Running for extinction? Aerobic exercise as an augmentation of exposure therapy in panic disorder with agoraphobia
Abstract
Exposure-based Cognitive Behavioral Therapy (eb-CBT) represents the most evidence-based psychotherapeutic approach in anxiety disorders. However, its efficacy may be limited by a delay in onset of action and a substantial number of patients does not respond sufficiently to treatment. In this context, aerobic exercise was found to be effective in reducing clinical anxiety as well as to improve (elements of) disorder-specific CBT in some mental disorders. We therefore investigated the effect of aerobic exercise supplementary to an eb-CBT in panic disorder and agoraphobia (PD/AG). 77 patients with PD/AG performed a 30 min treadmill task with moderate or low intensity (70% or 30% of the maximal oxygen uptake [VO 2max]) prior to five exposure sessions within a standardized seven-week CBT. At baseline, after completing the treatment period (post) and six month after post (follow-up), several measures of (un)specific psychopathology (Hamilton Anxiety Rating Scale [Ham-A], Mobility Inventory [MI], Panic and Agoraphobia Scale [PAS], Agoraphobic Cognitions Questionnaire [ACQ], Body Sensations Questionnaire [BSQ]) were established to assess for clinical changes. All patients experienced a significant improvement of symptoms from baseline to post (for all measures p < .001) but repeated-measures analyses of variance found a trend towards a significant time × group interaction in the Ham-A in favor for the moderate intense exercise group (f[1, 74] = 4.15, p = .045, α=.025). This trend, however, disappeared at follow-up since the low-intense exercise group further improved significantly in Ham-A after post. Our findings therefore might point to an accelerating effect of moderate-intense exercise within an exposure-based CBT for AG/PD.
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Aerobic exercise in addition to cognitive behavioural therapy improved symptoms in people with panic disorder and agoraphobia, possibly acting through the breathing hypotheses.
“An innovative recent study found that aerobic exercise in addition to cognitive behavioural therapy improved symptoms in people with panic disorder and agoraphobia, possibly acting through the “breathing hypotheses” [68].”
From Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety (2018) · cites this paper as [68]
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- Authors
- Bischoff, S., Wieder, G., Einsle, F., Petzold, M. B., Janßen, C., Mumm, J. L. M., Wittchen, H.-U., Fydrich, T., Plag, J., & Ströhle, A.
- Affiliations
- Humboldt-Universität zu Berlin (DE)
- Technische Universität Dresden (DE)
- Corresponding author
- Bischoff, Sophie
- ORCID
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 101
- Pages
- 34-41
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W2793652765
- Cited by
- 36
- References
- 42
- Citations by year
- 2026: 3 · 2024: 9 · 2023: 8 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 2 · 2018: 3
- FWCI
- 4.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- aerobic exercise, exposure therapy, panic disorder, agoraphobia, cognitive behavioral therapy, treadmill exercise, exercise intensity, anxiety reduction, treatment response
- MeSH terms
- Adult, Agoraphobia, Combined Modality Therapy, Exercise Therapy, Female, Humans, Implosive Therapy, Male, Middle Aged, Exercise, Cognitive Behavioral Therapy, Panic Disorder, Outcome Assessment, Health Care, Young Adult
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