath er." The hem ophiliacs have slightly sm aller "D" sco res on the evaluative and |potency factors and slightly larger ”D” sco res on the activity factor. Since none of the differences reach the .05 lev el of significance, the third hypothesis is rejected. Both groups of adolescent m ales have identified to a sim ila r degree with the lik e-sex ed parent. Hypothesis 4 states that non-hem ophiliacs have a greater degree of identification with m ales than do hem ophiliacs. The "D" score com parisons of the concepts "m e-m ale” in Tables 2 to 5 do not reveal any significant differences between the hem ophiliacs and non- 64 hem ophiliacs in any of the factor areas. It is interesting to note that the "D" sc o res are consistently sm aller for the hem ophiliac group on all fa cto rs, but the resulting F ratio does not reach the . 05 lev el I j which is the lea st acceptable lev el of significance in this in vestiga- j j j tion. The evaluative factor and total factor sco res are significant at i j the . 10 lev el in the opposite direction from that which was hypothe- | I i sized , and this does indicate at lea st a trend for the hem ophiliac to j i t i ] i i | have a som ewhat m ore p ositive identification with m ales. According to criteria, however, the fourth hypothesis m ust be rejected. Hypothesis 5 states that hem ophiliacs have a greater degree of identification with the op posite-sexed parent than they do with the lik e-sex ed parent. In term s of the Word Meaning T est this would m ean a significantly sm aller "D" sco re on the concepts "m e-m other” than on "m e-father. ” T able 6 indicates that this hypothesis cannot be 1 accepted, as the hem ophiliacs are not differentiated by the "D" i j sc o res on these concepts. The p values for the evaluative and potency factors show a trend for identification to be in the direction of the lik e-sex ed parent rather than with the opposite-sexed parent. r H ypothesis 6 declares that hem ophiliacs have a greater degree of identification with fem ales than with m ales. Thus, the i sm a ller "D" sco res on the concepts "m e-fem ale" in com parison with the concepts "m e-m ale" would be evidence of the hypothesized s e x - 65 I TABLE 6 COMPARISON OF HEMOPHILIAC "D" SCORES AS INDEXES OF SEX-ROLE IDENTIFICATION a (H ypotheses 5 and 6) i i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ i Concepts Factor Mean S .D . t Value P M e-M other vs M e-F ather : Evaluative 1 .1 0 0. 90 0 .7 9 0 .8 1 1 .1 0 0 .2 8 Potency 1.2 8 1.04 0 .8 8 0 .7 6 1.04 0.31 A ctivity 0 .9 6 1 .1 0 0 .9 5 0 .9 5 -0 . 66 0 .5 2 M e-F em ale vs M e-M ale Evaluative 0 .9 5 0. 67 0 .7 5 0 .5 9 1.89 0 .0 6 1 ] j i i Potency 2 .0 0 1 .1 5 0 .7 8 0 .9 9 0 .7 2 0 .6 5 4 .3 2 0.00* Activity 0 .8 3 0 .7 0 -0 .3 4 0 .7 4 d Com parison by t te st, pooled variance estim ate, 76 de grees of freedom . ^Significant at the . 005 lev el. 66 role identification. In Table 6 the "D" sco re com parisons for these concepts indicate not only a lack of significant difference in the predicted direction for any of the three fa cto rs, but a difference on i I the p o te n c y factor in the opposite direction and significant at the . 005 i I ! ! ! le v e l. The hem ophiliac identifies to a significantly greater degree I ! ' I | with the potency of the m ale than he does with the potency of the j ! j j fem ale. The evaluative factor p value of .0 6 , a lso in the opposite | i | ; f direction from that which w as predicted, falls just short of criterion acceptance. It does reveal n everth eless, a clo ser identification on this factor with the m ale than with the fem ale. In sum m ary, the sixth hypothesis m ust be rejected for lack of supportive sta tistica l evidence. Hypothesis 7 states that non-hem ophiliacs have a greater degree of identification with both m ales and lik e-sex ed parent than with fem ales and opposite-sexed parent. As in the previous two I hypotheses the com parison of the "D" sco res of the concepts "m e- m other v s. "m e-father” and "m e-fem ale" vs. "m e-m ale" are used as the indexes for se x -r o le identification. The resu lts of these com parisons are found in Table 7 and indicate that this hypothesis is j confirm ed only in the non-hem ophiliacs’ identification with the potency i i ! |factor of the m ale. None of the other com parisons on the various factors reach the criterion lev el of significance. The non-hem ophiliac TABLE 7 COMPARISON OF NON-HEMOPHILIAC "D" SCORES AS INDEXES OF SEX-ROLE IDENTIFICATION a (Hypothesis. 7) 67 Concepts Factor Mean S .D . t Value P M e-M other 1.07 0 .8 6 vs Evaluative 0 .9 0 0 .3 8 M e-Father 0 .9 7 0 .8 0 1. 38 1 .0 2 Potency 1.73 0 .0 9 1.14 1.01 0 .9 4 0.71 Activity -0 .0 7 0 .9 5 0 .9 5 0 .7 7 M e-F em ale 0 .8 0 0. 60 vs Evaluative -0 . 64 0 .5 3 M e-M ale 0 .8 5 0 .6 9 2.05 1 .2 2 Potency 4 .0 0 0.00* 1 .4 4 0 .9 4 0 .8 9 0. 80 Activity -0 .2 4 0 .8 2 0.91 0 .8 1 Si Comparison by t test, pooled variance estim ate, 206 degrees of freedom. ^Significant at the . 005 lev el. Separate variance estim ate used for p value because S.D. are significantly different. 68 s identifies approxim ately to the sam e degree with mother as he does j i with father and sim ila rly identifies to the sam e extent with fem ales asj j he does with m ales. The only exception to this pattern is the greater I I identification with the potency factor of the m ale. Thus, the seventh j ; j j hypothesis is rejected except in regards to the potency factor of the j | i I m ale. j j | j T ables 6 and 7 confirm the sim ila rities in the se x -r o le i identity patterns of both the hem ophiliacs and the non-hem ophiliacs. Both groups identify with the potency of the m ale and also identify with both parents on the evaluative, potency, and activity factors. The two groups also identify with both m ales and fem ales on the evaluative and activity factors. R esults of the tests of the fir st seven hypotheses suggest that adolescent hem ophiliacs and non-hem ophiliacs are quite sim ila r ! ! | in their se x -r o le identity patterns. T hese resu lts failed to support ? i the belief that hem ophiliacs identify m ore clo sely with the opposite- sexed parent and a lso with the fem ale. Hypotheses R elating to Self-Concept Hypothesis 8 states that hem ophiliacs have a lower s e lf- concept and have le s s self-accep tan ce than do non-hem ophiliacs. The rating of the concept "me" on the Word Meaning T est is the m easure 69 of self-con cep t here, w hile the "D" sc o res on the concepts M m e-how i ! I would m ost like to be” and "m e-m y body" are the m easures of s e lf- j acceptance. Tables 2 to 5 report the resu lts of the tests of this j i i | hypothesis. The low er self-con cep t of hem ophiliacs is supported on j j | ! the evaluative factor at the .01 lev el, as noted on Table 2, but not i ! I { supported on the potency and activity factors. j | In term s of self-accep tan ce, the "D" sc o r es on the concepts I "me-how I would m ost like to be" and "m e-m y body" reveal profile j sim ila rities and no significant differences between the groups on any of the factors. The eighth hypothesis is rejected in every resp ect except in that area which reveals a low er self-con cep t of hem ophiliacs on the evaluative factor. The hem ophiliac has a le s s favorable attitude toward h im self than does the non-hem ophiliac, but he se e s h im self as potent and as i active as his normal adolescent p eer. He also is as self-accep tin g i in term s of an ideal s e lf as is the non-hem ophiliac. j Hypothesis 9 proposes that hem ophiliacs are m ore accepting of hem ophilia as a m edical condition than are non-hem ophiliacs. The j "D" sc o re com parisons of the concepts ”m e-hem ophilia" on Tables 2 j I to 5 indicate that this hypothesis is accepted on the evaluative and | total factor sco res at the .01 lev el and on the potency factor at the .05; lev el. The groups are not significantly differentiated on the activity j . 1 \ 5 70 j i i factor. This hypothesis confirm s the b elief that hem ophiliacs have j ! a m ore positive attitude toward an acceptance of hem ophilia than do j non-hem ophiliacs. ! i 1 Hypothesis 10 states that hem ophiliacs are m ore accepting j i I of the concept of taking risk s than are non-hem ophiliacs. Again i I Tables 2 to 5 present the resu lts of the "D" sco re com parisons of the | concepts "m e-taking r is k s .” Although the mean "D" sco res are consistently sm a ller for the hem ophiliacs on the evaluative, potency, and activity factors, the F ratios do not reach the criterion lev el of ' significant difference except on the total factor "D" sco re. On the total factor sco re the groups are significantly different in the p re dicted direction at the . 02 le v el. T hus, the tenth hypothesis is accepted on the total factor sco re, with each of the separate factor sc o res contributing to the total in the predicted direction. Hemophil- ! ia cs are m ore accepting of the concept of taking risk s than are non- j hem ophiliacs when all factors from the Word Meaning T est are taken [ into account. Hypothesis 11 is concerned with the relationship between risk-taking and hem ophilia. It is hypothesized that hem ophiliacs who have the greatest acceptance of risk-taking are le a st accepting of theiri | j ! m edical condition of hem ophilia. A chi-square test of the "D" sc o re s i I 1 Ion the concepts "m e-risk-taking" and "m e-hem ophilia” is used to test | this hypothesis and the resu lts are presented in Table 8. On the evaluative factor, hem ophiliacs who are m ost accepting of hem ophilia i ( Md on concepts "m e-hem ophilia") are a lso m ost accepting of risk - | taking ( >• Md on concepts "m e-taking risks"), w hile those who are i I I ; le a st accepting of hem ophilia ( < Md on concepts "m e-hemophilia") I ! - ! | are a lso le a st accepting of taking risk s ( < Md on concepts "me-taking| ; | i risk s" )0 The difference between th ese groups is significant at the .01 j ! ! ; lev el. On the potency factor, differences in the sam e direction are j I a lso found and are significant at the . 05 lev el. The activity factor does not rev ea l any significant differences. H ypothesis 11 cannot be accepted, and the evidence reveals significant differences in the opposite direction. Thus, it is found that hem ophiliacs who are m ost accepting of taking risks are a lso j m ost accepting of their m edical condition, and, conversely, hem o- J iphiliacs who are le a st accepting of taking risk s a re least accepting of their m ed ical condition. H ypothesis 12 focuses on the relationship between s e lf- acceptance and se x -r o le identity. This hypothesis states that there is a p o sitiv e relationship between self-accep tan ce and identity with lik e- i sexed parent and v/ith m ales for both hem ophiliacs and non-hem ophil- | i | ia c s. The "D" sc o res of the self-accep tan ce concepts are com pared j | with the s e x -r o le identity concepts and analyzed in a m ultiple r e g r e s- j | TABLE 8 | "D" SCORE COMPARISON FOR HEMOPHILIACS ON CONCEPTS ’’HEMOPHILIA” AND ’’TAKING RISKS" ; (Hypothesis 11) (N = 39) Factor C o n c e p t R a tin g < M d and > M d Chi- Square df Sig. Level Taking Risks <M d > M d Evaluative Hemophilia < 'Md (reject concept) > M d (accept concept) (reject concept (accept concept) iq a c 19(12> 5(7.5) 7 6 6 6(12) 10(7 .5) 1 .01 Potency Hemophilia < M d >M d 17(12) 7(12) 6(7 .5) 9(7 .5) 4.76 1 .05 Activity Hemophilia < Md >M d 15(13) U (13) 6(6 .5) 7(6 .5) 1.30 1 n. s. Q Expected frequencies are placed in parentheses next to actual frequency of occurrence. sion design. The results are presented in Tables 9 and 10. The direct correlations of concepts are presented first, followed by the partial r's which are tested for significance. Table 9 indicates that when the independent variables of age, I. Q ., and index of socioeconom ic status are partialed out (i. e . , j I i j j ; held constant, for hemophiliacs), then the partial r's for the concepts t I I | "m e-like to be” and "me-mother, " "m e-father," and "me-female" | i j are significant at the . 01 level. On the potency factor the concept of self - acceptance "m e-like to be" correlates positively at the . 01 level of significance with "me-male" and the .05 level with "m e-father," but correlates negatively at the .0 5 level with the "me-mother" and "me-female" concepts of sex -ro le identity. On the activity factor only the partial r between "m e-like to be" and "me-male" reaches significance at the . 05 level. The self-acceptance concept of "m e-my body" is significantly I correlated with only the sex-role identity concepts of "me-mother" and "me-male" on the evaluative factor at the .05 level. Thus, for hemophiliacs, the twelfth hypothesis is accepted on the evaluative factor of the self-acceptance concept "m e-like to be" and of identifi- I cation with the like-sexed parent, but not with m ales. On the potency I | factor, this hypothesis is accepted for identification with both the j like-sexed parent and m ales. The activity factor offers support for i 74 TABLE 9 "D” SCORE COMPARISONS OF SELF-ACCEPTANCE CONCEPTS3 AND SEX-ROLE IDENTITY CONCEPTS FOR HEMOPHILIACS (Hypothesis 12) Concepts: Self- S e x - R o le I d e n t it y Evaluative Factor Potency Factor Activity Factor Acceptance r Partial r t Pb Partial r r t P r Partial r t P Me-Like to be .36+ .40 2.49 .01 Me-Father .40** .37 2.25 .05 .14 .23 1.33 - Me-My body .04 .08 0.46 - ^ 1 1 to C O -1.33 - -.0 6 -.0 7 -0.39 - Me-Like to be .5 0 ^ .56 3.86 .01 Me-Mother -.2 5 -.3 5 -2.11 .05 .20 .26 1.55 - Me-My body .22 .28 1.68 .05 s 1 C O o -0.21 - .22 .15 0.8 6 - Me-Like to be .12 .14 0.81 Me-Male .49** .46 2.94 .01 .35* ,32 1.94 .05 Me-My body .31 .31 1.90 .05 .03 -.1 2 -0 .7 0 - -.0 5 1 h-• to -0 .7 0 - Me-Like to be .49** .53 3.56 .01 M e-Female -.2 4 -.3 0 -1 .8 0 .05 .19 .22 1.31 - Me-My body .21 .23 1.35 - . 36^ .24 1.43 “ .17 .23 1.34 - M ultiple regression analysis design with IQ, age, and Vaughn’s Index as independent variables. ^Probability based on t test of partial r with 37 degrees of freedom. ♦Significant at the . 05 level. ♦♦Significant at the . 01 level. 75 TABLE 10 "D" SCORE COMPARISONS OF SELF-ACCEPTANCE CONCEPTS a AND SEX-ROLE IDENTITY CONCEPTS FOR NON-HEMOPHILIACS (Hypothesis 12) Concepts: Self- Acceptance S e x - R o l e I d e n tity Evaluative Factor Potency Factor Activity Factor Partial r r t Pb Partial r r t P Partial r r t P Me-Like to be .2 3 ^ .24 2.44 .01 Me-Father . 5 6 ^ . 55 6.55 .01 .2 4 ^ .26 2.70 .01 Me-My body .20^ .20 1.99 .05 .3 0 ^ .29 3.04 .01 .15 .18 1.78 .05 Me-Like to be . 37++ .37 3.99 .01 Me-Mother -.0 3 -.01 -0 .1 2 .20^ .22 2.29 .05 Me-My body .33** .32 3.39 .01 H r © 1 -1 .0 7 .25*# .27 2.75 .01 Me-Like to be .05 .04 0.39 Me-Male ,5 8 ^ .57 6.88 .01 .4 8 ^ .50 5.77 .01 Me-My body .19^ .18 1.78 .05 . 17^ .1 6 1.65 .05 .30** .33 3.46 .01 Me-Like to be .12 .12 1.15 M e-Female -.3 1 +* -.3 0 -3 .1 0 .01 . 23^* . 25 2.54 .01 Me-My body -.0 8 -.1 1 -1.10 -.0 2 -.0 3 -0 .2 6 .14 .20 1.97 .05 M ultiple regression analysis design with IQ, age, and Vaughan's Index as independent variables. ^Probability based on t test of partial r with 102 degrees of freedom. ♦Significant at the . O S level. ♦♦Significant at the .01 level. this hypothesis only with the concept " m e-m a le." The s e lf- j | acceptance concept "m e-m y body" supports this hypothesis on the j evaluative factor for "m e-m ale" only. i I | i It was also found that hem ophiliacs with high self-acceptance ! I | identify on the evaluative factor with the opposite-sexed parent and ) ■ ‘ j fem ales as w ell as with the sa m e-sex ed parent. They identify with j the potency of the sa m e-sex ed parent and m ales, but reject identifi- j j I cation with the potency of the op posite-sexed parent and fem ales. Table 10 reports the resu lts of com parisons of the sam e self-accep tan ce concepts and se x -r o le identity concepts for the non- hem ophiliac group. Significant partial correlations w ere obtained in the predicted direction for both self-accep tan ce concepts with the s e x -r o le identity concepts of "m e-father" and "m e-m ale" on all three factors. Hypothesis 12 is accepted for the non-hem ophiliacs from I th ese findings. In addition, however, it was found that the non- ! I I | hem ophiliacs who have high self-accep tan ce also identify on the evaluative factor with the op p osite-sexed parent at the . 01 le v el and on the activity factor at the .0 5 le v el for the concept "m e-like to be" and the .01 lev el for the concept "m e-m y body." It is also in terest ing to note a significant rejection of the potency of the fem ale by the j non-hem ophiliacs who show the greatest self-acceptance on the concepts "m e-like to be. ” A su rp rising finding is the significant correlation between the self-accep tan ce concepts and the "m e-fem ale" i i concept on the activity factor. This finding is in sharp contrast with j J i i the hem ophiliac group and indicates that greater self-accep tan ce | means greater identification with fem ales in the activity area for the j \ j non-hem ophiliac, but not for the hem ophiliac. i i | Hypothesis 13 sta tes that hem ophiliacs with high m asculine in terests differ from those with low m asculine in terests in these ways: ■ ' i i 1. They identify m ore clo sely with the lik e-sex ed parent. 2. They have greater acceptance of their bodies. 3. They are m ore accepting of taking r isk s. 4. They are m ore accepting of hem ophilia. An analysis of covariance design was used to treat the "D" sco re data and the SVIB M -F sc a le data for th is hypothesis. The standard I sco re of 50 w as used as the cut-off point on the M -F sca le to define the low and high m asculine interest groups. Standard sc o res above 50 indicated high m asculine in terests, and sco res below 50 indicated low m asculine in terests. The results of the treatm ent of these data are reported in Table 11. ! 1 i T here is no difference between the high m asculine in terest ! j | group and the low m asculine interest group in their identification with ! I I jthe lik e-sex ed parent, and therefore part "a" of this hypothesis m ust | TABLE 11 "D" SCORE COMPARISONS OF HEMOPHILIACS WITH LOW AND HIGH MASCULINE INTEREST LEVELS ON SELECTED CONCEPTS a (Hypothesis 13) Group Concepts Evaluative Factor Potency Factor Activity Factor Mean Adj. Mean F Ratio P Mean Adj. Mean F Ratio P Mean Adj. Mean F Ratio p High MIb 1.01 1.01 0.89 0.90 0.86 0.85 Me-Father 0.74 0.95 2.21 Low MI 0.76 0.78 1.18 1.16 1.31 1.34 High MI 0.63 0.62 0.32 0.32 0.61 0.57 Me-My body 0.11 6.33 .05 0.08 Low MI 0.66 0.67 0.65 0.64 0.49 0.52 High MI 0.88 0.90 0.85 0.86 0.86 0.85 Me-Taking risks 4. 64 .05 0.01 0.45 Low MI 1.50 1.48 0.81 0.81 1.04 1.04 High MI 1.03 1.04 1.22 1.17 1.33 1.24 Me-Hemo- philia 5.01 .05 0.00 0.36 Low MI 2.00 1.97 1.10 1.14 1.39 1.47 cl | Analysis of covariance design with IQ, age, and Vaughan's Index as covariates, p .05 - 4.14, | p. 01 = 7.47 with 1 and 33 degrees of freedom, i h | MI ~ Masculine Interests as measured by standard scores on M -F scale of S. V .I. B. ^ 79 be rejected . Table 11 indicates that the high m asculine interest group differs at the .0 5 lev el of significance from the low m asculine interest! j j group on the potency factor of the concept "m e-m y body. " The high j i ! | in terest group shows m ore acceptance of the potency of their bodies. ! i This difference is not found with the evaluative and activity factors. Part ”b" of the thirteenth hypothesis is accepted only in resp ect to the : i I i potency factor. i The high m asculine in terest group is m ore accepting of taking r isk s, as can be seen in this group’s significantly sm a ller "D” sco re on the "m e-taking risks" concept, the evaluative factor. The difference between the groups bn this factor is significant at the . 05 lev el. No significant difference is seen on the potency and activity factors; therefore, part "c" of this hypothesis is accepted only in | resp ect to the evaluative factor. | The high m asculine group is m ore accepting of the concept "m e-hem ophilia" and differs at the .0 5 lev el in this respect from the low m asculine in terest group on the evaluative factor. There is no difference in the acceptance of this concept found on the potency or activity factors. Section " d ," the la st one proposed in the thirteenth j 5 hypothesis, can be accepted only in resp ect to the evaluative factor. | • V H ypothesis 14 states that hem ophiliacs and non-hem ophiliacs 1 1 80 I i I | who have high m asculine in terests have greater in terests in occu- ! pations rated as m asculine than do those individuals who have low m asculine in terests. To determ ine whether an in terest character- j i j istic of an occupation was high (Hi), low (Lo), or indeterm inate (N), j I ; the standard sco re which defines these lim its w as used from each i i j subject’s Strong Vocational Interest Blank. The mean sco res for each! I j I occupation w ere tested for significance both within and between the I ! j high m asculine in terest and low m asculine in terest groups. The j resu lts are reported on Tables 12, 13, and 14. The ratings of j I occupations as either m asculine or fem inine w ere done on the Occu pation Rating Scale by both the hem ophiliacs and non-hem ophiliacs. T hese resu lts are presented in Table 15. Of the fifteen occupations that the hem ophiliacs rated as m asculine occupations, nine of them significantly differentiate the low and high m asculine groups in the expected direction. Only the j i i i r occupation "lawyer" is significant in the opposite direction; i . e . , the j low m asculine in terest group has a higher in terest pattern in that occupation than does the high m asculine in terest group. Thus, for the hem ophiliac group, this fourteenth hypothesis is accepted only for the occupations which reach criterion significance. T h ese are presented in Table 12. T able 13 indicates that the non-hem ophiliacs rated thirty 81 TABLE 12 COMPARISON OF OCCUPATION INTEREST LEVELS OF HEMOPHILIACS WITH LOW AND HIGH MASCULINE INTERESTS a (Hypotheses 14 and 15) Rating on Occupation Rating Scale O ccupation In t e r e s t L ev els* 5 Within Group Low Ml High Ml Between Groups Low vs High MI Masculine Occupations Dentist N Hi** 6.17* Engineer N Hi** 7.87* Production Manager N Hi** 6.47* Farmer N Hi** 12.26** Carpenter Lo** Hi** 15.55** Forest Ranger N HI** 18.99** Aviator Hi** Hi** 8.18* Printer N Hi** 7.69* Police Officer N Hi** 13.90** Army Officer N Hi** 5.28 Minister Lo** Lo** 0.84 Banker N Lo* 0.43 Mortician N N 5.75 Lawyer Hi** N 6.16* President of Manufacturing Co. N N 1.79 Feminine Occupations Artist Hi* N 3.90 Psychologist Hi* N 5.24 Architect Hi** N 0.65 Physician Hi* Hi** 4.68 Osteopath N Hi** 5.95 Mathematician N N - 1.26 Chemist N Hi** 8.89* Math & Science Teacher N Hi** 11.17** Vocational Counselor N N 1.19 Social Science Teacher N N 1.29 Musician N N 0.82 C. P. A. Owner Hi* N 3.64 Office Worker N N 0.67 Purchasing Agent N Hi** 3.09 Real Estate Sales Hi* N 5.36 Advertising Person Hi** Lo** 20.33** Author-Journalist N Lo** 6.64* aCompared by means of chi-square test. N = indeterminate pattern of interest, Hi = high interest; Lo = low interest in occupation as measures by S. V. I. B. °Masculine Interests as measured by standard scores on M-F scale of S. V. I. B. •Significant at or beyond . 05 level. ••Significant at or beyond . 01 level. 82 TABLE 13 COMPARISON OF OCCUPATION INTEREST LEVELS OF NON-HEMOPHILIACS WITH LOW AND HIGH MASCULINE INTERESTS3 (Hypotheses 14 and 15) _______ O ccu p a tio n I n t e r e s t L evels*3 _____ Rating on Occupation Rating Scale Within Group Between Groups Low MI High M IC Low vs High MIC Masculine Occupations Architect Hi** N 6.72* Physician Hi** Hi** 2.17 Psychiatrist Hi** N 5.58 Osteopath Hi** Hi** 2.58 Dentist Hi** Hi** 0.27 Veterinarian Hi* Hi** 22.57** Mathematician N N 0.84 Chemist Hi*» Hi** 2.75 Engineer N Hi** 14.72** Production Manager N Hi** 41.96** Farmer N Hi** 29.04** Carpenter Lo** Hi** 46. 20** Forest Ranger Hi* Hi** 6.55* Aviator Hi* Hi** 21. 68** Printer Lo** Hi** 11.64** Police Officer Lo** Hi** 33.92** Army Officer Hi* Hi** 6.93* "Y" Physical Director N N 0 .38 Personnel Manager N Lo* 1.02 Public Administrator Hi* N 0.81 School Superintendent N Lo** 12.92** Minister N Lo** 16.25** Senior C. P. A. N Hi** 12.95** Purchasing Agent N Hi** 28.51** Banker Lo** N 10.43** Mortician N Hi** 17.25** Sales Manager Hi** Hi** 1.08 Life Insurance Sales N Lo** 9.83** Lawyer Hi** Lo** 31.37** President of Manufacturing Co. Hi**. Hi** 2.63 aCompared by means of chi-square test ^N = indeterminate pattern of interest, H = high interest; Lo = low interest in occupation as measured by S. V. I. B. °Masculine Interests as measured by standard scores on M-F scale of S. V. I. B. •Significant at or beyond . 05 level. ••Significant at or beyond . 01 level. TABLE 14 COMPARISON OF OCCUPATION INTEREST LEVELS OF NON-HEMOPHILIACS WITH LOW AND HIGH MASCULINE INTERESTSa (H ypotheses 14 and 15) „ . ^ . O c c u p a t i o n I n t e r e s t L evels^3 j a ting on ccupation Within Group Between Groups j Rating Scale_____________ Low MI High MIC Low vs High MIC | Fem inine Occupations A rtist Hi** N 21.16** Vocational Counselor N Lo* 1.40 Social Science Teacher N Lo** 4.65 M usician Hi** Lo** 21.48** Office Worker Lo** N 9.19* Real E state Sales N N 1.35 Author-Journalist Hi** Lo** 42.97** Si Compared by m eans of ch i-sq u are test. N = indeterm inant pattern of interest; Hi = high in terest, Lo = low in terest in occupation as m easured by S. V. I. B. c I M asculine in terests as m easured by standard scores on M -F sc a le of S. V. I. B. ^Significant at or beyond .0 5 le v e l. **Significant at or.beyond .0 1 le v el. 84 TABLE 15 OCCUPATION RATING SCALE SCORES FOR HEMOPHILIACS AND NON-HEMOPHILIACS a (Hypothesis 16) Title of Occupation O ccu p ation R a tin g s* Within Group Hemo Non-Hemo Between Groups Hemo vs Non-Hemo Artist p** F*+ 0.89 Psychologist P** f/m 8.38** Architect f/m M** 7.99** Physician F** 39.48** Psychiatrist f/m M** 6.23* Osteopath F** M** 12.24** Dentist M* M** 9. 68** Veterinarian f/m M** 2.23 Mathematician F* M* 2.90 Chemist F** M** 8.77** Engineer J y J * * M** 6.14* Production Manager M** M*» 9.21** Farmer M** M** 5.60 Carpenter M** M** 0.51 Forest Ranger M** M** 2.96 Aviator M** 1.20 Printer M** M** 4.75 Math. 8 c Science Teacher f/m 12.14** Police Officer M** . M** 1.56 Army Officer M** M** 2.80 "Y” Physical Director f/m M** 2.71 Personnel Manager f/m M** 3.15 Public Administrator f/m M** 10.50** Vocational. Counselor F** F** 2.15 Social Science Teacher F+* F** 0.66 School Superintendent f/m M** 3.76 Minister M** M** 0.00 Musician F** F** 0.64 C.P.A. Owner F** f/m 3.38 Senior C. P. A. f/m M** 6.93** Accountant f/m f/m 0.50 Office Worker F** F** 2.39 Purchasing Agent F** M** 11.67** Banker M** M** 5.45* Pharmacist f/m f/m 2.56 Mortician M** M** 2.21 Sales Manager f/m M** 7.70** Real Estate Sales P** F** 6.19* Life Insurance Sales f/m M** 1.86 Advertising Person F** f/m 7.30** Lawyer M** M** 1.27 Author-Journalist F** F** 1.93 President of Manufacturing Co. M** M** 3.02 Q Compared by means of chi-square test. "M = occupations rated as masculine, F = occupations rated as feminine and f/m = occupa tions rated as equally distributed between F and M. •Significant at or beyond . 05 level. ••Significant at or beyond .01 level. 85 occupations as m asculine; and of these, fourteen significantly I ! I differentiate the low and high m asculine in terest groups in the pre- I ! dieted direction. F ive occupations are significant in the opposite 'i direction, but only two reflect high in terest patterns (law yer and j architect) in the low m asculine in terest group. T herefore, for the non-hem ophiliacs also, the fourteenth hypothesis is accepted for those occupations which reach criterion sign ifican ce. j Hypothesis 15 is the counterpart of Hypothesis 14 and proposes that hem ophiliacs and non-hem ophiliacs who have low m asculine in terests have greater in terests in occupations rated as fem inine than do those individuals who have high m asculine in terests. For the hem ophiliac group, Table 12 shows that seventeen occupations are designated as fem inine. The high and low m asculine in terest groups are only significantly different in the hypothesized direction I on two of these occupations, "advertising person" and "author- journalist. ” The groups differ significantly in the opposite direction from that predicted for the occupations "chemist" at the . 05 lev el and "math and scien ce teach ef'at the .01 lev el. T h ese data indicate that for the hem ophiliac group the fifteenth hypothesis m ust be rejected . Table 14 reports that seven occupations are rated as [ i I fem inine by the non-hem ophiliacs and that three of these are sig n ifi- i i cant beyond the .01 lev el in differentiating the low and high m asculine j 8 6 I interest groups in the predicted direction. Two additional occupa- | I i j tions are shown to be in the predicted direction, but do not reach i ! i | criterion level of significance. The occupation "office worker" is i significant in the opposite direction from that which was predicted. j These data give partial support for Hypothesis 15, and therefore this i hypothesis is accepted only in reference to the occupations "artist," j i I | "musician," and "author-journalist," for the non-hemophiliacs. j t ' i t i Hypothesis 16 states that the hemophiliacs and non- j hemophiliacs differ in their rating of occupations as either m asculine or feminine. T hese ratings w ere made on the Occupation Rating Scale, which provided the rater the opportunity on a six point scale to rate forty-three occupation titles which were taken from the SVIB. The results of chi-square tests for ratings within groups and between groups are given in Table 15. A total of eighteen occupations are j rated differently by the two groups with thirteen occupations signifi- I | | cantly different at the . 01 level and five of them at the . 05 level. Of these, fourteen are rated as m ore m asculine occupations by the non hemophiliacs. This group rated thirty occupations as masculine and only seven as feminine, while in contrast the hemophiliacs rated fifteen as m asculine and seventeen as feminine. These results i l indicate that Hypothesis 16 is accepted in reference to eighteen of the j j forty-three occupations that were rated. Hypothesis 17 is the final one of this study, and it states I { 1 that hem ophiliacs who have spent the greatest number of days in the j ! ' i I j | hospital birth and five years of age, identify m ore c lo sely with the s i opposite-sexed parent. Hospital records w ere available for only j eighteen of the thirty-nine hem ophiliacs for their fir st five years of life . Table 16 shows the distribution of total number of days of | | | hospitalization for bleeding episodes for this group. C orrelations of j i ! i j the concept ”m e-m other, ” as w ell as all the other Word Meaning T est concepts used in this study—with number of days in the hospital, are presented in m atrix form in Appendix A. The correlation coefficients for number of days in hospital and ’’m e-m other" is in the predicted direction for both the evaluative and potency fa cto rs, but are not large enough to be significant; therefore, the seventeenth hypothesis j m ust be rejected. I TABLE 16 I HOSPITALIZATION RECORD DURING FIRST FIVE YEARS OF LIFE FOR EIGHTEEN HEMOPHILIACS Number of Days H ospitalized 1 to 10 11 to 20 21 to 30 31 to 40 100 to 200 Number of Hem ophiliacs 5 5 2 4 2 The findings are sum m arized in the next chapter. CHAPTER V j i SUMMARY, DISCUSSION, AND CONCLUSIONS ; i i i j This chapter presents a review of the study with a discussion of som e of the im plications. Follow ing a sum m ary of the findings, ; j | there is a d iscussion. The chapter ends with a presentation of the ; t i conclusions relating to the hypotheses which w ere the bases of the study. Summary Purpose of the study j It was the purpose of this study to explore the relationships that might exist between the intervening variables of se x -r o le identity, i self-con cept, and vocational in terests and the m edical disability of I i Ihemophilia in a group of adolescent hem ophiliacs. It was proposed j that through these intervening variables the connection between the disability of hemophilia and behavior was m ediated. A total of seventeen hypotheses w ere subm itted for in vesti gation. The first seven dealt with the relationship between hemophilia! 89 and se x -r o le identity, w hile the rem aining hypotheses focused on ] the areas of self-con cep t and vocational in terests. T h ese hypotheses I | are sp elled out in detail in Chapters I, III, and IV and therefore are } I | not repeated in this section. i i ! t ; i Procedure and test instrum ents j ■ ■ ■ ■ ■ ................ H4i.il an .................. i Two groups of boys ranging in age from 15 to 18 years w ere I given identical test batteries with the exception of one test. The j group consisting of thirty-nine hem ophiliacs w ere given an individual intelligence test, w hile the group consisting of 104 non-hem ophiliacs w ere given a group test of intelligence. The re st of the test battery con sisted of the Word Meaning T est (Goldfarb form ), the Occupation Rating Scale, and the Strong Vocational Interest Blank. Each group a lso com pleted the Vaughan’s Socioeconom ic Index Scale. The non hem ophiliac group w ere randomly selected from gym c la sse s at | Pasadena High School, and testing was com pleted with this group on j j i | two consecutive days in the spring of 1966. The hem ophiliacs w ere | tested as a group during the spring of 1966 at the Los A ngeles | Orthopaedic H ospital. Nine concepts and tw elve bipolar adjective sc a le s w ere used i i on the Word M eaning T est to yield resu lts in term s of the evaluative, ; activity, and potency factors. The "D" sta tistic was employed as the j ! ! | m easure of congruence of ratings on the concepts "me" and " fem a le,” ! 90 "m ost lik e to be," "my body," "m ale," "m other," "father," "taking r isk s," and "hem ophilia." The Strong Vocational Interest Blank was used to obtain I patterns of vocational in terests and a lso to m easure m asculinity of j | in terests. The Occupation Rating Scale perm itted each adolescent | to assign a rating of "masculine" or "feminine" to each occupational i ! title from the Strong Vocational Interest Blank. S tatistical procedures Appropriate computer program s w ere applied to the data to test each of the hypotheses. The partial correlations, "D" sc o r e s, m ultiple reg ressio n coefficien ts, and significance te sts w ere computed from the data by the IBM 360 M odel 75 com puter at the Health Sciences Computing F acility of the U niversity of California at Los A ngeles. Summary of findings The findings relative to the seventeen separate hypotheses are tabulated on Table 17. The first six hypotheses, which dealt with se x -r o le identity, w ere rejected and only Hypothesis 7 which in v esti gated this area had partial acceptance. T h ese resu lts w ere in ter preted as meaning that hem ophiliacs and non-hem ophiliacs have m ore : sim ila rities than differences in their patterns of se x -r o le identity. i Hypotheses 8 through 16 w ere a ll either partially or fully ! I 91 TABLE 17 SUMMARY TABULATION OF FINDINGS FOR ALL HYPOTHESES H ypotheses F i n d i n g s Supported Partially Supported Not Supported Opposite Finding Sex-R ole Identity 1 X 2 X 3 X 4 X 5 X 6 X 7 X Self-C oncept 8 X 9 X 10 X 11 X 12 X 13 X 14 X 15 X 16 X 17 X 92 | accepted with the exception of Hypothesis 11 which yielded findings ! | that w ere significant in the opposite of the predicted direction. T hese findings focused on the area of self-con cep t and supported the propo sition that hem ophiliacs and non-hem ophiliacs differ in sev era l s e lf- | concept ch aracteristics. The evaluative factor was m ore d iscrim - j j inant than either the potency or activity factors in discerning the self-! I ! concept differences. ! | The groups differed in their perceptions of occupations as j being either m asculine or fem inine, and the hem ophiliacs had so m e what different patterns of vocational in terests from those of the non hem ophiliacs . H ypothesis 17 was not accepted, although the resu lts w ere in the predicted direction. T his finding was lim ited in scope, because only eighteen of the thirty-nine hem ophiliacs had hospital I ! record s in lo ca l hospitals which accurately tabulated days of hospital- iization during the patients’ fir st five years of life. i i ! D iscussion Relationship between sex -ro le identity and hem ophilia Contrary to expectation, se x -r o le identity, as m easured by | | the Word Meaning T est, failed to differentiate the hem ophiliacs and j ] S | the non-hem ophiliacs except on the evaluative factor of the concept i 93 "fem ale." The non-hemophiliacs identified more closely with fem ales on this factor than did the hem ophiliacs. Osgood and his co- I ; | ; workers have shown the evaluative factor to be m ost closely related j | to attitude (17). Interpreted within this frame of reference, the ] i 1 j present finding would seem to indicate that the non-hemophiliac has ! | i | a more positive attitude (sm aller "D" score) toward fem ales than | j ! \ | ! does the hemophiliac. This may be due in part to the early enforced I j J dependency the hemophiliac child experiences with his mother and with nurses on hospital staffs, in contrast to the non-hemophiliac who does not encounter this hurdle in his development. With the exception of the potency factor on the concept "male," neither group proved to identify more closely with the lik e-sexed parent. Adolescent hemophiliacs and non-hemophiliacs w ere quite sim ilar in their sex -ro le identity patterns and the hemophiliacs did i i not identify more clo sely with fem ales or with the opposite-sexed j | parent. i i T hese results suggest that sex -ro le identity is not a useful | intervening variable for explaining the som atopsychological factors in j j hemophilia. j I i ' i Theoretical im plications j ! \ • ! | The finding that both the hemophiliacs and the non- j ! ; ;hemophiliacs identified to the sam e extent with "mother" and with____ 1 94 | "father" is in sharp contrast to current theory that norm al develop- ! ! I ment proceeds in the direction of stronger se x -r o le identity with the j I j j lik e-sex ed parent (11, 15). A sim ila r pattern of se x -r o le identifica- ! 1 ! ' | tion was found by Goldfarb in a control group of norm al adult m ales j ] I ; (105). He found that sexual identity and parental identification w ere j j I | reflected only by the body-im age concept on the sem antic differential j | ! i and believed his resu lts reflected the careful wording of the concepts I i I ' ) ! he used in contrast to previous stud ies. j i There are several p ossib le explanations for the resu lts obtained in this phase of the present study. Perhaps the develop m ental sequence of se x -r o le identity for m ales is currently under going som e change to the extent that differentiation of se x -r o le is much le s s clearly defined than has been suggested previously (73, 79). Another p ossib le explanation may be contained in the test instrum ent itself; i. e . , possibly the resp on ses to the Word Meaning |T e st concepts "m other," "father," "m ale," and "female" are not j actual m easures of se x -r o le identity. On the evaluative factor at [least, these concepts may be indicators of the subject's attitude toward the concepts rather than identification with them . Thus, the i resp onses m ay reflect the type of resp on ses that would be obtained j from a direct questionnaire (se x -r o le identity as a sse sse d by direct \ i questioning) rather than responses of an inferred nature such as j would be obtained by the use of projective psychological tests ! i (inferred sex -ro le identity). Parker has recently reported that sig - | I nificant differences are obtained when both self-report measurement | j | techniques and inferred self-m easurem ent scales are used in a s se ss- 1 ] ing self-concept (84). i A future study might employ the use of both a sem antic j I ’ i 1 differential technique and a projective technique with a single d is- j i ! 1 i ability group to see if the two techniques yield sim ilar results in defining the developmental patterns of sex -ro le identity. Relationship between self- concept and hemophilia i The self-concept of the hemophiliac, as m easured by the ! | evaluative factor of the concept "me" on the Word Meaning T est, was j found to be a meaningful intervening variable for explaining a segment t of the somatopsychological relationship found in this d isease. It was j I ' I jfound that the adolescent hemophiliac p o ssesses a le s s positive attitude about him self as a person at this point in his development than does the non-hemophiliac. This area of impairment of the se lf- concept does not sp ill over into the hemophiliac’s feelings of se lf- acceptance and acceptance of his body. In these areas of self-concept |he is much like his non-hemophiliac peer. | The hemophiliac has a greater acceptance of the evaluative | 96 | and potency aspects of hemophilia than does the non-hemophiliac. | This acceptance appears to be central to his "essence of self" as i I defined by Wright (34), and the strength of this self-connection I 5 | gradient (between "me" and "hemophilia”) seem s to be one of the i j valuable coping m echanism s for boys with this disability. The differ- ] | ence in acceptance between the groups also suggests what others have j j ! reported as being a lack of understanding and information regarding this m edical condition by the general public (9, 108). This also im plies that future attempts to inform and educate the general public about hemophilia would do w ell to focus som e of its efforts on the i | adolescent peer population of the hemophiliac. The hemophiliac incorporates into his self-concept an attitude about him self in relation to physical activities and the risks involved in such activities in his everyday experiences. This study | shows that the adolescent hemophiliac is more accepting of taking i I risks than is the non-hemophiliac. Agle (37) and Matteson and Gross (76) have noted that in the extrem es of risk-taking behavior the m echanism of denial of hemophilia has been an important factor. However, by going beyond the few clinical ca ses and looking at a j | larger group of hem ophiliacs, in the present study it was found that ! those who had the greatest acceptance of risk-taking also had the I ; | greatest acceptance of their m edical condition of hemophilia. 97 C onversely, those who w ere lea st accepting of taking risk s showed i | the least acceptance of hem ophilia. Translated into term s of s e lf- i [ | concept, this m eans that acceptance of one's disability also m eans i i the acceptance of the im plications of this disability. T h ese findings | support the idea that risk-taking is a coping m echanism and not a | | denial m echanism when viewed in a la rg e population of hem ophiliacs, | rather than in the isolated clinical ca se situation. The findings seem i j a lso to indicate that to accept the idea that taking risk s is a n ecessity of everyday living and then to subm erge this idea so that it is not dominant in the self-con cep t, im plies that the hem ophiliac m ust first recognize and accept his disability. Hemophiliacs who show the greatest self-accep tan ce also identify with both parents on the evaluative factor (attitude), and with the potency of the sa m e-sex ed parent and m ales w hile, at the sam e ; tim e, rejecting identification with the potency of the opposite-sexed |parent and fem a les. T his sam e finding with the non-hem ophiliac j I j group suggests again the sim ilarity between the groups. The groups did differ in important resp ect in this area, the non-hem ophiliacs who had the greatest self-accep tan ce identified with the fem ales on the activity factor. The sam e was not true of the hem ophiliacs and indicates that greater self-accep tan ce by the non-hem ophiliac m eans g reater identification with fem ales in the activity area. A p ossib le 98 explanation for this may be that the female is generally seen as a le s s active person than the m ale and that the adolescent hemophiliac is m ore concerned with working on the developmental task of positive j m asculine identification and sees him self as m ore active than the female* It was found that the level of m asculinity of interests was not related to the identification with the like-sexed parent. However, hem ophiliacs--who had high m asculine interests--show ed a greater acceptance of the potency of their own bodies, had a m ore positive attitude about taking risk s, and w ere more accepting of their medical condition. That aspect of the self-concept that has to do with m asculin ity of interests also indicated that these interests influence the direction of vocational in terests. Thus, hemophiliacs who had high * m asculine interests tended to have greater vocational interests in ; those occupations that w ere rated as m asculine by the total hemo philiac group than did the hemophiliacs who had low masculine in terests. The same was found to be true for the non-hemophiliacs. The groups differed in respect to their perceptions of whether an occupation was considered to be m asculine or feminine. The hem o- | philiacs see many more occupations as being feminine and show ! vocational interest patterns in these occupations. Non-hemophiliacs show high in terest patterns in the sam e occupations; however, they j i rate m ost of th ese occupations as m asculine rather than as fem inine, j i i The hem ophiliac appears to p erceive occupations as being fem inine if j they require lim ited p hysical activity. T his perception, coupled with j i i his perception that being inactive, is being fem inine; and his aw are- j i | n ess of his need to identify with m asculine activity may result in | t \ | erroneous self-d irected attem pts to enter into many occupations ’ j | m erely because they are perceived as being m asculine occupations. I S elected aspects of the hem ophiliac’s self-con cep t w ere found to contain meaningful intervening variables for understanding the som atopsychological relationship between hem ophilia and hem o philic behavior. T hese intervening variables are: evaluation of self, acceptance of hem ophilia (disability), self-accep tan ce (self-estee m ), acceptance of taking risk s, m asculinity of in terests, and vocational in terests. i I j Further research , using these variables with other disability groups, is needed in order to estab lish the applicability and generality of th ese findings. i Conclusions ! | — i . j Two com posite view s of the adolescent j hem ophiliac: hypothesized and j experim entally derived i The hypothesized adolescent hem ophiliac proposed in itially ! in this study on the basis of previous clin ical studies and reports | | ! w as seen as a young man who identified m ore with his mother and ! | I I j j with fem ales than with his father and m ales. He was seen as having i a different pattern of se x -r o le identity than the adolescent who did not have hem ophilia. His constant need to be aware of his physical lim itation s, in sp ite of the fact that he might physically appear the sam e as his p eers, caused him to have a m ore negative concept of ; h im self as a person and this negative concept exp ressed itself through a need to take greater risk s than seem ed warranted. The greater his | risk-taking behavior, the m ore he denied his hem ophilia. He w as j | | perceived as having a lim ited self-accep tan ce and w as seen as le s s j accepting of his body than his normal adolescent peer. Because of his fem inine identification he was seen as a person who had greater in terests in occupations that w ere perceived as fem inine. The d irec tion and intensity of his se x -r o le identification was felt to be d irectly I i related to the frequency with which he was hospitalized during the j j first five years of life . j t I The resultant view of the adolescent hem ophiliac gained ! 101 j i through this study is a young man with above average intelligence who i j i identifies with both parents equally and with the potency of m ales to a j I j greater extent than does his norm al peer. He is quite sim ila r to the non-hem ophiliac in his pattern of se x -r o le identity. He does not have i I a positive attitude toward h im self as a person, but in spite of this he I . I does not cope with his m edical condition by the u se of ex cessiv e | I denial. He accepts as part of his existence the n ecessity for taking I t i risk s and the m ore accepting he is of this concept, the m ore he is able to accept and cope with his disability. The degree with which he accepts h im self as an individual does not appear to bear any relation to the direction of his se x -r o le identity; however, the m ore self-accep ting he is , the m ore he ! identifies with both.parents and the m ore he rejects the potency of | 1 m other and of fem ales. He is as accepting of his body as is his non hem ophiliac p eer, and he m anifests a favorable attitude to hem ophilia, j He tends to view many occupations as being fem inine, but this p ercep tion appears to be based on the amount of physical activity that may be required in the occupation rather than on the degree of m asculinity of his in terests. The frequency of early hospitalization does not | appear to influence the direction of his se x -r o le identity. B IB L IO G R A P H Y BIBLIOGRAPHY Books 2. 3. 4. i ! 5* i ! 6. 1 1 j I 7. u . 9. Com bs, A. W. and Snygg, D. Individual Behavior. 2d ed. New York: Harper & B r o s., 1959. Connor, F. P. "Education of the Child with Hemophilia" in Institutes on H em ophilia. Edited by H. R usalem . New York: T eachers C ollege, Columbia U niversity P r e ss, 1965. F reud, S. New Introductory L ectures on P sychoanalysis. New York: W. W. Norton & C o ., 1933. Ginzberg, E . , Ginsburg, S. W ., Axelrad, S ., and H erm a, J. L'. Occupational Choice. New York: Columbia U niversity P ress, 1951. H all, C. W ., and Lindzey, G. T heories of P ersonality. New York: John W iley & Sons, I n c ., 1957. Ham ilton, K. W. Counseling the Handicapped in the R ehabil- j itation P ro cess. New York: Ronald P ress C o ., 1950. ! Hawke, W. A. "Emotional Problem s A ssociated with Hemophilia, " Hemophilia Today, A Handbook of Informa tion, 1962. H ougie, C. Fundamentals of Blood Coagulation in C linical M edicine. New York: M cGraw-Hill Book C o ., 1963. H usek, J. M. "Social A spects of Hemophilia" in Institutes on Hemophilia. Edited by H. R usalem . New York: T eachers C ollege, Columbia U niversity P ress, 1965. 103 Journard, S. Personal Adjustment: An Approach through the Study of Healthy Personality. 2d ed. New York: M acm illan C o ., 1963. Kagan, J. - A cquisition and Significance of Sex-Typing and Sex-R ole Identity, " Review of Child Developm ent R esearch . Edited by M. Hoffman and L. W. Hoffman. New York: R u ssell Sage Foundation, 1964. Layton, W. L. (e d .). The Strong Vocational Interest Blank: R esearch and U s e s . M inneapolis: U niversity of Minnesota P re ss, 1960. Lecky, P. Self C onsistency: A Theory of P ersonality. New York: Island P ress, 1945. M aslow, H. H. Motivation and P ersonality. New York: Harper & B r o s ., 1954. M owrer, O. H. Learning Theory and Personality D ynam ics. New York: Ronald P ress C o ., 1950. Murphy, L. B. The Widening World of Childhood. New York: Basic Books, Inc. * 1 962. Osgood, C. E . , Suci, G. J ., and Tannenbaum, P. N. The M easurem ent of M eaning. Urbana, Illinois: U niversity \ of Illinois P ress, 1957. Poinsard, P. J. ’’Psychiatric A spects of Hemophilia, ” Hemophilia and Hemophiloid D ise a se s. Chapel H ill, North Carolina: U niversity of North Carolina P ress, 1957. Ratnoff, O. D. "C lassic H em ophilia," Bleeding Syndrom es: C linical Manual. Springfield, Illinois: C. C. Thom as, Publisher, I960. R oe, A. The Psychology of O ccupations. New York: John W iley & Sons, In c., 1956. _________ , and Siegelm an, M. The Origin of In terests. Washington: Am erican Personnel and Guidance A ssociation, 1964. 105 R ogers, C. R. Client Centered Therapy. Boston: Houghton M ifflin C o ., 1951. "Toward a Science of the Person" in Behaviorism and Phenomenology. Edited by T. W. Wann. Chicago: U niversity of Chicago P ress, 1964. _________ , and Dymond, R. F . (e d s .). Psychotherapy and Personality Change. Chicago: U niversity of Chicago j P ress, 1954. S ears, R . , Maccoby, E. E . , and Levin, H. Patterns of Child R earing. New York: Row, Peterson & C o ., 1957. S ea rs, P. S ., and Sherman, V. S. In Pursuit of S elf-E steem : C ase Studies of Eight Elem entary School Children. Belmont, California: Wadsworth, 1964. Sheldon, W. H. The V arieties of Human Physique, an<Intro duction to Constitutional Psychology. New York: Harper & B r o s., 1940. _________ . The V arieties of Temperament; A Psychology of Constitutional D ifferen ces. New York: Harper & B r o s., 1942. j _________ . V arieties of Delinquent Youth: An Introduction to j Constitutional Psychiatry. New York: Harper & B r o s ., j 1949. Stephenson, W. The Study of Behavior: Q. Technique and Its Methodology. Chicago: U niversity of Chicago P ress, 1953: Super, D. E . The Psychology of C a reers. New York: Harper & B r o s., 1957. _________ , and C rites, J. O. Appraising Vocational F itn e s s . New York: Harper & B r o s., 1962. _________ , Starishevsky, R ., M atlin, N ., and Jordaan, J. P. j C areer Development: Self"Concept T heory. New York: I T eachers C ollege, Columbia U niversity, 1963. ! Wright, B. A. Physical D isability—A Psychological Approach. New York: Harper and Row P ubs., 1960. W ylie, R. C. The Self Concept. Lincoln, Nebraska: University of Nebraska P ress, 1961. A rticles and Periodicals Agle, D. P. "Pupura as a Psychosom atic Entity (a psychi atric study of autoerythrocte sensitization)," Internal M edicine, 1952, 109:685-694. _______ _ . "Psychiatric Studies of Patients with Hemophilia and Relates States, " Archives of Internal Medicine, 1964, 114:76-82. Alby, J. M ., Alby, N ., and Caen, J. "Psychological Prob lem s of H aem ophiliac," Nouv. Rev. Franc. Hematology, 1962, 2:119-130. Anastasiow, N. J. "Success in School and Boys’ Sex-Role Patterns," Child Development, 1965, 36:1053-1066. Astin, A. W ., and N ichols, R. C. "Life Goals and Voca tional-Choice, " Journal of Applied Psychology, 1964, 48:50-58. Ball, M. K ., and R ussell, D. "Relationships between M easures of Identification and Vocational Interests," Proceedings of the 73rd Annual Convention of the American Psychological A ssociation, 1965, 339-340. Barclay, A ., and Thumin, F . J. "A Modified Semantic Differential Approach to Attitudinal A ssessm en t," Journal of Clinical Psychology, 1963, 19:376-378. Barker, R. G ., Wright, B. A ., M yerson, L . , and Gonick, M. R. "Adjustment to Physical Handicap and Illness: A Survey of the Social Psychology of Physique and Disability' Social Science R esearch Council. 2d e d ., Bulletin 55 (New York, 1953). 107 Berger, E. M. "The Relation between E xp ressed A cceptance of Self and E xpressed Acceptance of O thers, " -Journal of Abnormal and Social Psychology, 1952, 47:778-782. Bieri, J ., Lobeck, Robin, and G alinsky. "A Com parison of D irect, Indirect, and Fantasy M easures of Identification,' Journal of Abnormal and Social Psychology, 1959, 58:253-258. B iller, H. B.-, and Borstelmann, L. J. "Intellectual Level and Sex-R ole Development in M entally Retarded Children," Am erican Journal of Mental D eficiency, 1965, 70:443-447. Bronson, G. W. "Identity Diffusion in Late A dolescence, " Journal of Abnormal Social Psychology, 1959, 59:414:417. Brown, D. G. "M asculinity-Fem inity Developm ent in Children," Journal of Consulting Psychology, 1957, 21:197-202. Browne, J. W ., M ally, M. A ., and Kane, R. P. "Psycho social A spects of Hemophilia: A Study of Tw enty-eight Hemophilic Children and Their F a m ilies," Am erican Journal of Orthopsychiatry, 1960, 30:730-740. Brunkan, R. J. "Perceived Parental Attitudes and Parental j Identification in Relation to F ield of Vocational Choice, " | Journal of Counseling Psychology, 1965, 12:39-47. C ass, L. K. "An Investigation of Parent-Child Relationships in Term s of A w areness, Identification, Projection, and Control," Am erican Journal of O rthopsychiatry, 1952, 22:305-331. C rites, J. O. "Parental Identification in R elation to Voca tional Interest Development," Journal of Educational Psychology, 1962, 53:262-278. D iller, L . , and Riklan, M. "Rorschach C orrelates in ! Parkinson’s D isease: M, Motor Inhibition, Perceived j Cause of Illn ess, and Self-A ttitudes, " Psychosom atic ! M edicine, 1957, 19:120-126. 54. Epstein, R ., and Liverant, S. "Verbal Conditioning and Sex-R ole Identification in C hildren," Child Developm ent, 1963, 34:99-106. 55. Erikson, E. H. "The Problem of Ego Identity," Journal of A m erican Psychoanalytic A ssociation , 1956, 4:56-121. 56. F auvre-G illy, J. "M edicosocial A spects of Hemophilia, " Hemophilia and Hemophiliod D ise a se s. Edited by K. Brinkhous. U niversity of North Carolina P ress, 1957, 254-261. 57. F ey, W. F . "Acceptance by Others and Its Relation to A cceptance of Self and Others: A R eevaluation,” Journal of Abnormal and Social Psychology, 1955, 50:274-276. 58. Fitzgerald, D ., and R oberts, K. "Semantic Profiles and Psychosexual Interests as Indicators of Identification," Personnel and Guidance Journal, 1966, 44:802-806. 59. Galinsky, M. C. "Personality Development and Vocational Choice of C linical P sychologists and P h ysicists," Journal of Counseling Psychology, 1962, 9:299-305. 60. Goldy, F . D ., and Katz, A. H. "Social Adaptation in Hem ophilia," Children (Septem ber, 1963), 189-193. 61. Hagen, D. "C areers and Fam ily Atmosphere: A T est of R oe’s Theory," Journal of Counseling Psychology, 1960, 7:251-256. 62. Hall, M ., and Keith, R. A. "Sex-R ole Preference among Children of Upper and Lower Social C la s s ," Journal of Social Psychology, 1964 , 62:101-110. 63. Holland, J. L. "Some Explorations of a Theory of Vocational Choice: I. One and T w o-Y ear Longitudinal S tu d ies,” Psychological M onographs, 1962, 76:545. 64. . "Explorations of a Theory of-Vocational Choice and Achievem ent: II. A Four-Y ear Prediction Study," Psychological R eports, 1963, 12:547-594. 109 Hurt, C. "A Total Program for the Patient with Hemophilia: Psychosocial Problem s," Journal of the Am erican Physical Therapy A ssociation , 1966, 46:1282-1283. Ikkala, E. "Haemophilia, A Study of Its Laboratory, C linical, G enetic, and Social A spects Based on Known Haem ophiliacs in Finland, ” Scandinavian Journal of C linical and Laboratory Investigation, Supplement 45, V ol. 12, 1960. j Jenkins, J. J ., and R u ssell, W. A. "An Atlas of Sem antic j Profiles for 360 W ords," -The Am erican Journal of ! Psychology, 1958, 71:688-699. Jourard, S. M. "Identification, Parent-C athexis, and S elf- E steem , " Journal of Consulting Psychology, 1957, 21:375-380. _________ , and Rem y, R. M. "Perceived Parental Attitudes, the Self, and Security, " Journal of Consulting Psychology, 1955, 19:364-366. _______ . "Individual V ariance Scores: An Indes of the D egree of D ifferentiation of the Self and the Body Im age," Journal of C linical Psychology, 1957, 13:62-63. Kallen, D. J. "Behavioral Science R esearch in Growth and D evelopm ent," A m erican P sychologist, 1965, 8:689-691. L axer, R. M. "Self-Concept Changes of D ep ressive Patients in General Hospital T reatm en t," Journal of Consulting Psychology, 1964, 28:214-219. Lazowick, L. M. "On the Nature of Identification," Journal of Abnormal Social Psychology, 1955, 51:175-183. Luria, A. "A Sem antic A nalysis of a Norm al and a Neurotic Therapy Group, " Journal- of Abnormal and Social Psychology, 1959, 58:216-220. M atteson, A ., and G ross, S. "Adaptational and D efensive Behavior in Young Hem ophiliacs and Their Parents, " Paper read at the 121st Annual M eeting of the Am erican Psychiatric A ssociation (New York City, May 3 -7 , 1965)._ ■f \ 110 M atteson, A ., and G ross, S. "Social and Behavioral Studies on H em ophilic Children and T heir F a m ilie s ," The Journal of Pediatrics, 1966, 68:952-964. Minuchin, P. "Sex-R ole Concepts and Sex-Typing in Child hood as a Function of School and Home Environm ents," Child Developm ent, 1965, 36:1033-1048. | M ussen, P. H. "Some Antecedents and Consequents of I M asculine Sex-Typing in A dolescent Boys, " Psychological j Monograph, 1961, 75:1-24. I _________ , and D istler, L. "Child-Rearing Antecedents of M asculine Identification in Kindergarten Boys," Child D evelopm ent, 1960, 31:89-100. _________ , and Bouterline-Young, H. "Relationships between Rate of Physical Maturing and Personality among j Boys of Italian D escen t," Vita Hum, 1964 , 7:186-200. ! _________ , and Jones, M. C. "Self-C onceptions, M otivations, and Interpersonal Attitudes of Late and E arly M aturing Boys," Child Developm ent, 1957, 28:243-256. \ t Nachmann, B. "Childhood E xperiences and Vocational } Choice in Law, D entistry, and Social Work," Journal of j Counseling Psychology, 1960, 7:243-250. j O’Hara, R. P ., and Tiedem an, D. V. "The Vocational Self- Concept in A d o lescen ce," Journal of Counseling Psychology, 1959, 6:292-301. Parker, J. "The Relationship of Self-R eport to Inferred S elf-C on cept," Educational and Psychological M easure m ent, 1966, 26:691-700. Prugh, D. G ., Staub, E . , Sands, H ., Kirschbaum, R ., and Lehihan, E. "A Study of the Emotional Reactions of Children and F am ilies to H ospitalization and Illn ess," A m erican Journal of O rthopsychiatry, 1953, 23:70-106. Raim y, V. V. "Self R eference in Counseling In terview ," j Journal of Consulting Psychology, 1948, 12:153-163. j I l l R ichardson, S. A ., H astorf, A. H ., and Dornbusch, S. M. "Effects of Physical D isability on a Child’s D escription of H im self," Child D evelopm ent, 1964 , 35:893-907. Roe, A. "Early D eterm inants of Vocational C h o ice," Journal of Counseling Psychology, 1957, 4:212-217. R osenberg, B. G ., Sutton-Smith, B ., and Morgan, E. F . "The U se of Opposite Sex Scales as a M easure of Psychosexual Deviancy, " Journal of Consulting Psychology, 1961, 25:221-225. Sheerer, E. T . "An A nalysis of the Relationship between Acceptance of and R espect for Self and Acceptance of and R espect for Others in Ten Counseling C ases, " Journal of Consulting Psychology, 1949, 13:169-175. S teim el, R. J. "Childhood Experiences and M asculinity- Fem ininity Scores, " Journal of Counseling Psychology, 1960, 7:212-217. Stewart, L. H. "Mother-Son Identification and Vocational Interest," Genetic Psychology, Monograph 60, 1959, 31-63. Suinn, R. M. "The Relationship between Self-A cceptance and Acceptance of Others: A Learning Theory A nalysis," Journal of Abnormal and Social Psychology, 1961, 63:37-42. ' Super D. E. "Vocational Adjustment: Implementing a S elf- C oncept," Occupations, 1951, 30:88-92. T aylor, C. "A Total Program for the Patient with Hemophilia; Educational-Vocational A spects," Journal of the A m erican Physical Therapy A ssociation, 1966, 46:1284- 1285. Turner, R. H ., and Vanderlippe, R. H. "Self-Ideal Congruence as an Index of Adjustm ent," Journal of Abnormal and Social Psychology, 1958, 57:202-206. i i 97. 98. , , 100. 101. 102. 103. 104. | 105. 112 T yler, L. E. "Relationships between Strong Vocational Interest Scores and Other Attitudes and Personality F actors," Journal of Applied Psychology, 1945, 29:58-67. _________ . "The Antecedents of Two V arieties of Vocational In terests," Genetic Psychological Monograph, 1964, 70:177-228. Utton, A. C. "R ecalled Parent-Child R elations as D eterm inants of Vocational C h oice," Journal of Counseling Psychology, 1962, 9:49-53. Vaughan, C. L. "A Scale for A sse ssin g Socioeconom ic Status in Survey R esea rch ," Public Opinion Quarterly, 1958, 22:19-34. W alker, R. N. "Body Build and Behavior in Young Children: II. Body Build and Parents' R atings," Child Developm ent, 1963, 34:1-23. _________ . "M easuring M asculinity and Fem ininity by Children’s Game C hoices, ” Child Developm ent, 1964, 35:961-971. Webb, A. P ., and H arris, J. T. "A Sem antic D ifferential Study of Counselors in an NDEA In stitu te," Personnel and Guidance Journal, 1963, 41:260-263. W orchel, P. Adaptability Screening of F lying Personnel, Development of a Self-C oncept Inventory for Predicting M aladjustm ent," School of Aviation M edicine, U. S. A. F . Report No. 56-62, 1957. M iscellaneous Reports Goldfarb, J. H. "The Concept of Sexual Identity in Norm als and T ransvestites: Its Relationship to the Body Im age, Self-Concept and Parental Identification. " Unpublished dissertation, U niversity of Southern C alifornia, 1963. 113 106. 107. i ! 108. 109. 110. Goldfarb, J. H. Goldfarb Word Meaning Survey (m im eo graphed form ), Hemophilia Dem onstration and Rehabilitation Project, 1964. Orthopaedic Hospital, Los A ngeles, California. Henderson, H. L. "The R elationships between Interests of Fathers and Sons and Sons' Identification with F a th e r s." Unpublished Ph. D. dissertation, T eachers C ollege, Columbia U niversity, New York, 1958. Katz, A. H ., and Husek, J. M. "Social and Vocational Adaptation of the Hemophiliac Adult. " U. C. L. A. School of Public Health, 1965, final report on project No. 647 of Vocational Rehabilitation Adm inistration. Shelsky, I. "The Effect of D isability on Self-C oncept, " Unpublished doctoral dissertation, Columbia U niversity, New York, 1957. Strong, E. K ., Jr. Strong Vocational Interest Blanks for Men and Women, R evised Blanks, Copyright 1959 by the Board of T rustees of the Leland Stanford Junior U niversity, Consulting Psychologists P ress, I n c ., Palo Alto, California. APPENDIX A CORRELATION MATRICES FOR CONCEPTS AND DAYS OF HOSPITALIZATION CORRELATION MATRIX FOR ALL CONCEPTS AND NUMBER OF DAYS . OF HOSPITALIZATION DURING FIRST FIVE YEARS OF LIFE* (N = 18) Concept E v a lu a tiv e F a c t o r 2 3 4 5 6 7 8 9 10 1. Me .34 .23 -.38 .02 .48 .15 -.37 -.42 -.10 2. M e-Female .30 .04 -.01 .26 .29 .13 .20 -.24 3. Me-Wish Tb Be .20 .15 .77 .34 .20 -.06 -.48 4. Me-My Body .24 -.02 -.32 .12 -.02 -.09 5. Me-Male .36 -.09 -.17 -. 32 -. 14 6. Me-Mother .39 .02 -. 28 -. 36 7. Me-Father .17 ,15 -.27 8. Me-Taking Risks .32 -.01 9. Me-Hemophilia .30 10. Days in Hospital *Correlation coefficient of r - .47 significant at .05 level. Correlation coefficient of r - .59 significant at . 01 level. CORRELATION MATRIX FOR ALL CONCEPTS AND NUMBER OF DAYS OF HOSPITALIZATION DURING FIRST FIVE YEARS OF LIFE* (N = 18) Concept A c t iv it y F a c to r 2 3 4 5 6 7 8 9 10 1. Me .15 .56 -.54 .68 .48 .48 .54 -.46 -.17 2. M e-Fem ale .16 .00 .09 .28 15 .00 .14 .04 3. Me-Wish To Be -.22 .52 .43 .33 .43 -.48 .07 4. Me-My Body -.14 .05 -.10 -.19 .19 .34 5. Me-Male .80 .72 . 64 -.14 .00 6. Me-Mother . 86 .57 -.03 ..23 7. Me-Father .73 -.07 .26 8. Me-Taking Risks .04 . 16 9. Me-Hemophilia .26 10. Days in Hospital * Correlation coefficient of r = . 47 significant a t , 05 level. Correlation coefficient of r - . 59 significant at .01 level. » — * I - * o CORRELATION MATRIX FOR ALL CONCEPTS AND NUMBER OF DAYS OF HOSPITALIZATION DURING FIRST FIVE YEARS OF LIFE* (N = 18) Concept P oten cy F a c t o r 2 3 4 5 6 7 8 9 10 1. Me -.72 .59 -.46 .49 -.85 .54 -.30 .18 .12 2. M e-Female - . 33 .50 -.04 .73 -.40 .00 ; "*17 -.15 3. Me-Wish To Be .15 .55 -.44 . 56 -. 14 .42 .29 4. Me-My Body -. 12 .32 -.07 -.07 .08 -.16 5. Me-Male -.17 .46 -.25 .14 .05 6. Me-Mother -.33 .26 -.20 -.04 7. Me-Father .33 . 60 .14 8. Me-Taking Risks .44 -.02 9. Me-Hemophilia .26 10. Days in Hospital ^Correlation coefficient of r = . 47 significant at . 05 level, Correlation coefficient of r - .59 significant at . 01 level. ^ APPENDIX B WORD MEANING TEST INSTRUCTIONS The purpose of this study is to m easure the m eanings of certain things to various people by having them judge the things against a s e r ie s of d escrip tive s c a le s . In taking this test, p lease m ake your judgments on the basis of what these things mean to you. On each page of this booklet, you w ill find a different concept (the word at the top of the page) to be judged and beneath it, a se t of sc a le s. You are to rate each concept on each sca le in order. For exam ple, if the concept at the top of the page is "MY HAND," and you feel that the concept is very clo sely related to one end of the sc a le, you should place your check m ark as follow s: MY HAND large X : _____ : _____ : ______: _____ : _____ : _____ sm a ll or large _____ : _____: _____ : ______: _____ : : X sm a ll If you feel that the concept is quite clo sely related to one or another end of the sc a le (but not extrem ely), you should place your check m ark as fo llo w s: MY HAND j large ___ : X : _____ : ______: _____: _____ : _____ sm a ll or large _____: ______: _____: ______: : X : ____ sm all If the concept seem s only slightly related to one sid e as opposed to the other sid e (but is not rea lly neutral), then you should check as follow s: MY ARM curved ____ : ______ : X : _____ : _____ : _____ : _____ straight or curved ____ : ______: _____ : ______ : X : _____ : _____ straight 120 The direction which you check, of course, depends upon which of the two ends of the sc a le seem s m ost ch aracteristic of the thing you are judging. If you consider the concept to be neutral on the sc a le, both sid es of the sca le equally associated with the concepts, or if the sc a le is com pletely irrelevant, unrelated to the concept, then you should place your check m ark in the m iddle space: MY ARM thick : : : X : : : thin Important 1. Place your check m arks in the m iddle of sp a ce s, not on the the boundaries. This : X : : : : : Not this :X 2. Be su re you check every sc a le for every concept— do not omit any. 3. N ever put m ore than one check m ark on a single sc a le. Som etim es you may feel as though you have had the sam e item before on the test. This w ill not be the ca se, so do not look back and forth through the item s. Do not try to rem em ber how you checked sim ila r item s ea rlier in the test. Make each item a separate and independent judgment. Work at fa irly high speed through this test. Do not w orry or puzzle over individual item s. It is your fir st im p ression s, the im m ediate "feelings” about the item s that w e want. On the other hand; p lease do not be c a r e le ss, because we want your true im p ression s. FEMALE 121 ugly strong I w ise light sm all p assive true ! fast m oving hard kind beautiful weak foolish heavy large active fa lse slow still soft cruel calm excitable 122 HOW I WOULD MOST LIKE TC BE sm a ll ____ : _____ : ______: _____: _____ : ______: _____ large m oving ____ : _____ : ______: : _____ : _____ : _____ still true ____ : _____ : ___ : _____ : _____ : ______: _____ fa lse p a ssiv e ____ : _____ : ______: _____: _____ : _______: _____ active ! w ise ____ : _____ : ______: _____: _____ : ______: _____ foolish kind ____ : _____ : ______: _____: _____ : _____ : _____ cruel i fast : _____ : ______: _____: _____ : ______: _____ slow | ugly ____ : _____ : ______: _____: ______ :_____ : _____ beautiful strong ___: _____ : ______: _____: _____ : _____ : _____ weak i calm ____ : _____ : ______: _____: _____ : _____ : _____ excitable light ____ : _____ : ______: _____: _____ : _____ : _____ heavy hard soft HEMOPHILIA 123 ugly fast strong kind true moving s w ise ! ! [ | sm all | passive calm light hard beautiful slow weak cruel fa lse still foolish large active excitable heavy soft MALE calm w ise i } sm all hard m oving ugly p assive kind light true strong fast excitable foolish la rg e soft still beautiful active cruel heavy fa lse weak slow FATHER ugly ____ : ______: : ___________ : _____ : ____ beautiful fast : : : : : : slow true : : : : : : false j moving ____ : _____ : _____ : _____ : _____ : ______: still strong ____ : _____ : _____: ______: : : ____ weak sm all ____ : _____ : _____ : _____ : _____: _____ : _____ large ! hard : : : : : : soft ! J ! passive ' : _____ : _____ : : _ : _____ : _______ active light ____ : _____ : _____ : _____ : _____: _____ : _____ heavy kind : : : : : : cruel calm : : : : : : excitable w ise foolish kind TAKING RISKS 126 | j cruel ! fast i ! moving w ise ugly hard i i sm all i i |stron g i i } ! true i calm i p assive slow still foolish beautiful soft large weak false excitable active light heavy MOTHER 127 sm all large calm excitable fast slow m oving still p assive ugly active beautiful I true I I light fa lse heavy w ise foolish strong ____ : _____ : _____ : _____ : _____ : _____ : _____ weak hard ____ : ______: _____: _____ : _____ : : ____ soft kind : : : : : : cruel i 128 MY BODY fast w ise strong sm all moving true passive ) kind j I light hard ugly calm slow foolish weak large still false active cruel heavy soft beautiful excitable ME 129 moving kind light strong true fast sm all | ugly i I calm w ise p assive hard still cruel heavy weak fa lse slow large beautiful excitable foolish active soft APPENDIX C OCCUPATION RATING SCALE 131 OCCUPATION RATING SCALE D irections The purpose of this sc a le is to m easure the degree to which you feel each occupational title listed below is either m asculine or fem inine. If you feel the occupation is very clo sely related to one end of the sc a le (feminine) or to the other end (m asculine), then place the mark as follow s: Sales Clerk M asculine ____ : ______: ____ : _____ : ______ : x F em inine or M asculine x : _____ : _____ : ___________________ Fem inine If you feel that the occupation is quite clo sely related to one end of the i sca le, but not extrem ely, you should place your check mark as [ t follow s: Sales Clerk M asculine ____ : ______: ____ : ______ : x : ____ Fem inine or M asculine : x : ____ : _____ : ______: _____ F em inine If you feel that the occupation is only sligh tly related to one sid e as opposed to the other sid e, you should check as follow s: Sales Clerk M asculine : : : x : : Fem inine 132 M asculine Important 1. 2 . 3. 4. or : x : : : Fem inine Place your check m arks in the m iddle of the spaces and not on the boundaries. Be sure you check every sca le as either m asculine or fem inine for each occupation title. N ever put m ore than one check m ark on a single sca le. Som etim es you may feel as though you have had the sam e item before on the test. This w ill not be the case, so do not look back and forth through the item s. Do not try to rem em ber how you checked sim ilar item s earlier in the test. Make each item a separate and independent judgment. Work at fairly high speed through this test. Do not w orry or puzzle over individual item s. It is your first im pressions, the im m ediate "feelings" about the item s that we want. On the other hand, please do not be c a r e le ss, because we want your true im pressions. Artist 133 Masculine Feminine Psychologist Masculine • • » • Feminine Architect Masculine « • Feminine Masculine Masculine Masculine Masculine Masculine Masculine Physician • • Psychiatrist * « Osteopath Dentist Veterinarian • • Chemist • • • Feminine « • Feminine Feminine Feminine « • * t Feminine Feminine M athematician 134 M asculine « • F em inine Engineer M asculine • • • * Fem inine Production Manager M asculine F em inine Farm er M asculine Fem inine Carpenter M asculine F em inine Printer M asculine • « F em inine Math and Science Teacher M asculine Fem inine Police O fficer M asculine Fem inine F orest Ranger M asculine Fem inine M asculine M asculine M asculine M asculine M asculine M asculine Army Officer • * Aviator 'Y" Physical Education D irector Personnel Manager Public Adm inistrator Vocational Counselor 135 Fem inine Fem inine Fem inine Fem inine Fem inine Fem inine M asculine M asculine M asculine Social Science Teacher City School Superintendent • • M inister Fem inine Fem inine Fem inine M usician 136 M asculine • • M asculine M asculine M asculine M asculine M asculine M asculine M asculine 9 • Fem inine C. P. A. Partner • • • » • • • • a * Senior C. P. A. • • • • * » • Office W orker * ■ • • * • • • • • Purchasing Agent • « • • a a a a • Banker » • • • • • • • m • M ortician » • a • » • 1 * • • Pharm acist • * • • * • * • F em inine Fem inine Fem inine Fem inine Fem inine Fem inine Fem inine Sales Manager M asculine • • Fem inine M asculine M asculine Real E state Sales Life Insurance Sales 137 Fem inine Fem inine M asculine M asculine M asculine M asculine Advertising Person Lawyer Author-Journalist President of Manufacturing Concern Fem inine Fem inine Fem inine Fem inine I APPENDIX D VAUGHAN’S SCALE 139 Vaughan, C. L. A sc a le for a sse ssin g socioeconom ic status in survey research . Pub. Opin. Q u a rt., 1958, 22:19-34. Telephone Home Car Ownership Ownership Ownership Occupation: Head House Education Head House Score Private Line Party Line No Phone Own Home Rent Home Two or m ore ca rs, or one car bought new One car bought used No car, ? Prof. and Completed S e m i-p ro f.; C ollege 3 Proprietors M anagers Salesm en, Some C lerical College; 2 W orkers HS Comp. C raftsm en, 1-3 Y ears Forem an, of HS, ? R etired, Un em ployed, ? 1 Protective W orkers, O peratives Other serv ice 8th grade w ork ers, or le s s 0 D o m estics, Laborers Sim ply add the sco res in the five categories to get a socioeconom ic sco re (SES). The SES's are approxim ately norm ally distributed with a mean of about 7, and a standard deviation of about 3. Questions to be asked 1. A re you or is somebody e ls e the chief wage earner in your home? 2. (About the chief wage earner) What is (your, his, her) occupation? (Record occupation of chief wage earner in detail by type of work, and position.) 3. (About the chief wage earner) How far did (you, he, she): go in school? 8th grade or less; 1 to 3 years of high school; completed high school; som e college; completed college. 4. Is there a car in your home? (If yes) How many? (If one car only) Was it bought new or used? 5. Is there a telephone in your home? (If yes) Party or private line? 6. Do you own or rent or own the place where you are living? Socio econom ic Score DISTRIBUTIONS OF SCALED SOCIO ECONOMIC SCORES FROM TWO NATIONAL SURVEYS Per Cent of Households Achieving Each Score Suggested Letter Grade Equivalent ■ and Description j Study #1 Urban & Rural Village Study #2 Urban Only 13 2.7 3 .6 A Top (15%) 12 5.1 4. 6 11 6.7 6.5 10 9.1 8.4 9 10.0 10.5 B Upper (31%) 8 11.6 11.6 Middle 7 12.6 12.9 6 13.3 12.5 C Lower (36%) 5 11.2 10.8 Middle 4 8.8 8 .6 3 6.0 6.1 2 2.9 3.9 D Bottom (18%) 141 Questions Related to Vaughan’s Socioeconom ic Index 1. Who is the ch ief wage earner in your home?(Check one): Y ourself Other person If other person, what is his (or her) relationship to you? 2. Indicate the occupation of the chief wage earner:______________ 3. Indicate le v el of form al education com pleted by the chief wage earner (Check one): Eighth grade o f le s s One to three years of high school Completed high school Som e college Completed college 4. Is there a car in your home: No | ! 1 If y es, indicate how many:____________________ If there is a sin gle car, was it bought: New U sed 5. Is there a telephone in your home? Y es No If y es, indicate if you have: Party line Private line Indicate below if you rent or own the place where you are now living: Rent Own
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Weise, Phillip
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Sex-Role Identity, Self-Concept, And Vocational Interests Of Adolescent Hemophiliacs
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