title: Psychophysiological outcome of cognitive, behavioral and psychophysiologically-based treatments of agoraphobia.
abstract: Psychophysiological process and outcome phenomena were analyzed to examine differential temporal patterns within and across cognitive, behavioral and physiologically-based treatments of agoraphobia. Eighty-eight severe and chronic agoraphobics with panic attacks (DSM-III) were randomly assigned to one of three treatments: Paradoxical Intention, Graduated Exposure or Progressive Deep Muscle Relaxation Training. Protocol therapists, whose treatment integrity was objectively monitored, conducted 12 two-hour weekly sessions. All subjects received programmed practice instructions concurrent with their primary treatment. Analyses revealed numerous significant reductions on in vivo psychophysiological measures for the relaxation condition, a few improvements for the exposure treatment and no effects for the paradoxical intention modality. The mediating role of pretreatment physiological reactivity in treatment outcome and follow-up status was examined and revealed no significant associations. Synchrony-desynchrony patterns were found to vary widely according to both treatment phase and the time interval between assessments. No between-group differences were observed on the proportion of synchronizers. However, synchronizers exhibited superior outcome and follow-up compared to desynchronizers on all domains except the physiological measures. Conceptual, methodological and clinical implications of these findings are discussed with recommendations for future research.
authors.affiliation: Pennsylvania State University, Department of Psychology, University Park 16802.
authors.forename: L
authors.initials: L
authors.lastname: Michelson
authors.forename: M
authors.initials: M
authors.lastname: Mavissakalian
authors.forename: K
authors.initials: K
authors.lastname: Marchione
authors.forename: R F
authors.initials: RF
authors.lastname: Ulrich
authors.forename: N
authors.initials: N
authors.lastname: Marchione
authors.forename: S
authors.initials: S
authors.lastname: Testa
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000523:psychology / Q000628:therapy*; D001143:Arousal; D001521:Behavior Therapy / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012064:Relaxation Therapy