PROBLEM
I n recent years, a great deal of promising research on the process-reactive dimension in schizophrenia has appeared. It appears to be an unusually useful concept for bringing order to the often confusing and contradictory body of literature on schizophrenia. In these studies, "process" and "reactive" have been operationally defined in a variety of ways, but the most frequent definitions have been in terms of the Phillips Premorbid Scale") and the Elgin Prognostic Scale originated by Wittman@) and modified by Becker'l' 2 , 3 ) .
On a purely rational basis, there seems to be considerable reason to suspect the interjudge reliability of Phillips and Elgin scale ratings. Both rely on social history and/or patient interview material and are highly susceptible to the defensive and psychotic distortions of schizophrenics and their relatives. Undoubtedly, these distortions are sometimes badly exacerbated by the anxiety-producing probes of the social worker or psychologist.
Further reducing the credibility of future ratings is the ongoing de-emphasis of history-gathering in the social worker's role. Yet another problem lies in the combining of characteristics with apparent weak correlations into single rating items in the Elgin. For example, item I11 (L) assumes timidity to be negatively correlated with withdrawal and it contains no pigeonhole into which the patient displaying both traits may be easily placed.
Particularly in view of their widespread use, it is apparent that the Elgin and Phillips scales are in need of thorough evaluation. As part of a larger project, the authors collected Phillips and Elgin ratings on 101 schizophrenic males. This data permitted an evaluation of the inter-rater reliability of the two scales.