title: Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia.
abstract: Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.
authors.affiliation: Dresden University of Technology, Dresden, Germany.
authors.forename: A T
authors.initials: AT
authors.lastname: Gloster
authors.forename: H U
authors.initials: HU
authors.lastname: Wittchen
authors.forename: F
authors.initials: F
authors.lastname: Einsle
authors.forename: M
authors.initials: M
authors.lastname: Höfler
authors.forename: T
authors.initials: T
authors.lastname: Lang
authors.forename: S
authors.initials: S
authors.lastname: Helbig-Lang
authors.forename: T
authors.initials: T
authors.lastname: Fydrich
authors.forename: L
authors.initials: L
authors.lastname: Fehm
authors.forename: A O
authors.initials: AO
authors.lastname: Hamm
authors.forename: J
authors.initials: J
authors.lastname: Richter
authors.forename: G W
authors.initials: GW
authors.lastname: Alpers
authors.forename: A L
authors.initials: AL
authors.lastname: Gerlach
authors.forename: A
authors.initials: A
authors.lastname: Ströhle
authors.forename: T
authors.initials: T
authors.lastname: Kircher
authors.forename: J
authors.initials: J
authors.lastname: Deckert
authors.forename: P
authors.initials: P
authors.lastname: Zwanzger
authors.forename: V
authors.initials: V
authors.lastname: Arolt
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000523:psychology / Q000628:therapy*; D002568:Certification; D015928:Cognitive Behavioral Therapy; D016208:Databases, Factual; D003887:Desensitization, Psychologic; D004311:Double-Blind Method; D005239:Fear / Q000523:psychology; D005260:Female; D014644:Genetic Variation; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016584:Panic Disorder / Q000523:psychology / Q000628:therapy*; D018579:Patient Selection; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors