title: The effects of aggression on symptom severity and treatment response in a trial of cognitive behavioral therapy for panic disorder.
abstract: BACKGROUND
  Previous research suggests that patients with panic disorder exhibit higher levels of aggression than patients with other anxiety disorders. This aggression is associated with more severe symptomatology and interpersonal problems. However, few studies have examined whether higher levels of aggression are associated with a worse treatment response in this population.
  
  
  METHODS
  The present study sought to examine the association of aggression with panic disorder symptom severity in a sample of 379 patients who participated in a trial examining long-term strategies for the treatment of panic disorder.
  
  
  RESULTS
  We found that aggression was significantly associated with higher baseline levels of panic disorder symptoms, anxiety, depression, and functional impairment. Further, we found that patients higher in aggression did not achieve the same level of improvement in general anxiety symptoms during treatment compared to patients lower in aggression, even when controlling for baseline anxiety symptom severity.
  
  
  CONCLUSIONS
  These results suggest that more research is needed concerning patients with anxiety disorders with higher aggression, as they may be a group in need of additional treatment considerations.
authors.affiliation: Center for Anxiety and Related Disorders, Boston University, USA. Electronic address: ccassiel@bu.edu.
authors.forename: Clair
authors.initials: C
authors.lastname: Cassiello-Robbins
authors.affiliation: Center for Anxiety and Related Disorders, Boston University, USA.
authors.forename: Laren R
authors.initials: LR
authors.lastname: Conklin
authors.affiliation: Center for Anxiety and Related Disorders, Boston University, USA.
authors.forename: Ujunwa
authors.initials: U
authors.lastname: Anakwenze
authors.affiliation: Franklin Behavioral Health Consultants, Bronx, NY, USA.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Gorman
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, USA.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
authors.affiliation: Department of Psychiatry and School of Social Work, Columbia University, USA.
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Shear
authors.affiliation: Center for Anxiety and Related Disorders, Boston University, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Barlow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D012720:Severity of Illness Index; D063189:Symptom Assessment; D016896:Treatment Outcome; D055815:Young Adult