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Biomedical subjects

A L Sterne

Publications and source records attributed to A L Sterne.

10 recordsLinked to original sources

Patients' expectancies and hospital outcome.

Although it is widely held that patients' expectancies for therapeutic gain are related causally to treatment outcome, a recent review of expectancy research found scant evidence for the hypothesized expectancy-outcome relationship. Supportive findings were reported only in studies with serious methodological weaknesses. This study tested the relationship between the prognostic expectancies of hospitalized schizophrenic patients and several objective measures of hospital outcome. It also tested the hypothesis that expectancies may bear primarily a predictive, not causal, relationship to outcome. Multiple regression analyses found patients' expectancies to be correlated significantly with 8 of 15 measures of posthospital adjustment and with 14 of 15 measures of prehospital adjustment. The findings supported the expectancy-outcome relationship and also were consistent with a predictive interpretation of patients' expectancies.

Adult↗

Therapists prophesy.

Therapists' expectancies for therapeutic gain in patients reputedly are linked to the actual outcome of treatment for their patients. Theoretical papers have suggested that therapists' expectancies may cause or facilitate patient therapeutic response to treatment. Unfortunately, empirical data related to these notions are greatly lacking. The present study tested the relationship between therapist expectancy and treatment outcome for hospitalized schizophrenic patients. It also tested two opposing hypotheses re the nature of the link between therapist expectancy and outcome (causative vs. predictive). Multiple regression analyses revealed that therapists' expectancies are multi-dimensional, formed partly on the basis of therapists' knowledge of psychopathology in general and partly on their perception of their patients' pretreatment adjustment. The analyses also revealed that therapists' expectancies were associated significantly with treatment outcome; the data supported a predictive, not causative, interpretation of the nature of therapists' expectancies.

Adaptation, Psychological↗

IQ deficit in schizophrenia: a test of competing theories.

This study tested competing interpretations of IQ deficit in schizophrenic patients. One interpretation (concomitancy hypothesis) holds that IQ loss is a product of schizophrenic symptoms and is remedied as the symptoms remit. The second (prodromal hypothesis) holds that IQ deficit preceeds and facilitates the development of schizophrenic disorder and is not remedied with symptom remission. The IQs of schizophrenic patients were obtained before and three times after hospital treatment. All mean IQs fell within average limits and did not increase significantly after treatment although test-retest correlations suggested slight disruption of IQ in the morbid state. Remitting cases did not differ significantly from nonremitting cases. Paradoxically, chronic patients earned slightly higher IQs than acute patients. The findings are interpreted as providing some support for both interpretations of schizophrenic IQ deficit. It is concluded that the specific IQ tests used and the nature of the patient samples tested will have a significant bearing on which hypothesis is supported in individual studies of schizophrenic IQ deficit.

Acute Disease↗

Patient characteristics and expectancy measures as factors that influence the expectancy-improvement relationship.

A recent study found factored measures of patient's expectancies for therapeutic gain significantly correlated with 1 of 15 objective measures of treatment outcome for the hospitalized patients. A subsequent study of the same relationship that used unfactored expectancy measured with a diagnostically homogenous sample of patients found the patients' expectancies significantly correlated with 10 of the same 15 measures of improvement. This study reexamined the initial expectancy-improvement data using unfactored measures of expectancy. The overall results showed that characteristics of samples of Ss and the adequacy of expectancy measures both significantly influence the results of tests of the expectancy-improvement relationship.

Attitude to Health↗

Affection for patients as a factor in therapists' outcome judgements.

This study was concerned with psychotherapists' evaluations of the outcome of therapy. Staff and resident psychiatrists employed in 23-item questionnaire to rate the seccess of psychotherapy with 85 of their inpatients. These were patients for whom psychotherapy constituted a significant part of the treatment that they received in the hospital. The therapists' responses to the questionnaire items were intercorrelated. The results indicated that a major aspect of a psychotherapist's judgment of the success of treatment-as these judgments usually are employed in current psychotherapy research-is the therapist's affective reaction to the patient, Better-liked patients were viewed as having improved more. However, when the therapists' responses were subjected to factor analysis, independent Improvement and Affection factors emerged. It is suggested that when therapists' ratings of success are used in psychotherapy research they should be treated or refined statistically to minimize potential confounding with their affection for patients.

Adolescent↗