An investigation of outcome expectancies as a predictor of treatment response for combat veterans with PTSD: comparison of clinician, self-report, and biological measures

Depress Anxiety. 2015 Jun;32(6):392-9. doi: 10.1002/da.22354. Epub 2015 Feb 19.

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.

Keywords: multilevel modeling; multimodal assessment; outcome expectancy; posttraumatic stress disorder; virtual reality.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Alprazolam / therapeutic use
  • Combat Disorders / diagnosis
  • Combat Disorders / physiopathology
  • Combat Disorders / psychology*
  • Combat Disorders / therapy*
  • Combined Modality Therapy
  • Culture*
  • Cycloserine / therapeutic use
  • Female
  • Humans
  • Hydrocortisone / blood*
  • Implosive Therapy
  • Male
  • Middle Aged
  • Reflex, Startle / physiology*
  • Self Report*
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / physiopathology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy*
  • Treatment Outcome
  • Veterans / psychology*
  • Virtual Reality Exposure Therapy

Substances

  • Cycloserine
  • Hydrocortisone
  • Alprazolam