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Mechanisms of change in the treatment of panic

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Abstract

A growing body of research indicates that cognitive-behavioral (CB) treatments are superior to no treatment for panic. However, few compelling differences exist between treatments, questioning whether the addition of CB elements is necessary for effective treatments. The current study examined two questions. First, does the addition to treatment of CB elements enhance outcome? Second, can a more general construct such as self-efficacy account for treatment outcome? Nineteen subjects with panic disorder were assigned to one of two treatments (panic education or guided imaginal coping). There were minimal differences in outcome between groups. Subjects became more efficacious and efficacy appeared to lead to reductions in catastrophic thoughts, but not panic symptoms. Results are discussed in terms of the potential role of personal control in the treatment of panic and in terms of the necessity to conduct more powerful comparisons to clarify the role of CB strategies in the treatment of panic.

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References

  • American Psychiatric Association. (1980).Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1987).Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

    Google Scholar 

  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavior change.Psychological Review 84, 191–215.

    Google Scholar 

  • Barlow, D. H., & Cerny, J. A. (1988).Psychological treatment of panic. New York: Guilford Press.

    Google Scholar 

  • Barlow, D. H., Cohen, A. S., Waddell, M. T., Vermilyea, B., Klosko, J. S., Blanchard, E. B., & DiNardo, P. A. (1984). Panic and generalized anxiety disorders: Nature and treatment.Behavior Therapy 15, 431–449.

    Google Scholar 

  • Barlow, D. H., Craske, M. G., Cerny, J. A., & Klosko, J. S. (1989). Behavioral treatment of panic disorder.Behavior Therapy, 20, 261–268

    Google Scholar 

  • Beck, A. T., & Emery, G. D. (1985).Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.

    Google Scholar 

  • Borden, J. W., Clum, G. A., & Broyles, S. E. (1986, August). Imaginal coping and flooding as treatments of panic attacks. In G. A. Clum (Chair),Treating panic attacks: Are there alternatives to drugs? Symposium presented at the American Psychological Association, Washington, DC.

  • Borden, J. W., Clum, G. A., Broyles, S. E., & Watkins, P. L. (1988). Coping strategies and panic.Journal of Anxiety Disorders 2, 339–352.

    Google Scholar 

  • Clark, D. M. (1986). A cognitive approach to panic.Behaviour Research and Therapy 24, 461–470.

    Google Scholar 

  • Clark, D. M. (1988). A cognitive model of panic attacks. In S. Rachman & J. D. Maser (Eds.),Panic: Psychological perspectives (pp. 71–89). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Clum, G. A., Borden, J. W., Broyles, S. E., & Watkins, P. L. (1990).Guided imaginal coping in the treatment of panic. Unpublished manuscript.

  • Clum, G. A., Broyles, S. E., Borden, J. W., & Watkins, P. L. (1990). Validity and reliability of the Panic Attack Symptoms and Cognitions Questionnaires.Journal of Psychopathology and Behavioral Assessment 12, 233–246.

    Google Scholar 

  • Clum, G. A., & Pickett, C. (1984). Panic disorders and generalized anxiety disorders. In H. E. Adams & P. B. Sutker (Eds.),Comprehensive handbook of psychopathology (pp. 201–221). New York: Plenum Press.

    Google Scholar 

  • Craske, M. G., & Barlow, D. H. (1986, November).Behavioral treatment of panic: A controlled study. Paper presented at the Association for Advancement of Behaviour Therapy, Boston.

  • DiNardo, P. A., O'Brien, G. T., Barlow, D. H., Waddell, M. T., & Blanchard, E. B. (1983). Reliability of DSM-III anxiety disorder categories using a new structured interview.Archives of General Psychiatry 40, 1070–1074.

    Google Scholar 

  • Hibbert, G. A. (1984). Ideational components of anxiety: Their origin and content.British Journal of Psychiatry 144, 618–624.

    Google Scholar 

  • Kazdin, A. E. (1983). Treatment research: The investigation and evaluation of psychotherapy. In M. Hersen, A. E. Kazdin, & A. S. Bellack (Eds.),The clinical psychology handbook (pp. 265–284). New York: Pergamon Press.

    Google Scholar 

  • Klosko, J. S., Barlow, D. H., Tassinari, R., & Cerny, J. A. (1990). A comparison of alprazolam and behavior therapy in treatment of panic disorder.Journal of Consulting and Clinical Psychology 58, 77–84.

    Google Scholar 

  • Lang, P. J. (1977). Psychological assessment of anxiety and fear. In J. D. Cone & R. P. Hawkins (Eds.),Behavioral assessment: New directions in clinical psychology (pp. 178–195). New York: Brunner/Mazel.

    Google Scholar 

  • Last, C. G., O'Brien, G. T., & Barlow, D. H. (1985). The relationship between cognitions and anxiety.Behavior Modification 9, 235–241.

    Google Scholar 

  • Ost, L. (1988). Applied relaxation versus progressive relaxation in the treatment of panic disorder.Behaviour Research and Therapy 26, 13–22.

    Google Scholar 

  • Sanderson, W. C., Rapee, R. M., & Barlow, D. H. (1989). The influence of an illusion of control on panic attacks induced via inhalation of 5.5% carbon dioxide-enriched air.Archives of General Psychiatry 46, 157–162.

    Google Scholar 

  • Waddell, M. T., Barlow, D. H., & O'Brien, G. T. (1984). A preliminary investigation of cognitive and relaxation treatment of panic disorder: Effects on intense anxiety vs. background anxiety.Behaviour Research and Therapy 22, 393–402.

    Google Scholar 

  • Yalom, I. D. (1975).The theory and practice of group psychotherapy. New York: Basic Books.

    Google Scholar 

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The Authors would like to acknowledge the most helpful comments of Diane B. Arnkoff, Ph.D., James K. Beggan, Ph.D., and an anonymous reviewer on an earlier version of this paper.

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Borden, J.W., Clum, G.A. & Salmon, P.G. Mechanisms of change in the treatment of panic. Cogn Ther Res 15, 257–272 (1991). https://doi.org/10.1007/BF01205172

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