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Published Online:https://doi.org/10.1176/ajp.107.9.667

The major findings of this study reinforce the hypothesis that failure to get along in our society is chiefly due to behavior disorder and thus is primarily a problem requiring individual rather than social therapy.

In comparing patients of the Tewksbury State Hospital and Infirmary with their siblings, it was found that in 43.5% of the families the patient was the only member to have had any contacts with the police or welfare agencies. In other families there were additional members who were having trouble, but we very rarely saw a familial pattern of arrests and dependency. It is remarkable that 67% of the patients have probation as well as Social Service Index records, while only 13.6% of the siblings have probation records and 5.9% have both probation and Social Service Index records.

Throughout our investigations we find the differences between patients and their siblings pointing out the superior adjustment of the sibling group in various phases of life. Thus the patients completed approximately a grade less of school than their siblings, fewer of them married, and when they did marry, they were less successful than their brothers and sisters. Whereas the siblings did about as well as their fathers with regard to occupational achievement, the patients represent a much lower level of attainment. As was indicated in One Thousand Unsuccessful Careers, the devastating effect of alcoholism in causing failure is an outstanding feature of our findings.

The results obtained in this study would justify the conclusion that attempts to deal with dependency on a mass basis are doomed to failure. Only through programs involving the concept of personality disorder and its individual treatment can we hope to deal with the great problem of the failure of individuals to function in society.

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