Mechanism of Change in Cognitive-Behavioral Treatment of Panic Disorder: Evidence for the Fear of Fear Mediational Hypothesis.
- 1 January 2004
- journal article
- Published by American Psychological Association (APA) in Journal of Consulting and Clinical Psychology
- Vol. 72 (4) , 646-652
- https://doi.org/10.1037/0022-006x.72.4.646
Abstract
Numerous clinical trials have demonstrated the efficacy of cognitive-behavioral treatment (CBT) for panic disorder. However, studies investigating the mechanisms responsible for improvement with CBT are lacking. The authors used regression analyses outlined by R. M. Baron and D. A. Kenny (1986) to test whether a reduction in fear of fear (FOF) underlies improvement resulting from CBT. Pre- and posttreatment measures were collected from 90 CBT-treated patients and 40 wait-list control participants. Overall, treatment accounted for 31% of the variance in symptom reduction. The potency of FOF as a mediator varied as a function of symptom facet, as full mediation was observed for the change in global disability, whereas the effects of CBT on agoraphobia, anxiety, and panic frequency were partially accounted for by reductions in FOF. Clinical implications and future research directions are discussed.Keywords
This publication has 41 references indexed in Scilit:
- A modern learning theory perspective on the etiology of panic disorder.Psychological Review, 2001
- Extinction of panicogenic effects of a 35% CO₂ challenge in patients with panic disorder.Journal of Abnormal Psychology, 1997
- Misinterpretation of body sensations in panic disorder.Journal of Consulting and Clinical Psychology, 1997
- Anxiety sensitivity, suffocation fear, trait anxiety, and breath-holding duration as predictors of response to carbon dioxide challengeBehaviour Research and Therapy, 1996
- Change in danger cognitions in agoraphobia and social phobia during treatmentBehaviour Research and Therapy, 1996
- Exposure versus cognitive restructuring in the treatment of panic disorder with agoraphobiaBehaviour Research and Therapy, 1996
- A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic DisorderThe British Journal of Psychiatry, 1994
- How does anxiety sensitivity vary across the anxiety disorders?Journal of Anxiety Disorders, 1992
- Effects of anxiety sensitivity on the response to hyperventilation.Journal of Abnormal Psychology, 1987
- The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology, 1986