Information Processing and Treatment for Panic Disorder

描述(由申请人提供)：焦虑的认知模型认为，不适应图式指导信息处理，因此焦虑的人有选择地注意威胁线索，将模棱两可的线索解释为威胁，并优先回忆威胁线索。许多假想的认知偏差都有确凿的证据，但关于这些偏差是如何相互关联的，它们与恐慌症状是如何关联的，或者它们是如何随着治疗的反应而改变的，人们知之甚少。这项建议旨在研究惊恐障碍中信息处理措施之间的关系，并检查治疗过程中认知和症状措施的变化模式，以确定哪些认知措施将预测症状的减轻。此外，这项研究将首次评估惊恐障碍中的隐性关联，并考虑这些关联对治疗的反应。此外，这项研究还将研究改变对身体感觉的灾难性误解以减轻症状的重要性。为了评估这些问题，一组惊恐障碍患者(N=30)在完成了包括惊恐的认知、情感、生理和行为测量以及信息处理测量(评估记忆中的内隐联系以反映图式加工的任务，以及评估注意力和解释偏差的任务)后，接受认知行为团体治疗。评估组合将在治疗前、12周治疗方案期间的3个时间点、治疗后和12个月的随访时完成。将使用纵向增长曲线建模：评估恐慌的不同认知和症状措施之间的变化轨迹和关系，并在随访期内预测恐惧的回归。对照组包括惊恐障碍延迟治疗组(N=30)和非焦虑健康对照组(N=30)，后者在与实验组匹配的时间点完成评估。

DESCRIPTION (provided by applicant): Cognitive models of anxiety propose that maladaptive schemata guide information processing so the anxious person selectively attends to threatening cues, interprets ambiguous cues as threatening, and preferentially recalls threat cues. There is robust evidence for many of the hypothesized cognitive biases, but little is known about how these biases relate to one another, how they relate to panic symptoms, or how they change in response to treatment. This proposal seeks to examine relationships among information processing measures in panic disorder, and to examine the patterns of change in cognitive and symptom measures over the course of treatment to determine which cognitive measures will predict symptom reduction. Further, this study would provide the first evaluation of implicit associations in panic disorder and consider how these associations respond to treatment. In addition, the study would examine the importance of changing catastrophic misinterpretations of bodily sensations to effect symptom reduction. To evaluate these questions, a group of patients with panic disorder (N = 30) would receive cognitive behavioral group therapy after completing an assessment battery including cognitive, affective, physiological and behavioral measures of panic, as well as information processing measures (tasks evaluating implicit associations in memory to reflect schematic processing, and tasks to evaluate attention and interpretation biases). The assessment battery would be completed pre-treatment, at 3 time points during the 12-week treatment protocol, and at post-treatment and 12-month follow-up. Longitudinal growth curve modeling would be used :o evaluate the trajectories of change and relationships among different cognitive and symptom measures of panic, and the follow-up period would allow prediction of return of fear. Control groups include a delayed- treatment group of persons with panic disorder (N = 30) who would complete the assessment battery at matched time points to the experimental group, and a non-anxious healthy control group (N = 30).