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Mental Illness Attributions and Their Association With Psychotherapy Change Process Expectations

  • Dana Elberg
  • , Pragya Sharma
  • , Javier Fernández Alvarez
  • , Kehan Shen
  • , Dana Tzur Bitan

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: – Although researchers have extensively studied expectations, we know little about their associations with individuals’ perceptions of illness. In this study, we explored whether individuals’ expectations of psychotherapy were associated with their mental illness attributions. Methods: – Participants (N=291) completed the Mental Illness Attribution Questionnaire (MIAQ) and the Expectations of Active Processes in Psychotherapy Scale (EAPPS). We utilized linear regressions to evaluate their associations while adjusting for potential confounders. Results: – The belief that mental illness originated in biology was associated with most change process expectations (p<0.007, .16<b<.27). Social/stress attributions were associated with the expectation that psychotherapy would foster resilience and sharing sensitive contents openly and securely (b=.31, p=0.000; b=.34, p=0.000). Supernatural attributions were associated with the expectation that psychotherapy would focus on exploring therapist–patient relations (b=.28, p=0.003). Conclusions: – Results suggest that individuals’ perceptions about the origins of mental illness are related to their psychotherapy change process expectations.

Original languageEnglish
JournalJournal of Nervous and Mental Disease
DOIs
StatePublished - 2026

Bibliographical note

Publisher Copyright:
© 2026 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • Change process
  • mental illness attributions
  • psychotherapy
  • treatment expectations

ASJC Scopus subject areas

  • Psychiatry and Mental health

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