title: Disorder-specific versus transdiagnostic and clinician-guided versus self-guided internet-delivered treatment for panic disorder and comorbid disorders: A randomized controlled trial.
abstract: Transdiagnostic cognitive behaviour therapy (TD-CBT) aims to target the symptoms of multiple disorders whereas disorder-specific CBT (DS-CBT) targets the symptoms of principal disorders. This study compared the relative benefits of internet-delivered TD-CBT and DS-CBT when provided in clinician-guided (CG-CBT) and self-guided (SG-CBT) formats for people with a principal diagnosis of Panic Disorder (PD). Participants (n=145) were randomly allocated to receive TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of PD (Cohen's d ≥ 0.71; avg. reduction ≥ 36%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d ≥ 0.71; avg. reduction ≥ 33%), generalised anxiety disorder (Cohen's d ≥ 0.91; avg. reduction ≥ 34%) and social anxiety disorder (Cohen's d ≥ 0.50; avg. reduction ≥ 15%) were found over the 24-month follow-up period. Highlighting their efficacy and acceptability, no marked and consistent differences were observed between TD-CBT and DS-CBT or CG-CBT and DS-CBT.
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: V J
authors.initials: VJ
authors.lastname: Fogliati
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: blake.dear@mq.edu.au.
authors.forename: B F
authors.initials: BF
authors.lastname: Dear
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: L G
authors.initials: LG
authors.lastname: Staples
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: M D
authors.initials: MD
authors.lastname: Terides
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Sheehan
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Johnston
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Kayrouz
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Dear
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: McEvoy
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Titov
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D016584:Panic Disorder / Q000453:epidemiology* / Q000628:therapy*; D000072861:Phobia, Social / Q000628:therapy; D040701:Stress Disorders, Traumatic, Acute / Q000628:therapy; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome
keywords: 24-month follow-up; Anxiety disorders; Depression, treatment; Disorder-specific; Internet; Panic disorder; Randomized controlled trial; Self-guided; Therapist-guided; Transdiagnostic