Correlation between treatment expectancy and clinical picture in psychiatric patients

Abstract

We were interested in exploring the relation between expectancy for change in psychiatric patients and treatment outcome, as well as in exploring the relation between expectancy for change and the type and expression of the problems that had led to their current psychiatric treatment. Four types of the treatment expectancies were examined: specific locus of control, specific and general self-efficacy, and perceptions of control. The following clinical variables were examined: diagnosis and distress index (Global index of illness severity). The research was carried out on 129 respondents who received treatment in psychiatric institutions in Vojvodina. A cluster analysis confirmed an existence of six interpretable groups of respondents concerning their treatment expectancies: discouraged patients with an internal locus of control, patients with average scores, self-confident patients with an internal locus of control, helpless patients with an external locus of control, self-confident patients with an external locus of control, and situational optimists. Further analyses indicated that there were statistically significant differences among the clusters concerning their distress index and diagnosis. The results support the hypothesis that high expectations of control and efficacy are related to better psychiatric condition of the respondents. However, there was a complex pattern of relations among individual measures of treatment expectancy. Perceptions of control appeared to be the best predictor of treatment outcome. Although it was suggested that a change toward an internal locus of control was associated with a better psychiatric status, the effects of specific locus of control seem unclear, inconsistent and dependent on the other treatment expectancy measures.