Information Processing and Treatment for Panic Disorder

描述（由申请人提供）：焦虑的认知模型认为，不适应图式引导信息加工，因此焦虑者选择性地关注威胁性线索，将模糊的线索解释为威胁性线索，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，但人们对这些偏差之间的关系、它们与恐慌症状的关系，以及它们在治疗后的反应如何变化，知之甚少。本研究旨在研究惊恐障碍中信息处理措施之间的关系，并研究在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，本研究将首次评估恐慌障碍的内隐关联，并考虑这些关联对治疗的反应。此外，该研究将检验改变对身体感觉的灾难性误解对减轻症状的重要性。为了评估这些问题，一组惊恐障碍患者（N = 30）在完成包括惊恐的认知、情感、生理和行为测量以及信息加工测量（评估记忆中的内隐关联以反映图式加工的任务，评估注意和解释偏差的任务）的评估单元后接受认知行为小组治疗。评估组将在治疗前、12周治疗方案中的3个时间点、治疗后和12个月随访时完成。使用纵向增长曲线模型来评估恐慌的不同认知和症状测量之间的变化轨迹和关系，并在随访期间预测恐惧的回归。对照组包括延迟治疗的惊恐障碍患者（N = 30），他们将在与实验组匹配的时间点完成评估组，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).