The Relative Contributions of Negative Cognitions and Self-efficacy to Severity of Panic Attacks in Panic Disorder

2002 ◽  
Vol 19 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Jeffrey C. Richards ◽  
Vanessa Richardson ◽  
Ciaran Pier
Keyword(s):  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Self Efficacy ◽  
Panic Attack ◽  
Panic Attacks ◽  
Cognitive Variables ◽  
Behaviour Therapy ◽  
Negative Cognitions ◽  
Cognitive Behaviour ◽  
Panic Symptoms

AbstractThe aim of this study was to determine the degree to which fearful and catastrophic cognitions, and self-efficacy for managing panic predicted various panic attack characteristics in panic disorder. The cognitive variables consisted of anxiety sensitivity, the frequency of fearful agoraphobic cognitions and measures of catastrophic misinterpretation of symptoms. The panic parameters were number and severity of panic symptoms, distress associated with panic attacks, worry about future panics, duration of panic disorder, and life interference due to panic disorder. These variables were measured in 40 people with panic disorder, 31 of whom also had significant agoraphobia. The frequency of fearful agoraphobic cognitions was the strongest predictor of panic attack symptomatology, predicting number of symptoms, symptom severity and degree of anticipatory fear of panic. Catastrophic misinterpretation of symptoms and anxiety sensitivity did not independently predict any panic parameters. Only self-efficacy for managing the rapid build-up of panic symptoms was specifically related to panic severity. The results therefore suggest that cognitive behaviour therapy for panic symptoms in panic disorder should reduce fearful cognitions rather than focus on panic coping strategies. The results offer little support for the contribution of the expectancy or catastrophic misinterpretation theories to the maintenance of panic disorder.

Fear of Autonomic Arousal and Use of Coping Strategies as Predictors of Agoraphobic Avoidance in Panic Disorder

1998 ◽  
Vol 15 (4) ◽  
pp. 228-236 ◽  
Author(s):  
Patricia Rayment ◽  
Jeff Richards
Keyword(s):  
Panic Disorder ◽  
Coping Strategies ◽  
Significant Proportion ◽  
Panic Attacks ◽  
Autonomic Arousal ◽  
Negative Cognitions ◽  
Considerable Controversy ◽  
Dsm Iv ◽  
Panic Symptoms ◽  
Behavioural Strategies

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.

Baseline Heartbeat Perception Accuracy and Short-Term Outcome of Brief Cognitive-Behaviour Therapy for Panic Disorder with Agoraphobia

2013 ◽  
Vol 43 (4) ◽  
pp. 426-435 ◽  
Author(s):  
Vasilios G. Masdrakis ◽  
Emilia-Maria Legaki ◽  
Nikolaos Vaidakis ◽  
Dimitrios Ploumpidis ◽  
Constantin R. Soldatos ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Cognitive Behaviour Therapy ◽  
Acute Treatment ◽  
Panic Attacks ◽  
Behaviour Therapy ◽  
Short Term ◽  
Term Outcome ◽  
Heartbeat Perception ◽  
Short Term Outcome ◽  
Cognitive Behaviour

Background: Increased heartbeat perception accuracy (HBP-accuracy) may contribute to the pathogenesis of Panic Disorder (PD) without or with Agoraphobia (PDA). Extant research suggests that HBP-accuracy is a rather stable individual characteristic, moreover predictive of worse long-term outcome in PD/PDA patients. However, it remains still unexplored whether HBP-accuracy adversely affects patients’ short-term outcome after structured cognitive behaviour therapy (CBT) for PD/PDA. Aim: To explore the potential association between HBP-accuracy and the short-term outcome of a structured brief-CBT for the acute treatment of PDA. Method: We assessed baseline HBP-accuracy using the “mental tracking” paradigm in 25 consecutive medication-free, CBT-naive PDA patients. Patients then underwent a structured, protocol-based, 8-session CBT by the same therapist. Outcome measures included the number of panic attacks during the past week, the Agoraphobic Cognitions Questionnaire (ACQ), and the Mobility Inventory-Alone subscale (MI-alone). Results: No association emerged between baseline HBP-accuracy and posttreatment changes concerning number of panic attacks. Moreover, higher baseline HBP-accuracy was associated with significantly larger reductions in the scores of the ACQ and the MI-alone scales. Conclusion: Our results suggest that in PDA patients undergoing structured brief-CBT for the acute treatment of their symptoms, higher baseline HBP-accuracy is not associated with worse short-term outcome concerning panic attacks. Furthermore, higher baseline HBP-accuracy may be associated with enhanced therapeutic gains in agoraphobic cognitions and behaviours.

A Controlled Study of Cognitive Behaviour Therapy with Buspirone or Placebo in Panic Disorder with Agoraphobia

1995 ◽  
Vol 167 (5) ◽  
pp. 635-641 ◽  
Author(s):  
Jean Cottraux ◽  
Ivan-Druon Note ◽  
Charly Cungi ◽  
Patrick Légeron ◽  
François Heim ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Multicentre Study ◽  
Cognitive Behaviour Therapy ◽  
Group Analysis ◽  
Panic Attacks ◽  
Controlled Study ◽  
Behaviour Therapy ◽  
Short Term ◽  
Double Blind ◽  
Cognitive Behaviour

BackgroundThis multicentre study compared a 16-week buspirone treatment with placebo in patients presenting with panic disorder with agoraphobia and also receiving cognitive behaviour therapy (CBT).MethodDouble-blind testing was maintained until week 68, but not tested; 91 patients were included; 14 placebo-responders excluded; 77 patients randomised; 48 reached week 16 and 41 reached week 68.ResultsAt week 16, within-group analysis showed significant improvements in agoraphobia, panic attacks, and depression in both groups. Generalised anxiety improved only in CBT + buspirone. Between-group comparisons showed buspirone to have an effect on generalised anxiety and agoraphobia. Changes in degree of agoraphobia and depression were correlated in subjects on CBT + buspirone only. A significantly higher proportion of women, and of subjects showing high avoidance dropped out. Positive expectations regarding medication predicted success in both groups. At week 68, improvement was retained without significant buspirone effect.ConclusionBuspirone enhanced the effects of cognitive behaviour therapy on generalised anxiety and agoraphobia in the short term.

Mechanisms of change in cognitive behaviour therapy for panic disorder: The role of panic self-efficacy and catastrophic misinterpretations

2013 ◽  
Vol 51 (9) ◽  
pp. 579-587 ◽  
Author(s):  
Hanne N. Fentz ◽  
Asle Hoffart ◽  
Morten B. Jensen ◽  
Mikkel Arendt ◽  
Mia S. O'Toole ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Self Efficacy ◽  
Cognitive Behaviour Therapy ◽  
Mechanisms Of Change ◽  
Behaviour Therapy ◽  
Cognitive Behaviour

The Indirect Effect of Anxiety Sensitivity in the Relationship Between Panic Symptoms and Panic Severity

2015 ◽  
Vol 29 (2) ◽  
pp. 123-133 ◽  
Author(s):  
Alexander M. Talkovsky ◽  
Peter J. Norton
Keyword(s):  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Indirect Effect ◽  
Cognitive Model ◽  
Primary Diagnosis ◽  
Panic Attacks ◽  
Symptom Intensity ◽  
Bodily Sensations ◽  
Panic Symptoms ◽  
The Relationship

The cognitive model of panic (Clark, 1988) suggests that panic attacks result from the catastrophic misinterpretation of bodily sensations rather than the sensations themselves. Anxiety sensitivity (AS) is fear of anxious bodily sensations (Reiss, 1991) and has implications in panic development, maintenance, and severity. Although previous work has demonstrated that AS amplifies symptoms in response to provocations, few have analyzed the role of AS in the relationship between panic symptoms and panic disorder severity. The purpose of this investigation was to determine if AS, a cognitive risk for panic, has an indirect effect on the association between self-reported panic symptoms and panic severity, both self-reported and clinician-assessed, among 67 treatment-seeking individuals with a primary diagnosis of panic disorder with or without agoraphobia. Data were analyzed using the bootstrapped conditional process indirect effects model. Results indicated that the overall total mediational effect on Panic Disorder Severity Scale (PDSS) was significant with evidence of partial mediation. The direct effect of Beck Anxiety Inventory (BAI) on PDSS remained significant although there was also a significant indirect effect of BAI via AS. Results showed a similar relationship when Clinician Severity Rating was the outcome. Moderation analyses were not significant. Therefore, AS was a significant partial mediator of the relationship between symptom intensity and panic severity, whether clinician-rated or self-reported. This investigation provides support for the importance of AS in panic, highlighting its importance but suggesting that it is not sufficient to explain panic disorder.

scholarly journals Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

2011 ◽  
Vol 60 (4) ◽  
pp. 301-308
Author(s):  
Anna Lucia Spear King ◽  
Adriana Cardoso de Oliveira e Silva ◽  
Alexandre Martins Valencça ◽  
Antonio Egidio Nardi
Keyword(s):  
Panic Disorder ◽  
Respiratory Symptoms ◽  
Behavioural Therapy ◽  
Panic Attacks ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Group 2 ◽  
Fear Of Bodily Sensations ◽  
Group 1

Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

Psychological Defenses in Patients with Comorbid Panic Disorder and Alcoholism

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Tsygankov ◽  
E. Agasaryan ◽  
D. Terekhova
Keyword(s):  
Panic Disorder ◽  
Life Style ◽  
Defense Mechanisms ◽  
Panic Attack ◽  
Alcohol Addiction ◽  
Panic Attacks ◽  
Fourth Group ◽  
Psychological Differences ◽  
Panic Symptoms ◽  
Psychological Defenses

The aim of this study was to examine psychological differences between various groups of patients with comorbid panic disorder and alcoholism (n = 214). We investigated the use of defense mechanisms by life style index of R. Plutchik. Patients of first group (who experienced there first panic attack during withdrawal of alcohol and then has stopped use of alcohol) significantly higher used projection, displacement and repression. Patients, who have originally suffered from panic attacks which they tried to release with the alcohol (second group), significantly higher used projection. Patients who experienced panic attacks only during ingestion of alcohol (third group), significantly higher used denial and repression. Patients with panic attacks during clinical remission of alcohol addiction, who used alcohol to weaken the panic symptoms, which resulted in the heavy alcoholism recurrence (fourth group), significantly higher used repression, projection and denial. So, there were differences between groups on preferred defense mechanisms. the results of the study can help in understanding the pathogenesis of comorbid panic disorder and alcoholism.The study is supported by the President's grant ÌÊ-2670.

Temporal Patterns of Change in Panic Disorder during Cognitive Behaviour Therapy: An Indian Study

2013 ◽  
Vol 42 (5) ◽  
pp. 513-525 ◽  
Author(s):  
M. Manjula ◽  
P.S.D.V. Prasadarao ◽  
V. Kumaraiah ◽  
R. Raguram
Keyword(s):  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Cognitive Behaviour Therapy ◽  
Temporal Patterns ◽  
Cognitive Restructuring ◽  
Structured Interview ◽  
Sensitivity Index ◽  
Behaviour Therapy ◽  
Cognitive Domains ◽  
Cognitive Behaviour

Background: CBT has been proven to be effective in the treatment of panic disorder; however, attempts to study the process of change are limited. Aim: The study evaluated the temporal patterns of change in the panic symptoms, cognitions, behaviours, and anxiety sensitivity in subjects with panic disorder being treated with CBT. Method: Thirty subjects with panic disorder were allocated to two groups: Cognitive Behaviour Therapy (CBT, n = 15) and Behaviour Therapy (BT, n = 15). Assessments were carried out weekly for five consecutive weeks using the Semi-Structured Interview Schedule, the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire, and the Texas Panic Attack Record Form. The CBT group received comprehensive CBT and the BT group received psycho-education and Applied Relaxation. Results: Following intervention the change was continuous and gradual on all the variables in the CBT group and the scores reduced to a functional range after 4–5 weeks of therapy. Such a change was not evident in the BT group. Significant change was evident in cognitive domains following the introduction of the exposure and cognitive restructuring within the CBT group. Both cognitive and behavioural techniques contributed to the overall change. Conclusion: CBT had an impact on the cognitive domains and significant changes were evident corresponding to the addition of cognitive restructuring and exposure techniques in the 3rd to 5th week. Both cognitive and behavioural components are therefore crucial for overall improvement to occur.

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