The Effect of Attributional Processes Concerning Medication Taking on Return of Fear

• Published in: Journal of consulting and clinical psychology 2008-06, Vol.76 (3), p.478-490
• Main Authors: Powers, Mark B, Smits, Jasper A. J, Whitley, Diana, Bystritsky, Alexander, Telch, Michael J
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Adult; Anxiety; Ascorbic Acid - therapeutic use; Attitude; Attribution; Attributions; Behavior therapy. Cognitive therapy; Biological and medical sciences; Claustrophobia; Cognitive Therapy; Diagnostic and Statistical Manual of Mental Disorders; Drug Therapy; Drugs; Effects; Exposure Therapy; Fear; Fear & phobias; Female; Health risk assessment; Human; Humans; Hypnotics and Sedatives - therapeutic use; Male; Medical sciences; Medical treatment; Middle Aged; Outcomes of Treatment; Phobic Disorders - diagnosis; Phobic Disorders - drug therapy; Phobic Disorders - psychology; Prescription drugs; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Safety; Self Efficacy; Severity of Illness Index; Surveys and Questionnaires; Treatments; Undergraduate Students; Volunteers; Waiting Lists
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/0022-006X.76.3.478

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.