Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.
Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improvements in PD severity were mediated by anxiety sensitivity in CBPT and by depression in MRT, although earlier levels of these mediators did not predict subsequent improvements. Attrition was high (40%) in both groups, albeit comparable to CBT studies targeting anxiety in Latinos. Additional strategies are needed to improve retention in this high-risk population. Both CBPT and MRT may be efficacious interventions for comorbid asthma-PD, and CBPT may offer additional benefits for improving medication adherence.
Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY 10461, USA; Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA. Electronic address: Jonathan.Feldman@einstein.yu.edu.
Jonathan M
JM
Feldman
Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY 10461, USA.
Lynne
L
Matte
Veterans Affairs New Jersey Health Care System, 151 Knollcroft Road, Lyons, NJ 07939, USA.
Alejandro
A
Interian
Department of Psychiatry, Rutgers - Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ 08854, USA.
Paul M
PM
Lehrer
Rutgers - School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA.
Shou-En
SE
Lu
Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY 10461, USA.
Bari
B
Scheckner
Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY 10461, USA.
Dara M
DM
Steinberg
Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY 10461, USA.
Tanya
T
Oken
Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, 3544 Jerome Avenue, Bronx, NY 10467, USA.
Anu
A
Kotay
Department of Medicine (Pulmonary Medicine), Montefiore Medical Center/Albert Einstein College of Medicine, 3332 Rochambeau Avenue, Bronx, NY 10467, USA.
Sumita
S
Sinha
Department of Medicine (Pulmonary Medicine), Jacobi Medical Center/Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY 10461, USA.
Chang
C
Shim
D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D001676:Biofeedback, Psychology / Q000502:physiology; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009519:New York City / Q000453:epidemiology; D016584:Panic Disorder / Q000453:epidemiology* / Q000628:therapy*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012064:Relaxation Therapy; D016896:Treatment Outcome; D055815:Young Adult
Asthma; Cognitive behavior therapy; Latinos; Panic; Patient compliance; Relaxation
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