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Timing matters: change depends on the stage of treatment in cognitive behavioral therapy for panic disorder with agoraphobia

Gloster, Andrew T. and Klotsche, Jens and Gerlach, Alexander L. and Hamm, Alfons and Ströhle, Andreas and Gauggel, Siegfried and Kircher, Tilo and Alpers, Georg W. and Deckert, Jürgen and Wittchen, Hans-Ulrich. (2014) Timing matters: change depends on the stage of treatment in cognitive behavioral therapy for panic disorder with agoraphobia. Journal of consulting and clinical psychology, 82 (1). pp. 141-153.

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Official URL: http://edoc.unibas.ch/dok/A6298925

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Abstract

The mechanisms of action underlying treatment are inadequately understood. This study examined 5 variables implicated in the treatment of panic disorder with agoraphobia (PD/AG): catastrophic agoraphobic cognitions, anxiety about bodily sensations, agoraphobic avoidance, anxiety sensitivity, and psychological flexibility. The relative importance of these process variables was examined across treatment phases: (a) psychoeducation/interoceptive exposure, (b) in situ exposure, and (c) generalization/follow-up.; Data came from a randomized controlled trial of cognitive behavioral therapy for PD/AG (n = 301). Outcomes were the Panic and Agoraphobia Scale (Bandelow, 1995) and functioning as measured in the Clinical Global Impression scale (Guy, 1976). The effect of process variables on subsequent change in outcome variables was calculated using bivariate latent difference score modeling. Change in panic symptomatology was preceded by catastrophic appraisal and agoraphobic avoidance across all phases of treatment, by anxiety sensitivity during generalization/follow-up, and by psychological flexibility during exposure in situ. Change in functioning was preceded by agoraphobic avoidance and psychological flexibility across all phases of treatment, by fear of bodily symptoms during generalization/follow-up, and by anxiety sensitivity during exposure.; The effects of process variables on outcomes differ across treatment phases and outcomes (i.e., symptomatology vs. functioning). Agoraphobic avoidance and psychological flexibility should be investigated and therapeutically targeted in addition to cognitive variables.
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Forschungsbereich Klinische Psychologie und Neurowissenschaften > Klinische Psychologie und Epidemiologie (Lieb)
UniBasel Contributors:Gloster, Andrew
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:American Psychological Association
ISSN:0022-006X
Note:Publication type according to Uni Basel Research Database: Journal article -- © American Psychological Association, [2014]. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: [see DOI]
Language:English
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Last Modified:28 Nov 2018 14:54
Deposited On:10 Oct 2014 09:19

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