Children of one schizophrenic or one manic-depressive parent were evaluated for clinical disturbance in the St. Louis risk research project between 1967 and 1971. This investigation employed a psychological battery using the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale, figure drawings, Thematic Apperception Test (TAT), Rorschach Inkblot Test, and Beery-Buktenica Developmental Form Sequence, plus blind clinical disturbance ratings from the test batteries. Tests were administered individually to children (chronological age: 6-20 years) from intact families with one schizophrenic, manic-depressive, or physically ill parent, or two normal parents (TV = 339). Children of psychiatrically ill parents were found to be more disturbed than children of nonpsychotic parents. Children with a schizophrenic parent demonstrated performance on psychometric evaluation that was in some ways continuous with that of adult schizophrenics. Children of schizophrenic and manicdepressive parents differed from one another and from controls on two measures. In the aggressive content of their TAT stories, children with a schizophrenic parent showed less aggression than normals, and children with a manic-depressive parent showed more aggression than normals. On the Rorschach, children of schizophrenics gave more primitive responses than children of manic-depressives, and the children of normal parents gave an intermediate number of such responses.Offspring of psychotic parents are consid-Psychiatric interviews and diagnoses have ered to be at risk for the development of been a frequent means of assessing clinical schizophrenia and other types of psychopa-disturbance in children of schizophrenics thology in adulthood (

A retrospective evaluation of stories told to three Thematic Apperception Test (TAT) cards by children at risk isolated six characteristics that were associated with functioning six to 10 years later. The characteristics included lack of individual initiative, denial of mother-child relationships, denial of negative outcomes, and lack of autonomy. The TATs of children at risk (due to one parent's hospitalization for a psychotic illness) who subsequently suffered major decompensation themselves (requiring hospitalization or intensive outpatient therapy) could be discriminated from those of children at risk with apparently normal development. The TAT characteristics were independent of the level of adjustment at the time the TATs were administered, not related to the child's IQ, socioeconomic status, race, or other family characteristics, and moderately negatively correlated with story length.

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