The Schizophrenic as Soothsayer

Abstract

It is generally believed that patients' prognostic expectancies are linked to the outcome of treatment. It is also generally believed that the nature of the expectancy-outcome relationship is causative: patients' expectancies are viewed as causing or facilirating patients' responses to treatment. The study reported here tested both notions. The expectancies of hospitalized schizophrenic patients were tested by multiple regression for association with objective measures of the patients' pre- and post-treatment adjustment. Expectancy measures were closely correlated with patients' pre-treatment adjustment at hospital admission, were moderately correlated with patients' post-treatment adjustment at discharge, and were almost completely independent of post-treatment adjustment at 9-mo. follow-up. It is speculated that patients may base their prognostic expectancies partly on their pre-treatment adjustment, that patients' expectancies are associated with short-term measures of outcome, and that patients' expectancies predict but do not primarily cause or facilitate a therapeutic response to treatment for hospitalized schizophrenic patients. Finally, limitations of the findings and their generalizability are discussed.