SUBJECTIVE THEORIES OF ILLNESS AMONG OUTP ATIENTS AT A PSYCHOTHERAPY CLINIC

Patients' subjective theories of illness have gained substantial atten tion in psychotherapy research, because they have been acknowledged as significant factors that influence the indication and acceptance of p sychotherapeutic measures. In the present study, causal attributions i n 195 psychotherapy patients attending a university outpatient departm ent were investigated using a self-report questionnaire. Items rated h ighest include: ''inner conflicts'', ''inner anxieties'', ''not being able to cope with problems'', ''lack of self-assertion'' and ''problem s 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. som atic causes. Higher age was associated with stronger beliefs in somati c 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 rat ed interpersonal attributions higher, respectively. Lay etiologies wer e connected with both locus of control and patients' expectations rega rding treatment. Therapists judged their relationship with the patient s 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.