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Importance of knowledge in the behavioural treatment of panic disorder

Published online by Cambridge University Press:  02 April 2019

Kathleen M. Grubbs ,
James D. Broussard ,
Emily L. Hiatt ,
Melissa A. Beason-Smith  and
Ellen J. Teng
Kathleen M. Grubbs
Affiliation:
Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
James D. Broussard
Affiliation:
Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
Emily L. Hiatt
Affiliation:
Michael E. DeBakey Veterans Affairs Medical Center, Houston, TXUSA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
Melissa A. Beason-Smith
Affiliation:
Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
Ellen J. Teng*
Affiliation:
Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Center for Innovative Treatment of Anxiety and Stress (CITRAS), Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA VA South Central Mental Illness Research, Education, and Clinical Center, Houston, TX, USA
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist.

Aims:

The aim of this study was to examine if increases within specific knowledge domains of panic disorder were related to improvement in panic symptoms following an intensive 2-day panic treatment.

Method:

Thirty-nine Veterans enrolled in an intensive weekend panic disorder treatment completed knowledge measures immediately before the first session of therapy and at the end of the last day of therapy. Four panic disorder experts evaluated items and reached consensus on subscales. Subscales were reduced further to create psychometrically sound subscales of catastrophic misinterpretation (CM), behaviours (BE), and self-efficacy (SE). A simple regression analysis was conducted to determine whether increased knowledge predicted symptom change at a 3-month follow-up assessment.

Results:

The overall knowledge scale was reduced to three subscales BE (n = 7), CM (n = 13) and SE (n = 8) with good internal consistency. Veterans’ knowledge of panic disorder improved from pre- to post-treatment. Greater increase in scores on the knowledge assessment predicted lower panic severity scores at a 3-month follow-up. A follow-up analysis using the three subscales as predictors showed that only changes in CM significantly contributed to the prediction.

Conclusions:

In an intensive therapy format, reduction in panic severity was related to improved knowledge overall, but particularly as a result of fewer catastrophic misinterpretations.

Keywords

knowledgemechanisms of changepanic treatmentpsychoeducation
Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 5 , September 2019 , pp. 611 - 615
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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