Cognitive mediation of panic reduction during an early intervention for panic

Authors: Meulenbeek, P.; Spinhoven, P.¹; Smit, F.; van Balkom, A.²; Cuijpers, P.

Source: Acta Psychiatrica Scandinavica, Volume 122, Number 1, July 2010 , pp. 20-29(10)

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Abstract:

Meulenbeek P, Spinhoven P, Smit F, van Balkom A, Cuijpers P. Cognitive mediation of panic reduction during an early intervention for panic. Objective:

This study investigated cognitive mediation of improvement in panic disorder (PD) symptomatology during and after an early intervention for panic symptoms in subthreshold and mild PD. Method:

We executed a pragmatic, pre-post, two-group, multi-site, randomized trial of an early intervention for panic symptoms, based on cognitive-behavioural therapy, vs. a wait-list control group in a sample of 217 participants with subthreshold PD or mild PD. Results:

First, two of the three subscales of the mediator variable Panic Appraisal Inventory (PAI-anticipation and PAI-coping) significantly mediated residual change in PD symptomatology on the PD Severity Scale-Self Report. Second, preintervention to postintervention PAI-anticipation and PAI-coping change scores significantly predicted postintervention to follow-up change in PD symptomatology after controlling for other change scores. However, the converse association was also significant. Conclusion:

The results suggest that changes in cognitions may mediate changes in PD symptomatology and that the process of change is circular.

Keywords: mediation; early intervention; panic disorder; cognitive-behavioural therapy; randomized controlled trial

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2009.01530.x

Affiliations: 1: Institute of Psychology and Department of Psychiatry, Leiden University, Leiden 2: Department of Psychiatry and EMGO Institute, VU-University Medical Center, Amsterdam, the Netherlands

Publication date: 2010-07-01