A-B therapist status, patient diagnosis, and psychotherapy outcome in a psychiatric outpatient population.

Previous research generally has supported the hypothesis that A therapists obtain better therapy outcomes with schizophrenics, while B therapists do better with neurotics. Based on recent evidence, a 2nd hypothesis (super A) has been advanced which predicts that A therapists do at least as well with neurotic patients as do B therapists and that As obtain significantly more positive outcomes with schizophrenics. To examine these hypotheses, the therapy outcomes of 7 A and 4 B therapists, differentiated by their scores on the 23-item Whitehorn and Betz (1957) A-B scale, with their 18 schizophrenic and 18 neurotic patients were examined. A multivariate ANOVA computed for the 2 outcome measures, therapists' ratings of patient improvement and number of therapy sessions, clearly supported the super-A hypothesis. Separate ANOVAs demonstrated further support for the super-A hypothesis with therapists' ratings as the dependent variable, whereas the interaction hypothesis received support with number of sessions attended as the dependent measure. Of considerable importance was the fact that the addition of ataractic medication to the treatment of schizophrenics did not attenuate the effect of the A-B therapist distinction on therapeutic outcome. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A-B therapist distinction, patient diagnosis, and outcome of brief psychotherapy in a college clinic.

Prior studies suggest that therapists' A-B status (types catagorized by the Whitehorn-Betz A-B scale) interacts with patient diagnosis in determining the outcome of psychotherapy (A > B with schizophrenics, B > A with neurotics). To discern whether the hypothesis would apply to brief psychotherapy in a college clinic, the "outcomes" obtained by 3 A and 3 B therapists with their schizoid and neurotic patients (N = 57) were examined in a 2 * 2 factorial design. Analysis of 3 dependent measures based on therapists' and patients' posttherapy ratings reveal considerable support for the hypothesis, particularly for therapists' appraisals of their own effectiveness (interaction, p     

Effectiveness of A and B therapists with schizophrenics and neurotics: A referral study.

A basic assumption in the therapist A-B variable literature has been that A therapists are more effective with schizophrenic patients and that B therapists are more effective with neurotic patients. This has not been adequately demonstrated among experienced, practicing therapists since the original work of J. C. Whitehorn and B. J. Betz (1954, 1957, 1960) and D. McNair et al (1962). The current study attempted such a demonstration. Assuming a close relationship between a therapist's effectiveness and his/her reputation among professional colleagues, the study asked each of 60 psychologists to "refer" each of 6 case vignettes (2 schizophrenic, 2 neurotic, and 2 "other") to the colleague he/she believed would be most effective with that case. 41 Ss (20 As and 21 Bs, as determined by the Schiffman et al A-B scale reported by D. E. Kemp and J. H. Stephens, 1972) completed the task. A therapists received more schizophrenic than neurotic referrals, whereas B therapists received more neurotic than schizophrenic referrals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The A-B therapy-type distinction, accurate empathy, nonpossessive warmth, and therapist genuineness in psychotherapy.

Assessed the therapist-offered conditions present among 4 A- and 2 B-type therapists paired variously with 29 neurotic and 20 schizophrenic patients. Results suggest that therapist-offered conditions relate to depth of patient self-exploration but not to rated improvement. Furthermore, A-type therapists were more empathetic with schizophrenic than with neurotic patients, but B-type therapists showed no significant increases of beneficial therapist qualities as a function of the patient's diagnosis. (16 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Accurate empathy" and the A-B dichotomy.

Compared B-type therapists with neurotic patients and A-type therapists with schizophrenic patients, with the opposite patient-therapist pairings for 2 criterion measures of "improvement" and a measure of "accurate empathy." 8 therapists were given the A-B scale and their sessions with a total of 31 patients recorded. Neither judged improvement nor length of hospitalization was significantly related to either high- vs. low-empathy ratings or to type of therapist-patient pairings. As predicted, however, B-type therapists with neurotic patients and A-type therapists with schizophrenic patients displayed more empathy than with the reverse pairings. Results indicate a relationship between the findings of 2 independent lines of research on therapy outcome, 1 basing outcome predictions on client-centered theoretical constructs, the other on the empirical value of the A-B scale. (16 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responses of A and B subjects to normal, neurotic, schizophrenic, and ambiguous communications.

Investigated the initial reactions of 20 A and 20 B undergraduates to "encounter situations" in which they were asked for help by 4 hypothetical patients communicating in normal, neurotic, schizophrenic, or ambiguous styles. For each patient communication, Ss responded to the following questions: (a) "What might he mean?" (b) "What might he be feeling?" (c) "How would you feel in this situation?" (d) "What do you think you would do?" Results indicate that (a) A's more frequently interpreted patient communications symbolically than did B's; and (b) A's exhibited greater congruence than B's, as indicated by their greater use of feeling words in describing their reactions to the hypothetical patients. Results were related to previous A-B findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practicing A and B psychotherapists' responses to schizoid and neurotic patient prototypes.

83 practicing male psychotherapists completed the A-B Scale of H. Schiffman et al (1967), responded to recordings of schizoid and neurotic patient prototypes, and rated their subjective reactions to each type. Multivariate analysis revealed a significant overall A-B Type by Patient Type interaction. Although liking and ease of responding were higher in therapist–patient dyads, which the literature suggests are effective (A—schizoid, B—neurotic), felt compatibility and desire to work with the patient were higher in the opposite ("mismatched") dyads. Results suggest that subjective reactions underlying the A-B interaction effect are complex and that therapists respond in a differentiated, not global, fashion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A and B undergraduate interviews of schizophrenic and neurotic inpatients: A test of the interaction hypothesis.

To clarify the personological basis of the differential compatability of A and B therapists with schizophrenic and neurotic patients, A and B (determined by the Personality Research Form and the A-B Scale) undergraduate volunteers (20 males, 20 females) conducted 20-min interviews with male state hospital inpatients (40 schizophrenics, 40 neurotics) in a 2 (interviewer A–B status) by 2 (interviewer sex) by 2 (patient type) factorial design. As expected from studies of the personality correlates of A–B status, many more B than A interviewers "looked forward" to conducting the interviews. Once in the interview situation, however, A-type interviewers elicited better self-disclosure from schizophrenic patients than did Bs, whereas the latter outperformed As with neurotic patients. Results are discussed in terms of a personological formulation that considers interviewer effectiveness to be a joint function of interviewer personality characteristics and the situational context. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Erratum to Matthews and Burkhart.

Reports an error in the article "A-B Therapist Status, Patient Diagnosis, and Psychotherapy Outcome in a Psychiatric Outpatient Population" by Jerry G. Matthews and Barry R. Burkhart (Journal of Consulting and Clinical Psychology, 1977, Vol. 45, No. 3, pp. 47S-482), the next to last sentence of the abstract is incorrect. The sentence reads: "Separate analyses of variance demonstrated further support for the super-A hypothesis with therapists' ratings as the dependent variable, whereas the interaction hypothesis received support, with number of sessions as the dependent measure." The sentence should read: "Separate analyses of variance demonstrated further support for the super-A hypothesis with number of sessions attended as the dependent measure, whereas the interaction hypothesis received support, with therapists' ratings as the dependent variable." (The following abstract originally appeared in record 1978-03783-001) Previous research generally has supported the hypothesis that A therapists obtain better therapy outcomes with schizophrenics, while B therapists do better with neurotics. Based on recent evidence, a 2nd hypothesis (super A) has been advanced which predicts that A therapists do at least as well with neurotic patients as do B therapists and that As obtain significantly more positive outcomes with schizophrenics. To examine these hypotheses, the therapy outcomes of 7 A and 4 B therapists, differentiated by their scores on the 23-item Whitehorn and Betz (1957) A-sub( scale, with their 18 schizophrenic and 18 neurotic patients were examined. A multivariate ANOVA computed for the 2 outcome measures, therapists' ratings of patient improvement and number of therapy sessions, clearly supported the super-A hypothesis. Separate ANOVAs demonstrated further support for the super-A hypothesis with therapists' ratings as the dependent variable, whereas the interaction hypothesis received support with number of sessions attended as the dependent measure. Of considerable importance was the fact that the addition of ataractic medication to the treatment of schizophrenics did not attenuate the effect of the A-sub( therapist distinction on therapeutic outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Application of electromyographic biofeedback to the relaxation training of schizophrenic, neurotic, and tension headache patients.

Examined the effects of EMG biofeedback on tension reduction by schizophrenic, neurotic, and tension headache patients. 14 patients (mean age 39 yrs) participated voluntarily in at least 10 weekly EMG biofeedback sessions at a public outpatient clinic. All had complained of chronic tension. Ss showed significant decreases in their muscle tension levels with successive biofeedback training sessions. No significant differences were found between the schizophrenic, neurotic, and tension headache groups. A further contribution is the finding that patients with diverse socioeconomic and educational levels benefited similarly from EMG biofeedback training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal interactions in the families of schizophrenic and bipolar affective patients.

Do verbal interactions between psychiatric patients and family members covary with the diagnosis of the patient? This study compared relatives (usually parents) of schizophrenic (n?=?42) and bipolar (n?=?22) patients on affective style (AS) or emotional-verbal behavior toward patients in family interaction. Patients were compared on coping style or verbal interactional behavior toward relatives. Relatives of schizophrenic patients made more negative AS (particularly intrusive) statements to patients than relatives of bipolar patients. Schizophrenic patients made fewer supportive statements and more self-denigrating statements to relatives than bipolar patients. Among families of bipolar patients, negative AS in relatives was associated with oppositional, "refusing" styles in patients. Implications for psychosocial interventions with these disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multidimensional interpretation and comparison of three A-B scales.

Notes that despite a rapidly expanding literature on the A-B therapist-type variable, an adequate conceptual and empirical understanding has not been forthcoming. The present study endeavored to increase the limited understanding of the A-B dimension as well as to compare 3 different versions of the A-B scale. A battery of interest, personality, and aptitude tests (e.g., the SVIB) was completed by 231 undergraduate males. This battery was subjected to a 2-step principal components analysis in order to minimize the effects of method-specific sources of variance. Each of the 3 A-B scales was then regressed against component scores, followed by multiple discriminant-function analyses. Results indicate that 2 of the 3 A-B scales seem to be tapping a dimension tentatively labeled as a "social interpersonal orientation vs an impersonal cognitively complex orientation toward concepts and things." Explanations for some inconsistencies in the literature, for the nature of the Therapist * Patient Type interaction effect, and for possible strategies for future research are discussed. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of the A-B variable to patient symptomatology and psychotherapy expectancies.

In previous research, therapists' A-B status has predicted differential therapist effectiveness with schizoid vs. neurotic patients, but patients' A-B status has not been studied. This study related the A-B scores of 60 male college clinic patients (As, controls, and Bs), to therapist ratings of presenting symptoms and S's own complaints and role expectancies. As exhibited turning against the self, intropunitive symptoms, whereas Bs showed extrapunitive tendencies. Role expectancy data suggested, surprisingly, that As enter therapy expecting to unburden themselves in active, productive manner, whereas Bs appear to seek rational guidance and correctives. With respect to these adjustive modes and role expectancies, therapist-patient complementarity, rather than similarity, may partially mediate the effectiveness of therapy interactions. (18 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reappraisal of the A-B therapist "type" distinction in terms of the Personality Research Form.

Assessed personality dimensions involved in the A-B therapist "type" distinction which has proven predictive of therapist-patient compatibility in several clinical and analogue studies. The A-B scale scores of 223 male undergraduates were related to the 22 variables of Jackson's Personality Research Form. Multiple discriminant analyses and factor analyses strongly supported the hypothesis that A-B status is explicable in personality terms: so-called A-type Ss (predicted to be compatible with schizoid patients) were characterized by cautious self-expression, social ineptness, and a restricted cognitive scope; B-type Ss (presumably compatible with neurotic patients) appeared socially ascendant and "open" to complex experiences. Results were supported by a cross-validation study of 50 professional Ss. As in prior research, the variables differentiating A-B statuses appeared to involve a prominent "masculinity-femininity" component. (30 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The comparison of self-concept and self-acceptance in patients with paranoid schizophrenia and neurotic disorder

Self-acceptance as a correlation between real and ideal self-concept distinguishes neurotic patients from paranoid schizophrenic patients. This fact may support the hypothesis that these groups of patients are characteristic of different personality traits.     

The effects of social and nonsocial censure on stimulus generalization in neurotics and schizophrenics.

36 schizophrenic and 36 neurotic depressive Ss were given a visual-spatial generalization task under either social or nonsocial (impersonal) censure conditions. The following hypotheses derived from previous investigations were tested: (1) schizophrenics would show higher gradients of generalization than neurotic depressives, and (2) generalization gradients would be higher under conditions of social as opposed to nonsocial censure, especially in schizophrenics. The data supported Hypothesis 1 but not Hypothesis 2. There was no evidence for differential responding between these 2 groups with respect to either stimulus generalization or response to censure. It was suggested that hypotheses concerning the schizophrenic's performance in these 2 situations have been biased and oversimplified by use of normal, rather than patient, control groups in previous investigations. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Skin conductance basal level and reactivity in schizophrenia as a function of chronicity, premorbid adjustment, diagnosis, and medication.

Examined the skin conductance basal level and GSR of 384 male schizophrenics divided into subgroups according to chronicity, premorbid adjustment, diagnosis, and medication. 10 male psychiatric aides served as normal controls. Results indicate that basal level differences between schizophrenic subgroups or between schizophrenics and normals were mainly due to long-term institutionalization. The novelty of the experimental situation, as contrasted with the usual minimal stimulation domicile of the chronic patient, resulted in extensive responsivity not exhibited by the acute schizophrenic, other hospitalized patients, or normals. An interaction of premorbid adjustment and diagnosis within the chronicity subgroups was also found. The GSR differences between schizophrenic subgroups were primarily due to begin on or off medication, and this was mainly evident in the premorbid adjustment grouping. The results of an examination of social censure stimulus effects were not supportive of a social censure hypothesis. (35 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multivariate structure of associations between verbal and nonverbal intelligence among brain-damaged, schizophrenic, neurotic, and alcoholic patients.

The scores of 380 male Ss—brain-damaged, process schizophrenic, reactive schizophrenic, neurotic, and alcoholic patients—on the Verbal and Performance subtests of the WAIS were subjected to canonical correlational and multiple discriminant analyses. Substantial associations between verbal and nonverbal abilities were found for all groups, although these correlations were sufficiently imperfect that each set of subtests contributed independently to group discrimination when combined with the other set. Results support C. Spearman's (1927) view that measures of intelligence contain both general and specific components of variance and not the high degree of differentiation that is sometimes postulated. It is concluded that major forms of psychopathology are characterized more by differences in intellectual profile patterns than by changes in the basic organization of abilities. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitude change in college students and chronic patients: A dual perspective.

Assessed both initial attitudes and attitude change among 30 college students and 320 chronic patients participating in a hospital companionship program. Student attitudes toward a number of mental health concepts were initially similar to 2 student control groups (N = 30 each). Patient expectations of college students likewise were similar to patient controls. At the conclusion of the program, students manifested significantly more favorable attitudes toward patients and less favorable attitudes toward the mental hospital; patients saw the students as more nurturant than they had initially expected. A social hierarchy hypothesis is advanced to partially account for the reported success of similar companionship programs. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The A-B scale and empathy, warmth, genuineness, and depth of self-exploration.

Studied initial interviews conducted by 25 senior medical students with 25 neurotic outpatients. There were no significant relationships between the therapists' A-B scale scores and their empathy, warmth, and genuineness. B-type therapists did elicit greater depth of exploration, a result consonant with existing research. Findings suggest that these 2 sets of variables the A-B scale and empathy, warmth, and genuineness are independent sources of variance in therapeutic outcome. The A-B scale offers the potential of leading to the discovery of a new set of determinants of psychotherapeutic success. (PsycINFO Database Record (c) 2010 APA, all rights reserved)