Article Summary
Clinical Summary: Health Belief Model and Treatment Adherence in Patients With Dissociative Disorders: A Cross-Sectional Study
Patients with dissociative disorders often have substantial impairment, complicated comorbidity, and management challenges, yet adherence remains a major determinant of symptom reduction and recovery. This study identifies which patient beliefs track most closely with adherence, giving clinicians concrete targets beyond demographics when treatment engagement starts to slip.
Design
This cross-sectional study examined the association between the constructs of the health belief model and treatment adherence among patients with dissociative disorders.
N
A total of 130 individuals diagnosed with dissociative disorders participated in the study.
Population
a stratified random sample of outpatients and inpatients
Duration
Data collection occurred over a 4-month period (July 1 to October 31, 2024)
Key Findings
- Current treatment engagement was strongly associated with adherence: 55 of 83, 66.26%, of individuals currently in therapy were in the “high adherence” group, and 61 of 106, 57.54%, of those taking medication also demonstrated higher adherence (P < .001 for both).
- Perceived benefit was significantly associated with compliance (P=.003), with 45 (61.64%) participants in the compliant group reporting high perceived benefits compared to only 28 (38.35%) in the noncompliant group.
- Perceived barriers showed a significant inverse relationship with treatment compliance (P=.007), with 47 (59.49%) individuals in the noncompliant group reporting high perceived barriers compared to only 32 (40.50%) in the compliant group.
- In multiple linear regression, perceived benefit was a significant predictor of treatment compliance (β=0.295, P =.001), while perceived barriers also showed a negative association with adherence (β=−1.633, P =.015).
- Perceived severity and perceived susceptibility showed no significant association with treatment compliance (P=1.0 for both), and cues to action were also not significant (P=.216).
Clinical Bottom Line
For patients with dissociative disorders, adherence tracks most strongly with whether they believe treatment will help and whether they face barriers to following through. Assessing and addressing benefits and barriers is more clinically useful than relying on demographic characteristics or emphasizing illness severity alone.
Practice Implications
- Ask directly whether the patient expects therapy or medication to improve symptoms; perceived benefit was the strongest positive predictor of adherence (β=0.295, P =.001).
- Screen routinely for practical and psychosocial barriers during follow-up, because high perceived barriers were more common in the noncompliant group (47 [59.49%] vs 32 [40.50%], P=.007).
- Prioritize early connection to therapy and medication follow-up when indicated, since patients currently in therapy and those taking medication were more likely to show high adherence (55 of 83, 66.26%, and 61 of 106, 57.54%, respectively; P < .001 for both).
- Do not depend on demographic profiling to identify likely nonadherence in this population; age (P=.366), sex (P=.415), marital status (P=.514), education level (P=.197), occupational status (P=.571), type of employment (P=.437), and duration of diagnosis (P =.189) were not significantly associated with treatment adherence.
