Examining patient characteristics as predictors of patient beliefs about treatment credibility and expectancies for treatment outcome.

Abstract

Although it is widely documented that a patient’s expectations for treatment outcome and credibility beliefs about treatment are consistent correlates of outcomes across settings and treatment modalities, few data exist regarding predictors of these expectations and beliefs. The current study aimed to test specific patient characteristics, such as demographic variables (e.g., age, sex, race) and clinical variables (e.g., diagnosis, level of depression, anxiety), as predictors of treatment expectancy, and credibility beliefs in a naturalistic treatment setting. Five hundred patients in a New England-based partial hospital program completed a battery of self-report measures and a structured diagnostic interview at admission following a program orientation, but prior to contact with their therapists. Multivariate regression models showed that only depression severity was a unique predictor of expectancy, .312, p .001. Male sex, .155, p .001, more severe depression, .167, p .003, and current social anxiety disorder (SAD), .123, p .006, predicted lower credibility beliefs. Patients with current posttraumatic stress disorder (PTSD) reported higher credibility beliefs, .122, p .008. Neither treatment-outcome expectancy nor treatmentcredibility belief differed significantly by race, level of education, or marital status. Patients with more severe symptoms and SAD may stand to benefit most from interventions aimed at enhancing expectations and credibility beliefs. Further research is needed to identify additional characteristics and treatment factors associated with treatment expectancy, as well as methods for enhancing expectancy.