[Psychological mechanisms of refusal reactions in schizophrenic patients]

The psychological study is based on the clinical typology of refusal reactions (RR) in schizophrenic patients--"capitulation", "avoidance", "absenteism". Seventy patients with RR, mean age 27 years, 25 women, 45 men, were examined with the use of a number of psychological methods. The findings prove the hypothesis on the disturbances of motivation as a psychological mechanism of RR in schizophrenic patients. Deficiency is related to functions of the motivational process: incentive function, goal achievement, sense making and strengthened by trait anxiety and desize to avoid danger. The main factor promoting RR formation is basic motivation deficiency caused by endogenous process (schizophrenia). A mechanism of capitulation reaction formation is closely related to expectation of failure and refusal from acting as an opportunity to preserve self-estimation; avoidance reaction is characterized by significant disturbance of the motivation at the stage of incentive, goal achievement and sense making. Motivation deficiency in patients with absenteism reactions is predominantly associated with an specific individual's sense.