Diagnosis and expectation for change: an inverse relationship?

The purpose of this study was a test the hypothesis that the use of psychiatric labels leads to reduced expectations for patient change and recovery. Thirty-nine staff members at a residential mental hospital were given a description of a patient and asked to indicate expected length of stay in the hospital, chance of readmission, chance of leading a normal life, and overall prognosis. A diagnosis of schizophrenia, paranoid type was included at the end of half of the descriptions and was omitted in the other half. It was found that staff working in the acute treatment areas were significantly negatively affected by the diagnosis when overall prognosis was considered. In addition, the findings of this study with respect to occupation, sex of patient, and treatment area suggested that such variables should not be overlooked when assessing staff attitudes or treatment orientation. Since an admitting diagnosis is required by most treatment facilities, the results highlighted the limitations of these preliminary labels and spoke to the necessity of individualized evaluations. Finally, further work was indicated on the development of scales which could measure expectations for change and the behavioral concomitants of such expectations.