Date of Award
Doctor of Philosophy in Psychology
James O. Prochaska
A client's stage of change at the beginning of therapy seems to be an important selection criterion to consider in relation to treatment outcome. A rational scale was developed in an earlier study to operationally define the theoretical stages of change. The present study attempted to cross-validate the scale on a new clinical sample (N = 327). The principal component, internal consistency, and cluster profile analyses demonstrated a replication of the original findings. The stages (Pre-Contemplation, Contemplation, Action, and Maintenance) were examined in relation to therapist ratings of treatment outcome, As predicted, Pre-Contemplators showed significantly less progress than subjects in the other three stages. This study also examined the relationships among stages of change and the six DSM-III diagnostic categories most frequently assigned to subjects in the present study (i.e., depression, adjustment disorder, paranoia, mixed affective disorder, schizophrenia, and borderline personality disorder). Schizophrenics, paranoids, and subjects with adjustment disorders scored higher on Pre-Contemplation than subjects with other diagnoses. Depressed subjects scored higher on Contemplation, and schizophrenics scored lower on Contemplation than other subjects. Using the present sample, the Psychic Distress symptom checklist was cross-validated by partially replicating the original components. Stages of change were examined in relation to these symptom complaints. Pre-Contemplators reported significantly fewer symptoms than subjects in the other stages. The relationship between therapist-assigned DSM-III diagnosis and self-reported symptom picture was of interest. Subjects with schizophrenia, paranoia, and adjustment disorders scored lower on the depression syndromes than subjects in the other diagnostic groups. Symptom complaints accurately predicted diagnosis 81% of the time for five of the diagnostic groups. Neither diagnosis nor self-reported symptoms could significantly predict treatment outcome. Diagnosis was related to drop out or continuation in therapy, however. Schizophrenics, paranoids, and borderline subjects were typically continuing treatment at four months, while subjects with affective disorders and adjustment disorders were more likely to leave therapy prior to four months
McConnaughy, Eileen A., "Relationships Among Stages of Change, Types of Psychopathology, and Psychotherapy Outcome" (1984). Open Access Dissertations. Paper 973.