Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome

Michael G T Dow, Justin A Kenardy, Derek W Johnston, Michelle G Newman, C Barr Taylor, Aileen Thomson

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background. Although the effectiveness of cognitive behavioural therapy (CBT) in the management of panic disorder (PD) is now well established, there have been few studies of predictors of outcome with this patient group using clinical effectiveness trial data, a hypothesis-testing model, and a dependent measure of clinically significant change.

Method. The data for this study came from a randomized controlled trial of three forms of CBT delivery for PD with and without agoraphobia (two 6-week CBT programmes, one of which was computer assisted, and one therapist-directed 12-week CBT programme), comprising a total of 186 patients across two sites. Based on previous related research, five hypothesized predictors of post-treatment and follow-up outcome were identified and examined, using a series of bivariate and multivariate analyses.

Results. The results in general supported the hypotheses. Strength of blood/injury fears, age of initial onset of panic symptoms, co-morbid social anxieties and degree of agoraphobic avoidance were predictive of both measures of post-treatment outcome. Degree of residual social difficulties and the continued use of anxiolytics at post-treatment were also shown to predict poor outcome at the 6-month follow-up. However, strength of continuing dysfunctional agoraphobic cognitions by the end of active treatment did not predict outcome at follow-up for the sample as a whole.

Conclusions. The identification of consistent predictors of outcome with CBT has many clinical and research benefits. As CBT, however, is being delivered increasingly in a variety of brief formats, further research is required to identify moderators of response to these 'non-standard' treatment formats.

Original languageEnglish
Pages (from-to)1493-1502
Number of pages10
JournalPsychological Medicine
Volume37
Issue number10
DOIs
Publication statusPublished - 2007

Keywords

  • Adolescent
  • Adult
  • Agoraphobia
  • Cognitive Therapy
  • Humans
  • Middle Aged
  • Panic Disorder
  • Predictive Value of Tests
  • Prognosis
  • Therapy, Computer-Assisted
  • Treatment Outcome
  • GENERALIZED ANXIETY DISORDER, COGNITIVE-BEHAVIOR THERAPY, BODY SENSATIONS, FOLLOW-UP, AGORAPHOBIA, EXPOSURE, ATTACKS, PSYCHOTHERAPY, IMPROVEMENT, ALPRAZOLAM

Cite this

Prognostic indices with brief and standard CBT for panic disorder : I. Predictors of outcome. / Dow, Michael G T; Kenardy, Justin A; Johnston, Derek W; Newman, Michelle G; Taylor, C Barr; Thomson, Aileen.

In: Psychological Medicine, Vol. 37, No. 10, 2007, p. 1493-1502.

Research output: Contribution to journalArticle

Dow, Michael G T ; Kenardy, Justin A ; Johnston, Derek W ; Newman, Michelle G ; Taylor, C Barr ; Thomson, Aileen. / Prognostic indices with brief and standard CBT for panic disorder : I. Predictors of outcome. In: Psychological Medicine. 2007 ; Vol. 37, No. 10. pp. 1493-1502.
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abstract = "Background. Although the effectiveness of cognitive behavioural therapy (CBT) in the management of panic disorder (PD) is now well established, there have been few studies of predictors of outcome with this patient group using clinical effectiveness trial data, a hypothesis-testing model, and a dependent measure of clinically significant change.Method. The data for this study came from a randomized controlled trial of three forms of CBT delivery for PD with and without agoraphobia (two 6-week CBT programmes, one of which was computer assisted, and one therapist-directed 12-week CBT programme), comprising a total of 186 patients across two sites. Based on previous related research, five hypothesized predictors of post-treatment and follow-up outcome were identified and examined, using a series of bivariate and multivariate analyses.Results. The results in general supported the hypotheses. Strength of blood/injury fears, age of initial onset of panic symptoms, co-morbid social anxieties and degree of agoraphobic avoidance were predictive of both measures of post-treatment outcome. Degree of residual social difficulties and the continued use of anxiolytics at post-treatment were also shown to predict poor outcome at the 6-month follow-up. However, strength of continuing dysfunctional agoraphobic cognitions by the end of active treatment did not predict outcome at follow-up for the sample as a whole.Conclusions. The identification of consistent predictors of outcome with CBT has many clinical and research benefits. As CBT, however, is being delivered increasingly in a variety of brief formats, further research is required to identify moderators of response to these 'non-standard' treatment formats.",
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T1 - Prognostic indices with brief and standard CBT for panic disorder

T2 - I. Predictors of outcome

AU - Dow, Michael G T

AU - Kenardy, Justin A

AU - Johnston, Derek W

AU - Newman, Michelle G

AU - Taylor, C Barr

AU - Thomson, Aileen

PY - 2007

Y1 - 2007

N2 - Background. Although the effectiveness of cognitive behavioural therapy (CBT) in the management of panic disorder (PD) is now well established, there have been few studies of predictors of outcome with this patient group using clinical effectiveness trial data, a hypothesis-testing model, and a dependent measure of clinically significant change.Method. The data for this study came from a randomized controlled trial of three forms of CBT delivery for PD with and without agoraphobia (two 6-week CBT programmes, one of which was computer assisted, and one therapist-directed 12-week CBT programme), comprising a total of 186 patients across two sites. Based on previous related research, five hypothesized predictors of post-treatment and follow-up outcome were identified and examined, using a series of bivariate and multivariate analyses.Results. The results in general supported the hypotheses. Strength of blood/injury fears, age of initial onset of panic symptoms, co-morbid social anxieties and degree of agoraphobic avoidance were predictive of both measures of post-treatment outcome. Degree of residual social difficulties and the continued use of anxiolytics at post-treatment were also shown to predict poor outcome at the 6-month follow-up. However, strength of continuing dysfunctional agoraphobic cognitions by the end of active treatment did not predict outcome at follow-up for the sample as a whole.Conclusions. The identification of consistent predictors of outcome with CBT has many clinical and research benefits. As CBT, however, is being delivered increasingly in a variety of brief formats, further research is required to identify moderators of response to these 'non-standard' treatment formats.

AB - Background. Although the effectiveness of cognitive behavioural therapy (CBT) in the management of panic disorder (PD) is now well established, there have been few studies of predictors of outcome with this patient group using clinical effectiveness trial data, a hypothesis-testing model, and a dependent measure of clinically significant change.Method. The data for this study came from a randomized controlled trial of three forms of CBT delivery for PD with and without agoraphobia (two 6-week CBT programmes, one of which was computer assisted, and one therapist-directed 12-week CBT programme), comprising a total of 186 patients across two sites. Based on previous related research, five hypothesized predictors of post-treatment and follow-up outcome were identified and examined, using a series of bivariate and multivariate analyses.Results. The results in general supported the hypotheses. Strength of blood/injury fears, age of initial onset of panic symptoms, co-morbid social anxieties and degree of agoraphobic avoidance were predictive of both measures of post-treatment outcome. Degree of residual social difficulties and the continued use of anxiolytics at post-treatment were also shown to predict poor outcome at the 6-month follow-up. However, strength of continuing dysfunctional agoraphobic cognitions by the end of active treatment did not predict outcome at follow-up for the sample as a whole.Conclusions. The identification of consistent predictors of outcome with CBT has many clinical and research benefits. As CBT, however, is being delivered increasingly in a variety of brief formats, further research is required to identify moderators of response to these 'non-standard' treatment formats.

KW - Adolescent

KW - Adult

KW - Agoraphobia

KW - Cognitive Therapy

KW - Humans

KW - Middle Aged

KW - Panic Disorder

KW - Predictive Value of Tests

KW - Prognosis

KW - Therapy, Computer-Assisted

KW - Treatment Outcome

KW - GENERALIZED ANXIETY DISORDER, COGNITIVE-BEHAVIOR THERAPY, BODY SENSATIONS, FOLLOW-UP, AGORAPHOBIA, EXPOSURE, ATTACKS, PSYCHOTHERAPY, IMPROVEMENT, ALPRAZOLAM

U2 - 10.1017/S0033291707000670

DO - 10.1017/S0033291707000670

M3 - Article

C2 - 17493294

VL - 37

SP - 1493

EP - 1502

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 10

ER -