Mechanisms of change in cognitive behaviour therapy for panic disorder: The role of panic self-efficacy and catastrophic misinterpretations
Mechanisms of change in cognitive behaviour therapy for panic disorder: The role of panic self-efficacy and catastrophic misinterpretations
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DOI：
10.1016/j.brat.2013.06.002
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发表时间：
2013-09-01
影响因子：
4.1
通讯作者：
Hougaard, Esben
中科院分区：
文献类型：
--
作者：
Fentz, Hanne N.;Hoffart, Asle;Hougaard, Esben
认知行为疗法（CBT）对伴有或不伴有广场恐怖症（PD）的惊恐障碍的疗效是公认的;然而，对治疗期间临床改善的潜在变化过程知之甚少。根据认知理论，帕金森病的CBT主要通过改变对身体症状和恐慌发作的灾难性误解来起作用。然而，惊恐自我效能，即感知的能力，以科普惊恐发作，也被认为是一个重要的变化机制，在认知行为疗法的PD。本研究的目的是调查，如果灾难性的误解和恐慌的自我效能介导的变化，在13个会议的过程中，PD组CBT的焦虑水平的变化。45名参与者每周完成一次自我报告，测量可能的认知介质和整个治疗过程中的焦虑水平。结果表明，在一个会议的恐慌自我效能的人内变化，但不是在灾难性的误解，预测在接下来的一周内的焦虑症状的人内水平。然而，在反向分析中，焦虑症状水平的先前变化也预测了接下来的恐慌自我效能的变化。这些结果支持惊恐自我效能作为PD CBT变化的中介，尽管惊恐自我效能和焦虑水平之间存在相互因果关系。(C)2013爱思唯尔有限公司保留所有权利。
The efficacy of cognitive behavioural therapy (CBT) for panic disorder with or without agoraphobia (PD) is well-established; however, little is known about the underlying change processes of clinical improvement during therapy. According to cognitive theories, CBT for PD primarily works by changing catastrophic misinterpretations of bodily symptoms and panic attacks. However, panic self-efficacy, i.e. the perceived ability to cope with panic attacks, has also been suggested as an important change mechanism in CBT for PD. The aim of the study was to investigate if change in catastrophic misinterpretations and panic self-efficacy mediated change in the level of anxiety during the course of thirteen sessions of group CBT for PD. Forty-five participants completed weekly self-report measures of the possible cognitive mediators and the level of anxiety throughout therapy. The results indicated that within-person change in panic self-efficacy in one session, but not in catastrophic misinterpretations, predicted within-person level of anxiety symptoms the following week. However, in a reversed analysis, prior change in level of anxiety symptoms also predicted change in panic self-efficacy the following session. These results support panic self-efficacy as a mediator of change in CBT for PD, although a reciprocal causal relationship between panic self-efficacy and level of anxiety seems to be implied. (C) 2013 Elsevier Ltd. All rights reserved.