Explanatory attributions of anxiety and recovery in a study of kava.
OBJECTIVE: A need exists to understand illness attribution and treatment beliefs among those seeking botanical treatment for anxiety. The objectives of this study are to evaluate explanatory beliefs about reasons for generalized anxiety disorder (GAD), and to evaluate the extent to which subjects thought different approaches might be most helpful, in a study of botanical treatment. DESIGN: Post hoc analysis of data from two similarly randomized controlled clinical trails. SETTING: Psychiatric research clinic in an academic medical center. SUBJECTS: Fifty-one (51) outpatients participating in two randomized, double-blinded, placebo-controlled trials of kava in GAD. INTERVENTIONS: Kava and placebo. MAIN OUTCOME MEASURES: Hamilton Anxiety Scale and Global Improvement Scale. RESULTS: Subjects thought their conditions were largely related to personality factors, stressful life experiences, or cognitive patterns. These beliefs correlated positively with treatment response, whereas endorsement of belief in an energy imbalance or biologic abnormality correlated negatively with improvement. CONCLUSION: Subjects felt more strongly that cognitive patterns, personality and stress were causative of their GAD and of greatest relevance to recovery. Biologic/genetic factors were somewhat relevant, whereas the importance of energy imbalance and spiritual/religious factors were minimal. When treating patients, it is important to consider the patient's belief systems regarding the disorder, as well as credibility of treatment.
Abraham, KC; Connor, KM; Davidson, JRT
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