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Psychol Med. 2007 Oct;37(10):1503-9. Epub 2007 May 10.

Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome.

Author information

1
NHS Fife, Department of Clinical Psychology, Stratheden Hospital, Cupar, Fife, UK. mgtd1@stir.ac.uk

Abstract

BACKGROUND:

Despite the growth of reduced therapist-contact cognitive behavioural therapy (CBT) programmes, there have been few systematic attempts to determine prescriptive indicators for such programmes vis-à-vis more standard forms of CBT delivery. The present study aimed to address this in relation to brief (6-week) and standard (12-week) therapist-directed CBT for panic disorder (PD) with and without agoraphobia. Higher baseline levels of severity and associated disability/co-morbidity were hypothesized to moderate treatment effects, in favour of the 12-week programme.

METHOD:

Analyses were based on outcome data from two out of three treatment groups (n=72) from a recent trial of three forms of CBT delivery for PD. The dependent variables were a continuous composite panic/anxiety score and a measure of clinical significance. Treatment x predictor interactions were examined using multiple and logistic regression analyses.

RESULTS:

As hypothesized, higher baseline severity, disability or co-morbidity as indexed by strength of dysfunctional agoraphobic cognitions; duration of current episode of PD; self-ratings of panic severity; and the 36-item Short Form Health Survey (SF-36) (Mental component) score were all found to predict poorer outcome with brief CBT. A similar trend was apparent in relation to baseline level of depression. With high and low end-state functioning as the outcome measure, however, only the treatment x agoraphobic cognitions interaction was found to be significant.

CONCLUSIONS:

While there was no evidence that the above variables necessarily contraindicate the use of brief CBT, they were nevertheless associated with greater overall levels of post-treatment improvement with the 12-week approach.

PMID:
17493295
DOI:
10.1017/S0033291707000682
[Indexed for MEDLINE]

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