Title: Inducers of expectancy for positive therapy outcome in a military setting
CITATION PDF VIEWER THUMBNAILS PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/UF00097471/00001
 Material Information
Title: Inducers of expectancy for positive therapy outcome in a military setting
Physical Description: xi, 103 leaves : ill. ; 28 cm.
Language: English
Creator: Klugman, Peter Jay, 1942-
Publication Date: 1978
Copyright Date: 1978
 Subjects
Subject: Psychotherapist and patient   ( lcsh )
Psychotherapy   ( lcsh )
Psychology thesis Ph. D   ( lcsh )
Dissertations, Academic -- Psychology -- UF   ( lcsh )
Genre: bibliography   ( marcgt )
non-fiction   ( marcgt )
 Notes
Statement of Responsibility: by Peter Jay Klugman.
Thesis: Thesis--University of Florida.
Bibliography: Bibliography: leaves 97-102.
Additional Physical Form: Also available on World Wide Web
General Note: Typescript.
General Note: Vita.
 Record Information
Bibliographic ID: UF00097471
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: alephbibnum - 000084890
oclc - 05296474
notis - AAK0236

Downloads

This item has the following downloads:

PDF ( 3 MBs ) ( PDF )


Full Text











INDUCERS OF EXPECTANCY FOR POSITIVE
THERAPY OUTCOME IN A MILITARY SETTING















By

PETER JAY KLUGMAN


A DISSERTATION PRESENTED TO THE
GRADUATE COUNCIL OF
THE UNIVERSITY OF FLORIDA
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY




UNIVERSITY OF FLORIDA


197 8
































Copyright 1978

by

Peter Jay Klugman






























This dissertation is dedicated
to all those who maintained faith
during the past six years.














ACKNOWLEDGEMENTS


Appreciation is extended to my supervisory committee

for being good teachers and good friends. A very special

thanks to my chairman, Benjamin Barger, Ph.D., for

providing support and encouragement when it was needed

most, and for his superb guidance throughout the develop-

mentt of this dissertation. Thanks to Louis D. Cohen,

Ph.D., for doing the right things at the right times and

pushing me on my way to completion. To Audrey S.

Schumacher, Ph.D., Vernon D. Van de Riet, Ph.D., and

William B. Ware, Ph.D., the remainder of my supervisory

committee, sincere appreciation for their sound advice

and support that always seemed to come when it was

needed most. The entire committee is deserving of much

more than can be expressed in words.

Thanks are also extended to William Dorfman, Ph.D.,

who was there when the seeds of this dissertation began

to sprout and who nurtured them by caring. To George D.

Bishop, Jr., Ph.D., who served as my statistical

consultant, and to Robert J. Schneider, Ph.D., who filled

in when Dr. Bishop was unavailable, I extend thanks for

assisting me to grasp some of the vaguer concepts of

statistical analysis. Mention must also be made of the








confederates who assisted in this study, Captain Stanley A.

Mize, Ph.D., Staff Sergeant Alan Moskovitz, and Specialist

Four George O. Johnson. They blindly followed the

instructions given them to the minutest detail, performing

a tiresome, often boring task without ever wavering. Linda

Van Sciver, who assisted with the typing, always maintained

her sense of humor and helped me in maintaining mine.

I wish to thank the United States Army for its finan-

cial support, the staff of the Fort Dix Community Mental

Health Activity for its patience, and my cousins, George

and Hilda Elson, who were with me from the very start and

were instrumental in my applying for the clinical psy-

chology program at the University of Florida. The Elsons

are true believers who never let me think they were losing

faith.

My wife, Marthanne, my daughters, Deborah and Rebekah,

and my son David have had to survive with a part-time

husband and father for the past six years. The empathy

that I feel for their past circumstance, and the love that

I have for them, will better be expressed by actions than

words.

To my parents, Shirley and Joseph Klugman, I say

thanks, you've done all that a son could hope for.



















TABLE OF CONTENTS


Page


.. iv


..Viii


ACKNOWLEDGEMENTS .......


ABSTRACT . . .. . .


CHAPTER


ONE INTRODUCTION ......


Problem .......
Literature Review ..
Hypotheses ......

TWO METHOD .........


Design . . . .
Subjects .......
Confederates .....
Independent Variables
Dependent Variables .
Procedure ......


THREE RESULTS ........


.
.


.


.


. . . . 10


. . . . 18


. . . . 18
. . . . 18
. . . . 20
. . . . 21
. . . . 22
. . . . 26



. . . . 32

. . . . 32


. . . . 38


. . . . 43


Method of Analysis .
Dependent Measures .

DISCUSSION ......


CONCLUSIONS .....


:ES


FOUR


FIVE


APPENDIC


A


CONFEDERATE'S INSTRUCTIONS


. 46


PHOTOGRAPHS OF EXPERIMENTAL SETTINGS


POSTED INSTRUCTIONS ........


RECEPTIONIST'S INSTRUCTIONS ....


CONSENT FORM............















F DEPENDENT VARIABLE MEASURES .. ... 70

G DEPENDENT VARIABLE SCORE MATRIXES .. 80

H SUMMARY TABLES OF CONFEDERATE EFFECTS .90

I MEAN SUMMARY TABLES:
PERSONAL IMPROVEMENT VARIABLE .. .. 93

REFERENCE LIST.. .. ... 97

BIOGRAPHICAL SKETCH .. .. .. .. .. .. 103


vii














Abstract of Dissertation Presented to the
Graduate Council of the University of Florida
in Partial Fulfillment of the Requirements
for the Degree of Doctor of Philosophy



INDUCERS OF EXPECTANCY FOR POSITIVE
THERAPY OUTCOME IN A MILITARY SETTING

By

Peter Jay Klugman

December 1978

Chairman: Benjamin Barger
Major Department: Psychology

Three variables that a client is likely to encounter

in an initial clinical interview were varied in an

analogue study under controlled conditions, to determine

how these variables would effect client expectation of

therapeutic gain. The three variables observed were

dress, i.e., white laboratory coat versus military uni-

form; credentials, i.e., lavish display of certificates

versus no display; and therapist's style, i.e., directive

versus non-directive. The subjects were 48 male soldiers

in their third week of basic training who were randomly

assigned to the eight treatments in this 2 X 2 X 2 ex-

perimental design. It was hypothesized that those

soldiers exposed to the white laboratory coat, the lavish

credentials, or the directive style, under circumstances


viii







that were not identified as treatment, would have a higher

expectancy of therapeutic gain than those who were exposed

to the other sets of conditions. It was further hypo-

thesized that these conditions would be additive, and

when two conditions existed for the same subject his

expectancy would be higher than for one condition, and

when a third condition was added expectancy would be even

higher.

Three confederate counselors were utilized in this

study and were not informed of the nature of the experi-

ment or of the expected outcome. They conducted what

was presented as an information gathering interview under

the circumstances that were established for them. Each

confederate served in each experimental condition two

times in order to control for the possibility of a

therapist effect.

Two measures of expectancy were devised to serve as

the dependent variables. The first measured the subject's

expectancy of personal improvement and the second, how

likely it was that the subject would refer others for

treatment. Both instruments were tested for internal

consistency on a population of 61 newly arrived trainees

at the Fort Dix, New Jersey Reception Station. Coefficient

Alpha for the personal improvement variable was .95, and

for the referral variable was .79.








A four-way analysis of variance was conducted on the

personal improvement variable using three levels of the

confederate variable. No significant main or interactive

effects were noted involving the therapist. The data

were then compressed to a 2 X 2 X 2 design and a three-way

analysis of variance was conducted. There was a signifi-

cant main effect attributable to therapist style which

supported the hypothesis that the directive style would

be a more powerful expectancy inducer in this setting than

the non-directive style. There were no significant

interactions. A similar four-way analysis of variance

using three levels of the confederate variable was

conducted on the referral variable. Here again there were

no significant main effects attributable to the

confederates, but there were significant interactions

between confederate and style, and between confederate,

style, and dress. There were no other significant main or

interactive effects.

The results only supported the single hypothesis

that in this particular population the directive thera-

peutic style is more likely to induce expectancy for

personal improvement than the non-directive therapeutic

style. There was no indication that dress or credentials

had any impact as expectancy inducers.

An unanticipated result of this study that warrants

further research was that the two dependent variables

failed to correlate very highly with each other (r = .23).






This leads one to ask the question of why an individual

might feel that a particular therapist might be helpful
to him, but still be reluctant to commend that therapist

to a friend, or why he might send a friend to a therapist

who he did not feel would be helpful to himself.














CHAPTER I
INTRODUCTION


Problem

The "placebo effect" in medicine has been shown on

numerous occasions, through rigorous research, to be a real

force that must be reckoned with when evaluating new treat-

ment modalities. The effect is so powerful that not only

can it lead to inert substances reducing symptoms, but it

can create new "symptoms." Placebo treated patients have

complained of a wide range of "negative side effects" that

include nausea, headaches, sleepiness, and reduced concen-

tration (Zimbardo & Ruch, 1977). Haas, Fink, and

Hartfelder (1959) even reversed the usual pharmacological

effect of Ipecac by suggesting that it would reduce nausea

of pregnancy. It has been postulated by many that it was

expectancy set alone that accounted for many of the ancient

cures brought about by early physicians, shamans, and

witch doctors. Claghorn (1976) points out that from the

time of Hammurabi there are documented evidences of

"priest-doctors" who provided treatment consisting of

medicinals, largely water, and incantations.

The role of expectancy as a curative was addressed

by Freud (1964) in 1933 when he wrote: "And here I should

like to add that I do not think our cures can compete with








those of Lourdes. There are so many more people who

believe in the miracles of the Blessed Virgin than in the

existence of the unconscious" (p. 152).

It was not until Rosenthal and Frank (1956) addressed

the issue two decades ago in an article entitled "Psycho-

therapy and the Placebo Effect" that the "placebo effect"

became an issue in psychotherapy outcome research. This

article attacked previous research as treating the "placebo

effect" as superficial and transient, and called for the

serious consideration of this effect in future studies.

They concluded that improvement under a special form of

psychotherapy cannot be taken as evidence for (a) cor-

rectness of the theory on which it is based; (b) efficacy

of the specific technique used, unless improvement can be

shown to be greater than, or qualitatively different from,

that produced by the patient's faith in the efficacy of

the therapist and his technique.

I must point out that while results ascribed to the

"placebo effect" cannot, in addition, be ascribed to a

therapy technique, they are, in fact, still results and

should not be discounted. Strupp (1976) has declared that

the deficiencies in the circumstances surrounding therapy

will predictably lessen optimal results and at times viti-

ate them completely. It appears that it would be beneficial

to maximize the "placebo effect" whenever possible, or at

the very least to assure that it does not work negatively.








It has been pointed out by Fiske, Hunt, Luborsky, Orne,

Parloff, Reiser, and Tuma (1970) that expectancy is suf-

ficiently important to be treated as a separate entity,

and they further feel that positive expectancy seems a

necessary condition to therapeutic effectiveness. While

this belief has become almost axiomatic in psychotherapy,

although disputed by Wilkins in a 1973a review article,

Fiske, et al. (1970) pointed out that little systematic

research has been done on the topic, and that it is

important for an investigator to ascertain and report

expectancy. In our present stage of methodology this is

a difficult but important requirement. They go on to

affirm that research is clearly needed on this whole

topic. Little has been done in the years since Fiske,

et al., made their observation that has shed any additional

light on the role of expectancy.



Literature Review

The literature on the role of expectancy in psycho-

therapy outcome has always revolved around the causative

effects of expectancy and results are not unlike much of

the results of other psychotherapy outcome research. The

expectancy literature is divided between studies that

support the premise that expectancy affects outcome, and

those that do not. Only as recently as 1977 (Martin,

Friedmeyer, Moore, and Claveaux) has it been suggested that

the relationship which exists is predictive, but not








causative, and this study takes a different tack from all

preceding research. Martin, et al., hypothesize the possi-

bility that a relationship exists between expectancy and

outcome that is not a causal relationship, but serves only

as a prognostic indicator. They liken the expectancy

state to some meteorological phenomenon that can be used

to predict the weather accurately, but has no role in

causing it. More will be said about this study later as

it tends to deal effectively with some of the criticism

of earlier studies, as well as to provide a different way

of looking at the results.



Correlational studies. Lipkin (1954) inve stigated

the hypothesis that the patterns of feelings which a

client exhibits towards himself, the patterns of atti-

tudes which he holds towards his therapist, and his

perception of the therapeutic process all bear a relation-

ship to the extent of change which he sustains as a

consequence of his experience in therapy. His findings

strongly suggest that the client who is positively

oriented to the counselor and the counseling experience,

and who anticipates that his experience in counseling

will be a successful and gratifying one, undergoes

more change in personality structure than does the client

who has reservations about the counseling experience. I

mention this study first not merely because it is

chronologically the earliest study in this review, but








because it answers a main criticism directed towards

other studies. This criticism is that the outcome of

therapy is usually based on client report, and this is

thought by many to be an invalid measure. In the Lipkin

study, outcome was determined by pre- and post-therapy

projective testing.

Other correlational studies were conducted by Friedman

(1963), Goldstein (1960a), Goldstein and Shipman (1961),

and Ulenhuth and Duncan (1968), and yielded positive sig-

nificant correlations, while Brady, Reznikoff, and Zeller

(1960), and Goldstein (1960b, 1966) failed to demonstrate

an expectancy-effect correlation.

Friedman (1963) used a correlational approach to

compare patient expectancy with symptom reduction. He first

measured the subject's degree of symptomatology on a discom-

fort schedule and then measured how the subjects thought

they would feel after therapy. The score differences were

considered to be a measure of "expected reduction" or

expectancy. After an evaluation interview was conducted,

with no attempt at formal therapy, the subject completed

the discomfort scale again. Subjects reporting marked

improvement tended to have high levels of expectancy

significantly more often than those reporting little

improvement. Friedman's data indicated linearity of cor-

relation between expected and reported reduction of symptom

intensity, in contrast to a correlational study conducted by

Goldstein and Shipman (1961) which reported a curvilinear

relationship.







Friedman concluded his article by drawing attention

to the fact that his results were found after only one

patient-clinician contact. He suggests that expectancy

of help is activated at the first patient-clinician contact

and may be an important determinant of symptom reduction in

neurotic outpatients.

The curvilinear relationship found by Goldstein and

Shipman (1961) was also based on outcomes resulting from the
initial interview only, but differed from the Friedman

results in that the most improvement was associated with

moderate initial expectancy. This study involved 30

neurotic outpatients and the significant curvilinear

relationship was between the degree to which patients

anticipate symptom reduction due to psychotherapy, and the

symptom reduction they perceive as taking place during

their initial interview. As Martin, et al., (1977) point

out, this sort of relationship is consistent with the

relationship that exists between motivation and performance

variables, and may tend to support a causative hypothesis.

The findings are, however, confounded by the fact that the

study was not blind, and the motivational level of the

therapist might have accounted for some of the lack of

linearity.

A study using medical student therapists and 105

psychoneurotic outpatients (Uhlenhuth a Duncan, 1968) was

conducted over a longer period of time (minimum of six

interviews). A change score on a symptom checklist between

the first and the last interviews was used as the dependent








variable and was correlated with the patient's level of

optimism about the probable outcome of treatment at the

outset as measured on a simple seven point scale. While

the investigators found that an initial weighted depres-

sion score was most highly correlated with the patient's

symptomatic change, greater general optimism at the outset

about probable outcome of treatment contributed signifi-

cantly to the prediction of the relief of symptomatic distress.

When research failed to demonstrate a correlation

between expectancy and outcome (Brady, et al., 1960; Gold-

stein, 1960b, 1966) investigators attributed the failure

to the procedures and measurements employed rather than to

the lack of validity of the expectancy effect.

The main problem with these early correlational

studies, as pointed out by Wilkins (1973a), was that in the

majority of them the only measure of therapeutic improve-

ment was client self-rating. I contend that since most of

the patients were being seen voluntarily because of their

perceived distress that their perceived improvement should

be considered a significant indicator of therapeutic gain.

Also, as mentioned earlier, Lipkin's (1954) positive results

were based on projective measures of change. Brady, et al.,

(1960) did attempt to use therapist's rating of change, but

failed to show a significant correlation.



Noncorrelational studies. Later experimental studies

attempted to instill high and low expectancy of improvement








in the patient. The usual approach here was to provide

the prospective patient with information that would lead

him to believe that the treatment he was about to receive

has been proven to be effective or was of questionable

efficacy. In his 1973 review article, Wilkins points out

that six experiments (Borkovec, 1972; Krause, Fitzsimmons,

& Wolf, 1969; Leitenberg, Agras, Barlow, & Oliveau, 1969;

Marcia, Rubin, & Efran, 1969; Oliveau, 1969; Oliveau,

Agras, Leitenberg, Moo0re, & Wright, 1969) lend support to

the positive effects of expectancy of gain and 11 (Bednar

& Parker, 1969; Grosz, 1968; Imber, Pande, Frank, Hoehn-

Saric, Stone, & Wargo, 1970; Krause, 1968; Marcia, Rubin,

& Efran, 1969; McGlynn & Mapp, 1970; McGlynn, Mealica, &

Nawas, 1969; McGlynn, Reynolds, & Linder, 1971a, 1971b;

McGlynn & Williams, 1970; Sloane, Cristol, Pepernik, &

Staples, 1970) were unsuccessful. Wilkins failed to

mention that expectancy set of the subject was assumed to

be influenced by the experimenter's instructions, and no

effort was made to actually measure the patient's level of

optimism or pessimism as was done in the earlier correla-

tional studies. I offer that the very fact that the subject

participated in the treatment implies some level of positive

expectancy and the degree is determined by many more subtle

influences than a set of verbal instructions.

Wilkins goes on to point out that in the studies pre-

senting evidence in favor of an expectancy effect the

therapists were aware of which subjects had received which







set of instructions, and in the studies failing to support

an expectancy effect interpretation the therapists were

uninformed as to which expectancies subjects had received.

This, of course, would imply more of a therapist effect than

an expectancy effect. He further claims that there is no

research evidence that the therapist's primary function is

a catalyst for client expectancy, but freely admits to the

possibility that such factors as prestige of the therapist,

the decor of his office, and other "placebo effect inducers"

may contribute to therapeutic gain. But here again he

points out that just as "expectancy set" has emerged with-

out empirical support, so has the concept "expectancy

effect inducer."

The recent Martin, et al., (1977) study, in its attempt

to eliminate some of the earlier methodological questions,

kept all involved in their studies unaware of the hypo-

theses under investigation. They used objective and

subjective measures of outcome, which included the MMPI,

diagnostic interviews by two independent clinicians who

were unfamiliar with the patient's problem and treatment,

and a brief psychiatric rating scale by Overall & Gorham

(1962). In all, they used 15 measures of improvement, 12

that reflected improvement in specific areas of adjustment,

and three that reflected global improvement. Their results

showed a significant linear relationship between the

measures of expectancy and improvement.








With this additional information, it is difficult to

dispute Wilkins' contention that there is some evidence,

as shaky as that evidence may be, to support the concept

of "expectancy effect," and perhaps we have put the cart

before the horse by investigating that effect before

determining what the inducers are, if in fact there are

any.



Hypotheses

It is not the purpose of this study to provide another

look at the role of expectancy on outcome, but to look at

some of the variables that might induce expectancy in order

to lay the groundwork for rigorous future studies of

"expectancy effect."

The variables that can effect expectancy are of course

infinite and include such obvious things as instructions to

expect positive results, such innocuous things as the

location of the building in the community, the respect for

the referral source, and perhaps even the past experiences

of friends or relatives with psychotherapy. Rather than

arbitrarily selecting some possible inducers for investi-

gation, I selected variables that it was in my power to

manipulate fully. These were variables that could be con-

trolled in the therapeutic setting if they were found to

De expectancy inducers.

Perceived expertness of the therapist by the client is

suspected to have a heavy influence on therapy outcome, or








stated in the other direction, when the therapist is not

perceived as an expert by the client, he is not likely to

have much input in behavior change. Persons presented as

a Nobel Prize winner (Bockner & Insko, 1966), a famous

writer (Aaronson, Turner, & Carlsmith, 1963), a psychiatrist

(Bergin, 1962), and a Ph.D. psychologist (Browning, 1966),

obtained greater opinion change when they presented discrep-

ant opinions than did persons with lesser credentials.

Strong and Schmidt (1970) showed that subjects' perceptions

of counselors as experts were influenced by objective evi-

dence of specialized training, such as diplomas, certificates,

and titles, as well as by reputation, and that these per-

ceived experts had greater success in getting a subject to

change a rating about himself than did the perceived

nonexpert. In a later study (Strong & Dixon, 1971) it was

shown that perceived expertness was even able to mask the

effects that counselor attractiveness might have on outcome.

Counselor attire would also seem to have some influence

on perceived expertness and this is probably the reason that

practicum supervisors often suggest a tie and jacket as the*

most appropriate attire for a male trainee. Schmidt and

Strong (1970) have shown that casual attire tends to be

interpreted as a sign of inexpertness. However, it

certainly seems that this could vary among subcultures

and needs further investigation. The two primary attire

options for a military therapist have been considered in

this study as potential "expectancy effect inducers."








Without reviewing the entire therapy outcome literature,

I feel I can state without argument that there is little

empirical evidence to support one therapy as being more

effective than any other when looked at without regard

to the specific circumstances in which it is applied.

However, the possibility that therapist's style may in

itself induce expectancy, depending on the perceptual set

of the client population, would be a reasonable place to

begin looking at the effects of different therapeutic

modalities.

The difficulty in dealing with induced expectancy is

that the definition of this state tends to be circular.

It was pointed out by Wilkins (1973b) that if subjects

given high-expectancy instructions demonstrated greater

improvement than subjects given low-expectancy instructions

it could be concluded that: (a) the groups of subjects did

indeed have different expectancies, and (b) the different

induced expectancies were responsible for differential out-

come. If subjects receiving high- and low-expectancy

instructions did not differ in improvement, it may be

concluded that: (a) the instructions were ineffective in

inducing differential expectancies, or (b) differential

expectancies were induced, but expectancy had no effect

under these treatment conditions. The presence or absence

of expectancy state is identified by the outcome which

expectancy is said to produce.








For expectancy to stand as a valid construct, it must

be identified by measures independent of the outcome which

it is said to produce. This was attempted by Imber, et al.

(1970), who found that their expectancy instructions pro-

duced very little change from the pre-instruction

expectancies that subjects held about therapy. Grosz (1968)

found that his instructions did establish different expec-

tancy sets. However, expectancy state had no effect on

therapy outcome. This brings us back to the basic issue

of this study, which is that before we can view expectancy

as a valid construct affecting therapy outcome, we must

first know if it exists and how to vary its intensity.

This study was designed to investigate some of the

aspects of an initial interview that might influence the

perceptions of the client regarding the expertness of the

therapist, and might therefore influence expectancy set.

It was hypothesized that among the more powerful variables

to be found would be client perception of therapist's

experience, dress, and therapeutic style. In the military

setting in particular, where uniforms and awards are part

of every day life, and a directive management style is the

rule, these aspects of a therapist might be reasonably

expected to affect the patient's expectancy for therapeutic

progress.

For the new recruit who perhaps for the first time is

experiencing rigid discipline demanded by the military, a

transient situational disturbance is likely to be








precipitated. The resulting ineffectual behavior often

results in a referral to the Community Mental Health

Activity for evaluation and treatment. The amount and

direction of the aforementioned variables on the recruits'

expectancy set is not known, but I hypothesize that it

would be influenced as follows.

Display of credentials. Credentials of any sort,

including military awards, civilian awards, certificates,

memberships, and honors, are likely to influence the re-

cruits' expectancy. These are the accoutrements that are

often associated with expertness in civilian life, and that

have even more meaning in the military. Very early the

recruit becomes aware of the fact that many of the more

"experienced," "expert" soldiers have ribbons and badges

on their uniforms that he does not have. He further

realizes that he is a long way from getting any of these

for himself. I hypothesize that this discovery will

generalize to any indication of accomplishment and will

lead to the attribution of more power to those with a large

number of visible credentials, and therefore to a higher

expectancy for positive outcome.

Dress. The uniform options for military medical

personnel are limited to the duty uniform or to white

medical attire with a name tag. While the former connotes

military expertness and authority, the latter indicates

medical expertness, which is likely to be seen as more

powerful for helping the recruit through a period of stress.







Counselor style. As Bednar (1970) points out,

improvement happens as long as each counseling system

successfully imparts to the client the expectation that

he should be improving as a result of the expert treatment

he is receiving and that success of psychotherapy is based

on this as opposed to the specific counselor methods

employed. If this is the case, therapist style itself may

be a situationally determined "expectancy effect inducer."

The therapist style most often used in the military is a

motivational, rational, cognitive-behavioral style that is

designed to support the recruit and give him direction. It

is highly directive and resembles the rational emotive ap-

proach advocated by Ellis (1973) and the cognitive-behavior

modification approach of Meichenbaum (1977). This provides

for an immediate course of action, challenges the patient's

current thinking, and is consistent with his perception of

the military authority figure. I believe he will see the

person with this therapeutic style as a more powerful

helper than a more non-directive therapist. As pointed

out by Staples, Sloane, Whipple, Cristol, and Yorkston (1976)-

research studies have not isolated those therapist behaviors

that lead to improved outcome with sufficient consistency

or precision. Even the apparently well-established

triumvirate of accurate empathy, unconditional positive

regard, and therapist's self-congruence is currently

undergoing critical re-evaluation. While these need not

be sacrificed in the directive approach, it is not felt








that they are sufficient unto themselves to induce an

initial expectancy of positive outcome in an Army recruit.

Cumulative effect. It is further hypothesized that

the expectancy effect inducers are independent of each

other and will therefore be additive. Any combination of

two or more of the heavily-credentialed, white-coated,

directive therapist variables will induce a higher level

of expectancy than any of these variables when presented

in combination with the contrasting variables, i.e., no

credentials, the military uniform, and the non-directive

therapeutic style.

In summary the following specific hypotheses will be

tested:

1. A lavish display of credentials in a military

setting will induce a higher level of client expec-

tancy for positive therapy outcome than no display

of credentials in the same setting.

2. A military officer dressed in a white laboratory

coat will induce a higher level of client expectancy

for positive therapy outcome than will the same

individual dressed in a military uniform.

3. An individual using a directive therapy style

in a military setting will induce a higher level

of client expectancy for positive therapy outcome

than the same individual, in the same setting, using

a non-directive therapy style.




17


4. The expectancy induced by the lavish credentials

display, the white coat, and the directive style

will combine additively.













CHAPTER II
METHOD



Design

The experimental design used in this study was a com-

Plete three-way factorial with equal n's. The design

consisted of eight cells defined by two levels of counselor

credentials, crossed by two levels of dress, crossed by

two levels of counselor style. Each subject participated

in only one cell of the design while three confederate

counselors each participated in each cell twice. Wh~en

confederates were taken into account, the experimental

design actually had 24 cells of two subjects per cell.

The plan of the study was to rule out any effect

attributable to the confederates and to compress the data

into a 2 X 2 X 2 design with six subjects per cell.



Subjects

The subjects for this study were 48 Army trainees

who were in Basic Combat Training (BCT) at Fort Dix,

New Jersey, in the spring of 1978. They were all in their

third week of training and assigned to the same battalion.

They were randomly selected from a pool of approximately

120 trainees. Three of the original selectees were







excluded from the study and replacements were selected

from the same pool. Two of the excluded subjects were

Spanish-speaking and could not read English, the third,

a native-born caucasian, could not understand the instruc-

tions and later admitted that he could not read.

The subjects were randomly assigned to the experimental

conditions and no effort other than randomization was used

to control for the wide variety of backgrounds and experi-

ences that can be ascribed to the thousands of trainees

that annually attend BCT at Fort Dix. Brady, Zeller, and

Reznikoff (1959) have shown that the factor of favorableness

of conscious attitudes is not greatly dependent on commonly

considered background and experiential factors.

Random distribution checks. As a check on the random

distribution of subjects to experimental treatments a one-

way analysis of variance was- computed on the ages of the

subjects. The null hypothesis could not be rejected at

g 4.20 (F =.57), and it shows that at least
-7,40
on this variable, the distribution was random.

As a means of checking if the subject population was

in fact a cross-section of the country the subjects' home

states were divided into nine geographic sections of the

continental United States (World Book Encyclopedia, 1958).

It was found that all geographic areas, and Puerto Rico,

were included in the subject population with the exception

of the mountain states.








These two checks were considered adequate

demonstrations of the randomness of the assignment

process.


Confederates

The confederates in this analogue study played the

part of counselors at the Community Mental Health Activity

and were role-played by three individuals in the helping

professions. All three were caucasian males with no gross

differences in appearance. Their ages were 23, 31, and 35

with the two youngest being paraprofessionals and the

oldest being a clinical psychologist with three years post-

doctoral experience. Three confederates were used in order

to provide a basis for generalizing the study's findings and

at the same time every effort was made to reduce hetero-

geneity to rule out any main effects due to the confederates.

Prior to the study the confederates were thoroughly

briefed as to what was expected of them. They were oriented

as a group to the room setting, and were presented with a

set of instructions (see Appendix A). The instruction

packet included the instructions they were to give the

subjects as well as the styles they were to affect. At no

time were the confederates made aware of the dependent

variable being measured or the hypotheses being tested.

They remained blind to these conditions throughout the

entire study.







A fourth confederate was used in the role of a re-

ceptionist. The receptionist was responsible for making

initial contact with the subject, explaining the study to

him, getting the consent form signed, and administering

the dependent variable instruments. A more thorough

description of the receptionist's duties, as well as the

scripts used, is given later in the Procedures section.



Independent Variables

The variables that were experimentally manipulated

were clearly defined by the hypotheses to be tested and

were easily controlled in the Community Mental Health

Activity setting at Fort Dix.

Uniform versus laboratory coat. To test the effect

of the military uniform versus the traditional white-garbed

appearance of the health provider as an "expectancy effect

inducer" the confederates wore a regulation Army khaki

uniform by itself or covered by a full-length white

laboratory coat. Most Army hospital staff members wear

white laboratory coats over their regular duty uniform.

To prevent contamination of the credentials variable, no

decorations were worn on the uniform.

Credentials versus no credentials. The question of

expertise as determined by some observable external source

was presented to the subjects in the formr of a lavish

display of military and civilian awards framed and hung on

the office wall. No attempt was made in this study to








differentiate between military or civilian awards and the

display was either a lavish generalized one, or none at

all.

The two experimental rooms were matched in all

aspects and were mirror images of each other. The only

difference was the single "credentials wall," which in one

room had the lavish display and in the other had two large

pictures. Photographs of these rooms are to be found in

Appendix B, with a listing of the certificates displayed.

Directive versus non-directive. This final independent

variable concerns the interviewing technique used by the

confederate. To test the directive approach, the con-

federate attempted to change the subject's thinking about

an issue on a minimum of one and a maximum of two

occasions. At no time did he become abusive or provocative,

and he always presented his ideas from a rational perspec-

tive, and on occasion, suggested behavior change to deal

with problems presented by the subject. When using the

non-directive style, the confederate tended to listen more

than talk, supported the subject's rational statements,

was more reflective, and attempted to get the subject to

express all of his views on the issue. The instructions

concerning style are included in the confederate instruc-

tion packet and are found in Appendix A.



Dependent Variables_

In order to test the hypotheses established for this








study it was necessary to have a measure of expectancy.

Many such instruments have been devised but none were

appropriate for the analogue design of this study, since

the subjects had not been identified by themselves or

others as patients, were not under treatment, and have

not even been looking at the setting from a client-therapist

perspective.

Most inventories designed to measure outcome expec-

tancy were directed towards a patient with a specific

problem or a long psychiatric history (Reznikoff, Brady,

& Zeller, 1959; Goldstein & Shipman, 1961; Martin & Sterne,

1976; Martin, Sterne, & Hunter, 1976; Bloch, Bond, Qualls,

Yalom, & Zimmerman, 1976). Dell (1977; Dell & Schmidt,

1976) had designed and used an expectancy questionnaire

of an appropriate type, but it was designed for college

students and included areas of concern about exams,

choosing a major, and academic performance. Research as

well as personal correspondence with Jerome Frank (1977),

Arnold Goldstein (1977), E.H. Uhlenhuth (1978), and Don

Dell (1977), failed to yield a satisfactory instrument.

For the purpose of this study it was necessary to

design an expectancy questionnaire that would accurately

reflect subject's expectancy level. It was decided to

tap conscious attitudes as these tend to be related to

therapeutic outcome to a significant degree, whereas

subconscious attitudes as tapped by projective techniques








seem to bear no statistically significant relationship to

outcome as rated by therapists (Brady, et al., 1959).

It was further felt that the cognitive approach to

measuring expectancy is supported by the theoretical basis

of client-centered therapy (Rogers, 1951) which has been

confirmed by Lipkin (1954), and states that ".. the

individual behaves in accordance with his perception that

reality is for each individual the field as perceived ...

(p. 29).

It seemed apparent to me that an individual's expec-

tancy of outcome would be generalized to the extent that

it would include expectancy for his own improvement as

well as expectancy for the improvement of others. However,

it also appeared apparent that while expectancy level may

be the same there is a different risk level associated

with a self-referral and a referral of a friend, relative,

or other acquaintance. There is a difference between what

one thinks and what one thinks others will think. For

this reason, it was decided to evaluate these two contin-

gencies separately, even though it was expected that the

two measurements would behave in the same manner.

Personal improvement variable: The first instrument

used was designed to measure the subject's expectancy for

his own improvement. It contains 48 questions that are

scored on a five point, Likert type scale (see Appendix i).

The instrument includes areas of concern that might

trouble a basic trainee. The areas of concern themselves







were selected from the Hopkins Symptom Checklist (Derogatis,

Lipman, Rickles, Uhlenhuth, & Covi, 1974) and my experience

as director of the Community Mlental Health Activity at

Fort Dix for approximately 18 months. It should also be

noted that these items were reviewed by a committee of the

University of Florida graduate faculty as a means of

insuring their face validity. The entire instrument was

then evaluated for internal consistency.

The evaluation of internal consistency took place in

the following manner. A 40 minute stress innoculation

lecture (Beach & Klugman, 1977) was presented to 61

trainees at the Fort Dix Reception Station. The trainees

were then asked to complete the expectancy questionnaire

anonymously after being informed that their cooperation was

voluntary. Only 57 questionnaires were useable since four

subjects failed to respond to one or more pages. The re-

sponses to the questionnaire were then evaluated using

Coefficient Alpha as a measure of internal consistency

(Anastasi, 1976). The statistical analysis resulted in a

Coefficient Alpha of .95, which indicates an extremely high

degree of item reliability. A matrix of the actual test

scores can be found in Appendix G.

Referral variable. The second dependent measure,

likelihood to refer, was designed in the same manner as

the first and consisted of eight items (see Appendix F).

Here Coefficient Alpha was .79 which is also an accep-

table level of reliability. A matrix of the actual test

scores can be found in Appendix G.








For both instruments the expectancy score was a

single number representing the summation of the scores

of each individual item. Highly unlikely was rated as

1, and highly likely as 5. The questionnaires were

designed to discourage straight-line marking by alter-

nating the direction of the scales. This was carefully

explained to the subjects to avoid confusion.


Procedure

A roster of trainees from A and C Companies of the

First Battalion, Third BCT Brigade, was obtained and

represents the subject pool. This roster contained the

names of 119 men from which 59 were randomly selected

for inclusion in the study. Eleven extra subjects were

selected to allow for the possibility of some subjects

not being able to take part in the study for various

reasons. As it turned out, two individuals were excluded

because of language difficulties and one, due to a reading

deficiency.

A subject list was prepared assigning two subjects to

each experimental hour. This was done in such a way to

assure that the subject's company would not be in some

crucial training phase that the subject could not miss

or make-up. This system of assignment worked out well

since during the five days during which the study was

conducted, it was rare to find that both A and C Companies

were undergoing critical training.








The experimental treatments (see Figure 1) were

divided into two groups based on whether the credentials

(treatments A, B, E, & F) or no-credentials (treatments C,

D, G, & H) room was to be used. This was done to allow both

rooms to be used at the same time to a maximum degree.

Each treatment was then randomly listed six times, twice

for each confederate. Since the total study took five days

to conduct, this random presentation of treatments was used

to control for the variables that were not a concern in

this study such as the time of day, the day of the week,

the weather, training the subject had just undergone, if

he had guard duty the night before, etc. Each subject

was assigned to the next treatment on the list as he

arrived. Only when random selection resulted in the

same confederate being assigned to both rooms at the

same time was it necessary to lose a portion of an hour.

On the occasions when this did occur, the lost time was

made up with little difficulty by altering the schedule

slightly.

All subjects were seated in a central waiting area

and were allowed to read magazines and interact with each

other. None had been informed of why they were there, or

what they should expect. A check was made on this by

asking each subject why he thought he was there, and

virtually all of them claimed total ignorance.

Experimental treatment began when the subject was led

into the appropriate treatment room where the question was

















r
o
c,
H
z
3


O



O


r








posed if he knew why he was there. When a negative answer

was received, the receptionist outlined the purpose of

the study to the subject, informed him of his right not

to take part, and directed him to read two framed sets of

instructions (see Appendix C) on the wall. It must be

noted at this time that the framed set of instructions was

centered on the credentials wall and placed between the

two large pictures in the non-credentials room. Before

departing, the receptionist drew the subject's attention

to the wall "decorations" as outlined in the script. The

introductory script used by the receptionist is to be found

in Appendix D.

The subject was then left alone for five to seven

minutes to read the study description and instructions.

There were no magazines or other reading material in the

rooms, which were furnished as typical counselor's offices

(see Appendix B).

After the waiting period, the receptionist re-entered

the room and asked if there were any questions. If the

subject consented to take part in the study he was offered

a consent form for his signature (see Appendix E). When

the consent form was signed, as it was in all cases, the

receptionist went out to get the confederate who appeared

wearing the appropriate dress for the experimental condition.

The two dress options, as mentioned earlier, were the

Army khaki uniform, with name tag and without decorations,

or the white laboratory coat with name tag. To insure that








rank was not a confounding factor, all confederates wore the

rank of captain and the same name tag on their uniform. On

the lab coat they all wore red name tags with white letters

which included both the rank and the name.

Each confederate was then left alone with the subject

and began with an identical set of instructions. The actual

script used is included in Appendix A with the entire set of

instructions that the confederate received on how he was to

conduct his portion of the study.

At the termination of the interview the interviewer

thanked the subject and excused himself to get the recep-

tionist who administered the measures of the dependent

variables.

The receptionist's instructions on the administra-

tion of the questionnaire are to be found in Appendix D

with the entire receptionist's packet. The receptionist

made every effort to assure that the subjects understood

all aspects of the measuring instrument and that there

was no question of confusion. Each questionnaire was

explained separately.

After the questionnaires were completed each subject

filled out a brief demographic data sheet, was thanked, and

returned to his unit with instructions not to share what

happened with anyone in the unit for the next seven days.

It was explained that this was necessary to insure that

the other trainees did not have an opportunity to formulate

opinions before their interview or to be contaminated by

the opinions of others.




31



Since virtually none of the trainees reported knowing

what to expect when they entered the experimental setting,

apparently the early subjects refrained from discussing

their experiences with those who entered the study later.














CHAPTER III
RESULTS



Method of Analysis

For the analysis of the data, the experimental cells

were arranged in a 2 (credentials) X 2 (dress) X 2 (style)

design. Each of the dependent variables was tested

separately using analysis of variance to first rule out

the possibility of a confederate effect and then to test

for significant effects attributable to the independent

variables.



Dependent Measures

Personal improvement variable. A four-way analysis

of variance was conducted using three levels of the con-

federate variable to determine if there was any effect

that could be attributed to the confederates. To insure

that a type 2 error, i.e., not rejecting the hypothesis

of zero interaction when it should be rejected, was kept

numerically small, these preliminary tests were made at a

numerically high type 1 error, d = .20 (Winer, 1962). This

preliminary testing indicated no significant confederate

effects (see Table H-1).








Having found no confederate effects, it was considered

appropriate to adjust the model by compressing it to a

2 X 2 X 2 design, and to conduct a three-way analysis of

variance (Winer, 1962). As indicated in Table 1, there

was one significant main effect which was attributable to

therapist style. There were no other significant main

effects or interactions.

Further analysis of the main effect for therapist

style indicated that the directive style (mean for all sub-

jects equals 177.25) was more effective than the non-

directive style (mean for all subjects equals 158.25) in

inducing expectancy on the personal improvement variable.

Summary tables of the mean scores for this dependent

variable are located in Appendix I.

Referral variable. As with the personal improvement

variable a four-way analysis of variance was conducted

using three levels of the confederate variable to deter-

mine if there was any main effect that could be attributed

to the confederates. Again, efforts were made to keep the

possibility of a type 2 error numerically small, d = .20.

There was no main effect attributable to the confederates.

However, there were significant interactions between

conedeateandstye (2,24 = 4.26; E L .20), and between

confederate, dress, and style (F2,24 = 2.31; E <.20) (see

Table H-2).

Scrutiny of the confederates and style interaction

indicated that confederate A was more effective in getting






























Source SS df MS F


Setting (A) 96.3 1 96.3 .15
Dress (IB) 705.3 1 705.3 1.10
Style (C) 4332.0 1 4332.0 6.78*
Ax B 243.0 1 243.0 .38
Ax C 645.3 1 645.3 1.00
B x C 21.3 1 21.3 .03
Ax B x C 507.0 1 507.0 .79
Error 25560.7 40 639.0


Table 1

Summary Table of Compressed Data for

Personal Improvement Variable


.025







a subject to report that he would refer a friend, when

using the non-directive therapeutic style. Confederate C

was more effective when using a directive therapeutic

style, and the effectiveness of confederate B was not

differentially effected by the style he used (see Figure 2).

When dress was added to form a three-way interaction

between confederate, style, and dress, it became even

more obvious that the effect of the style variable and

the style X dress interaction was idiosyncratic to the

experimenter, and therefore the effect of the style and

dress variables were uninterpretable (see Table 2).

The credentials variable showed no significant main or

interaction effect and as a result there were no inter-

pretable effects on this dependent variable.







































i I
DIRECTIVE NON-DIRECTIVE
THERAPIST STYLE


Figure 2. Likelihood to refer a friend as a
function of therapist style and
confederate.


34

33


Confederate A




Confederate C




Confederate B


32


31


30

29

28



















Ot r m m


O UI

-H O

CI 0

kC O 0
H &

0m U
6 a, a, .l .
k k kl m mi c
k Q -






O, a
0 0 E
P; 0 0




r( >,



k Q
Oa
*H E
Oa k




~w o

m o O
a~u r:














CHAPTER IV
DISCUSSION



The anticipated superiority of the credentials over

the non-credentials and of the white laboratory coat over

the military uniform was not observed. This would seem

to imply that these two variables have little or no

independent impact on the development of expectancy set,

for self or others, in male Army basic trainees. Since

there were no significant differences observed, it could

be hypothesized that development of positive expectancy

for therapeutic outcome is not influenced by what appears

to be some of the more obvious indicators of expertise.

The results of these data appear to run counter to

research cited earlier showing that changes of behavior

and perceptions are affected by perceived expertise. This

might very well be the result of the unique nature of the

military setting and the three weeks of indoctrination

received by the trainee subjects. At this point in

training, the trainee has already been pushed to his

physical limits on many occasions, has been denied the

right to speak his mind, and has been discouraged from

thinking for himself or acting independently. He has

begun to become part of a team and is being trained to








function as a single cell rather than as a unique organism.

I suspect that in order to deal with the dissonance

associated with giving up personal rights and freedoms,

the trainee must believe that this is all being done for

his own good, and that individuals directing him know

what they are doing. This in turn could logically lead

to the belief that everyone has been certified as able

to do the job for which he has been selected and ergo

possesses the necessary level of expertness. If this is

so, additional indicators of expertness may just be re-

dundant. Is the individual introduced as a Nobel prize

winner seen as more prestigious if he has a certificate

stating this fact on his wall? This possibility is

supported by the fact that the mean for the referral

variable was 30.8, and the mean for the personal improve-

ment variable was 167.8. The possible range of scores

for the referral variable was 8 to 40, and for the

personal improvement variable 48 to 240. On both variables

the obtained mean scores were on the positive side of the

scale. This implies a positive expectancy level for the

group and supports the possibility that there was already

an existing level of positive expectations.

These results suggest the need for a study that looks

at expectancy change based on a pre-test, post-test design

to insure that the population being scrutinized does not

already have a skewed expectancy set. It would be

interesting to see if a change score emerges as a post-








test, when a pre-test indicates that an individual has a

negative or neutral expectancy. However, a suitable set

of instruments for making such a test must first be

developed.

Another area for research of this nature might be to

compare baseline expectancies of various populations such

as first-week basic trainees and seventh-week basic train-

ees, or basic trainees and high school seniors, as

expectancy may be more a facet of experiential history

than of a belief system that is supported or refuted in a

single visit. The main question here seems to be, what

makes an expert? One of the original premises of this

study was that "doctors," or white-coated individuals,

would be seen as more powerful healers than individuals

wearing military uniforms. This was based on the belief

that there is an experiential set that doctors are experts

at helping others. The basic trainee may very well have

developed an expectancy set unique to his population,

where all military personnel are seen as qualified and

expert in their job. The confederate might have been

viewed as a qualified counselor hired by the army, as

opposed to the officer-doctor dichotomy that was predicted.

Another area for investigation is the possibility

that expectancy is not significantly influenced in a

single session. Friedman's (1963) findings suggest that

expectancy of help is activated at the first patient-

physician contact, and Lennard and Bernstein (1960)








support the idea that a single session can be seen as a

miniature reflection of the overall therapeutic series,

expectancy, like the neurosis may incubate over time. If

one develops a slight negative or positive set this may not

be blatant enough to show up early, but may become more

clearly defined over time.

The one manipulated variable that did have a

significant effect acted only on the personal improvement

variable and not on the referral variable. This was the

directive as opposed to the non-directive style. This

suggests to the author that style did not actually effect

expectancy due to the dynamic suggested in the original

hypothesis, that is that the directive therapist is seen

as a more powerful helper. The possibility now emerges

that expectancy for improvement existed regardless of the

manipulated conditions and the subject merely "liked" the

directive confederate more because he was more active in

the discussion. The reason that this was not reflected on

the referral variable could be that the subject was not

willing to risk that the individual whom he "liked" would

be "liked" by someone else. However, the confederate

interactions that did emerge support the possibility that

there is a personality component that should be considered.

Regardless of the reason, it is a fact that there

emerged a real distinction between subjects' expectancy

for personal improvement and willingness to refer others.

The correlation between the two dependent variables was








only .23. While the possibility that these two variables

would behave differently was suspected it was surprising

to find them so divergent. This opens a whole area of

study into the risks patients associate with therapy and

with how much value they place on a therapist they were sent

to see as opposed to one they find themselves. An inter-

esting question for future study might be to see if

expectancy level differs for self-referrals as opposed to

those referred by others.














CHAPTER V
CONCLUSIONS



The fact that expectancy level did vary as the re-

sult of the style affected by the confederate lends

support to the belief that expectancy is a valid construct

that can be manipulated in the therapeutic setting. The

fact that it was measured by an instrument that was

independent of the outcome which it was expected to pro-

duce further supports expectancy as an entity to be

considered in therapeutic intervention. However, the

fact that expectancy was differentially induced as a

result of the style used does not necessarily mean that

it is a condition essential to therapeutic effectiveness.

Based on the results of this study this possibility is

still not ready for testing, nor are we ready to evaluate

the claims made by other researchers as to the effect of

expectancy on outcome. While this study showed that

style can effect expectancy, the other methods that may

be used to induce expectancy with any consistency are

still not clear. Since the induction of expectancy and

the measurement of its degree and direction are tasks

that have not yet been accomplished satisfactorily,

psychology still seems to be ill prepared to investigate








the role of expectancy on therapeutic outcome. It is

essential thatbthe characteristics of the population being

investigated be scrutinized to isolate the other external

variables that might prove to be powerful expectancy in-

ducers.

This study has provided little evidence to support

the possibility that expectancy for positive therapy

outcome is a function of the widely accepted expectancy

inducers such as the perceived expertness of the thera-

pist. While these results may very well be population

specific, further research is required to test this

possibility.

This study has made it clear that the induction of

expectancy of positive therapeutic outcome is not as

easily accomplished as some investigators would imply.

Merely telling the client that one therapy style or one

therapist is better than another does not necessarily

mean that a differential outcome expectancy has been

induced. It is still necessary to determine what the

inducers are for the population being treated, if in

fact there are any, and how to measure whether or not

they have induced some level of expectancy.

This study has provided some groundwork for basic

research in this area by developing a scale, and obtain-

ing some data for comparison, that might be used in

other studies of a similar nature.




45


In conclusion, as Claghorn (1976) pointed out, the

"Priest-Doctor" role is no longer an adequate model for

psychotherapy. While psychology and medicine should not

discount the non-specific therapeutic effect of expectancy,

the inducers may be so diverse, that research time and

money might better be spent on the more specific thera-

peutic interventions applied to the identifiable areas

of human distress and personal dysfunction.














APPENDIX A
CONFEDERATE'S INSTRUCTIONS

Subject Instructions by Interviewer

The interviewer, after being introduced, will offer

his hand to the subject and will then ask the subject to

please be seated. He will then explain what is about to

happen as follows:

"This study that we are conducting actually has two

parts; the first part is concerned with learning more

about your view of the operation at the Fort Dix Recep-

tion Station, and we'll learn this by having a brief

interview with you and other trainees in your company.

If you don't mind, I would like to tape record this

interview so that I won't have to take notes. But, if

the tape recorder makes you uncomfortable, just let me

know and I won't have to put it on. The second part of

this study involves gathering some information that might

help us in improving the services of the Community Mental

Health Activity here at Fort Dix, and this part will be

in the form of a questionnaire that you will be asked to

fill out after the interview. Do you have any questions?"








It is not anticipated that there will be any questions

at this point, but if there are, they will be answered

briefly and honestly. The interviewer will then turn on

the tape recorder and begin the interview.

"I would like you to begin by telling me about your

experience during your assignment at the Reception Station

here at Fort Dix. Anything that happened, from the time

you arrived to the time you were assigned to your basic

training company that you found to be pleasant and satis-

factory, or unpleasant and unsatisfactory is important.

Some of the things you might want to cover would be how

you were greeted upon your arrival, your first night,

issuance of military uniforms, whether you felt like you

had enough time or not enough time to get things done,

and things that you really do not think should be changed,

and things that you really would like to see changed in

the operation of the Reception Station. Please go ahead."

If the subject is reluctant to speak freely, or

claims that everything went well and he really has nothing

to say, conversation may be stimulated with one or more of

the following remarks:

1. "Do you feel that a week is enough time to
spend at the Reception Station, or should it be
extended by a few days?"

2. "What did you do during your spare time?
Were you allowed to watch television, read books,
go to the PX, or were you restricted to the
barracks?"








3. "How did you feel about not being
able to call home?"

4. "Was there anybody there you felt
you could talk to if you were feeling
homesick and had a need to talk to
somebody?"

5. "Was there a chaplain available,
and did he spend much time with your
group as they moved through the Recep-
tion Station?"

6. "How did clothing issue go?"

7. "What would you like to see changed
that would make the Reception Station
experience a little more enjoyable?"

8. "I'm told that some people change
their mind about being in the Army after
being at the Reception Station for a while.
What about the Reception Station do you
think causes this?"

9. "How were the meals, and was the
meal time experience pleasurable?"

After about 20 minutes the interviewer, after having

played the proper role called for by the experiment

itself (see style instructions), will terminate the

interview and ask the subject if he has anything else

to add. He will then thank the subject for his assistance

and inform him that there is now a brief questionnaire

that they would like him to fill out and that he will

send the receptionist back into the office. He will then

turn off the tape recorder, remove the tape, and leave

the room, closing the door behind him.














Style Instructions



After providing the basic instructions to the subject,

the interview will commence. The therapist will be sitting

in the chair by the desk facing the door, and the subject

will be sitting in the chair located in the corner facing

into the room. The therapist will use maximum eye contact

during the entire interview, and one of the following

interview styles.



Style 1: Non-directive

In the non-directive experimental setting, the

therapist will support the subject's rational statements,

will be reflective and empathetic, and will encourage

the subject to express all of his views on the issue

at hand. He will not attempt to influence the subject's

thinking in any manner, and will tend to listen more

than talk. He will communicate to the subject that he

is actively listening through the use of non-verbal cues,

such as maintaining eye contact, nodding agreement when

appropriate, sitting comfortably but not sloppily, and

leaning towards the subject on occasions when appropriate.

Active listening can be conveyed verbally without intro-

ducing new information or questions by responding to








what the subject is saying. Ways of doing this include

feeding back the last part of the subject's communication

to let him know that he was heard, use of phrases such as

"IYes, go on," "I see," "I understand," and "mmhm."

Following this set of instructions is some additional

guidance to assist you in reflecting subject feeling and

content.



Style 2: Directive

Under this experimental condition, the confederate is

free to present his own views to the trainee. On a mini-

mum of one occasion, and on no more than two, during the

brief interview he will make an active attempt to change

the trainee's thinking on an issue. At no time will the

therapist become abusive or provocative, and he will always

present his ideas from a rational perspective, and might

even suggest behavior changes to assist the subject in

dealing with the particular problem. As in Style 1, the

therapist under this condition will also be an active

listener who will attempt to get the subject to express

all of his views on the issue. Again, the key difference

is that on a minimum of one, and a maximum of two occasions,

he will attempt to get the subject to change one of his

views.














Reflections of Feeling and Content



Reflection is a technique used by a counselor to ex-

press in fresh words the essential feelings or ideas

expressed by the client. This technique helps the indivi-

dual to go below the surface of the words he uses and

become aware of obscure, or perhaps unconscious feelings

associated with those words. In other words, reflection

helps the individual to get his feelings or ideas out

front where both he and the counselor can better look at

them. In addition, it lets the client know that the

counselor is "with him" and understands where he is

coming from.



Difficulties in Reflecting

Stereotyping. Unvaried use of introductory phrases

such as "you feel." Some variations are: "you think,"

"~you believe," "it seems to you," "as I get it," "you

felt that," and "I hear you saying."

Timing. Waiting for the client to stop talking

before reflecting is not always correct. If something

important comes up, it is alright to interrupt.

Selection of feeling. The client may express several

feelings. The counselor must choose the most important

feelings that need clarification.








Four Errors of Reflection

Reflecting verbatim. This means giving back the

identical words used by the client. Reflect underlying

feelings and ideas, attitudes, etc.

Inappropriate depth of feeling. Reflect the same

degree of emotion used by the client. Don't be too

shallow or too deep in depth of emotional reflection.

Changed meaning. Don't add to or take away from

the meaning of the client's words. Listen to what he

says and don't read something into or out of his

statements.

Inappropriate language. Respond to the client's

frame of reference. Use language he can understand and

relate to. There is a limit, however, as to how far you

can go with this.



Summary Reflection

This is similar to reflection as described previously

except that it brings together several feelings and/or

ideas into a meaningful whole.



Benefits of Reflection

1. It helps the client to feel really understood.

2. It helps the client to look at his feelings,

attitudes, and ideas more objectively and thus understand

himself better,

3. It helps to clarify the client's feelings and


ideas.



































APPENDIX B

PHOTOGRAPHS OF EXPERIMENTAL SETTINGS


















I C*
=*P*Ciii'~


I


~b~ ..
p~L~-~S~filO
k

a a,
.; ~e


O
r tL~L CiL~~--llr~;L~--T;;~Y k
4-1

, E
o
~-;f~C~ ~ ~r ~lu U~ CDcL~~ O
e
5~ ~3 .rT~C
~ ~~s~jilII)

_.--;~~b~;~u~Ls~=~_-~i ~-* rl
4L~

a
r a,
v
t:~c~-- -- u
la ;---~c~I a,
i i~- ~e,
4-1

E ~- 3
i: c-- ~7 J;31~ _~ i' ~'~~ll'!~anl?~;lCc~ ~
3
~13

rl
rs


lL21-L.~ F
i;;~ y. ~

























:,i




am ..:Iilialuilia


~CC


"~ rll

Pt




56






E ~ ..~-l" -- I ~ -T -yy
311








I 1~ '") ii:::








If~ O





x O



r~~P' I o





f e,
1.~~~~~~r ..e 68 ,ads








C~ ..... 1,




































APPENDIX C

POSTED INSTRUCTIONS














STUDY DESCRIPTION


The purpose of this study is to gather information

that will assist the Fort Dix Reception Station in

improving their processing procedures and in gaining

knowledge that will assist the Community Mental Health

Activity in better dealing with some of the psychological

problems that basic trainees encounter. In this study you

will be given a brief interview and asked to complete a

short questionnaire. The entire procedure will take

less than one hour and each person will be interviewed

and will fill out the questionnaire privately. Any

information you give in this interview and questionnaire

will be held in the strictest confidence and any refer-

ence to the results of this study will be in general or

statistical form, which cannot be traced back to you.

While we would like you to answer all of the questions,

you may refuse to answer any that you wish. If at any

time you wish to withdraw from the study, you may do so

without any prejudice whatsoever.














INSTRUCTIONS

You have been selected to take part in a study that
is designed to get your views on the processing procedure
at the Fort Dix Reception Station. Following is informa-
tion concerning this study that may be of some use to you.

1. Your interviewer is a behavioral science
professional on the staff of the Fort Dix Community Mental
Health Activity.

2. The counselor is interested in your views and
expects you to take an active part in the discussion.

3. Everything you say is confidential and nothing
will be passed on to be used for or against you.

4. The interview will last for about 20 minutes.

5. The meeting will be recorded so that the
counselor will not have to take notes. This will not be
done if you object.

6. After completion of the interview you will be
requested to complete a brief questionnaire.

7. If you have any questions, please ask the counselor
before the interview begins.














APPENDIX D

RECEPTIONIST'S INSTRUCTIONS



Introductory Instructions by Receptionist



The receptionist will escort the subject to the ap-

propriate room and provide him with basic information and

instructions as outlined below in the following narrative.

"You have been chosen to take part in this voluntary

study because you are a basic trainee who has the sort of

information that we feel will be useful in improving some

of the Army's services. You are not required to take

part in this survey, and if at any time you want to stop

all you have to do is say so. We are interested in your

views, but you do not have to give them if you do not

want to. Nothing you say or do, or fail to say or do, will

ever be used for or against you in any way. This piece

of paper (Study Description) will help to explain more

fully what this study is all about. This piece of paper

(Instructions) will explain the way the study will be

conducted. Please read them over carefully and I will

be back in five minutes to answer any questions you may

have." (The following is said in a light, jovial manner.)








"If you finish reading the two sheets before I get back

feel free to read the walls (look at the pictures), while

you wait."

The receptionist will then leave the client alone in

the room to read the framed instructions, that have been

pointed out to him, for a period of five to seven minutes.

During this time the subject will be left alone in the room

with the door shut. After the necessary time period has

elapsed, the receptionist will return and ask if the subject

has any questions. At this time questions will be answered

and the receptionist will have the subject sign a consent

form. Responses to questions will be as brief as necessary

to satisfy the subject, and any specific questions about

what will happen in the study will be answered by explaining

that he will be asked some questions about his experience

in the Reception Station and asked to fill out a brief

questionnaire when it is over. It is anticipated that

questions about the nature of the study will include the

following:

Q. "Do I have to do this?"

A. "No, this study is voluntary, but we are
interested in your answers, and nothing will
be used against you."

Q. "What are you going to do with my answers?"

A. "We will use your answers to help improve
the operation of the Reception station and
the Community Mental Health Activity. We aire
not really so much interested in your individual
answers as we are in the general comments ob-
tained from everyone. You will never be
personally identified as having made any








particular statement, and it is very
likely that our results will not even
be all put together until you are gradu-
ated and no longer in training at Fort
Dix. "

"Now that you understand a little about what is

going to happen, please read this form, and if you volun-

tarily wish to participate in the study, sign it at the

bottom, indicating that you do volunteer."

After the subject signs the consent form, the recep-

tionist will excuse himself and tell the subject that he

will go get the interviewer. At this time he will leave

the room, close the door, get the interviewer, escort him

back to the experimental office, and introduce him to the

subject. The receptionist will insure that the subject

sits in the seat that provides a view of the entire room

by stating; "Would you please sit in this chair, as the

tape recorder picks up better over here."














Questionnaire Instructions by Receptionist



The receptionist will re-enter the testing room and

will have in his possession all questionnaires to be used,

to include a demographic data sheet. He will offer the

subject a seat behind the desk where he can be comfortable

and have a hard writing surface. At this time, he will

explain the questionnaire.

"We would now like you to fill out two questionnaire

forms that I will explain to you. The forms appear to be

the same, but are really very different, and may appear to

be a little confusing. If you have any trouble with the

instructions, be sure to ask me to explain them to you

again before you begin. First, let's read the instructions

together. On the scale below, that means these series

of lines (he points out the scale) put an "'X" in one of

the spaces after each question, to indicate how likely it

is that the counselor you have just seen, that was Captain

Klugman who just interviewed you, could help you if you

were experiencing one or more of the following concerns.

It is very important for you to understand that we are

not saying that you do have these concerns, or that you

ever will have these concerns. The question we are








asking you is, IF you were experiencing one of the concerns

listed below (receptionist indicates list of concerns

with his finger) how much do you believe that the man

you just saw could be of some help to you in dealing with

those concerns? Note that the scale has a range from

highly UNlikely that he could be of help to you to

highly LIKELY that he could be of help to you. You may

mark anyplace along that scale to indicate how much help

you think he would be. Also note that the scales are

mixed up with highly likely and highly unlikely being

switched around, so be sure to read what is under the

scale before you mark it. Only mark on the line, not

between them, and be sure to answer every question."

(During this narrative the receptionist is pointing to

the various items and spaces as he talks about them.)

"Do you have any questions?"

"This next questionnaire is very different from the

first. Even though it looks very much the same, it is

asking a very different question. Let's read the instruc-

tions together. Now imagine that someone in your company,

note here that this is not you but one of the men in your

unit, is suffering from one of the problem areas listed

below, and that he comes to you with the request that you

refer him to a counselor for help. On the scale below

each problem area, put an "X" in one of the spaces to

indicate how likely it is that you would recommend to

this friend that he see the counselor you have just seen,








that's Captain Klugman, in order to get help with this

problem. Here again, as on the last questionnaire, you

are to mark the scale with an "X", and be very careful

that you read what you're marking since the scales are

mixed up."

"Let me again remind you of the difference between

the two questionnaires. On the first, the question is IF

YOU had one of the problems how likely is it that YOU would

come to see Captain Klugman for help with that problem?

On the second questionnaire we are assuming that one of

your FRIENDS does have one of the problems, and he ASKS

YOU to tell him where he might go to seek help. On this

second questionnaire you are to decide how likely it is

that you would reply to him, 'I saw a counselor at CMHA

by the name of Captain Klugman, who I think may be able

to help you with your problem.'" (During the above nar-

rative the receptionist will be pointing to the appropriate

places on the questionnaire.)

"When you have finished, please fill out this sheet

with the requested information about yourself. You will

notice there is no place for your name or your social

security number. We are interested in your background and

your past history, but don't really need to identify you

personally. When you have finished, please take the entire

package to the front desk, where they will give you a taxi

token so you can return to your unit. I wish to thank you

very much for your cooperation and assistance."




































APPENDIX E

CONSENT FORM















CONSENT FORM



I unit

hereby attest that I have read a written description of the

study being conducted at the Fort Dix Community Mcental

Health Activity that I have been requested to take part

in. The written description has fully explained to my

satisfaction the requirements, responsibilities, and factors

involved in becoming a participant in this research, as well

as the fact that any and all contents of my participation in

the research shall be held by the Fort Dix Community Mental

Health Activity as medically confidential and utilized in

such a way as not to lead to my identification. I recog-

nize that my participation in this research is voluntary,

and that I have the right to withdraw at any time.

Given these understandings, I hereby freely consent

to participate in these studies.



Signature



Date



































APPENDIX F

DEPENDENT VARIABLE MEASURES









Personal Improvement Variable

On the scale below put an "X" in one of the spaces after
each question to indicate how likely it is that the
counselor you have just seen could help you if you were
experiencing one or more of the following concerns.

1. A strong fear of not making it through basic training.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


2. A tendency to "panic" when the drill sergeant yells at you.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


3. Crying a great deal.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


4. Being sick and not getting any help at the hospital.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


5. Feeling that you are "losing your mind".


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


6. Concerns about sexual problems.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely









7. Feeling very sad most of the time.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


8. Not knowing why you do some things.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


9. Conduct that gets you into trouble with other people.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


10. Feelings that you are "different" or that others are out to get you.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


11. Getting angry.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


12. Feeling exhausted or worn out.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


13. Feeling afraid.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


14. Having strange ideas and ways of acting.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely









15. Being over excited with too much energy.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


16. Having to depend too much on other people and not being able to
make up your own mind.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


17. Behavior and interests that a male should not have.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


18. Feeling worried.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


19. Problems with feeling nervous or shaky inside.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


20. Having emotional problems.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


21. Being unable to get rid of bad thoughts or ideas.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely









22. Feeling critical of others.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


23. Having bad dreams.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


24. Difficulty speaking when you are excited.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


25. Feeling easily annoyed or irritated.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


26. Thoughts of ending your life.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


27. Trembling.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


28. Feeling confused.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely

29. Crying easily.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely








30. Feeling shy or uneasy with the opposite sex.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


31. Temper outbursts you could not control.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


32. Blaming yourself for things.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


33. Feeling that you cannot get things done right no matter how
hard you try.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


34. Feeling lonely.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


35. Feeling no interest in things.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely

36. Your feelings being easily hurt.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


37. Feeling others do not understand you or are unsympathetic.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely








38. Feeling that people are unfriendly or dislike you.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


39. Having to do things very slowly in order to be sure that you are
doing them right.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


40. Feeling inferior to others.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


41. Difficulty in falling asleep or staying asleep.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


42. Difficulty making decisions.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


43. Wanting to be alone most of the time.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


44. Having to avoid certain places or activities because they
frighten you.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely








45. Your mind going blank.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


46. Feeling hopeless about the future.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


47. Trouble concentrating.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


48. Feeling sick most of the time even though you know nothing is
wrong with you.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely




77



Referral Variable

Now imagine that someone in your company is suffering from
one of the problem areas listed below, and that he comes to
you with the request that you refer him to a counselor for
help. On the scale below each problem area, put an "X" in
one of the spaces to indicate how likely it is that you
would recommend to this friend that he see the counselor
you have just seen in order to get help with his problem.


1. He is having difficulty in deciding whether or not to stay in
the Army.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


2. He has a very strong fear of the drill sergeants.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


3. He has difficulty in making or keeping friends.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


4. He is unable to get to sleep easily or to stay asleep.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely


5. He is concerned about his sexual adjustment.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


6. He fears that he is losing his mind.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely




78


7. He has a general feeling of sadness and doesn't know why.


Very /Likely /Undecided /Unlikely /Very
Likely Unlikely


8. He feels very nervous most of the time.


Very /Unlikely /Undecided /Likely /Very
Unlikely Likely




































APPENDIX G

DEPENDENT VARIABLE SCORE MATRIXES









L


Personal


Improvement Variable Score Matrix


SUBJECT
1 2 3 4 5


TEST
ITEM


6 7 8 9 10




81




TEST SUBJECT
ITEM 11 12 13 14 15 16 17 18 19 20

1 4 3 4 4 5 2 4 2 4 2
2 3 4 3 4 5 2 4 3 5 2
3 3 4 3 4 5 2 3 2 4 2
4 2 5 5 4 5 2 4 4 1 3
5 3 3 1 4 5 2 4 3 3 2
6 5 4 4 4 5 1 2 3 4 3
7 4 4 3 3 5 2 2 4 5 4
8 4 4 4 4 5 3 4 4 3 4
9 4 4 3 4 5 2 4 1 4 2
10 4 4 2 5 5 2 3 2 2 4
11 4 4 3 4 5 3 2 4 4 4
12 4 3 4 5 5 2 2 1 3 5
13 4 4 2 4 5 2 4 4 2 4
14 3 4 2 4 5 2 4 3 3 4
15 3 4 3 5 5 2 3 4 4 3
16 2 4 5 2 5 2 4 2 4 3
17 3 4 3 4 5 1 4 2 4 2
18 4 5 4 4 5 4 4 4 3 4
19 4 4 1 4 5 4 4 4 4 4
20 4 4 3 4 5 2 3 4 3 2
21 5 4 4 4 5 4 4 3 4 4
22 3 4 4 4 5 2 4 3 4 2
23 4 3 2 2 4 1 3 3 4 2
24 4 4 5 4 5 2 4 4 2 1
25 4 4 3 2 5 2 4 3 4 3
26 3 3 2 1 5 4 5 1 4 3
27 4 4 3 4 5 4 3 4 4 4
28 4 4 2 4 5 4 3 5 3 4
29 3 3 3 4 5 2 3 3 4 3
30 2 3 3 4 5 2 3 2 4 2
31 4 3 2 3 5 2 4 4 3 3
32 3 4 3 4 5 2 4 2 3 4
33 4 4 2 4 5 2 4 2 3 4
34 4 3 4 4 5S 4 3 5 3 5
35 3 4 4 2 5 2 3 2 3 3
36 3 3 3 2 5 2 3 3 3 2
37 3 4 4 2 5 4 1 3 3 3
38 4 3 4 2 5 2 4 2 3 4
39 4 3 2 2 5 2 2 2 3 4
40 3 4 1 2 5 2 4 3 3 3
41 4 3 1 4 5 2 2 1 3 2
42 4 4 4 2 5 3 3 3 3 2
43 2 4 3 2 5 2 4 3 3 2
44 3 3 3 2 4 2 4 3 5 2
45 3 5 1 2 4 2 4 2 1 2
46 4 4 1 3 5 2 4 1 5 2
47 4 4 2 2 5 2 3 2 1 2
48 4 4 5 2 5 2 3 1 4 4









TEST SUBJECT
ITEM 21 22 23 24 25 26 27 28 29 30

1 4 5 5 1 4 1 4 4 3 5
2 4 3 5 1 1 1 3 2 3 5
3 3 4 3 1 3 4 3 3 2 5
4 4 1 1 1 2 1 2 2 3 4
5 1 3 2 1 5 1 2 4 4 5
6 3 1 2 4 2 1 1 2 2 4
7 4 2 4 1 5 5 3 3 3 3
8 4 3 5 2 1 1 3 2 4 4
9 4 2 4 5 1 1 4 2 4 5
10 3 1 4 1 3 3 2 2 3 4
11 4 4 4 4 3 5 2 2 4 2
12 2 5 1 5 1 4 2 4 5 2
13 3 4 4 1 3 3 2 4 3 5
14 4 4 3 1 2 4 1 4 3 4
15 3 1 4 2 2 3 2 4 3 3
16 4 3 2 1 2 1 2 3 3 5
17 4 1 4 1 4 1 2 4 3 5
18 4 5 5 4 3 3 4 3 3 5
19 4 5 4 4 5 5 3 2 4 5
20 4 4 3 1 2 2 2 2 4 4
21 4 4 3 4 3 4 3 2 4 4
22 4 3 4 3 2 3 2 2 4 4
23 3 4 1 2 2 2 1 3 4 5
24 1 3 4 2 2 4 3 4 3 5
25 4 4 4 3 3 5 2 3 3 4
26 3 3 3 2 3 1 3 2 4 5
27 4 4 3 2 3 3 4 3 4 3
28 4 4 4 4 3 4 2 4 4 5
29 4 4 3 1 3 1 2 4 4 5
30 4 1 3 1 3 3 2 3 3 5
31 3 4 3 4 3 4 3 2 4 4
32 4 3 3 1 3 3 4 3 3 4
33 3 4 4 3 3 3 2 4 3 4
34 4 5 4 4 3 1 4 2 3 3
35 2 4 3 2 3 3 4 2 4 5
36 4 3 4 2 3 3 2 3 3 4
37 3 4 4 3 3 3 3 4 3 5
38 4 2 4 2 3 3 2 3 4 4
39 3 4 4 3 3 3 3 4 4 4
40 4 1 4 2 3 3 3 2 3 4
41 4 4 3 4 3 3 4 3 3 4
42 4 4 4 2 3 3 4 3 3 5
43 4 5 4 2 3 3 3 4 3 4
44 4 5 4 2 3 1 1 2 3 5
45 4 1 4 2 3 3 1 4 3 5
46 4 3 5 2 3 2 3 3 3 5
47 3 4 5 2 3 1 3 3 3 4
48 4 3 4 2 3 4 3 2 4 5




83




TEST SUBJECT
ITEM 31 32 33 34 35 36 37 38 39 40

1 4 4 4 3 1 4 5 4 1 5
2 4 5 4 3 3 5 4 4 4 5
3 4 4 2 1 1 2 5 3 1 5
4 5 5 4 5 1 1 2 2 5 3
5 4 4 4 2 1 1 5 4 1 4
6 4 4 2 1 2 4 5 4 2 4
7 4 3 4 3 1 2 2 3 2 5
8 4 5 2 2 1 4 5 3 1 4
9 5 4 4 2 1 1 5 4 1 4
10 4 5 2 2 1 2 5 4 5 5
11 4 1 2 4 5 4 5 2 3 5
12 4 2 3 4 5 5 5 2 5 4
13 4 4 4 3 1 2 2 3 3 5
14 4 4 4 2 1 5 5 4 5 4
15 4 5 2 3 2 4 5 3 5 3
16 4 4 2 3 1 2 1 4 5 4
17 5 5 2 1 3 3 5 3 3 4
18 4 4 4 3 3 1 1 4 2 5
19 4 4 4 3 4 5 1 2 3 5
20 4 4 4 3 4 4 3 3 3 5
21 4 5 4 3 2 3 5 3 3 5
22 4 4 4 3 3 5 1 2 3 4
23 4 3 2 2 1 5 1 3 4 4
24 4 3 2 3 5 1 '1 3 1 4
25 4 4 4 3 3 5 1 3 3 4
26 4 5 2 1 1 4 5 4 1 4
27 4 4 3 1 4 1 3 4 1 5
28 4 4 4 4 2 5 1 4 1 4
29 4 5 3 1 1 2 5 3 4 4
30 4 5 2 1 4 1 3 3 5 5
31 4 4 4 1 3 2 5 3 1 4
32 4 54 2 2 2 5 4 1 4
33 4 5 4 3 1 3 4 4 1 4
34 4 4 4 3 4 2 1 5 1 4
35 4 5 2 3 1 3 4 4 1 4
36 4 1 4 2 4 3 1 4 1 4
37 4 5 2 3 1 4 4 4 3 3
38 4 5 4 2 1 1 4 4 3 4
39 5 5 4 3 1 4 1 2 2 4
40 4 5 4 3 4 3 3 4 5 4
41 4 4 2 2 1 4 1 3 4 3
42 4 5 4 3 2 3 2 3 1 4
43 4 5 2 2 5 3 2 3 4 4
44 4 5 4 2 1 1 4 3 3 4
45 4 4 4 1 1 4 2 3 1 3
46 4 5 2 2 1 2 4 4 1 4
47 4 5 4 3 1 3 3 3 1 4
48 4 5 4 3 1 1 4 3 1 4




84




TEST SUBJECT
ITEM 41 42 43 44 45 46 47 48 49 50

1 5 4 4 5 4 4 3 1 1 1
2 3 4 3 5 4 3 1 1 5 1
3 2 4 4 5 4 4 2 1 4 1
4 2 3 1 5 4 4 2 3 3 2
5 2 4 5 5 4 4 2 1 5 1
6 3 3 3 5 3 2 2 2 4 3
7 2 4 3 5 4 3 4 2 2 5
8 3 4 4 5 4 2 3 4 5 1
9 2 4 3 5 4 3 2 3 2 4
10 1 4 4 5 4 4 5 2 5 1
11 4 5 4 5 4 4 4 4 3 4
12 4 2 2 1 3 2 4 5 4 4
13 4 3 4 5 4 4 2 3 3 1
14 1 3 3 5 4 4 4 5 4 1
15 4 3 2 5 3 2 4 2 2 2
16 1 3 4 5 4 4 2 1 5 1
17 1 3 4 5 4 2 3 1 5 4
18 4 4 4 5 4 2 2 5 3 4
19 3 4 5 5 4 4 2 1 4 4
20 3 4 4 5 4 3 2 2 5 4
21 4 4 3 5 4 4 2 2 5 1
22 4 3 3 5 4 4 2 2 4 2
23 4 3 2 5 3 2 2 3 1 4
24 4 4 2 1 3 5 3 1 1 4
25 4 3 3 5 4 3 2 3 1 4
26 1 5 4 5 4 2 2 1 1 1
27 4 4 2 5 3 2 2 1 1 3
28 4 4 5 5 4 2 4 4 3 5
29 1 4 1 5 4 2 2 2 1 2
30 2 3 1 1 4 5 2 5 1 4
31 3 4 3 5 3 4 4 2 1 4
32 4 4 3 5 4 4 3 2 2 4
33 3 3 4 5 4 4 4 2 1 4
34 4 3 4 1 4 3 4 2 3 4
35 3 4 2 1 4 4 2 2 1 1
36 3 4 4 5 4 5 2 2 4 2
37 4 3 1 5 4 3 4 2 3 1
38 4 3 2 5 4 2 2 3 1 1
39 4 4 2 5 4 2 4 3 2 4
40 4 3 2 3 4 2 3 2 1 1
41 4 4 3 5 3 2 3 2 1 4
42 4 4 2 5 4 4 3 2 3 4
43 4 3 3 5 3 3 4 2 3 1
44 4 3 3 5 4 4 3 2 1 1
45 3 3 4 5 3 3 2 1 1 4
46 2 4 4 5 4 5 3 1 1 4
47 4 3 4 1 3 4 3 1 1 2
48 3 4 5 5 4 3 2 1 1 5









TEST SUBJECT
ITEM 51 52 53 54 55 56 57

1 3 4 5 4 2 1 5
2 4 2 3 3 4 1 1
3 4 2 4 1 2 15
4 1 4 4 3 4 14
5 3 2 4 4 2 1 4
6 1 4 2 3 11 1
7 2 2 5 3 3 1 2
8 4 4 5 2 2 1 2
9 3 1 2 4 2 1 1
10 4 2 4 2 3 1 2
11 4 4 5 3 4 1 4
12 4 4 4 4 4 1 4
13 4 1 4 4 4 1 2
14 3 2 4 3 4 1 2
15 3 2 4 1 3 3 2
16 2 4 5 2 2 1 2
17 1 4 2 2 1 1 1
18 5 4 4 4 4 1 2
19 4 4 5 4 4 2 2
20 2 4 4 4 4 1 2
21 3 1 1 3 4 2 2
22 3 2 3 4 2 1 2
23 4 2 3 4 2 2 1
24 2 2 2 2 4 2 1
25 4 2 2 2 3 2 3
26 1 1 1 5 1 1 1
27 4 4 1 4 4 4 2
28 4 4 4 4 4 2 2
29 4 1 2 4 2 5 2
30 1 2 4 1 2 2 1
31 4 1 2 3 2 1 2
32 3 2 1 4 2 2 2
33 2 4 4 5 4 1 1
34 4 5 4 4 2 1 2
35 2 2 3 3 2 1 2
36 4 4 2 3 2 2 2
37 2 4 2 3 2 1 2
38 4 4 1 3 4 2 2
39 4 4 4 4 3 2 2
40 2 1 3 4 3 1 3
41 3 4 4 4 2 2 2
42 2 1 4 4 4 2 2
43 3 1 1 3 2 2 2
44 2 2 2 3 2 1 2
45 2 1 1 4 2 1 2
46 2 2 2 1 3 1 1
47 2 2 4 1 3 2 2
48 2 1 4 1 2 1 2









Referral Variable Score Matrix

SUBJECT
2 3 4 5 6 7

5 5 4 4 2 4

1 5 5 4 2 4

3 2 3 2 2 4

5 2 1 4 2 4

3 5 1 2 2 4

5 5 4 2 2 4

5 5 4 4 2 4

5 5 2 4 2 4


TEST
ITEM

1

2

3

4

5

6

7

8








TEST
ITEM

1

2

3

4

5

6

7

g


10

3

5

4

2

5

1

3

4









20


SUBJECT
14 15

2 4

2 5

3 4

3 4

5 4

2 5

4 5

2 4




87




TEST SUBJECT
ITEM 21 22 23 24 25 26 27 28 29 30

1 4 4 5 2 1 3 4 4 4 5

2 3 2 5 2 3 3 4 4 4 5

3 2 4 4 5 3 3 3 2 3 5

4 4 4 4 4 3 3 2 2 4 4

5 4 5 4 5 3 3 3 2 4 5

6 4 5 5 4 3 5 3 2 4 5

7 4 3 4 2 3 4 2 2 4 5

8 4 2 4 2 3 4 4 2 4 4









TEST SUBJECT
ITEM 31 32 33 34 35 36 37 38 39 40

1 4 3 5 4 1 2 2 5 5 5

2 4 5 4 4 1 5 4 5 1 5

3 4 3 4 3 1 3 3 4 1 4

4 4 4 2 3 1 5 1 3 4 4

5 5 3 5 3 2 3 3 3 1 3

6 4 4 5 3 1 4 5 5 1 4

7 4 4 4 4 2 3 4 1 1 4

8 5 5 4 3 1 2 3 3 1 4









TEST
ICTEM

1

2

3

4

5

6

7

8


SUBJECT
44 45

5 2

5 2

5 2

5 2

5 1

5 2

5 4

5 4


TEST
ITEM 51

1 4

2 4

3 4

4 4

5 4

6 5

7 4

8 4


SUBJECT
52 53 54 55 56 57 58 59 60 61

1 5 4 2 1 2 5 5 4 5

5 1 4 4 2 4 5 2 4 4

5 4 2 2 2 3 5 4 4 3

5 1 3 2 2 4 3 3 4 3

4 3 1 2 2 1 3 5 4 4

1 4 1 4 2 4 3 1 4 5

2 1 3 4 2 2 3 4 4 4

5 4 3 4 2 4 3 1 4 4


































APPENDIX H

SUMMARY TABLES OF CONFEDERATE EFFECTS




University of Florida Home Page
© 2004 - 2010 University of Florida George A. Smathers Libraries.
All rights reserved.

Acceptable Use, Copyright, and Disclaimer Statement
Last updated October 10, 2010 - - mvs