Information Processing and Treatment for Panic Disorder

描述（由申请人提供）：焦虑的认知模型提出，适应不良图式指导信息处理，因此焦虑的人选择性地注意到威胁性线索，将模糊的线索解释为威胁，并优先回忆威胁线索。许多假设的认知偏差都有强有力的证据，但关于这些偏差如何相互关联，它们如何与恐慌症状相关，或者它们如何响应治疗而变化，我们知之甚少。该建议旨在研究惊恐障碍中信息处理措施之间的关系，并研究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减轻。此外，这项研究将提供第一个评估的内隐协会在恐慌症，并考虑这些协会如何应对治疗。此外，该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）将接受认知行为团体治疗后，完成一系列评估，包括认知，情感，生理和行为措施的恐慌，以及信息处理措施（任务评估内隐联想记忆，以反映图式处理，任务，以评估注意力和解释偏差）。将在治疗前、12周治疗方案期间的3个时间点以及治疗后和12个月随访时完成评估组合。将使用纵向增长曲线模型：o评估变化的轨迹以及不同认知和恐慌症状测量之间的关系，并且随访期将允许预测恐惧的回归。对照组包括在与实验组匹配的时间点完成评估组合的惊恐障碍患者的延迟治疗组（N = 30），以及非焦虑的健康对照组（N = 30）。

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).