Autoprotective efforts of schizophrenics have hardly been systematically investigated until now, although the role of coping processes in regard to numerous psychic disorders is increasingly recognized. The investigation of autoprotective efforts, however, is of special significance in view of the different current formulations of the vulnerability stress concept of schizophrenia. Thus the cognitive disorders in the sense of information processing deficits among schizophrenics deserve our special attention, since they are described consistently as vulnerability characteristics and as cause of a heightened susceptibility to stress, and since they can be considered an explanatory basis for a wide range of subjectively experienced basic disorders of schizophrenia. In the present study the two disorder dimensions and the corresponding autoprotective efforts were investigated among 60 schizophrenic patients, 30 neurotic patients and 30 healthy controls. The schizophrenic patients had both significantly more experimental psychologically operationalized dysfunctions in information processing and subjectively experienced basic disorders. However, we found no correlation between the two levels of investigation. This may mainly be attributed to the fact that on the level of subjective experience the primary disorder, the perception of the disorder and the individual response to the disorder cannot be differentiated unequivocally. All of the schizophrenic patients reported consciously performed autoprotective efforts in regard to basic disorders. In this connection it is of interest that the schizophrenic patients had a significantly higher percentage of problem solving oriented attempts in comparison with the two non-schizophrenic comparison groups, and that this percentage even increased by a progressive amount of disorders. The schizophrenic patients experienced basic disorders with much more emotional tension and existential, ego-threatening anxiety. They were interpreted by the schizophrenic patients as danger signals, by the neurotic patients, however, predominantly as concomitant symptoms of their neurosis, whereas healthy persons comprehended them within the framework of ordinary psychological explanatory models. The relevance of these results in regard to further research in autoprotective efforts of schizophrenic patients and in their possible therapeutic implications is discussed.

New experimental findings show that schizophrenics, as well as some of their non-schizophrenic relatives, manifest basic cognitive disorders defined in terms of variables from the field of experimental psychology. These basic disorders can be regarded as markers--if not, indeed, as psychological manifestations--of vulnerability to schizophrenia. They can be associated with subjectively experienced forms of non-clinically manifest impairments in psychological functioning. It was therefore hypothesised that schizophrenics, as well as non-schizophrenic subjects vulnerable to schizophrenia, will, in the course of learning processes, develop compensatory efforts which may be more or less effective. It is assumed that effective efforts of this kind will take on special significance in stress situations which would tend to elicit the occurrence of a schizophrenic episode. Effective efforts at compensation for basic disorders should be able to act as a 'buffer' against negative stressor effects (moderator function), thus reducing the danger of a psychotic breakdown. These compensation efforts were studied in 40 inpatients in remission after an acute schizophrenic episode. It was found that significant correlations exist between the extent of subjectively experienced basic disorders and the number and kind of conscious compensation attempts. Although the findings to date are of a preliminary and purely descriptive nature they would seem to justify further research.

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It has repeatedly been demonstrated that both acutely psychotic and remitted schizophrenics, as well as some relatives of schizophrenics, show experimentally assessable cognitive dysfunctions, i.e. attentional or information-processing deficits. It is therefore assumed that these are at least potential vulnerability indicators for schizophrenia (Nuechterlein & Dawson, 1984; Nuechterlein, 1987).

A unique case of a homicide committed by a young male psychotic inpatient on a fellow-patient is reported and discussed with regard to the special victim-offender relationship, the relationship between suicide and homicide, the phenomenon of aggression and the question of the management of a highly suicidal psychotic patient, including the issue of continuous observation.