Table 4.
Predictors of person-level perceived helpfulness of treatment (composite outcome) and of the decomposed episode-level outcomes of helpful treatment and persistence (pooled across professionals seen), among people with lifetime DSM-IV specific phobia who obtained treatment
| Composite outcome |
Decomposed outcomes |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Model 1. Predicting perceived helpfulness of treatment across specific phobia patients |
Model 2. Predicting episode-level helpful treatment (pooled across professionals seen) |
Model 3. Predicting episode-level persistence (pooled across treatment failure) |
||||||||||
| Prevalence | Multivariate | Prevalence | Multivariate | Prevalence | Multivariate | |||||||
| Mean/% | (SE) | AOR | (95% CI) | Mean/% | (SE) | AOR | (95% CI) | Mean/% | (SE) | AOR | (95% CI) | |
| Age at first specific phobia treatment | 32.3a | (0.4) | 1.01 | (1.00-1.02) | 30.7a | (1.4) | 1.00 | (0.99-1.01) | 30.0a | (1.7) | 1.01* | (1.00-1.02) |
| χ21 | 2.20 (p=0.14) | 0.37 (p=0.54) | 4.51 (p=0.034)* | |||||||||
| Gender | ||||||||||||
| Female | 69.7a | (1.3) | 1.11 | (0.84-1.46) | 70.1a | (3.0) | 1.13 | (0.91-1.40) | 69.8a | (3.7) | 1.00 | (0.79-1.27) |
| Male | 30.3a | (1.3) | 1.00 | Ref | 29.9a | (3.0) | 1.00 | Ref | 30.2 a | (3.7) | 1.00 | Ref |
| χ21 | 0.56 (p=0.46) | 1.18 (p=0.28) | 0.00 (p=0.98) | |||||||||
| Marital status | ||||||||||||
| Never married | 43.2 | (1.5) | 0.75* | (0.58-0.99) | 50.2 | (3.8) | 0.67* | (0.53-0.84) | 52.9 | (4.7) | 1.09 | (0.85-1.39) |
| Previously married | 12.4 | (0.8) | 0.73 | (0.50-1.07) | 11.4 | (1.4) | 0.88 | (0.64-1.20) | 11.2 | (1.6) | 0.83 | (0.61-1.12) |
| Currently married | 44.4 | (1.5) | 1.00 | Ref | 38.3 | (3.1) | 1.00 | Ref | 36.0 | (3.7) | 1.00 | Ref |
| χ22 | 5.88 (p=0.05) | 11.98 (p=0.003)* | 2.43 (p=0.30) | |||||||||
| Education | ||||||||||||
| Low | 12.8 | (0.8) | 1.22 | (0.80-1.85) | 12.6 | (1.8) | 0.95 | (0.68-1.32) | 12.0 | (2.2) | 1.26 | (0.89-1.78) |
| Low-average | 19.6 | (1.1) | 0.96 | (0.66-1.41) | 17.0 | (1.6) | 0.97 | (0.71-1.33) | 16.2 | (1.9) | 0.96 | (0.70-1.30) |
| High-average | 28.9 | (1.2) | 0.92 | (0.65-1.30) | 30.0 | (2.8) | 0.82 | (0.64-1.05) | 29.3 | (3.4) | 1.13 | (0.86-1.49) |
| Student | 21.7 | (1.1) | 0.53* | (0.34-0.82) | 26.5 | (5.0) | 0.44* | (0.31-0.63) | 30.0 | (6.1) | 1.27 | (0.88-1.83) |
| High | 17.0 | (1.0) | 1.00 | Ref | 13.9 | (1.2) | 1.00 | Ref | 12.4 | (1.4) | 1.00 | Ref |
| χ24 | 12.81 (p=0.012)* | 23.03 (p<.001)* | 4.59 (p=0.33) | |||||||||
| Treatment delay (years)b | 21.2 | (0.4) | 0.99 | (0.98-1.00) | 20.0 | (1.0) | 1.00 | (0.99-1.01) | 19.5 | (1.3) | 0.99* | (0.98-1.00) |
| χ21 | 1.31 (p=0.25) | 0.30 (p=0.58) | 5.47 (p=0.019)* | |||||||||
| Started specific phobia treatment >= 2000 (vs. 1990-1999) | 47.3 | (1.2) | 1.17 | (0.89-1.53) | 40.9 | (3.0) | 1.23* | (1.00-1.52) | 38.3 | (3.6) | 0.94 | (0.76-1.16) |
| χ21 | 1.26 (p=0.26) | 3.98 (p=0.046)* | 0.34 (p=0.56) | |||||||||
| Treatment typec | ||||||||||||
| Mental health specialist + Psychotherapy | 52.7 | (1.4) | 1.48* | (1.01-2.17) | 56.8 | (4.2) | 1.07 | (0.81-1.41) | 55.4 | (5.2) | 1.34 | (0.94-1.91) |
| Mental health specialist + Medication | 38.2 | (1.3) | 1.70* | (1.18-2.46) | 44.9 | (3.7) | 1.09 | (0.83-1.43) | 43.9 | (4.5) | 1.85* | (1.39-2.45) |
| General medical | 70.6 | (1.3) | 0.80 | (0.57-1.14) | 74.7 | (2.4) | 0.59* | (0.46-0.76) | 77.0 | (2.7) | 1.13 | (0.86-1.50) |
| Complementary/alternative medicine | 17.6 | (0.9) | 1.22 | (0.87-1.70) | 23.4 | (2.2) | 0.84 | (0.67-1.06) | 24.1 | (2.8) | 1.42* | (1.11-1.82) |
| Human services | 10.2 | (0.8) | 1.00 | Ref | 16.3 | (2.4) | 1.00 | Ref | 17.7 | (2.9) | 1.00 | Ref |
| χ24 | 19.57 (p<.001)* | 25.73 (p<.001)* | 25.10 (p<.001)* | |||||||||
| Two or more of the above | 47.2 | (1.4) | 1.01 | (0.62-1.64) | 54.1 | (4.0) | 0.91 | (0.63-1.29) | 53.5 | (5.0) | 1.20 | (0.83,1.75) |
| χ21 | 0.00 (p=0.97) | 0.30 (p=0.59) | 0.95 (p=0.33) | |||||||||
| χ25 | 45.85 (p<.001)* | 27.29 (p<.001)* | 82.72 (p<.001)* | |||||||||
| Comorbidity | ||||||||||||
| Number of lifetime anxiety disordersd | ||||||||||||
| Three or more lifetime anxiety disorders | 20.6 | (1.1) | 2.13* | (1.51-3.00) | 25.3 | (2.8) | 1.44* | (1.15-1.82) | 24.9 | (3.4) | 1.65* | (1.23-2.21) |
| Exactly 2 lifetime anxiety disorders | 25.4 | (1.2) | 1.35* | (1.00-1.81) | 23.3 | (1.9) | 1.11 | (0.86-1.43) | 22.5 | (2.3) | 1.20 | (0.94-1.52) |
| Exactly 1 lifetime anxiety disorder | 54.0 | (1.2) | 1.00 | Ref | 51.4 | (3.7) | 1.00 | Ref | 52.6 | (4.6) | 1.00 | Ref |
| χ22 | 18.46 (p<.001)* | 11.05 (p=0.004)* | 11.18 (p=0.004)* | |||||||||
| Mood disorder | ||||||||||||
| Major depressive disorder | 28.6 | (1.1) | 0.99 | (0.74-1.34) | 31.6 | (2.8) | 0.85 | (0.68-1.08) | 31.7 | (3.5) | 1.20 | (0.96-1.49) |
| Bipolar disorder | 8.2 | (0.6) | 1.27 | (0.81-1.99) | 11.6 | (2.2) | 0.90 | (0.64-1.26) | 12.2 | (2.8) | 1.43* | (1.03-1.98) |
| χ22 | 1.18 (p=0.56) | 1.77 (p=0.41) | 5.88 (p=0.05) | |||||||||
| Substance use disorder | ||||||||||||
| Alcohol and/or drug abuse | 14.0 | (0.9) | 1.01 | (0.71-1.44) | 16.7 | (2.3) | 1.03 | (0.80-1.33) | 17.1 | (2.7) | 0.93 | (0.71-1.22) |
| Alcohol or drug dependence (without abuse) | 1.1 | (0.3) | 0.34 | (0.09-1.23) | 1.1 | (0.2) | 0.83 | (0.44-1.57) | 1.1 | (0.2) | 0.40 | (0.13-1.22) |
| χ22 | 2.74 (p=0.25) | 0.55 (p=0.76) | 2.91 (p=0.23) | |||||||||
| χ26 | 24.87 (p<.001)* | 11.77 (p=0.07) | 23.10 (p<.001)* | |||||||||
| Childhood adversities | ||||||||||||
| Family dysfunctione | 39.2 | (1.3) | 1.02 | (0.78-1.33) | 42.5 | (3.3) | 0.90 | (0.73-1.11) | 43.1 | (4.2) | 1.13 | (0.92-1.39) |
| Otherf | 23.2 | (1.1) | 0.65* | (0.49-0.86) | 23.6 | (2.5) | 0.75* | (0.59-0.95) | 24.4 | (3.2) | 0.84 | (0.67-1.06) |
| χ22 | 9.44 (p=0.009)* | 6.23 (p=0.044)* | 3.00 (p=0.22) | |||||||||
| Number of specific phobia subtypes | 2.1 | (0.0) | 0.94 | (0.85-1.03) | 2.1 | (0.1) | 0.96 | (0.90-1.03) | 2.1 | (0.1) | 0.97 | (0.89-1.04) |
| χ21 | 1.87 (p=0.17) | 1.05 (p=0.31) | 0.78 (p=0.38) | |||||||||
| Full model χ224 | 135.20 (p<.001)* | 112.51 (p<.001)* | 211.40 (p<.001)* | |||||||||
Abbreviations: SE, standard error; AOR, adjusted odds ratio; CI, confidence interval.
Significant at .05 level, two-sided test.
This value is different from the sample-wide value reported in Model 1 due to the fact that the value reported Model 1 is at the respondent level (the first entry in the upper left corner of Table 2), whereas the value reported in Model 2 is at the person-encounter level (the cumulation of the numbers in the first column of Table 2) and the value reported in Model 3 is at the level of all person encounters after a prior unhelpful visit (the cumulation of the numbers in the first column of Table 3).
Treatment delay (years) = Age at first specific phobia treatment - Age at onset of specific phobia
Treatment providers: mental health specialists (psychiatrist, psychiatric nurse, psychologist, psychiatric social worker, mental health counselor), primary care providers, human services providers (social worker or counselor in a social services agency, spiritual advisor), and complementary/alternative medicine (other type of healer or self-help group).
Lifetime anxiety disorders included generalized anxiety disorder, panic disorder, agoraphobia with or without panic disorder, post-traumatic stress disorder, specific phobia, and social phobia.
Family Dysfunction includes Physical abuse, Sexual abuse, Neglect, Parental mental disorder, Parental substance use disorder, Parental criminal behavior and Family violence.
Other includes Parental death, Parental divorced, Other loss of a parent, Physical illness and Economic adversity.