Subjective theories of illness among outpatients at a psychotherapy clinic

Journal/Book: Z Klin Psychol Psychiatr Psyc. 1997; 45: Postfach 2540, W-4790 Paderborn, Germany. Verlag Ferdinand Schoningh. 264-278.

Abstract: Patients' subjective theories of illness have gained substantial attention in psychotherapy research, because they have been acknowledged as significant factors that influence the indication and acceptance of psychotherapeutic measures. In the present study, causal attributions in 195 psychotherapy patients attending a university outpatient department were investigated using a self-report questionnaire. Items rated highest include: ''inner conflicts'', ''inner anxieties'', ''not being able to cope with problems'', ''lack of self-assertion'' and ''problems in partnership or family''. The least supported attributions were, ''sensitivity to climate'' and, ''sensitivity to pollution''. By means of factor analysis four dimensions of attributions could be found: 1. Intrapsychic causes; 2. Interpersonal causes; 3. Social causes; 4. Somatic causes. Higher age was associated with stronger beliefs in somatic causes. Female patients favoured more intrapsychic and interpersonal causes, as a tendency. Higher education was correlated with stronger intrapsychic and interpersonal and weaker somatic causal attributions. Patients with somatoform disorders scored significantly lower on the scale, ''intrapsychic causes'' and, as a tendency higher on, ''somatic causes''. Patients with depressive disorders and eating disorders rated interpersonal attributions higher, respectively. Lay etiologies were connected with both locus of control and patients' expectations regarding treatment. Therapists judged their relationship with the patients the better, the more the patients favoured intrapsychic and the less they endorsed somatic causes. The results support the suggestion that patients' subjective theories of illness are important indicators of psychotherapy motivation.

Note: Article Faller H, Univ Wurzburg, Inst Psychotherapie & Med Psychol, Klin Str 3, D-97070 Wurzburg, GERMANY

Keyword(s): LAY THEORIES; ATTRIBUTIONS; SYMPTOMS

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