Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity
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The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment.
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There is growing evidence that during CBT earlier changes in cognitive processes may impact subsequent decreases in social anxiety symptoms.
“Thus, there is growing evidence that during CBT earlier changes in cognitive processes may impact subsequent decreases in social anxiety symptoms.”
From Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder (2017) · cites this paper as Gallagher et al., 2013
The Discussion (page not supplied) reports that changes in anxiety sensitivity early in CBT predicted subsequent decreases in panic symptoms. This supports the proposed sequence of cognitive change followed by symptom improvement, but the study examined panic disorder, not social anxiety symptoms. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA study of CBT for panic disorder found that antecedent changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms.
“A study of CBT for panic disorder found that antecedent changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms (Gallagher et al., 2013).”
From Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder (2017) · cites this paper as Gallagher et al., 2013
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- Authors
- Gallagher, M. W., Payne, L. A., White, K. S., Shear, K. M., Woods, S. W., Gorman, J. M., & Barlow, D. H.
- Affiliations
- Boston University (US)
- University of California, Los Angeles (US)
- University of Missouri–St. Louis (US)
- Columbia University (US)
- Yale University (US)
- Corresponding author
- Gallagher, Matthew W.
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 51
- Issue
- 11
- Pages
- 767-777
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC3866809
- OpenAlex
- W2014211531
- Cited by
- 153
- References
- 71
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 7 · 2023: 14 · 2022: 9 · 2021: 15 · 2020: 14 · 2019: 20 · 2018: 14 · 2017: 5 · 2016: 13 · 2015: 11 · 2014: 5 · 2013: 1
- FWCI
- 13.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- panic disorder, cognitive behavioral therapy, mechanisms of change, self-efficacy, anxiety sensitivity, panic symptoms, parallel process model, latent difference score models, latent growth curve models
- MeSH terms
- Adult, Anxiety, Female, Humans, Male, Models, Psychological, Time Factors, Cognitive Behavioral Therapy, Panic Disorder, Self Efficacy, Symptom Assessment
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