OBJECTIVE This study aimed to provide evidence for treatment credibility (TC) as a potential mechanism of change in cognitive behavioral therapy (CBT). Therefore, it focused on within-person effects that are free of the influence of stable characteristics and thus allow to exclude certain alternative explanations for the association under study. METHOD The sample included 1,423 patients receiving outpatient CBT, who presented a wide variety of psychiatric diagnoses (mostly affective and anxiety disorders). TC, depression, and anxiety were measured every fifth session from Session 5 to 25 using the Credibility Expectancy Questionnaire (CEQ), the Patient Health Questionnaire-9 (PHQ-9), and the General Anxiety Disorder-7 (GAD-7), respectively. Symptom severity was assessed every session using the Hopkins Symptom Checklist-11. Within- and between-person effects of TC, depression, and anxiety were analyzed using the latent curve model with structured residuals (LCM-SRs). In exploratory analyses, within-person effects of TC on next-session symptom severity were assessed using a modification of the LCM-SR. RESULTS LCM-SRs exhibited excellent fit in main analyses. There were significant negative correlations of both intercepts and slopes (between-person level) of CEQ and PHQ-9 as well GAD-7. No significant cross-lagged effects (within-person level) were found over the five-session interval. However, session-wise analyses revealed significant cross-lagged effects of CEQ on Hopkins Symptom Checklist-11. CONCLUSIONS This study is the first to find significant within-person effects of TC in session-wise analyses. This lends preliminary support to the notion of TC as a mechanism of change. The lack of significant findings at the five-session interval is discussed considering the specific design used in this study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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治疗可信度作为认知行为治疗改变的机制：对抑郁和焦虑的影响。


目的 本研究旨在为治疗可信度 (TC) 作为认知行为治疗 (CBT) 改变的潜在机制提供证据。因此，它侧重于不受稳定特征影响的人内效应，从而可以排除所研究关联的某些替代解释。方法 样本包括 1,423 名接受门诊 CBT 的患者，他们提出了各种各样的精神科诊断（主要是情感障碍和焦虑障碍）。使用可信度预期问卷 (CEQ)、患者健康问卷 9 (PHQ-9) 和一般性焦虑症 7 (GAD-7)，从第 5 节到第 25 节，每五节测量一次 TC、抑郁和焦虑。分别。每次治疗时均使用霍普金斯症状检查表 11 评估症状严重程度。使用具有结构化残差的潜在曲线模型（LCM-SR）分析了 TC、抑郁和焦虑的人内和人间影响。在探索性分析中，使用 LCM-SR 的修改来评估 TC 对下一次症状严重程度的人内影响。结果 LCM-SR 在主要分析中表现出极好的拟合度。 CEQ 和 PHQ-9 以及 GAD-7 的截距和斜率（人与人水平）均存在显着负相关。在五个疗程间隔内没有发现显着的交叉滞后效应（人内水平）。然而，会话分析显示 CEQ 对霍普金斯症状清单 11 具有显着的交叉滞后影响。结论 这项研究首次在会话分析中发现了 TC 对人的显着影响。这为 TC 作为变革机制的概念提供了初步支持。 考虑到本研究中使用的具体设计，讨论了在五次会议间隔内缺乏重大发现的情况。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。