Patients' styles of adaptation to the institutional demands posed by psychiatric hospitalization were conceptualized and assessed in terms of patients' reputations held by the staff. Day nurses', evening nurses' and doctors' ratings of 133 shortterm patients were each factored. Three reputations consistently emerged among all staff groups: Critical Manipulators, Involved Helpers, and Model Patients. A factor analysis of day nurses' ratings of 50 long-term patients produced three similar reputations. The Critical Manipulator reputation was particularly replicable. Although role orientation and setting differences among the staff did not appreciably effect the conceptual generality of the reputations, they did exert a substantial effect on staff consensus in ascribing reputations to individual patients. The latter is consistent with a growing body of data concerning the importance of both person and situation variables to the prediction of behavior.
Alan F. Fontana. Patient ReputationsManipulator, Helper, and Model. Arch Gen Psychiatry. 1971;25(1):88–93. doi:10.1001/archpsyc.1971.01750130090011