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The historical pendulum never ceases to swing back and forth. Our present era,
in which investigation of the nervous system is clearly king of the psychopathology
patch, still tends to emphasize one side over the other. Just as in the recent past
psychologists were given to the excess of interpreting behavior and spending an
equal amount of time speculating about the nervous system-to a degree that
resulted in some scientists talking about behavior and the conceptual nervous
system, so we now seem to be indulging in the exquisitely detailed investigation
of the nervous system and speculating about how it controls behavior (a conceptual
behavioral system?). Current advances in both arenas of research, however, pro-
vide the opportunity to make connections between data on both sides.
The object of this paper is to review some aspects of this situation and to point
to a theory that promotes bridges between body and behavior towards the end of
elucidating various forms of psychopathology. As a side note, I would like to say
that I feel quite comfortable writing this paper in a volume honoring Samuel Sutton.
I had the privilege of discussing research in psychopathology with him on many
occasions. Despite the fact that he spent so much of his time working on the
physiological aspects of psychophysiology, or perhaps because of it, he always
considered the psychological part paramount. Not long before his untimely death,
he told me that he disliked being called a neuroscientist and having his area of
research referred to in this manner. He is a psychologist, he maintained, and his
interest in measuring physiological aspects of an individual in particular psycholog-
ical situations is to shed light on those psychological aspects and not Ferely for
measuring physiological functioning.
Interaction between psychology and biology (I shall be using these terms as if
they were exclusive of one another merely for convenience, not because they
really are unrelated) takes a variety of forms:
1) separate but equal, buttressed by mutual benign neglect-each area going
along its own way, trying to discern distinct characteristics of various psychi-
atric diseases in its own way;
2) complete takeover-assuming that all behavior is caused by the biology of
the body-as Linus Pauling was reported to have said, every crooked
thought has a crooked molecule;
276
SALZINGER: BEHAVIOR & NERVOUS SYSTEM 277
ioral variables (many of which are found in the environment but some of which
are response-produced), can we do the kind of integration suggested by point
number 4 above. Behavior unexamined, with its controlling variables unspecified
or unknown cannot be fruitfully related to any findings about the brain, no matter
how carefully the latter is measured.
Perhaps the most surprising part of Stampfer and Germans (1989) article is the
authors use of the statement we know practically nothing about how it (the
brain) works (p. 154, italics the authors) as justification for the belief that a
revolution in psychiatry will be forthcoming in this area. Here is a group of
investigators who believe, not in benign neglect, but in a takeover approach:
knowledge of all psychiatry through an understanding of the brain only. They say
(p. 154): Understanding of the brain, it should be noted, will also shed fresh light
on important questions as to how it interacts with and is influenced by its social
milieu, and this knowledge is likely to revolutionize the social sciences. Finally,
let us see what Stampfer and German say about problems in living: they are,
according to them, the province of priests, counselors and psychotherapists. No
place here for science or scientific discoveries, whether produced by studies of
the brain or of behavior. But how do we discover that a schizophrenic patient has
a problem? By doing a PET scan? When they abdicate problems in living, are they
not fleeing their own field?
Zubin (1989) also commented on this article showing that the psychosocial
sciences had indeed made some worthwhile discoveries or at least some which the
biologically oriented cannot ignore. He points out (p. 159) that it is the interaction
between the wired-in portion of the brain and the environmental forces, including
especially the psychosocial, that determines our behavior. Elsewhere, he talks
about a neuroplastic portion of the brain that develops as a function of the interac-
tion of the person with hidher environment. Thus, what has to be noted in seeking
connections in the area of psychopathology is not only the interaction of the
sciences-social, behavioral, and neural-but also the interaction of the organisms
that we are all trying to study and understand, the interaction between the insides,
the brain, and the outside, their environment, which impinges on it and interacts
with it. As the person behaves, hidher brain is surely modified even if not always
permanently, and whatever the modifications, they always are in some way related
to subsequent behavior. Under those circumstances, how can one ever talk of
understanding the person-a goal that is critical in helping someone whose behav-
ior is awry-without taking into account both hidher behavior and neural func-
tioning?
Having made clear that we must make every effort to integrate biology and
behavior, it now remains for us to explain how that is to be accomplished. I shall
argue that we need not only to measure (quantify) behavior, but also to analyze it
by discovering the underlying behavioral mechanism as outlined in FIGURE1
(Salzinger, 1980). According to this figure, behavior occurs in the presence of
certain stimuli and has certain consequences. The variable sets that precede the
behavior include the physical state of the organism, a box that the biologically
oriented investigators examine with great enthusiasm. Note that the discontinuous
lines show feedback circuits, in accordance with which the consequences of behav-
ior are such as to alter the state of the organism. Whether that state of the organism
is to be altered by behavior in turn depends on the environment consisting of
stimuli both social (for example, the presence of a friend, or a member of the
opposite sex, a group of individuals or a threatening letter), and/or physical that
promote certain behaviors as a function of their physical effect (for example, the
gravitational pull of a slanted walk, the glare of a light in ones eyes, or the presence
SALZINGER: BEHAVIOR & NERVOUS SYSTEM 279
of delicious food within one's view). The power of these stimuli will depend on
their unconditioned eliciting strength as well as on their conditioned significance.
They acquired significance by becoming discriminative stimuli, that is, occasions
for the occurrence of reinforcement when some behavior is emitted.
Here the importance of the reinforcement history box enters, in that stimuli
have different degrees of control over behavior as a function of the person's
reinforcement history. If a threatening letter had in the past been followed up by
the execution of that threat, then one would expect a different response from the
person receiving the letter than if the person had received such letters in jest only.
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FIGURE 1. The behavioral mechanism explains the various ways in which behavior is
controlled by variables that precede or follow it.
These variable sets are also such as to make certain groups of stimuli more
outstanding and, therefore, more likely to function as controlling stimuli than
others. The environment may make it difficult for a driver to see a traffic light and,
in this way, eliminate some very important control over an individuals driving
behavior. This has the consequence that he/she might be injured in an accident,
impinging on that persons physical state of being able to drive the next time or of
having hidher eyesight injured. The result is that a large set of stimuli no longer
controls that persons behavior. The discontinuous lines show how consequences
of behavior impinge on the variable sets and thus how the biology of the organism
can never be considered as a pristine initiator of a persons actions. Like behavior
itself, all behavioral determinants are in dynamic change. The changes that occur
in individuals consist of wear and tear, fatigue, development of muscles, practice
in mental tasks through learning, and so on. One can also add in this diagram
the input of foods, both nutritious and injurious, the intake of drugs, curative,
entertaining, or injurious to ones nervous system, and so on.
This diagram shows not only how behavior is controlled but also that one can
never consider an organism in any other way but in interaction with the environ-
ment. A number of cautions follow. One cannot measure behavior without being
able to specify the other conditions of the environment both in terms of the stimuli
that precede and the stimuli that follow the behavior of interest. In addition, one
cannot measure any physiological functioning without knowing the conditions
under which the data were collected. An obvious example is the measurement of
blood pressure which will respond to such momentary factors as running up a flight
of stairs, being frightened by something, or even by thinking of some incident.
This is true even when one looks at permanent changes such as the size of venricles
in the brain. Here, one must ask not only whether the ventricles of schizophrenic
patients are reliably larger than those of normals, but also whether this reliable
difference is due to the disease or the consequences of having the disease, which
is, in part, to receive medication that might well produce exactly such a condition.
Let us examine the recent dramatic finding of the ventricle size difference
of schizophrenic patients and their normal monozygotic twins. Using magnetic
resonance imaging, Suddath and colleagues (1990) found that in 12 of the 15
discordant pairs, the schizophrenic twin had larger ventricles; they found no
difference in two of the pairs, and in one, the difference was reversed. They also
found significant differences in the size of the hippocampus of the schizophrenic
and nonschizophrenic twins. These findings revealed an important nongenetic
factor in schizophrenia by using a genetic variable, namely, that of identical genetic
make-up found in monozygotic twins. For some time, it has been claimed that
schizophrenia is a genetic disease, but the percentage of concordance has varied
mightily for identical twins in different studies (Salzinger, 1973). In this study, they
simply took advantage of the discordance with respect to schizophrenia to look
for other differences between schizophrenic patients and normals.
Such an approach would be equally useful for the study of social and behavioral
variables because for monozygotic twins living together, the identity in genetic
make-up reduces the variation not only of genetic causation but also the secondary
effect of differences in social and behavioral variation. Many of the latter effects
are due to such differences as those in physique, physical appearance, and the
environmental differences contingent on those differences. Physical characteristics
often determine the kinds of environments that people will be exposed to. By way
of contrast, similarities of genetic identity and the environmental effects due, for
example, to living in the same family, at the same time, and with the same parents,
will reduce those secondary differences. But what about the crucial question of
SALZINGER: BEHAVIOR & NERVOUS SYSTEM 281
because they found that schizophrenics did not differ from normal subjects in a
continuous performance task. As I shall show below, attention is not merely a
matter of attending too much or too little to stimuli, rather it is a matter of which
stimuli one attends to. In any case, this study is headed in the right direction in
trying to connect body and behavior. What needs to be done in addition is to
narrow down the behavior to a behavioral mechanism.
I wish to mention a recent review by Gray and colleagues (1991)of the neuropsy-
chology of schizophrenia which related biology and behavior in a much more
precise way, at least on the biology side. Unfortunately, it failed to specify the
behavioral side in equal detail. It is recommended that the reader consult the paper
for an excellent example of biological specification of what should be examined to
correspond to behavior in a schizophrenic patient. My comment (Salzinger, 1991),
specifically on that paper, should be read along side it.
Allow me now to discuss what I submit to be an appropriate approach to
specifying the behavioral side ofthe connection. It must first be noted that behavior
is multiply determined. FIGURE I makes that abundantly clear. What remains to
be portrayed is how the basic difference in the patient interacts with all the variables
specified in the behavioral mechanism. Let us suppose that we have before us a
man who suffers from impaired hearing. Clearly, such a man will be exposed to
only a subset of stimuli to which others are subjected. FIGURE 1 shows that stimuli
are present in various ways, for example in setting a n occasion, as in instructions
given or a signal indicating that some form of behavior is now appropriate or
inappropriate. It also makes itself felt in having been involved in that way in the
past.
Stimuli are also present as consequences so that when this man asks for
something and only hears the answer some of the time, he is likely to ask again or
to misinterpret the answer. The general consequences of this might be that the
man might not do something he should have done or he might ask again and again,
annoying the persons around him, with the consequence that he might ultimately
be ignored by others, that he might get angry, thus alienating people; alternatively,
he might think he hears one thing when, in fact, something else is being said, thus
leading to the wrong behavior.
A small problem with one set of stimuli might affect a range of behaviors and
might do so in varying ways depending on the environment; for example, if the
environment is very quiet then the hearing loss might have minimal effect; when
the environment becomes very noisy, however, then the hearing loss would be
very much aggravated. If the people are patient, they might well be willing to
repeat and to make certain that he did understand what they said as opposed to
an environment of impatient people who refused to repeat anything or got angry
easily with people who do not hear. This points out how variable the effect of a
so-called defect might be as a function not only of how it interacts with the man
in question but the way in which that environment responds to him. Even complete
deafness is sometimes missed in young children for quite a time with incorrect
diagnoses of retardation given to them when nobody thinks to test their hearing.
In social situations, people do not go around testing for hearing deficits and
thus the dynamic of the behavioral interaction quickly takes over. The general
consequences of this is considerable variability of behavioral difficulties that such
people display; in some it is the direct consequence of the deficit, but in most it is
the result of the interaction of their deficit with its consequences.
Let us turn then to what might be the basic deficit to be found in schizophrenia.
Allow me to suggest the immediacy effect (Salzinger, 1984). According to that
theory, the behavior of schizophrenic patients is determined by their responding
284 ANNALS NEW YORK ACADEMY OF SCIENCES
but their behavior extinguishes more rapidly than that of normals. When the critical
stimulus, the reinforcer, is no longer there, as is true in extinction, they act as if
conditioning had not taken place. They speak in such a way as to produce speech
more difficult to predict than the speech of normal individuals. In perceptual
constancy experiments, they display greater stimulus constancy than do normals,
thus being controlled by retinal stimulation rather than by object constancy, which
is the main controlling variable of normal individuals. In semantic generalization
experiments, they show greater generalization to sound than to meaning. In sorting
experiments, they are more distractible by unrelated stimuli than are normals,
again showing that stimuli are responded to, not in terms of their appropriateness,
but rather in terms of which stimuli the subject happens to come upon at the time.
With respect to memory, schizophrenic patients are as effective as normal in a
recognition task where the critical stimulus is immediate, but they do considerably
less well when they have to recall-the critical stimulus is now remote. All of
these effects and others similar in content can be found in my review paper. Indeed,
taking all studies on schizophrenic behavior in one year of the Joiirnal ofAbnormal
Psychology, I found in general that all were interpretable in terms of the Immediacy
Theory (Salzinger, 1984).
Another point about the theory is its fit in making connections to biology. There
are many ways in which one can characterize schizophrenic behavior. Most of
these are picturesque but imprecise, and that includes diagnostic descriptions
which unfortunately mix dimensions. Immediacy Theory uses a simple concept in
describing the basic fault, the time dimension. This dimension is, of course, one
that can easily be applied to the nervous system. The dopamine theory of schizo-
phrenia in fact fits very well with it. A greater concentration of dopamine for
whatever reason would allow impulses to pass from neuron to neuron with greater
ease making it more likely for the person so beleaguered to respond to the first
stimulus producing that impulse rather than waiting for another stimulus or relating
it to another stimulus. It also fits well with the deficit in the Wisconsin Sorting Test
where the subject has to learn to respond to different stimuli at different times.
Since all the stimuli are present simultaneously, that always allows the patient to
respond to an inappropriate stimulus, given that hidher eye can easily fall on the
wrong one. The fact that schizophrenic patients do only worse at this task, how-
ever, suggests that given enough time they can learn to respond to the appropriate
stimulus, and suggests that if we devise a therapeutic technique that allows the
patient to be reinforced for responding to remote stimuli, that patient might improve
with respect to other symptoms as well. There is not space to develop this notion
here; it is discussed elsewhere (Salzinger, 1984). The point is that this theory,
which allows an easy connection to biology, also allows a connection to therapy.
In conclusion, to make connections between biological findings and behavioral
ones, first we must devise theories that lend themselves easily to correspond to
biological facts. Second, they must show how the interaction of the basic deficit
with the environment, both social and physical, could, by way of the laws of
learning and conditioning, produce the symptomatology of the disease in question.
REFERENCES