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Importance of knowledge in the behavioural treatment of panic disorder

  • Kathleen M. Grubbs (a1), James D. Broussard (a2), Emily L. Hiatt (a3) (a4), Melissa A. Beason-Smith (a5) and Ellen J. Teng (a6) (a7) (a8)...

Abstract

Background:

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.

Copyright

Corresponding author

*Corresponding author. Email: Ellen.Teng@va.gov

References

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Barlow, D. H. and Craske, M. G. (1994). Mastery of Anxiety and Panic II (MAP II). Albany, NY: Graywind.
Barrera, T. L., Graham, D. P., Dunn, N. J. and Teng, E. J. (2013). Influence of trauma history on panic and PTSD in returning veterans. Psychological Services, 10, 168176.
Bryan, C. J., Wertenberger, E. D., Wilkinson, E. B., Breitbach, J., Bruce, T. O. and Rudd, M. D. (2012). Defining treatment completion according to patient competency: a case example using brief cognitive behavioral therapy (BCBT) for suicidal patients. Professional Psychology: Research and Practice, 43, 130136.
Cho, Y., Smits, J. A. J., Powers, M. B. and Telch, M. J. (2007). Do changes in panic appraisal predict improvement in clinical status following cognitive behavioral treatment for panic disorder? Cognitive Therapy and Research, 31, 695707.
Craske, M. G., Barlow, D. H. and Meadows, E. (2000). Therapist Guide for Anxiety, Panic and Agoraphobia: Mastery of Your Anxiety and Panic (3rd edn). San Antonio, TX: Graywind Publications, Inc.
Teng, E. J., Barrera, T. L., Hiatt, E. L., Chaison, A., Dunn, N. J., Peterson, N., et al. (2015). Intensive weekend group treatment for panic disorder and its impact on co-occuring PTSD: a pilot study. Journal of Anxiety Disorders, 33, 17.

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Importance of knowledge in the behavioural treatment of panic disorder

  • Kathleen M. Grubbs (a1), James D. Broussard (a2), Emily L. Hiatt (a3) (a4), Melissa A. Beason-Smith (a5) and Ellen J. Teng (a6) (a7) (a8)...

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Importance of knowledge in the behavioural treatment of panic disorder

  • Kathleen M. Grubbs (a1), James D. Broussard (a2), Emily L. Hiatt (a3) (a4), Melissa A. Beason-Smith (a5) and Ellen J. Teng (a6) (a7) (a8)...
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