The role of pretreatment outcome expectancies and cognitive–behavioral skills in symptom improvement in an acute psychiatric setting
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Background Prior research has found that pretreatment expectations of symptom improvement are positively correlated with depressive symptom change. The current investigation extends previous research by examining whether pretreatment outcome expectancies predict symptom change across several diagnostic categories within the context of an acute, naturalistic psychiatric setting.Methods Analyses were conducted to examine whether pretreatment outcome expectancies (credibility/expectancy questionnaire [CEQ]) predicted symptom improvement within major depression (N=420), bipolar disorder (N=120) and psychosis (N=36). Bootstrap mediation analyses were conducted to examine whether acquisition of cognitive behavioral therapy (CBT) skills (cognitive behavior therapy skills questionnaire [CBTSQ]) may mediate expectancy-outcome relations.Results Results indicated a differential pattern of associations across diagnoses. Patient CBT skills emerged as a significant mediator of expectancy-outcome relations, but only in the major depression group. Both behavioral and cognitive skills were significantly, and independently, associated with symptom improvement.Limitations Sample sizes were small in the bipolar manic subgroup and psychosis group. CBT skills and symptom measures were assessed at concurrent time points.Conclusions The present findings suggest that patient expectancies and CBT skills may have a differential impact on symptom change as a function of diagnostic category. The implication of these results and directions for future research are discussed.
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The CES-D-10 has high internal consistency in similar psychiatric samples and in the current study.
“The CES-D-10 has been shown to have high internal consistency in similar psychiatric samples (α = .87; Webb et al., 2013) and in the current study (α = .85).”
From Differential role of CBT skills, DBT skills and psychological flexibility in predicting depressive versus anxiety symptom improvement (2016) · cites this paper as Webb et al., 2013
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- Authors
- Webb, C. A., Kertz, S. J., Bigda-Peyton, J. S., & Björgvinsson, T.
- Affiliations
- Harvard University (US)
- Corresponding author
- Webb, Christian A.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 149
- Issue
- 1-3
- Pages
- 375-382
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC4280263
- OpenAlex
- W2064415720
- Cited by
- 55
- References
- 77
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 8 · 2015: 5 · 2014: 1
- FWCI
- 5.19
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (F32MH099801)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- symptom improvement, major depressive disorder, bipolar disorder, psychosis, acute psychiatric inpatient care
- MeSH terms
- Acute Disease, Bipolar Disorder, Major Depressive Disorder, Humans, Psychotic Disorders, Surveys and Questionnaires, Cognitive Behavioral Therapy, Treatment Outcome
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