Psychological treatment for panic disorder with agoraphobia: A randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT.

Gloster, Andrew T.; Wittchen, Hans‐Ulrich; Einsle, Franziska; Lang, Thomas; Helbig-Lang, Sylvia; Fydrich, Thomas; Fehm, Lydia; Hamm, Alfons O.; Richter, Jan; Alpers, Georg W.; Gerlach, Alexander L.; Ströhle, Andreas; Kircher, Tilo; Deckert, Jürgen; Zwanzger, Peter; Höfler, Michael; Arolt, Volker

doi:10.1037/a0023584

Cited by 190 publications

(198 citation statements)

References 59 publications

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“…In contrast, patients who participated in the present study were treated with a specific therapeutic manual for panic disorder with agoraphobia [36]. This treatment manual has been found to be highly effective [7], also showing a high effect in this study (d=2.17) and a reduction of the symptoms comparable to previous studies [7].…”

Section: Acta Psychopathologica Issn 2469-6676mentioning

confidence: 48%

“…The therapy therefore lasted a total period of six weeks. A study by Gloster et al [7] showed the treatment manual to be highly effective. After each session, interim measurements were taken to record changes in symptom intensity.…”

Section: Acta Psychopathologica Issn 2469-6676mentioning

confidence: 99%

“…Research results confirm that exposure is very important for treatment success [5][6]. Although CBT is recognized as an empirically welldocumented treatment, the exact mechanisms that cause a change have not been explored so far [7]. Studies investigating the effectiveness of CBT in psychotherapy have shown that the positive treatment expectations of a patient play a central role and are directly related to the therapy result [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Does Expectancy and Homework Compliance Predict Change in CBT?

Schröder¹

2017

Acta Psychopathol

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Objective: For treating panic disorder with agoraphobia, a high efficacy of cognitive behavioral therapy (CBT) has been demonstrated. However, the exact mechanisms leading to symptom change have been hardly explored. Previous evidence demonstrated that patients with positive expectations regarding treatment outcome before start of therapy and with high homework compliance experience an early response in the course of treatment. Furthermore the correlation between homework compliance and the treatment outcome of a patient was mediated by an early response. The aim of the present study was to conceptually replicate these findings.Method: Twenty-three patients who met the diagnostic criteria for a panic disorder with agoraphobia according to the DSM-IV were treated in an exposure-based therapy with a total of 12 sessions. After each session, interim measurements were taken to measure symptom intensity. To test the research questions, multiple regression analyses were calculated. Results:Patients who experienced an early response according to the definition (n=19) showed this change on average in session 5.11 (SD=2.94). Testing the mediation hypotheses replicated neither that the relationship between positive treatment expectations and early change was mediated by homework compliance, nor that the relationship between homework compliance and treatment outcome was mediated by early change. Conclusions:The results show that previous findings on the relationship of positive treatment expectation, homework compliance and early symptom change cannot be generalized to a different setting. Given this conclusion, there should be an increased interest in replication studies.

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Section: Acta Psychopathologica Issn 2469-6676mentioning

confidence: 48%

Section: Acta Psychopathologica Issn 2469-6676mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does Expectancy and Homework Compliance Predict Change in CBT?

Schröder¹

2017

Acta Psychopathol

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“…A number of RCT studies and meta-analyses have shown overall evidence for the effectiveness of CBT for panic disorder/agoraphobia (Ruhmland & Margraf 2001;Mitte 2005;Haby et al 2006;Gloster et al 2011). Concerning the sustainability of the effects of CBT, findings are contradictory: Some studies found long-term success for CBT over a period of 1 to 2 years (Hunt & Andrews 1998;Stuart et al 2000;Gloster et al 2013;Fava et al 2001).…”

Section: Effectiveness and Sustainability Of Cbt For Anxiety Disordermentioning

confidence: 99%

A Comparison of Psychoanalytic Therapy and Cognitive Behavioral Therapy for Anxiety (Panic/Agoraphobia) and Personality Disorders (APD Study): Presentation of the RCT Study Design

Benecke

Huber

Schmitz

et al. 2016

Zeitschrift für Psychosomatische Medizin und Psychotherapie

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Fragestellung: Angststörungen, insbesondere Panikstörungen und Agoraphobie, sind weitverbreitete psychische Störungen, die eine hohe Komorbidität mit Persönlichkeitsstörungen aufweisen. Randomisierte kontrollierte Studien, die sich mit dieser sehr relevanten Gruppe von Patienten befassen, fehlen bisher. Methode: Die multizentrisch durchgeführte Studie zu Angst-und Persönlichkeitsstörungen (APS) untersucht 200 Patienten mit Panikstörung und/oder Agoraphobie mit komorbiden Persönlichkeitsstörungen in einer randomisierten, kontrollierten Vergleichsstudie zwischen Analytischer Psychotherapie (psychoanalytic therapy, PT) und Kognitiver Verhaltenstherapie (cognitive behavioral therapy, CBT), wobei jede Gruppe 100 Patienten enthält. Jeder Patient wird über einen Zeitraum von sechs Jahren untersucht, unabhängig von der Dauer der individuellen Behandlung. Die wesentlichen Fragestellungen dieser Studie beziehen sich auf den Vergleich der Effektivität von PT und CBT in dieser speziellen Patientenpopulation, auf den Vergleich der Nachhaltigkeit der Effekte von PT und CBT, den Vergleich der langfristigen Kosten-Nutzen-Relation von PT und CBT, sowie die Untersuchung von prädiktiven Patientenmerkmalen für individuelle Therapieempfehlungen (Differenzielle Indikationsstellung). Diskussion: Die APS-Studie vergleicht Effektivität, Nachhaltigkeit und Kosten-Nutzen-Relation von PT und CBT für Angst-plus Persönlichkeitsstörungen in einem randomisierten, kontrollierten Design. Das Studiendesign erfüllt damit die Anforderungen an eine Effektivitätsstudie für PT, die unlängst definiert wurden. Studienregistrierung: Current Controlled Trials ISRCTN12449681.

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“…Additionally, exposurebased interventions (including virtual reality exposure, Meyerbröker, 2014) show strong effect sizes in reducing agoraphobic avoidance behavior (Meyerbroeker et al, 2013;Moscovitch, 2009). Interestingly, therapist guidance during exposures appears important (Gloster et al, 2011). This large Randomized Control Trial showed that guided exposure in vivo was more effective than exposure without therapist guidance in reducing the number of panic attacks, avoidance behavior, and improvement in global functioning.…”

Section: Psychoeducationmentioning

confidence: 99%

Panic Disorder and Agoraphobia Across the Lifespan

Meyerbröker

Powers

2015

International Encyclopedia of the Social &Amp; Behavioral Sciences

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This article is aimed to give a short overview over the most important features and research findings about panic disorder and agoraphobia. The diagnostic criteria will be discussed reviewing the changes in the history of the Diagnostic Statistical Manual for Mental Disorders. Epidemiology will be reviewed within development and maintenance factors. Different theoretical models will be discussed and the evidence-based treatment approach will be explained. Possible mechanisms of change are explained and the article ends with a short overview of clinical implications and future directions of research.

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Psychological treatment for panic disorder with agoraphobia: A randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT.

Cited by 190 publications

References 59 publications

Does Expectancy and Homework Compliance Predict Change in CBT?

Does Expectancy and Homework Compliance Predict Change in CBT?

A Comparison of Psychoanalytic Therapy and Cognitive Behavioral Therapy for Anxiety (Panic/Agoraphobia) and Personality Disorders (APD Study): Presentation of the RCT Study Design

Panic Disorder and Agoraphobia Across the Lifespan

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