Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder.
OBJECTIVE
Recently, innovative statistical tools have been used to model patterns of change in psychological treatments. These tools can detect patterns of change in patient progress early in treatment and allow for the prediction of treatment outcomes and treatment length.


METHODS
We used growth mixture modeling to identify different latent classes of early change in patients with panic disorder (N = 326) who underwent a manualized cognitive-behavioral treatment.


RESULTS
Four latent subgroups were identified, showing clusters of change trajectories over the first 5 sessions. One of the subgroups consisted of patients whose symptoms rapidly decreased and also showed the best outcomes. This information improved treatment prediction by 16.1% over patient intake characteristics. Early change patterns also significantly predicted patients' early treatment termination. Patient intake characteristics that significantly predicted class membership included functional impairment and separation anxiety.


CONCLUSIONS
These findings suggest that early treatment changes are uniquely predictive of treatment outcome.
Department of Psychology, University of Trier.
Wolfgang
W
Lutz
Department of Psychology, Boston University.
Stefan G
SG
Hofmann
Department of Psychology, University of Trier.
Julian
J
Rubel
Department of Psychology, University at Albany, State University of New York.
James F
JF
Boswell
Department of Psychology, Columbia University.
M Katherine
MK
Shear
Franklin Behavioral Health Consultants.
Jack M
JM
Gorman
Department of Psychology, Yale University.
Scott W
SW
Woods
Department of Psychology, Boston University.
David H
DH
Barlow
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D016584:Panic Disorder / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D028761:Withholding Treatment; D055815:Young Adult