Disorders - Panic Disorder
Leyfer, O., Carpenter, A., Pincus, D.
Panic disorder (PD) can result in significant functional impairment. Studies of cognitive behavioral therapy (CBT) for PD have demonstrated response rates ranging between 38 and 65%. D-cycloserine (DCS), a partial NMDA agonist, may enhance the effects of exposure-based therapy for PD in adults; however, no studies have examined its effect in adolescents with PD. This study examined the feasibility and acceptability of the use of DCS to augment intensive CBT for PD in adolescents. Twenty-four adolescents (ages 12-17) participated in this randomized, double-blinded, placebo-controlled trial, to compare CBT + DCS to CBT + placebo. The results demonstrated the feasibility and acceptability of the treatment to participants. No significant differences were found between the two groups, but both groups showed significant improvement. This is the first investigation of DCS in the treatment of PD in adolescents and it provides initial support for a more extensive study of DCS augmentation of CBT among adolescents with PD. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Child Psychiatry and Human Development, 50(2) : 268-277
- Year: 2019
- Problem: Panic Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, D-cycloserine (DCS)
Giusti, L., Ussorio, D., Salza, A., Malavolta, M., Aggio, A., Bianchini, V., Casacchia, M., Roncone, R.
Background: People with anxiety disorders tend to focus on unpleasant and threatening stimuli. Our aims were to evaluate: (1) the presence of paranoid ideation, and the jumping to conclusions (JTC) bias in young suffering from an anxiety disorder and (2) the effectiveness of a cognitive-behavioural intervention (CBT) to manage anxiety combined with 2 modules to reduce the JTC bias. Methods: Psychopathology, social functioning, metacognition and the JTC bias were investigated in 60 subjects, randomly assigned to the experimental CBT group + treatment-as-usual (TAU) (n = 35) or to a wait-list group (n = 25) receiving only TAU. Each group was divided into 2 subgroups based on the score of the SCL-90 subscale paranoid ideation (high paranoid ideation, HP; low paranoid ideation, LP). The experimental group received a weekly session of a CBT for a 3-month period. Results: At baseline, 46.7% of our sample showed a HP and 38% showed a JTC biasAt the end of the intervention, greater effectiveness in improving anxious symptoms, paranoid ideation, interpersonal sensitivity and interpersonal relationship was reported in the experimental CBT + TAU group, with a statistically significant reduction of the JTC bias, displayed by 14.3% of the experimental group versus the 36% of the TAU group. In the same variables, greater benefits were reported for the HP experimental subgroup. Conclusions: Our study suggests the gains to integrate an anxiety CBT with modules to reduce the JTC bias in subjects with paranoid ideation, which may negatively impact the course of the disease. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Early Intervention in Psychiatry, 12(6) : 1072-1080
- Year: 2018
- Problem: Generalized Anxiety Disorder, Panic Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Perez, M. I. A., Cabezas, A., Minano, M. J., Algora, M. J., Estrada, F., Sole, M., Barbero, J. D., Montalvo, I., Gutierrez-Zotes, A., Sanchez-Gistau, V., Monreal, J. A., Vilella, E., Palao, D., Labad, J.
Background: Group psychotherapeutic treatments can improve negative symptoms and social functioning deficits in the treatment of schizophrenia. These treatments may include different modalities including group cognitive behavioral therapy, psychoeducation and metacognitive training (MCT). MCT is effective for preventing delusions by modifying the cognitive biases most related to psychosis. Our primary goal was to address whether cognitive biases improve more specifically with MCT when compared to psychoeducation in a sample of patients with recent onset psychosis. Methods: Design: a multicenter randomized, pilot clinical trial was performed, in which one group received psychoeducation and the other MCT. Sample: 49 patients aged between 18-35 years and with a diagnosis of psychotic disorder according to DSM-IV-TR criteria and less than 3 years of duration of illness. All patients were recruited at two Early Psychosis Programmes in Spain (ParcTauli Hospital Universitari, Sabadell; Hospital UniversitariInstitut Pere Mata, Reus). Ethical approval was obtained from the local Ethics Committees of both institutions. Outcomes: Patients were evaluated at baseline and at the end of each intervention. The primary outcome was cognitive biases, assessed with Cognitive Biases Questionnaire for Psychosis (CBQ). Secondary outcomes included cognitive insight, psychopathological symptoms (positive, negative, depressive) and psychosocial functioning. Interventions: The interventions consisted of 8 weekly group sessions of MCT (developed at the University of Hamburg-Eppendorf by Steffen Moritz) or psychoeducation. MCT program included sessions dealing with attributional style, jumping to conclusions, changing beliefs, empathy, memory, and depression and self-esteem. The psychoeducational program included sessions addressing aspects related to psychotic illness (psychotic symptoms, risk factors of relapse, stress management, psychopharmacological treatment, substance use, physical health and social skills). Statistical analysis: A general linear model for repeated measures was performed in order to compare the longitudinal effect of the intervention and to test whether changes in outcome variables differed by treatment group. All analyses were adjusted for gender. A p value < 0.05 (two-tailed) was considered to be significant. Results: Of all 49 patients, 38 (77.6%) completed at least 50% of the sessions, and were included in the final analyses. 21 received psychoeducation and 16 MCT. Cognitive biases improved significantly in both psychoeducation (43.8 +/- 11.2 vs 40.8 +/- 10.4) and MCT groups (44.2 +/- 7.6 vs 39.6 +/- 5.0). The time effect was significant (F= 18.9, p<0.001) without a different pattern in the change of CBQ scores between groups (interaction time x group, F= 0.63, p= 0.431). An improvement in negative symptoms was also observed after receiving both treatments, without significant differences between groups. No significant changes over time were observed in positive symptoms, depressive symptoms or psychosocial functioning. Discussion: Both group psychoeducation and MCT improve cognitive biases in recent onset psychosis. Our study does not support a superiority of one intervention over the other in terms of improving cognitive biases.
Schizophrenia Bulletin, 44 (Supplement 1) : S303-S304
- Year: 2018
- Problem: Panic Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive remediation therapy, Psychoeducation
Sass, S. M., Evans, T. C., Xiong, K., Mirghassemi, F., Tran, H.
Attentional bias for threatening stimuli in anxiety is a common finding in the literature. The present study addressed whether attention training toward pleasant stimuli can reduce anxiety symptoms and induce a processing bias in favor of pleasant information in nonpatients who were selected to score similarly to individuals with generalized anxiety or panic disorder on a measure of worry or physiological arousal, respectively. Participants were randomly assigned to attention training to pleasant (ATP) stimuli or to a placebo control (PC) condition. All participants completed baseline and post-test dot-probe measures of attentional bias while event-related brain potentials were recorded. As expected, worry symptoms decreased in the ATP and not PC condition. ATP was also associated with early evidence (P100 amplitude) of greater attentional prioritization of probes replacing neutral stimuli within threat-neutral word pairs from pre-to-post intervention and later RT evidence of facilitated processing of probes replacing pleasant stimuli within pleasant-threat word pairs at post compared to PC. PC was associated with later evidence (P300 latency) of less efficient evaluation of probes following pleasant stimuli within pleasant-threat word pairs from pre-to-post and later RT evidence of facilitated processing of probes following threat stimuli within pleasant-threat word pairs at post compared to ATP. Results highlight early and later mechanisms of attention processing changes and underscore the potential of pleasant stimuli in optimizing attention-training interventions for anxiety. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Biological Psychology, 122 : 80-92
- Year: 2017
- Problem: Generalized Anxiety Disorder, Panic Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Beadel, J. R., Mathews, A., Teachman, B. A.
This study tested an intervention to enhance resilience among people at risk for developing panic disorder. Participants (N = 50) high in anxiety sensitivity (fear of anxiety symptoms) were randomly assigned to either four sessions of resilience-enhancing interpretation bias modification (CBM-I) or a control (Sham) condition. Following the intervention, participants engaged in a 7.5 % steady state carbon dioxide (CO2) breathing challenge, an established panic stressor. In line with hypotheses, CBM-I resulted in an increase in resilience-congruent interpretations (though no change for general panic interpretation bias) at post-training, and a trend for a greater reduction in anxiety sensitivity at 2-month follow-up. Additionally, CBM-I resulted in less intense cognitive symptoms of panic during the CO2 challenge, though not less intense physical or total panic symptoms. These results, though somewhat mixed, provide preliminary support for the value of training resilience using CBM-I. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Cognitive Therapy and Research, 40(6) : 799-812
- Year: 2016
- Problem: Panic Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Whiteside, S. P., Ale, C. M., Young, B., Dammann, J. E., Tiede, M. S., Biggs, B. K.
This preliminary randomized controlled trial (RCT) examines the feasibility of dismantling cognitive behavioral therapy (CBT) for childhood anxiety disorders. Fourteen children (10 girls) ages 7 to 14 (m = 10.2) with social phobia, generalized anxiety disorder, separation anxiety disorder, or panic disorder were randomized to receive 6 sessions of either a) the pre-exposure anxiety management strategies presented in traditional CBT, or b) parent-coached exposure therapy. The sample was selected from a treatment seeking population and is representative of children in clinical settings. Examination of fidelity ratings, dropouts, and satisfaction ratings indicated that the interventions were distinguishable, safe, and tolerable. The overall sample improved significantly with pre-post effect sizes generally in the large range for both conditions. Between-group effect sizes indicating greater improvement with parent-coached exposure therapy were moderate or large for ten of 12 variables (i.e., 0.53 to 1.52). Re-evaluation after three months of open treatment suggested that the intervention emphasizing exposure early maintained its superiority while requiring fewer appointments. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 73 : 83-89
- Year: 2015
- Problem: Anxiety Disorders (any), Panic Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Exposure therapy, Exposure and response prevention
Deacon, Brett, Kemp, Joshua J., Dixon, Laura J., Sy, Jennifer T., Farrell, Nicholas R., Zhang, Annie R.
Cognitive-behavioral treatments for panic disorder (PD) emphasize interoceptive exposure (IE) to target anxiety sensitivity (AS) but vary considerably in its manner of delivery. This randomized controlled trial was conducted to compare the efficacy of the low-dose delivery of IE exercises often prescribed in treatment protocols to an intensive form of IE hypothesized to optimize inhibitory learning. Participants (N = 120) with elevated AS were randomly assigned to one of four single-session interventions: (a) low-dose IE as prescribed in Barlow and Craske's Panic Control Treatment, (b) low-dose IE without controlled breathing or a lengthy between-trial rest period, (c) intensive IE, or (d) expressive writing control. Compared to the other conditions, intensive IE produced significantly greater reductions in AS and fearful responding to a straw breathing task from pretreatment to posttreatment. Maintenance of gains during the follow-up period did not differ between conditions. Changes in fear toleration and negative outcome expectancies fully mediated the superior efficacy of intensive IE over low-dose IE. The two low intensity IE conditions produced particularly high rates of fear sensitization on between-trial and outcome variables. The findings suggest that the intensive delivery of IE exercises has the potential to improve the efficacy of exposure-based treatments for PD.; Copyright © 2013 Elsevier Ltd. All rights reserved.
Behaviour Research & Therapy, 51(9) : 588-596
- Year: 2013
- Problem: Panic Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Creative expression: music, dance, drama, art
Gallo, K. P., Chan, P. T., Buzzella, B. A., Whitton, S. W., Pincus, D. B.
Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets. (copyright) 2011.
Behavior Therapy, 43(1) : 153-159
- Year: 2012
- Problem: Panic Disorder, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Psychoeducation, Other Psychological Interventions
Pincus, D. B., May, J. E., Whitton, S. W., Mattis, S. G., Barlow, D. H.
This investigation represents the first randomized controlled trial to evaluate the feasibility and efficacy of Panic Control Treatment for Adolescents (PCT-A). Thirteen adolescents, ages 14 to 17, were randomized to 11 weekly sessions of PCT-A treatment, whereas 13 were randomized to a self-monitoring control group. Results indicate that adolescents receiving immediate PCT-A showed a significant reduction in clinician-rated severity of panic disorder and in self-reported anxiety, anxiety sensitivity, and depression, in comparison to control group participants. These treatment gains were maintained at 3 and 6-month follow-up. Clinical severity of panic continued to improve from posttreatment to 3-month follow-up and then remained stable at 6-month follow-up. In light of study limitations, these findings suggest that cognitive-behavioral treatment for panic disorder in adolescence is a feasible and potentially efficacious intervention for this debilitating condition in youth. (copyright) Taylor & Francis Group, LLC.
Journal of Clinical Child & Adolescent Psychology, 39(5) : 638-649
- Year: 2010
- Problem: Panic Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Feldner, M. T., Zvolensky, M. J., Babson, K., Leen-Feldner, E. W., Schmidt, N. B.
Consistent with a risk reduction model of targeted prevention, the present investigation piloted and empirically evaluated the feasibility and short-term efficacy of a first-generation panic prevention program that targeted two malleable risk factors for panic development-anxiety sensitivity and daily cigarette smoking. Members of a high risk cohort, defined by high levels of anxiety sensitivity and current daily smoking (n = 96), were randomly assigned to either (1) a one session intervention focused on proximally increasing motivation to quit smoking and reducing anxiety sensitivity to distally prevent the development of panic or (2) a health information control condition of comparable length. Participants were followed for 6 months. Consistent with hypotheses, those in the treatment condition showed reduced anxiety sensitivity and this effect was maintained across the follow-up period. Limited evidence also suggested the intervention increased motivation to quit smoking. We discuss how this prevention protocol can be modified in the future to enhance its effects as part of second-generation larger-scale outcome evaluations. copyright 2008 Elsevier Ltd. All rights reserved.
Journal of Anxiety Disorders., 22(7) : 1227-1243
- Year: 2008
- Problem: Panic Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
In-Albon, T., Schneider, S.
Background: The present study compared the efficacy of psychotherapy for childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder). Methods: The meta-analysis included studies that met the basic CONSORT (consolidated standards of reporting trials) criteria. Several outcome variables (e.g. effect sizes, percentage of recovery) were analyzed using completer and intent-to-treat analyses during post-treatment and follow-up assessment. Twenty-four studies published by March 2005 were included in this meta-analysis. Results: In all the included studies, the active treatment condition was cognitive-behavioral. The overall mean effect of treatment was 0.86. No differences in outcome were found between individual and group treatments or child- and family-focused treatments. Follow-up data demonstrated that treatment gains were maintained up to several years after treatment. Conclusions: These findings provide evidence that anxiety disorders in children can be treated efficaciously. The gathered data support the clinical utility of cognitive-behavioral therapy in this regard. Randomized controlled trial studies investigating treatments other than cognitive-behavioral therapy are missing. Copyright copyright 2007 S. Karger AG.
Psychotherapy & Psychosomatics., 76(1) : 15-24
- Year: 2007
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Panic Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Systematic reviews
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)