Abstract
Two forms of multiple regression analysis, one based upon a set of individual variables, one based upon a set of orthogonal factors generated from them, were used to predict response to treatment in a group of 199 primarily anxious, neurotic outpatients treated for a 4 week period with either diazepam or phenobarbital. Greater improvement, irrespective of medication received, was found in patients who: 1. enjoyed greater social and personal advantage, 2. participated in a more empathetic treatment relationship, 3. were oriented toward drugs and away from psychotherapy as a primary treatment modality, 4. had less severe presenting symptomatology, and 5. had sufficient cognitive differentiation to realize that their problems were emotional in origin. Diazepam was superior to phenobarbital in employed patients and in patients with more severe somatizing tendencies, while the relative effectiveness of the 2 medications was reversed in unemployed patients and those with limited somatizing tendencies. Weaknesses in one form of regression analysis were complemented by strengths in the other.
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References
Blalock, H. M.: Causal inferences in nonexperimental research. Chapel Hill: University of North Carolina Press 1964
Bottenberg, R. A., Ward, J. H.: Applied multiple linear regression. (PRL-TDR-63-6). Texas: Lackland Air Force Base 1963
Burket, G. R.: A study of reduced rank models for multiple prediction. Psychometric Monograph, Nr 12 (1964)
Cattell, R. B., Rickels, K.: The relationship of clinical symptoms and IPAT factored tests of anxiety, regression, and asthenia: A factor analytic study. J. nerv. ment. Dis. 146, 147–160 (1968)
Cohen, J.: Multiple regression as a general data-analytic system. Psychol. Bull. 70, 426–443 (1968)
Darlington, R. B.: Multiple regression in psychological research and practice. Psychol. Bull. 69, 161–182 (1968)
Downing, R. W., Rickels, K.: Patient personality and demographic factors as predictors of early response to psychotropic drug treatment. Compr. Psychiat. 11, 568–575 (1970a)
Downing, R. W., Rickels, K.: The prediction of placebo response in anxious and depressed outpatients. In: Psychopharmacology and the individual patient. J. R. Wittenborn, S. C. Goldberg, and P. R. A. May, eds., pp. 160–188. New York: Raven Press 1970b
Downing, R. W., Rickels, K.: Predictors of amitriptyline response in neurotic depression. J. nerv. ment. Dis. 154, 248–263 (1972)
Dowinng, R. W., Rickels, K.: Predictors of response to amitriptyline and placebo in three outpatient treatment settings. J. nerv. ment. Dis. 156, 109–129 (1973)
Downing, R. W., Rickels, K., Wittenborn, J. R., Mattsson, N.: The interpretation of data from investigations assessing the effectiveness of psychotropic agents. In: Principles and problems in establishing the efficacy of psychotropic agents. J. Levine, B. C. Schiele, and L. Bouthilet, eds., pp. 267–288. Public Health Service Publication No. 2138 (1971)
Goldberg, S. C. and Mattsson, N.: Symptom changes associated with improvement in schizophrenia. J. cons. Psychol. 31, 175–180 (1967)
Harman, H. H.: Modern factor analysis. Chicago: University of Chicago Press 1960
Health Services Computing Facility. BMD X 72 Factor Analysis. Los Angeles: University of California, undated
Hesbacher, P. T., Rickels, K., Gordon, P. E., Gray, B., Meckelnburg, R., Weise, C. C., Vandervort, W. J.: Setting, patient, and doctor effects on drug response in neurotic patients: I. Differential attrition, dosage deviation and side reaction responses to treatment. Psychopharmacologia (Berl.) 18, 180–208 (1970a)
Hesbacher, P. T., Rickels, K., Hutchison, J., Raab, E., Sablosky, L., Whalen, E. M., Phillips, F. J.: Setting, patient, and doctor effects on drug response in neurotic patients: II. Differential improvement. Psychopharmacologia (Berl.) 18, 209–226 (1970b)
Hollingshead, A. B.: Two factor index of social position. New Haven, Conn.: Mimeographed report 1957
Overall, J. E., Hollister, L. E., Prusmack, J. J., Shelton, J., Pokorny, A.: Controlled comparison of SK & F 14336 and chlorpromazine in newly admitted schizophrenics. J. clin. Pharmacol. 9, 328–338 (1969)
Rickels, K.: Drug use in outpatient treatment. Amer. J. Psychiat. 124 (Suppl.)., 20–31 (1968)
Rickels, K., Downing, R. W.: Minor tranquilizers in anxiety: Some prognostic indicators. In: Relaxation therapy for psychosomatic disorders. P. Kielholz, ed., pp. 11–34. Basel, Switzerland: Ciba-Geigy Limited 1971
Rickels, K., Downing, R. W.: Verbal ability (intelligence) and improvement in drug therapy of neurotic patients. J. New Drugs 5, 303–307 (1965)
Rickels, K., Downing, R. W., Howard, K.: Predictors of chlordiazepoxide response in anxiety. Clin. Pharmacol. Ther. 12, 263–273 (1971)
Rickels, K. Howard, K.: The physician questionnaire: A useful tool in psychiatric drug research. Psychopharmaclogia (Berl.) 17, 338–344 (1970)
Rickels, K., Lipman, R., Raab, E.: Previous medication, duration of illness and placebo response. J. nerv. ment. Dis. 142, 548–554 (1966)
Uhlenhuth, E. H., Covi, L., Rickels, K., Lipman, R. S., Park, L. C.: Predicting the relief of anxiety with meprobamate. Arch. gen. Psychiat. 26, 85–91 (1972)
Uhlenhuth, E. H., Duncan, D. B., Park, L. C.: Some nonpharmacologic modifiers of the response to imipramine in depressed psychoneurotic outpatients: A confirmatory study. In: Psychotropic Drug Response: Advances in Prediction. P. R. A., May and J. R. Wittenborn, eds., pp. 155–197. Springfield, Ill.: C. C. Thomas 1969
Wheatley, D.: Effects of doctors' and patients' attitudes and other factors on response to drugs. In: Non-specific factors in drug therapy. K. Rickels, ed., pp. 73–79. Springfield, Ill.: C. C. Thomas 1968
Wittenborn, J. R.: Factors which qualify the response to iproniazid and imipramine. In: Prediction of response to pharmacotherapy. J. R. Wittenborn and P. R. A. May, eds., pp. 125–146. Springfield, Ill.: C. C. Thomas 1966
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Mr. Dreesmann is a graduate student in psychology, University of Braunschweig, Germany.
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Downing, R.W., Rickels, K. & Dreesmann, H. Orthogonal factors vs. interdependent variables as predictors of drug treatment response in anxious outpatients. Psychopharmacologia 32, 93–111 (1973). https://doi.org/10.1007/BF00428681
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DOI: https://doi.org/10.1007/BF00428681