MANIFEST OBJECT REPRESENTATIONS IN CHRONIC PHYSICAL DISEASE (JUVENILE RHEUMATOID ARTHRITIS (JRA), CEREBRAL PALSY (CP))

Abstract

Manifest object representations were examined in adolescent girls with the chronic, fluctuating and progressively crippling disease of juvenile rheumatoid arthritis (JRA) and compared with a control group of girls with the stable, similarly functionally limiting condition of cerebral palsy (CP) and with a control group of physically healthy girls. The manifest object representations of their mothers were also examined and compared.;The Blatt scale of the concept of the object on the Rorschach was used to assess the developmental level of human percepts in terms of differentiation, articulation and integration. It was found that physically healthy children perceived more well-differentiated, highly articulated and integrated human figures seen in constructive and reciprocal interaction than did the JRA or CP children. It was also found that mothers of Healthy and CP children gave more of these developmentally advanced percepts than mothers of JRA children.;The Kelly Role Repertory Grid was used to examine themes in the literature on JRA and corroborated previous postulates regarding conflicts in the areas of inhibition of feelings and anger for both JRA children and mothers. Additionally, JRA children reported themselves to be more likely to experience unhappiness and to prefer to be more socially isolated than Healthy or CP children, confirming literature postulates. Literature postulates of increased symbiosis and dependency in JRA children and mothers was not shown in this study. These findings were discussed in the context of learned helplessness and the unpredictability of JRA.;The Kelly Grid was also used to illustrate representational worlds and showed that the JRA and CP mothers saw their families split into mother-ill child and father-healthy sibling pairings and the mothers also introduced their best friend into the family system. In the context of "illness" constructs, fathers were seen by the two illness groups of mothers as being identical to people whom these mothers disliked and who disliked them. These findings were discussed in the context of maternal overprotectiveness toward a handicapped child.;Healthy mothers and children were concerned with social, ethical issues; the CP group with activity and success; and the JRA group with caretaking and damage issues.