title: An investigation of outcome expectancies as a predictor of treatment response for combat veterans with PTSD: comparison of clinician, self-report, and biological measures.
abstract: BACKGROUND
  Outcome expectancy, or the degree to which a client believes that therapy will result in improvement, is related to improved treatment outcomes for multiple disorders. There is a paucity of research investigating this relation in regards to posttraumatic stress disorder (PTSD). Additionally, the bulk of the research on outcome expectancy and treatment outcomes has relied mostly on self-report outcome measures.
  
  
  METHODS
  The relation between outcome expectancy on self-report measures, clinician-rated measures, and two biological indices (fear-potentiated startle and cortisol reactivity) of PTSD symptoms was explored. The sample included combat veterans (N = 116) treated with virtual reality exposure therapy for PTSD.
  
  
  RESULTS
  Results supported a negative association between outcome expectancy and both self-report and clinician-rated symptoms at the conclusion of treatment, but outcome expectancy was related to the magnitude of change during treatment for self-report measures only. Outcome expectancy was unrelated to biological measures of treatment response.
  
  
  CONCLUSIONS
  These findings suggest that outcome expectancy may be related to patient and clinician perceptions of outcomes, but not biological indices of outcome for PTSD.
authors.affiliation: Department of Psychology, University of Vermont, Burlington, Vermont.
authors.forename: Matthew
authors.initials: M
authors.lastname: Price
authors.affiliation: Department of Psychology, University of Georgia.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Maples
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University.
authors.forename: Tanja
authors.initials: T
authors.lastname: Jovanovic
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University.|Mental Health Service Line, Trauma Recovery Project, Atlanta VA Medical Center, Decatur, GA.
authors.forename: Seth D
authors.initials: SD
authors.lastname: Norrholm
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University.
authors.forename: Mary
authors.initials: M
authors.lastname: Heekin
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University.
authors.forename: Barbara O
authors.initials: BO
authors.lastname: Rothbaum
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000627:therapeutic use; D003130:Combat Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D003131:Combined Modality Therapy; D003469:Culture; D003523:Cycloserine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007171:Implosive Therapy; D008297:Male; D008875:Middle Aged; D013216:Reflex, Startle / Q000502:physiology*; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*; D063367:Virtual Reality Exposure Therapy
chemical_list: D003523:Cycloserine; D006854:Hydrocortisone; D000525:Alprazolam
keywords: multilevel modeling; multimodal assessment; outcome expectancy; posttraumatic stress disorder; virtual reality