Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia : Results from a Large Multicentre Trial
Copyright © 2014 John Wiley & Sons, Ltd..
UNLABELLED: We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed.
METHOD: Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied.
RESULTS: Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted.
CONCLUSIONS: The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level.
KEY PRACTITIONER MESSAGE: Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. Symptom severity and comorbid diagnoses might affect treatment outcome negatively. Beyond these two factors, most patients share a similar likelihood of treatment success when treated according to the manual by Clark and Wells. Copyright © 2014 John Wiley & Sons, Ltd.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
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| Enthalten in: |
Clinical psychology & psychotherapy - 23(2016), 1 vom: 06. Jan., Seite 35-46 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hoyer, Juergen [VerfasserIn] |
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| Links: |
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| Themen: |
CBT |
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| Anmerkungen: |
Date Completed 09.11.2016 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/cpp.1936 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM244569088 |
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| 100 | 1 | |a Hoyer, Juergen |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia |b Results from a Large Multicentre Trial |
| 264 | 1 | |c 2016 | |
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| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 John Wiley & Sons, Ltd. | ||
| 520 | |a UNLABELLED: We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed | ||
| 520 | |a METHOD: Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied | ||
| 520 | |a RESULTS: Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted | ||
| 520 | |a CONCLUSIONS: The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level | ||
| 520 | |a KEY PRACTITIONER MESSAGE: Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. Symptom severity and comorbid diagnoses might affect treatment outcome negatively. Beyond these two factors, most patients share a similar likelihood of treatment success when treated according to the manual by Clark and Wells. Copyright © 2014 John Wiley & Sons, Ltd | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a CBT | |
| 650 | 4 | |a Comorbidity | |
| 650 | 4 | |a Interpersonal Problems | |
| 650 | 4 | |a Predictors | |
| 650 | 4 | |a Social Phobia | |
| 650 | 4 | |a Treatment Outcome | |
| 700 | 1 | |a Wiltink, Joerg |e verfasserin |4 aut | |
| 700 | 1 | |a Hiller, Wolfgang |e verfasserin |4 aut | |
| 700 | 1 | |a Miller, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Salzer, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Sarnowsky, Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Stangier, Ulrich |e verfasserin |4 aut | |
| 700 | 1 | |a Strauss, Bernhard |e verfasserin |4 aut | |
| 700 | 1 | |a Willutzki, Ulrike |e verfasserin |4 aut | |
| 700 | 1 | |a Leibing, Eric |e verfasserin |4 aut | |
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