Psychological treatment of comorbid asthma and panic disorder in Latino adults: results from a randomized controlled trial
Open accessAbstract
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.
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Some success on panic disorder symptoms and medical adherence was observed in modified panic disorder protocols for asthma.
“Some success on panic disorder symptoms (Ross et al., 2005) and medical adherence (Feldman et al., 2016) was observed.”
From Targeting excessive avoidance behavior to reduce anxiety related to asthma: A feasibility study of an exposure-based treatment delivered online (2021) · cites this paper as Feldman et al., 2016
Most trials of CBT for asthma and anxiety have specifically studied asthma patients with a comorbid panic disorder using an established panic disorder protocol.
“Most trials have specifically studied asthma patients with a comorbid panic disorder (Feldman et al., 2016; Lehrer et al., 2008; Parry et al., 2012; Ross et al., 2005) using an established panic disorder protocol (Barlow & Barlow and Craske, 2000).”
From Targeting excessive avoidance behavior to reduce anxiety related to asthma: A feasibility study of an exposure-based treatment delivered online (2021) · cites this paper as Feldman et al., 2016
The CBT investigated have mainly targeted panic disorder and do not address the broader range of increased anxiety related to asthma.
“Furthermore, the CBT investigated have mainly targeted panic disorder and does not address the broader range of increased anxiety related to asthma (Feldman, Matte, Interian et al., 2016;Lehrer, Karavidas, Lu et al., 2008;Ross, Davis & Macdonald, 2005), which has been suggested to be important (Thoren & Petermann, 2000).”
From Exposure‐based cognitive behavior therapy for anxiety related to asthma: A feasibility study with multivariate baseline design. (2020) · cites this paper as Feldman, Matte, Interian et al., 2016
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BackgroundMy Life in HRV Biofeedback Research
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- Authors
- Feldman, J. M., Matte, L., Interian, A., Lehrer, P. M., Lu, S.-E., Scheckner, B., Steinberg, D. M., Oken, T., Kotay, A., Sinha, S., & Shim, C.
- Affiliations
- Albert Einstein College of Medicine (US)
- Yeshiva University (US)
- VA New Jersey Health Care System (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Feldman, Jonathan M.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 87
- Pages
- 142-154
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC5127738
- OpenAlex
- W2465741996
- Cited by
- 59
- References
- 80
- Citations by year
- 2026: 10 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 9 · 2021: 7 · 2020: 9 · 2019: 3 · 2018: 2 · 2017: 5 · 2016: 1
- FWCI
- 5.17
- 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 (1R34MH087679)
- Einstein-Montefiore (ICTR 5UL-1TR001073-02)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- asthma, panic disorder, comorbidities, Latino adults, Puerto Rican adults, heart rate variability biofeedback, asthma education, inhaled corticosteroid adherence, anxiety sensitivity, depression, attrition, culturally tailored interventions
- MeSH terms
- Adult, Asthma, Biofeedback, Psychology, Female, Heart Rate, Hispanic or Latino, Humans, Male, New York City, Patient Dropouts, Relaxation Therapy, Comorbidity, Cognitive Behavioral Therapy, Panic Disorder, Treatment Outcome, Medication Adherence, Young Adult
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