Journal o[ Studies on Alcohol, Vol. 39, No. 1, 1978
Relationships amongControlOrientation, theFIRO-B,andtheWardAtmosphere Scale in Hospitalized Men Alcoholics' Edward A. Greenberg,FrederickW. Obitz and Bruce W. Kaye SUSIMARY. Internally oriented patients' scoreson Rotter's Internal-External Locus
o[ ControlScaleremained the sameovertreatmentbut thoseo1;externallyoriented patients shifted toward greater internal control.
EVERAL RECENTINVESTIGATIONS havefoundthatalcoholics generally perceive themselves in controlof their
k_• ownbehavior (1, 2, 3) asmeasured by Rotter's InternalExternalLocusof Control(x-w) Scale(4). Buttsand Chotlos(5) have argued,however,that theseresultsare inconclusive because controlgroupswere either inappropriately relatedto the samples of alcoholics or not used.Consequently, the questionwhetheralcoholics in generalare moreexternallyor internallyorientedthan comparablegroupsof nonalcoholics cannot yet be definitively answered.Furtherexplorations of the controlorientationconstruct, however,have indicated a consistentrelationshipbetween perceivedcontrolof behaviorand lengthof time in treatmentfor alcoholism:alcoholics perceivethemselves in greatercontrolof their behavioras they experience moretime in treatment(6-10). In spiteof the fact that oneconsequence of treatmenthasbeen increasedinternalitythere are, of course,both internallyand externallyorientedalcoholics. Somedifferencesbetweenthesetwo categories of alcoholics on dimensions otherthan controlorientation have been found. The most studied variables have been the Min-
nesotaMultiphasicPersonalityInventory (MMeI) subscales(1, x From the Veterans Administration Hospital, Phoenix, AZ 85012.
Reprintrequeststo FrederickW. Obitz, Ph.D., VeteransAdministrationHospital, 7th St. and Indian School Rd., Phoenix, AZ 85012. Received for publication: 9 July 1976. Revision: 8 February 1977. 68
CONTROl. OBIENTATION
IN ALCOHOLICS
69
2, 11). These studies,however, have limited themselvesto data collectionat a singlepoint in time, usuallywithin severaldaysof admissionto a treatmentprogram.None have measuredvariables at the onsetof treatmentand again at the conclusion.
Sincealcoholics shiftalongthe controldimension in conjunction with treatmentit is reasonable to hypothesize that they may likewise changeon other pertinentvariablesand that thesevariables may interactwith both treatmentexposureand the •-•, dimension. It was the intent of the presentstudy,therefore,to examinethe differencesat the onsetof treatmentbetweeninternallyand externallycontrolledalcoholics on selectedvariablesand to monitor differential changesbetween the two groupsover the courseof treatment.
The followingmeasureswere selectedfor inspectionin relation to controlorientation:(1) the F•RO-B(12) becauseof its six subscales,Expressedcontrol,or the need to controlothers,and Wanted control,or the needto be controlledby others,may be conceptually related to the •-•, construct,and becausethe remainingfour subscales(Expressedand Wanted inclusionand affection) appear to tap socialcharacteristics ascribedto internal and externalalcoholicsby others( 11); (2) the Ward Atmosphere Scale(WAS)(13) becauseoneof its subscales, Staff control,or the perceptionby inpatientsof staff authorityand regulationin a treatmentprogram, may differ accordingto control orientation;(3) a Staff Rating Scale (sRs), devisedto measurecounselors'perceptionsof their patients,becauseit has been reportedthat psychologists tend to like internallycontrolledpatientsbetter than externallycontrolled ones(14). METHOD
All patientsadmitted to the Phoenix Veterans AdministrationHospital alcoholism treatmentprogram(ATe) during the 41/2-month period from the beginningof Januaryto the middle of April 1976 were asked to participatein the study. The ATe is a 5-•veekinpatient rehabilitation program. The program adopts an abstinencemodel and includesindi-
vidual and group therapy,didacticinput about alcoholism,and Alco-
holicsAnonymous meetings. Patientsenterthe programvoluntarilyafter detoxication. All patientsin the studywere men who had a primary diagnosisof alcoholism.
During the study,54 alcoholics were admittedto the Aaa,;they comprisedthe research sample.Their meanagewas48.6__+ 7.82years(range 26-64). They were testedin small groupsand were assuredas to the
70
E.A.
GREENBERG,F. XV. OBITZ AND B. XV'. KAYE
confidentialityof the results.All subiectsreadily agreedto participate. The •-E scaleand the •mo-B were administeredto thc subiectswithin 4 daysof admission to treatmcntand again4 weekslater. Thc WAS was administeredafter 2 weeks in the program and again after the 4th week in trcatment.The administrationof the w•,s was delaycdbe-
causeit askedquestions aboutward routincwhichpatientscouldnot answeruntil theyhad had morethan4 days'experience in the program. Each •,T•, staff member was asked to completethe sns on each of
his patientsat 2 weeksinto treatmentand againat 4 weeks.The administration of the sns•vasalsodelayedto permitthe counselorenough contactwith his patientto rate the patientmeaningfully. The snsis a simple7-pointrating scaleaskingthe counselor to rate his client on eightvariables:(1) liking or disliking,(2) probabilityof completion of treatment,(3) popularitywith other patients,(4) degreeof selfdisclosure in therapy,(5) frequencyof statinga commitment to change behavior,(6) frequency of seekingout a counselor, (7) responsibility in attendingtherapysessions, and (8) responsibility in completing therapy assignments.
Data gatheredfrom thesemeasures will be presentedand analyzed from two perspectives. First, for the entire sample,correlationsbetween the •-E scaleand all other subscalesat the first and last testing point will be presented. For convenience, thesewill be referredto as pre and post measures.
Second,in order to define more specificallythe implicationsof control orientation, the data from the •-• scale on its first administration
were divided into quartiles.Data on subiectsin thc upper and lower
quartileswere then usedfor further analyses,eliminatingsubiectsin the middle two quartiles.The data •vere thcn subiectedto a seriesof 2 X 2 repeated measuresanalysesof variance.The design was as follows: the first factor was control orientation,either upper quartile externalor lower quartile internal.The secondfactor was time of testing, either at thc beginningof treatment (pre) or at the conclusion (post). Thesetwo factorsrepresentedthe independentvariables.The dependentvariable for each analysisof variancewas one of the subscalesfrom thc other test measures.This designpermitted simultaneous assessmentof the influence of control orientation, time in treatment and the interaction of the two, on each subscaleof all other test measures. RESULTS
Data fi'omthe total samplewill be presentedfirst. The Pearson r between scoreson the x-E scale, each of the subscalesof the
Fmo-Band WASand each of the items of the sRs,for both preand posttestings, are presentedin Table 1. From the pretesting data, the followingemerged:Two correlations reachedsignificance from the Fmo-Bsubscales, Wanted affection(r =--.38, p (.01) and Expressed inclusion(r = --.30, p (.05). Three correlations
CONTROL ORIENTATION IN ALCOHOLICS
TABLE 1.-Correlations
between
Control
Orientation
7].
and Scores on the
FIRO-B, WAS and SRS, Pre- and Posttesting FIRO-B
Pre
Post
WAS
Pre
Wanted inclusion
--.26
.02
Anger and aggression
Wanted affection Wanted control
--.38•' .09
--.01 .44•
Order and organization Program clarity
.21 --.35•
Expressed inclusion Expressed affection Expressed control
--.30* --.24 --.12
--.21 --.26 --.20
Staff control
--.22
WAS
.40•'
Post
--.07 .18 --.13 .15
SRS
.11
.18
Programcompletion
Liking or disliking
--.03
.16
.06 .08 --.08 --.06
.22 ,12 .07 .17
Involvement Support Spontaneity Autonomy
0 --.31 ø --.04 0
.10 .19 --.10 --,17
Popularity with patients Self-disclosure Commitment to change Seeking counselor
Practical orientation
--.24
--,08
Attendance at therapy
--.09
,06
Personal problem orientation --.16
--.21
Completing assignments
--.04
--.02
* P < .05.
? P < .01.
from the ;VA$subscales were significant,Support(r----.31,
p
Relationships amongControlOrientation, theFIRO-B,andtheWardAtmosphere Scale in Hospitalized Men Alcoholics' Edward A. Greenberg,FrederickW. Obitz and Bruce W. Kaye SUSIMARY. Internally oriented patients' scoreson Rotter's Internal-External Locus
o[ ControlScaleremained the sameovertreatmentbut thoseo1;externallyoriented patients shifted toward greater internal control.
EVERAL RECENTINVESTIGATIONS havefoundthatalcoholics generally perceive themselves in controlof their
k_• ownbehavior (1, 2, 3) asmeasured by Rotter's InternalExternalLocusof Control(x-w) Scale(4). Buttsand Chotlos(5) have argued,however,that theseresultsare inconclusive because controlgroupswere either inappropriately relatedto the samples of alcoholics or not used.Consequently, the questionwhetheralcoholics in generalare moreexternallyor internallyorientedthan comparablegroupsof nonalcoholics cannot yet be definitively answered.Furtherexplorations of the controlorientationconstruct, however,have indicated a consistentrelationshipbetween perceivedcontrolof behaviorand lengthof time in treatmentfor alcoholism:alcoholics perceivethemselves in greatercontrolof their behavioras they experience moretime in treatment(6-10). In spiteof the fact that oneconsequence of treatmenthasbeen increasedinternalitythere are, of course,both internallyand externallyorientedalcoholics. Somedifferencesbetweenthesetwo categories of alcoholics on dimensions otherthan controlorientation have been found. The most studied variables have been the Min-
nesotaMultiphasicPersonalityInventory (MMeI) subscales(1, x From the Veterans Administration Hospital, Phoenix, AZ 85012.
Reprintrequeststo FrederickW. Obitz, Ph.D., VeteransAdministrationHospital, 7th St. and Indian School Rd., Phoenix, AZ 85012. Received for publication: 9 July 1976. Revision: 8 February 1977. 68
CONTROl. OBIENTATION
IN ALCOHOLICS
69
2, 11). These studies,however, have limited themselvesto data collectionat a singlepoint in time, usuallywithin severaldaysof admissionto a treatmentprogram.None have measuredvariables at the onsetof treatmentand again at the conclusion.
Sincealcoholics shiftalongthe controldimension in conjunction with treatmentit is reasonable to hypothesize that they may likewise changeon other pertinentvariablesand that thesevariables may interactwith both treatmentexposureand the •-•, dimension. It was the intent of the presentstudy,therefore,to examinethe differencesat the onsetof treatmentbetweeninternallyand externallycontrolledalcoholics on selectedvariablesand to monitor differential changesbetween the two groupsover the courseof treatment.
The followingmeasureswere selectedfor inspectionin relation to controlorientation:(1) the F•RO-B(12) becauseof its six subscales,Expressedcontrol,or the need to controlothers,and Wanted control,or the needto be controlledby others,may be conceptually related to the •-•, construct,and becausethe remainingfour subscales(Expressedand Wanted inclusionand affection) appear to tap socialcharacteristics ascribedto internal and externalalcoholicsby others( 11); (2) the Ward Atmosphere Scale(WAS)(13) becauseoneof its subscales, Staff control,or the perceptionby inpatientsof staff authorityand regulationin a treatmentprogram, may differ accordingto control orientation;(3) a Staff Rating Scale (sRs), devisedto measurecounselors'perceptionsof their patients,becauseit has been reportedthat psychologists tend to like internallycontrolledpatientsbetter than externallycontrolled ones(14). METHOD
All patientsadmitted to the Phoenix Veterans AdministrationHospital alcoholism treatmentprogram(ATe) during the 41/2-month period from the beginningof Januaryto the middle of April 1976 were asked to participatein the study. The ATe is a 5-•veekinpatient rehabilitation program. The program adopts an abstinencemodel and includesindi-
vidual and group therapy,didacticinput about alcoholism,and Alco-
holicsAnonymous meetings. Patientsenterthe programvoluntarilyafter detoxication. All patientsin the studywere men who had a primary diagnosisof alcoholism.
During the study,54 alcoholics were admittedto the Aaa,;they comprisedthe research sample.Their meanagewas48.6__+ 7.82years(range 26-64). They were testedin small groupsand were assuredas to the
70
E.A.
GREENBERG,F. XV. OBITZ AND B. XV'. KAYE
confidentialityof the results.All subiectsreadily agreedto participate. The •-E scaleand the •mo-B were administeredto thc subiectswithin 4 daysof admission to treatmcntand again4 weekslater. Thc WAS was administeredafter 2 weeks in the program and again after the 4th week in trcatment.The administrationof the w•,s was delaycdbe-
causeit askedquestions aboutward routincwhichpatientscouldnot answeruntil theyhad had morethan4 days'experience in the program. Each •,T•, staff member was asked to completethe sns on each of
his patientsat 2 weeksinto treatmentand againat 4 weeks.The administration of the sns•vasalsodelayedto permitthe counselorenough contactwith his patientto rate the patientmeaningfully. The snsis a simple7-pointrating scaleaskingthe counselor to rate his client on eightvariables:(1) liking or disliking,(2) probabilityof completion of treatment,(3) popularitywith other patients,(4) degreeof selfdisclosure in therapy,(5) frequencyof statinga commitment to change behavior,(6) frequency of seekingout a counselor, (7) responsibility in attendingtherapysessions, and (8) responsibility in completing therapy assignments.
Data gatheredfrom thesemeasures will be presentedand analyzed from two perspectives. First, for the entire sample,correlationsbetween the •-E scaleand all other subscalesat the first and last testing point will be presented. For convenience, thesewill be referredto as pre and post measures.
Second,in order to define more specificallythe implicationsof control orientation, the data from the •-• scale on its first administration
were divided into quartiles.Data on subiectsin thc upper and lower
quartileswere then usedfor further analyses,eliminatingsubiectsin the middle two quartiles.The data •vere thcn subiectedto a seriesof 2 X 2 repeated measuresanalysesof variance.The design was as follows: the first factor was control orientation,either upper quartile externalor lower quartile internal.The secondfactor was time of testing, either at thc beginningof treatment (pre) or at the conclusion (post). Thesetwo factorsrepresentedthe independentvariables.The dependentvariable for each analysisof variancewas one of the subscalesfrom thc other test measures.This designpermitted simultaneous assessmentof the influence of control orientation, time in treatment and the interaction of the two, on each subscaleof all other test measures. RESULTS
Data fi'omthe total samplewill be presentedfirst. The Pearson r between scoreson the x-E scale, each of the subscalesof the
Fmo-Band WASand each of the items of the sRs,for both preand posttestings, are presentedin Table 1. From the pretesting data, the followingemerged:Two correlations reachedsignificance from the Fmo-Bsubscales, Wanted affection(r =--.38, p (.01) and Expressed inclusion(r = --.30, p (.05). Three correlations
CONTROL ORIENTATION IN ALCOHOLICS
TABLE 1.-Correlations
between
Control
Orientation
7].
and Scores on the
FIRO-B, WAS and SRS, Pre- and Posttesting FIRO-B
Pre
Post
WAS
Pre
Wanted inclusion
--.26
.02
Anger and aggression
Wanted affection Wanted control
--.38•' .09
--.01 .44•
Order and organization Program clarity
.21 --.35•
Expressed inclusion Expressed affection Expressed control
--.30* --.24 --.12
--.21 --.26 --.20
Staff control
--.22
WAS
.40•'
Post
--.07 .18 --.13 .15
SRS
.11
.18
Programcompletion
Liking or disliking
--.03
.16
.06 .08 --.08 --.06
.22 ,12 .07 .17
Involvement Support Spontaneity Autonomy
0 --.31 ø --.04 0
.10 .19 --.10 --,17
Popularity with patients Self-disclosure Commitment to change Seeking counselor
Practical orientation
--.24
--,08
Attendance at therapy
--.09
,06
Personal problem orientation --.16
--.21
Completing assignments
--.04
--.02
* P < .05.
? P < .01.
from the ;VA$subscales were significant,Support(r----.31,
p
