[Irrational attitudes and social stress in outpatient behavior therapy: changes, prognostic and mediating influences]

Various studies suggest that social stress and cognitive dysfunction contribute to the development of psychiatric disorders. Their roles as moderators and mediators of recovery have rarely been studied. Aim of the present research was to investigate 1. the change of irrational attitudes and perceived social stress during outpatient behavioral treatment and their contribution to 2. the prediction and 3. mediation of success in patients with heterogeneous diagnoses.

A diagnostically unselected sample of 62 outpatients participated in a questionnaire study at the beginning and at the end of treatment. Success of treatment was assessed by the Symptom Check-List-90-R. Cognitive dysfunction was measured by the Irrational Attitudes Questionnaire (IAQ). Instruments for the assessment of perceived social stress were the Scale of Recent Life Events (SRL), the Contractual Conditions-Scale (CCS) and the Impact of Event-Scale (IES).

1. Psychological symptoms, irrational attitudes and perceived social stress decreased during therapy, while the number of life events remained constant. 2. Clinically reliably changed patients scored higher in Self-Blame (IAQ) than non-responders at the beginning of therapy. 3. The reduction of Negative Self-Evaluation (IAQ) was stronger in patients with clinical change than in unchanged patients.

The results were disputed with reference to the literature and to limitations of the study.