The effect of attributional processes concerning medication taking on return of fear.
In this investigation, the authors examined the effect of attributional processes concerning medication taking on return of fear following exposure-based treatment. Participants (87% undergraduate students and 13% community volunteers) displaying marked claustrophobic fear (N = 95) were randomly allocated to a waitlist condition, a psychological placebo condition, a 1-session exposure-based treatment, or the same exposure treatment given in conjunction with an inactive pill. Attributions concerning medication taking were manipulated by further randomly assigning participants in the exposure-based treatment plus pill condition to 1 of 3 instructional sets immediately following treatment completion and posttreatment assessment: (1) The pill was described as a sedating herb that likely made exposure treatment easier; (2) the pill was described as a stimulating herb that likely made exposure treatment more difficult; or (3) the pill was described as a placebo that had no effect on exposure treatment. Return of fear rates for the 3 conditions were 39%, 0%, and 0%, respectively. Moreover, the deleterious effects of the sedation instructions were mediated by reduced self-efficacy. These findings highlight the importance of assessing patient attributions regarding the improvements achieved with combined exposure-based and pharmacological treatments for anxiety disorders.
Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, the Netherlands. mpowers@fmg.uva.nl
Mark B
MB
Powers
Jasper A J
JA
Smits
Diana
D
Whitley
Alexander
A
Bystritsky
Michael J
MJ
Telch
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001205:Ascorbic Acid / Q000627:therapeutic use; D001290:Attitude; D015928:Cognitive Behavioral Therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005239:Fear; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014850:Waiting Lists
D006993:Hypnotics and Sedatives; D001205:Ascorbic Acid