Self-Efficacy and Attributions about Change in Persons Attempting to Reduce Compulsive Sexual Behavior with Medication vs. Placebo

Self-efficacy is well-established as an important predictor of long-term health outcomes. There is an emerging literature indicating that taking psychiatric medications without combined behavioral interventions result in poorer long-term outcomes. This is particularly relevant for those using medication for short-term symptom management, including individuals suffering from compulsive sexual behavior (CSB). The purpose of this pilot study was to examine whether post-treatment attributions about change and self-efficacy for future behavior change differed between those taking a placebo or medication for persons attempting to reduce CSB. Participants were 26 gay and bisexual men seeking treatment for CSB who participated in a 12-week double blind placebo controlled trial examining the short-term effectiveness of citalopram. Self-efficacy and attribution assessments were presented to participants after breaking the blind. Participants in the medication group scored significantly lower on post-treatment self-efficacy to change in the future without medication and were more likely to attribute change in CSB to the medication, though no group differences existed on the primary CSB outcome measure. Results suggest that prescription practices for CSB should at minimum include therapeutic techniques that increase confidence to change without medication once it is discontinued.