COGNITIVE RESTRUCTURING AND INTEROCEPTIVE EXPOSURE IN THE TREATMENT OF PANIC DISORDER: A CROSSOVER STUDY

1998 ◽  
Vol 26 (2) ◽  
pp. 115-131 ◽  
Author(s):  
Jeffrey E. Hecker ◽  
Christine M. Fink ◽  
Nancy D. Vogeltanz ◽  
Geoffrey L. Thorpe ◽  
Sandra T. Sigmon
Keyword(s):  
Panic Disorder ◽  
Cognitive Therapy ◽  
Exposure Therapy ◽  
Cognitive Restructuring ◽  
Crossover Design ◽  
Similar Degree ◽  
Relative Efficacy ◽  
Interoceptive Exposure ◽  
Subsequent Intervention

The relative efficacy of cognitive restructuring and interoceptive exposure procedures for the treatment of panic disorder, as well as the differential effects of the order of these interventions, was studied. Eighteen clients with panic disorder were seen for four sessions of exposure therapy and four sessions of cognitive therapy in a crossover design study. Half of the participants received exposure therapy followed by cognitive therapy and for half the order was reversed. There was a 1-month follow-up period between the two interventions and after the second intervention. Questionnaire measures and independent clinician ratings were used to assess outcome. Participants expected greater benefit from cognitive therapy, but tended to improve to a similar degree with either intervention. The order in which treatments were presented did not influence outcome. Participants tended to improve with the first intervention and maintain improvement across the follow-up periods and subsequent intervention. Several methodological limitations qualify the conclusions that can be drawn from this study. These limitations, as well as some conceptual and methodological challenges of conducting this type of research, are discussed.

Does Rational Role-play Enhance the Outcome of Exposure Therapy in Dysmorphophobia?

1995 ◽  
Vol 167 (3) ◽  
pp. 399-402 ◽  
Author(s):  
Paul Cromarty ◽  
Isaac Marks
Keyword(s):  
Mechanism Of Action ◽  
Exposure Therapy ◽  
Controlled Trial ◽  
Role Play ◽  
Cognitive Restructuring ◽  
Previous Exposure ◽  
Patient Case ◽  
Social Leisure

BackgroundDysmorphophobia may improve after a variety or combination of treatments, but which elements of a treatment are useful is usually not certain.MethodIn a single out-patient case study rational role-play (‘paradoxical discourse’) was added to exposure plus cognitive restructuring (CR) for a dysmorphic delusion study comprised of 20-minute sessions one week apart.ResultsPrevious exposure plus attempted CR had improved anxiety, phobias, work and social leisure, but not dysmorphic belief. Added brief rational role-play was followed by resolution of the dysmorphic belief. All measures remained much improved at 18-month follow-up.ConclusionsRational role-play deserves a controlled trial in dysmorphophobia and other problems and exploration of its mechanism of action.

Cognitive Therapy for Posttraumatic Stress Disorder

2001 ◽  
Vol 15 (4) ◽  
pp. 321-329 ◽  
Author(s):  
Patricia A. Resick
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcome ◽  
Cognitive Therapy ◽  
Posttraumatic Stress ◽  
Cognitive Processing ◽  
Stress Disorder ◽  
Exposure Therapy ◽  
Cognitive Processing Therapy ◽  
One Year

Cognitive therapy for posttraumatic stress disorder is in the early stages of development and study. This article will examine seven controlled studies that included at least a component of cognitive therapy. Two studies specifically focused on early intervention to treat PTSD and included both cognitive therapy and exposure therapy. Three studies examined cognitive processing therapy, which is predominantly cognitive therapy. Two other studies compared pure cognitive therapy with exposure therapy. Overall, cognitive therapy for PTSD appears to be highly effective compared to no-treatment, relaxation, or supportive counseling, and similar to exposure treatments. Treatment effects appear to continue through follow-up periods of up to one year. At this point, little is known about who benefits best with cognitive therapy or predictors of treatment outcome.

scholarly journals Neurocognitive mechanisms of d-cycloserine augmented single-session exposure therapy for anxiety

2019 ◽  
Author(s):  
Andrea Reinecke ◽  
Alecia Nickless ◽  
Michael Browning ◽  
Catherine J. Harmer
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Exposure Therapy ◽  
Psychological Treatment ◽  
Self Report ◽  
Clinical Effects ◽  
Single Session ◽  
Threat Bias ◽  
Fearful Faces

AbstractObjectiveDrugs targeting the N-Methyl-D-aspartic acid (NMDA) system and the ability to learn new associations have been proposed as potential adjunct treatments to boost the success of exposure therapy for anxiety disorders. However, the effects of the NMDA partial agonist d-cycloserine on psychological treatment have been mixed. We investigated potential neurocognitive mechanisms underlying the clinical effects of d-cycloserine-augmented exposure, to inform the optimal combination of this and similar agents with psychological treatment.MethodsUnmedicated patients with panic disorder were randomised to single-dose d-cycloserine (250mg; N=17) or matching placebo (N=16) 2hrs before one session of exposure therapy. Neurocognitive markers were assessed one day after treatment, including reaction-time based threat bias for fearful faces and amygdala response to threat. Clinical symptom severity was measured using self-report and clinician-rated scales the day before and after treatment, and at 1- and 6-months follow-up. Analysis was by intention-to-treat.ResultsOne day after treatment, threat bias for fearful faces and amygdala threat response were attenuated in the drug compared to the placebo group. Lower amygdala magnitude predicted greater clinical improvement during follow-up across groups. D-cycloserine led to greater clinical recovery at 1-month follow-up (d-cycloserine 71% versus placebo 25%).DiscussionD-cycloserine-augmented single-session exposure therapy reduces amygdala threat response, and this effect predicts later clinical response. These findings highlight a neurocognitive mechanism by which d-cycloserine may exert its augmentative effects on psychological treatment and bring forward a marker that may help understand and facilitate future development of adjunct treatments with CBT for anxiety disorders. (D-cycloserine Augmented CBT for Panic Disorder; clinicaltrials.gov;NCT01680107)

Panic Disorder and Suicidal Behavior

Crisis ◽  
2011 ◽  
Vol 32 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Tamas Zonda ◽  
Gabriella Nagy ◽  
David Lester
Keyword(s):  
Suicidal Ideation ◽  
Panic Disorder ◽  
Cognitive Therapy ◽  
Suicidal Behavior ◽  
Attempted Suicide ◽  
Suicidal Risk ◽  
Comorbid Disorder ◽  
Panic Disorders ◽  
Hungarian Population

Background: Previous research has suggested that patients with panic disorder but no comorbid disorder are not at greater risk for suicidal behavior. Aims: The present study followed up patients with panic disorder in order to assess the frequency of their suicidal behavior. Methods: A sample of 281 outpatients with panic disorder, but without a comorbid psychiatric disorder, was followed up for an average of 5 years. The patients were given 6–8 weeks of cognitive therapy, and 65% were prescribed SSRIs. Results: At the time of first admission, 5 patients (1.7%) reported a previous (lifetime) suicide attempt, and 53 patients (18.2%) reported previous (lifetime) suicidal ideation (both thoughts and plans), not greatly different from the Hungarian population in general. During the follow-up period, no patient committed suicide, 2 patients attempted suicide (0.7%), and 4 patients (1.4%) reported suicidal ideation. Conclusions: This study indicates that people with panic disorders without comorbid disorders have no higher suicidal risk than the general population in Hungary. After treatment with cognitive therapy and SSRIs, 38.5% were symptom-free, and only 7.8% required continued close therapeutic contact after the follow-up period.

BRIEF PSYCHOLOGICAL TREATMENT FOR THE RELIEF OF PANIC DISORDER

2002 ◽  
Vol 30 (4) ◽  
pp. 423-430 ◽  
Author(s):  
Karin Elsesser ◽  
Angelika Mosch ◽  
Gudrun Sartory
Keyword(s):  
Treatment Outcome ◽  
Panic Disorder ◽  
Cognitive Therapy ◽  
Psychological Treatment ◽  
Management Training ◽  
Clinical Change ◽  
Treatment Groups ◽  
Cognitive Behavioural ◽  
Before And After

This study compared complaints management training and cognitive therapy (reattribution) in treating panic disorder. Both treatment groups received three sessions with initial psychoeducation. Thirty patients with panic disorder took part in the study. Assessments were carried out before and after treatment and again at a 4-week follow-up. Both groups showed similarly significant improvements and maintenance of the clinical change over the follow-up period. It is concluded that the initial psychoeducation, which conveyed to patients the cognitive-behavioural model of panic disorder, contributed to the treatment outcome.

Cognitive therapy and exposure therapy for hypochondriasis (health anxiety): A 3-year naturalistic follow-up.

2017 ◽  
Vol 85 (10) ◽  
pp. 1012-1017 ◽  
Author(s):  
Florian Weck ◽  
Laura Carlotta Nagel ◽  
Volkmar Höfling ◽  
Julia M. B. Neng
Keyword(s):  
Cognitive Therapy ◽  
Exposure Therapy ◽  
Health Anxiety

A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic Disorder

1994 ◽  
Vol 164 (6) ◽  
pp. 759-769 ◽  
Author(s):  
David M. Clark ◽  
Paul M. Salkovskis ◽  
Ann Hackmann ◽  
Hugh Middleton ◽  
Pavlos Anastasiades ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Effective Treatment ◽  
Cognitive Therapy ◽  
Predictors Of Outcome ◽  
Pharmacological Treatments ◽  
Cognitive Measures ◽  
End Of Treatment ◽  
Booster Sessions ◽  
Applied Relaxation

Recent studies have shown that cognitive therapy is an effective treatment for panic disorder. However, little is known about how cognitive therapy compares with other psychological and pharmacological treatments. To investigate this question 64 panic disorder patients were initially assigned to cognitive therapy, applied relaxation, imipramine (mean 233 mg/day), or a 3-month wait followed by allocation to treatment. During treatment patients had up to 12 sessions in the first 3 months and up to three booster sessions in the next 3 months. Imipramine was gradually withdrawn after 6 months. Each treatment included self-exposure homework assignments. Cognitive therapy and applied relaxation sessions lasted one hour. Imipramine sessions lasted 25 minutes. Assessments were before treatment/wait and at 3, 6, and 15 months. Comparisons with waiting-list showed all three treatments were effective. Comparisons between treatments showed that at 3 months cognitive therapy was superior to both applied relaxation and imipramine on most measures. At 6 months cognitive therapy did not differ from imipramine and both were superior to applied relaxation on several measures. Between 6 and 15 months a number of imipramine patients relapsed. At 15 months cognitive therapy was again superior to both applied relaxation and imipramine but on fewer measures than at 3 months. Cognitive measures taken at the end of treatment were significant predictors of outcome at follow-up.

Cognitive therapy of panic disorder and social phobia — A follow-up study

1998 ◽  
Vol 13 (S4) ◽  
pp. 195S-195S
Author(s):  
N.K. Rosenberg ◽  
E. Hougaard ◽  
T. Falk ◽  
P. Elsass
Keyword(s):  
Panic Disorder ◽  
Social Phobia ◽  
Cognitive Therapy ◽  
Follow Up Study
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