7 - (IOP 37) Clinical Characteristics Associated with CBT Suitability in American Veterans with Anxiety Symptoms

Introduction: The CBT Suitability Scale (CBT-SUITS) measures CBT mindedness, or how aligned an individual’s mental and emotional mindset is with cognitive-behavioral therapy (CBT) approaches to treatment (McLellan et al., 2016). This scale has not yet been explored in an American adult patient population. Several clinical characteristics may be related to CBT mindedness and capacity to benefit from CBT, including CBT skill use, coping self-efficacy, and mental health symptomology. We hypothesized that in a sample of U.S. Veterans recruited for primary care-based anxiety treatment, CBT mindedness would be: 1) positively correlated with CBT skill use, 2) positively correlated with coping self-efficacy, and 3) negatively correlated with anxiety symptom severity.

Method: Secondary cross-sectional data analysis was conducted using baseline (pre-treatment) assessment data from a randomized controlled trial of a CBT-based anxiety intervention conducted 2021-2025 at 2 Northeastern VA healthcare systems. Participants were 169 Veteran primary care patients (age M=51 [15] years, 30% female, 8% Hispanic/Latino/a, 86% White) who reported clinically significant anxiety symptoms (≥8 on the GAD-7) at eligibility screening and were randomized to treatment condition. Pearson’s correlations were used to examine CBT-SUITS’s associations with validated measures of CBT skill use (cognitive restructuring, behavioral activation), coping self-efficacy (problem-focused coping, emotion-focused coping), and anxiety symptom severity (worry, physiological, behavioral avoidance).

Results: CBT-SUITS scores (α=.79, M=47.9 [6.4], observed range: 28-65 out of 13-65) were positively correlated (ps <.001) with CBT skill use and coping self-efficacy, specifically with cognitive restructuring (r=0.47), behavioral activation (r=0.44), and self-efficacy for problem-focused (r=0.37) and emotion-focused (r=0.33) coping. CBT-SUITS scores were not correlated (ps>.05) with worry (r=-0.05), physiological anxiety (r=-0.10), or behavioral avoidance (r=-0.09).

Discussion: The mean pre-treatment CBT-SUITS score in this American adult Veteran sample was comparable to those from samples of Australian adults (Ms 39, 47, 49). While results confirmed our hypotheses that CBT mindedness was positively correlated with CBT skill use and coping self-efficacy, it was not correlated with anxiety symptom severity. Patients who are more CBT minded may have greater propensity to use CBT coping skills, which may increase the effectiveness of their coping strategies, and thus, their coping self-efficacy. The lack of correlation between CBT mindedness and anxiety symptom severity supports the divergent validity of the CBT-SUITS scale but may be related to restricted range in this sample. This study is limited by its cross-sectional nature, and results may not generalize to non-Veteran samples. Future research should explore how CBT mindedness is related to clinical characteristics and mental health symptoms in other samples using longitudinal designs. Increasing our understanding of who is more suitable for CBT treatments based on clinical characteristics can help to inform identification of patients who would be more likely to benefit from CBT.