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Anticipated Benefits of Care (ABC): psychometrics and predictive value in psychiatric disorders

Published online by Cambridge University Press:  29 September 2009

D. Warden ,
M. H. Trivedi ,
T. J. Carmody ,
J. K. Gollan ,
T. M. Kashner ,
L. Lind ,
M. L. Crismon  and
A. J. Rush
D. Warden*
Affiliation:
Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
M. H. Trivedi
Affiliation:
Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
T. J. Carmody
Affiliation:
Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
J. K. Gollan
Affiliation:
Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
T. M. Kashner
Affiliation:
Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
L. Lind
Affiliation:
Department of Veterans Affairs, North Texas Health Care System, Dallas, TX, USA
M. L. Crismon
Affiliation:
University of Texas College of Pharmacy, Austin, TX, USA
A. J. Rush
Affiliation:
Duke-National University of Singapore, Singapore
*
*Address for correspondence: D. Warden, Ph.D., M.B.A., Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX75390-9119, USA. (Email: Diane.Warden@UTSouthwestern.edu)
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Abstract

Background

Attitudes and expectations about treatment have been associated with symptomatic outcomes, adherence and utilization in patients with psychiatric disorders. No measure of patients' anticipated benefits of treatment on domains of everyday functioning has previously been available.

Method

The Anticipated Benefits of Care (ABC) is a new, 10-item questionnaire used to measure patient expectations about the impact of treatment on domains of everyday functioning. The ABC was collected at baseline in adult out-patients with major depressive disorder (MDD) (n=528), bipolar disorder (n=395) and schizophrenia (n=447) in the Texas Medication Algorithm Project (TMAP). Psychometric properties of the ABC were assessed, and the association of ABC scores with treatment response at 3 months was evaluated.

Results

Evaluation of the ABC's internal consistency yielded Cronbach's α of 0.90–0.92 for patients across disorders. Factor analysis showed that the ABC was unidimensional for all patients and for patients with each disorder. For patients with MDD, lower anticipated benefits of treatment was associated with less symptom improvement and lower odds of treatment response [odds ratio (OR) 0.72, 95% confidence interval (CI) 0.57–0.87, p=0.0011]. There was no association between ABC and symptom improvement or treatment response for patients with bipolar disorder or schizophrenia, possibly because these patients had modest benefits with treatment.

Conclusions

The ABC is the first self-report that measures patient expectations about the benefits of treatment on everyday functioning, filling an important gap in available assessments of attitudes and expectations about treatment. The ABC is simple, easy to use, and has acceptable psychometric properties for use in research or clinical settings.

Keywords

Attitudesbenefit of treatmentbipolardepressionoutcome expectanciespredisposingpsychometricsschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 6 , June 2010 , pp. 955 - 965
Copyright
Copyright © Cambridge University Press 2009

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