scholarly journals Pain in Patients with Panic Disorder: Relation to Symptoms, Cognitive Characteristics and Treatment Outcome

2002 ◽  
Vol 7 (3) ◽  
pp. 134-141 ◽  
Author(s):  
Norman B Schmidt ◽  
Helen T Santiago ◽  
John H Trakowski ◽  
J Michael Kendren
Keyword(s):  
Treatment Outcome ◽  
Chest Pain ◽  
Panic Disorder ◽  
Joint Pain ◽  
Behavioural Therapy ◽  
Depression Symptoms ◽  
Diagnostic And Statistical Manual ◽  
Cognitive Behavioural ◽  
Stomach Pain ◽  
Pain Symptoms

OBJECTIVE:Although there has been a link between certain types of pain, notably chest pain, and panic disorder, the relation between pain and panic disorder has not been systematically evaluated. In the present study, the relation between pain symptoms (headache, chest pain, stomach pain, joint pain) and the clinical presentation of patients with panic disorder was evaluated.HYPOTHESES:Pain was generally hypothesized to be related to increased symptoms of anxiety, panic-relevant cognitive domains and treatment outcome. In terms of specific pain domains, headache and chest pain were expected to be more closely related to anxiety-related symptoms.PARTICIPANTS AND METHODS:Patients (n=139) meeting the criteria of theDiagnostic and Statistical Manual of Mental Disorders - Fourth Editionfor panic disorder completed a set of standardized clinician-rated and self-reported measures. Moderator analyses were used in a subset of these patients completing a treatment outcome study.RESULTS:Approximately two-thirds of the participants endorsed at least one current pain symptom. The hypotheses were partially supported, with pain being associated with higher levels of anxiety and depression symptoms, as well as panic frequency. Pain was also related to several cognitive features, including anxiety sensitivity and panic appraisals. Headache and chest pain were more highly associated with anxiety symptoms than was joint pain. Cognitive measures did not mediate the relation between anxiety and pain, and pain did not significantly moderate outcome in response to cognitive-behavioural therapy.CONCLUSIONS:Co-occurring pain symptoms appear to be more highly related to phenomenology than to treatment response in patients with panic disorder.

Comparing Two Brief Psychological Interventions to Usual Care in Panic Disorder Patients Presenting to the Emergency Department with Chest Pain

2011 ◽  
Vol 40 (2) ◽  
pp. 129-147 ◽  
Author(s):  
Marie-Josée Lessard ◽  
André Marchand ◽  
Marie-Ève Pelland ◽  
Geneviève Belleville ◽  
Alain Vadeboncoeur ◽  
...  
Keyword(s):  
Chest Pain ◽  
Panic Disorder ◽  
Usual Care ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Diagnostic Interview ◽  
Management Intervention ◽  
Cognitive Behavioural ◽  
High Prevalence ◽  
Post Test

Background: Panic disorder (PD) is a common, often unrecognized condition among patients presenting with chest pain to the emergency departments (ED). Nevertheless, psychological treatment is rarely initiated. We are unaware of studies that evaluated the efficacy of brief cognitive-behavioural therapy (CBT) for this population. Aim: Evaluate the efficacy of two brief CBT interventions in PD patients presenting to the ED with chest pain. Method: Fifty-eight PD patients were assigned to either a 1-session CBT-based panic management intervention (PMI) (n = 24), a 7-session CBT intervention (n = 19), or a usual-care control condition (n = 15). A structured diagnostic interview and self-reported questionnaires were administered at pre-test, post-test, 3- and 6-month follow-ups. Results: Statistical analysis showed significant reduction in PD severity following both interventions compared to usual care control condition, but with neither showing superiority compared to the other. Conclusions: CBT-based interventions as brief as a single session initiated within 2 weeks after an ED visit for chest pain appear to be effective for PD. Given the high prevalence of PD in emergency care settings, greater efforts should be made to implement these interventions in the ED and/or primary care setting.

Utilization of learned skills in cognitive behavioural therapy for panic disorder

2019 ◽  
Vol 47 (6) ◽  
pp. 645-658
Author(s):  
Asala Halaj ◽  
Nitzan Yekutiel ◽  
Asher Y. Strauss ◽  
Jonathan D. Huppert
Keyword(s):  
Treatment Outcome ◽  
Panic Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Individual Therapy ◽  
Mechanisms Of Change ◽  
Symptom Improvement ◽  
Cognitive Behavioural ◽  
The Impact ◽  
Therapy Sessions

AbstractBackground:Research has long investigated the cognitive processes in the treatment of depression, and more recently in panic disorder (PD). Meanwhile, other studies have examined patients’ cognitive therapy skills in depression to gain insight into the link between acquiring such skills and treatment outcome.Aims:Given that no scale exists to examine in-session patient use of panic-related cognitive behavioural therapy (CBT) skills, the aim of this study was to develop a new measure for assessing patients’ cognitive and behavioural skills in CBT for PD.Method:This study included 20 PD patients who received 12 weekly individual therapy sessions. The Cognitive Behavioral Therapy Panic Skills (CBTPS) rating system was developed. Three independent raters coded tapes of therapy sessions at the beginning and end of treatment.Results:The coefficient alphas and inter-rater reliability were high for the cognitive and behavioural subscales. Improvement in the patients’ CBTPS scores on both subscales indicated overall symptom improvement, above improvement in anxiety sensitivity.Conclusion:To our knowledge, this is the first study examining the impact of patient acquisition of CBT PD skills on treatment outcome. A new measure was developed based on the observations and was deemed reliable and valid. The measure facilitates the examination of the mechanisms of change in treatment for PD. An in-depth examination of the CBTPS may refine our understanding of the impact of each skill on PD treatment outcome. Further research relating to acquiring CBT skills could shed light on the mechanisms of change in treatment.

Importance of knowledge in the behavioural treatment of panic disorder

2019 ◽  
Vol 47 (5) ◽  
pp. 611-615
Author(s):  
Kathleen M. Grubbs ◽  
James D. Broussard ◽  
Emily L. Hiatt ◽  
Melissa A. Beason-Smith ◽  
Ellen J. Teng
Keyword(s):  
Panic Disorder ◽  
Intensive Therapy ◽  
Behavioural Therapy ◽  
Behavioural Treatment ◽  
Knowledge Domains ◽  
Cognitive Behavioural ◽  
Severity Scores ◽  
Good Internal Consistency ◽  
Knowledge Scale

AbstractBackground:Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist.Aims:The aim of this study was to examine if increases within specific knowledge domains of panic disorder were related to improvement in panic symptoms following an intensive 2-day panic treatment.Method:Thirty-nine Veterans enrolled in an intensive weekend panic disorder treatment completed knowledge measures immediately before the first session of therapy and at the end of the last day of therapy. Four panic disorder experts evaluated items and reached consensus on subscales. Subscales were reduced further to create psychometrically sound subscales of catastrophic misinterpretation (CM), behaviours (BE), and self-efficacy (SE). A simple regression analysis was conducted to determine whether increased knowledge predicted symptom change at a 3-month follow-up assessment.Results:The overall knowledge scale was reduced to three subscales BE (n = 7), CM (n = 13) and SE (n = 8) with good internal consistency. Veterans’ knowledge of panic disorder improved from pre- to post-treatment. Greater increase in scores on the knowledge assessment predicted lower panic severity scores at a 3-month follow-up. A follow-up analysis using the three subscales as predictors showed that only changes in CM significantly contributed to the prediction.Conclusions:In an intensive therapy format, reduction in panic severity was related to improved knowledge overall, but particularly as a result of fewer catastrophic misinterpretations.

Blended cognitive behavioural therapy for adolescents with panic disorder co-morbid with autism spectrum disorder: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Sayo Hamatani ◽  
Kazuki Matsumoto ◽  
Yukihiko Shirayama
Keyword(s):  
Autism Spectrum Disorder ◽  
Panic Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Central Coherence ◽  
Behavioural Science ◽  
Cognitive Behavioural ◽  
Visual Aid

Abstract Cognitive behavioural therapy (CBT) is an effective treatment for improving anxiety symptoms in patients with autism spectrum disorder (ASD). However, some patients with ASD take extra time for learning, and they can find it hard to change their thinking styles and behaviour due to cognitive deficits. The therapist must be creative when implementing CBT in this context. Here, it may be helpful for the patient with ASD to understand CBT’s concepts by using visual aid material. Blended CBT during which the patient is shown visual aid material with his or her therapist has been suggested as effective for adults without ASD to reduce anxiety. Blended CBT combines face-to-face treatment with internet guided support and resource. Blended CBT may facilitate an understanding of essential knowledge and help people with ASD and anxiety acquire skills based on cognitive behavioural science. However, as far as we know, no previous studies have reported on the use of blended CBT for patients with panic disorder co-morbid with ASD. This study, therefore, consecutively performed 16 blended CBT sessions on a biweekly basis to treat panic disorder (PD) in an adolescent Japanese female co-morbid with ASD. The patient exhibited improvements in PD symptoms and agoraphobia after treatment: the Panic Disorder Severity Scale score decreased from 18 to 2. These results indicate that visual aid-assisted treatment may help patients with impaired imagination and social cognition related to ASD. Furthermore, this study’s therapist notes the need for paced treatments and repeated psychoeducation for patients with impairments in central coherence and cognitive flexibility. Key learning aims (1) Blended CBT may patients with panic disorder (PD) co-morbid with autism spectrum disorder (ASD) to understand concepts based on cognitive behavioural science and symptoms. (2) Blended CBT sessions can each be conducted in approximately 20 min (about one-third of the time needed for typical 45- to 90-min CBT sessions); in other words, it is less burdensome for the patient and therapist. (3) How to adjust blended CBT for those who have low average intelligence quotients (IQ) and/or ASD.

A randomized study of massed three-week cognitive behavioural therapy schedule for panic disorder

2009 ◽  
Vol 120 (3) ◽  
pp. 187-195 ◽  
Author(s):  
M. K. Bohni ◽  
H. Spindler ◽  
M. Arendt ◽  
E. Hougaard ◽  
N. K. Rosenberg
Keyword(s):  
Panic Disorder ◽  
Cognitive Behavioural Therapy ◽  
Randomized Study ◽  
Behavioural Therapy ◽  
Cognitive Behavioural
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