Global versus specific symptom attributions: predicting the recognition and treatment of psychological distress in primary care.

OBJECTIVE Researchers have shown that primary care patients utilize global attribution styles to interpret ambiguous physical symptoms, diminishing the ability of practitioners to recognize psychological disorders. The present study examined the extent to which patients' specific beliefs about their presenting symptoms versus their global symptom attribution styles predict physician recognition of psychological distress and mental health treatment recommendations. METHODS Participants included primary care patients attending a five-physician medical practice. Patients completed surveys regarding their level of psychological distress, symptom attribution style, and perceptions of their presenting problems and medical consultations. Physicians completed brief assessments of each patient encounter. RESULTS Patient gender, age, severity of psychological distress, and beliefs about their presenting symptoms were reliable predictors of physician recognition and treatment recommendations. Global symptom attribution styles did not relate to these outcomes above and beyond the specific beliefs of patients. CONCLUSION Patients' specific beliefs about their presenting symptoms play an important role in predicting physician recognition and treatment of psychological distress.