Client correlates of community informant adjustment ratings

Explored similarities and differences among home and community adjustment ratings by clients, community informants, and psychiatrists. Minnesota Multiphasic Personality Inventories, and Personality Adjustment and Role Skills (PARS) scales (Ellsworth, 1975) were administered to 169 consecutively-admitted psychiatric patients. Psychiatrists rated each client on the Brief Psychiatric Rating Scales and 141 community informants rated client's home and community adjustment on the PARS. Simple, multiple, and canonical correlational analyses were performed with scores from these tests. Although clients, community informants, and psychiatrists agree when rating clients' symptomatology, nevertheless each person highlighted different aspects of adjustment. Moreover, "impression management" (as measured by subtle-obvious MMPI scales) emerged as influential. These two findings suggest that outcome assessment must be based not only on ratings from multiple perspectives but also outcome assessment must entertain possible biases among raters. Supplementary analyses indicated that outcome assessment for psychiatric clients can be improved by adding response style scales which evaluate dimensions of "sick" and "healthy" symptom presentation and by identifying interaction of diagnosis with ratings of home and community and adjustment.