Cognitive mediation of panic reduction during an early intervention for panic.
OBJECTIVE
This study investigated cognitive mediation of improvement in panic disorder (PD) symptomatology during and after an early intervention for panic symptoms in subthreshold and mild PD.


METHODS
We executed a pragmatic, pre-post, two-group, multi-site, randomized trial of an early intervention for panic symptoms, based on cognitive-behavioural therapy, vs. a wait-list control group in a sample of 217 participants with subthreshold PD or mild PD.


RESULTS
First, two of the three subscales of the mediator variable Panic Appraisal Inventory (PAI-anticipation and PAI-coping) significantly mediated residual change in PD symptomatology on the PD Severity Scale-Self Report. Second, preintervention to postintervention PAI-anticipation and PAI-coping change scores significantly predicted postintervention to follow-up change in PD symptomatology after controlling for other change scores. However, the converse association was also significant.


CONCLUSIONS
The results suggest that changes in cognitions may mediate changes in PD symptomatology and that the process of change is circular.
Meulenbeek
P
P
Department of Clinical Psychology and EMGO Institute, VU-University, Amsterdam, the Netherlands. p.meulenbeek@compaqnet.nl <p.meulenbeek@compaqnet.nl>
Spinhoven
P
P
Smit
F
F
van Balkom
A
A
Cuijpers
P
P
D000328:Adult; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000628:therapy*; D011594:Psychometrics; D011615:Psychotherapy, Group / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome