Journal oj Consulting and Clinical Psychology 1975, Vol. 43, No. 2, 276
Intrapsychic and Environmental Variables as Predictors of Length of Hospitalization George A. Glum University of Virginia School of Medicine The purpose of this study was to examine the competing hypotheses that environmental variables contribute independent variance to the prognosis of general psychological disorders or that their predictive potential is accounted for by their relationship to initial level of psychopathology and other biographical data. A survey of the last 10 years of prognostic research for hospitalized psychiatric patients (Clum, Note 1) suggests that the patient's role in the family and their expectations of him play significant parts in his adjustment. Others (Fulkerson & Barry, 1961) have argued that whatever prognostic validity psychological tests have could be attributed to the extent to which they measure severity of illness. A multiple regression analysis which included level of symptomatology, measures of the family environment, and biographical data provided the vehicle for testing these hypotheses. The measure of symptomatology was provided by the Katz Adjustment Scales (Katz & Lyerley, 1963) (significant-other forms), whcih yielded six symptom factors. The significant other was ,asked to rate his expectations of the patient's performance after hospitalization and the kinds of deviant behavior that would be tolerated before a hospital or mental health professional would be consulted. The patient's role in the family was inferred from two biographical variables, age and living with spouse after hospitalization. Length of hospitalization was the criterion used to determine prognosis. Subjects (JV=119) were consecutively admitted psychiatric patients at the University of Virginia Hospital. This sample was divided to test cross-validities of any significant relationships. The results demonstrated no significant correlations between level of symptomatology and Reprints and an extended report of this study may be obtained without charge from George A. Clum, Box 190, University of Virginia School of Medicine, Charlottesville, Virginia 22901.
length of hospitalization. Likewise, significant other's tolerance for deviance and level of expectations were unrelated to the criterion. Patient age was negatively related to length of hospitalization in one sample (r = —.3T,p < .01) but only approached significance in the other (r~— .21). Consequently, compound probabilities were computed for the two correlations, resulting in a significant combined probability of .01 for age. The same situation obtained for "not living with spouse after hospitalization" (/• = .30, p < .01 in one sample; r = .17', p > .05 in the other). Again, compound probabilities yielded a probability of less than .01 for the two samples. This study suggests that neither level of psychopathology nor expectations of significant others were related to length of hospitalization. The results suggested, however, that the patient's role in the family plays a significant part in the length of his hospitalization. Younger patients, and especially those who are not heads of households (inferred from marital status) and who play less important roles in running a household, are to an extent "expendable" for longer periods of time. Since level of psychopathology played no role in length of hospitalization in this sample, it must be concluded that role in family is an important prognostic factor independent of severity of illness. REFERENCE NOTE 1. Clum, G. A. Intrapsychic variables and the patient's environment as factors in prognosis. Unpublished manuscript, University of Virginia, 1973. REFERENCES Fulkerson, S. C., & Barry, J. R. Methodology in Research and the Prognostic Use of Psychological Tests. Psychological Bulletin, 1961, 58, 177-204. Katz, M. M., & Lyerley, S. B. Methods for measuring adjustment and social behavior in the community: I. Rationale, description, discriminative validity and scale development. Psychological Reports, 1963, 13, 503-S3S. (Received August 15, 1974)
276
Intrapsychic and Environmental Variables as Predictors of Length of Hospitalization George A. Glum University of Virginia School of Medicine The purpose of this study was to examine the competing hypotheses that environmental variables contribute independent variance to the prognosis of general psychological disorders or that their predictive potential is accounted for by their relationship to initial level of psychopathology and other biographical data. A survey of the last 10 years of prognostic research for hospitalized psychiatric patients (Clum, Note 1) suggests that the patient's role in the family and their expectations of him play significant parts in his adjustment. Others (Fulkerson & Barry, 1961) have argued that whatever prognostic validity psychological tests have could be attributed to the extent to which they measure severity of illness. A multiple regression analysis which included level of symptomatology, measures of the family environment, and biographical data provided the vehicle for testing these hypotheses. The measure of symptomatology was provided by the Katz Adjustment Scales (Katz & Lyerley, 1963) (significant-other forms), whcih yielded six symptom factors. The significant other was ,asked to rate his expectations of the patient's performance after hospitalization and the kinds of deviant behavior that would be tolerated before a hospital or mental health professional would be consulted. The patient's role in the family was inferred from two biographical variables, age and living with spouse after hospitalization. Length of hospitalization was the criterion used to determine prognosis. Subjects (JV=119) were consecutively admitted psychiatric patients at the University of Virginia Hospital. This sample was divided to test cross-validities of any significant relationships. The results demonstrated no significant correlations between level of symptomatology and Reprints and an extended report of this study may be obtained without charge from George A. Clum, Box 190, University of Virginia School of Medicine, Charlottesville, Virginia 22901.
length of hospitalization. Likewise, significant other's tolerance for deviance and level of expectations were unrelated to the criterion. Patient age was negatively related to length of hospitalization in one sample (r = —.3T,p < .01) but only approached significance in the other (r~— .21). Consequently, compound probabilities were computed for the two correlations, resulting in a significant combined probability of .01 for age. The same situation obtained for "not living with spouse after hospitalization" (/• = .30, p < .01 in one sample; r = .17', p > .05 in the other). Again, compound probabilities yielded a probability of less than .01 for the two samples. This study suggests that neither level of psychopathology nor expectations of significant others were related to length of hospitalization. The results suggested, however, that the patient's role in the family plays a significant part in the length of his hospitalization. Younger patients, and especially those who are not heads of households (inferred from marital status) and who play less important roles in running a household, are to an extent "expendable" for longer periods of time. Since level of psychopathology played no role in length of hospitalization in this sample, it must be concluded that role in family is an important prognostic factor independent of severity of illness. REFERENCE NOTE 1. Clum, G. A. Intrapsychic variables and the patient's environment as factors in prognosis. Unpublished manuscript, University of Virginia, 1973. REFERENCES Fulkerson, S. C., & Barry, J. R. Methodology in Research and the Prognostic Use of Psychological Tests. Psychological Bulletin, 1961, 58, 177-204. Katz, M. M., & Lyerley, S. B. Methods for measuring adjustment and social behavior in the community: I. Rationale, description, discriminative validity and scale development. Psychological Reports, 1963, 13, 503-S3S. (Received August 15, 1974)
276
