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Cited by 98Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPosttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology Research

The role of trauma and dissociation in cognitive-behavioral psychotherapy outcome and maintenance for panic disorder with agoraphobia

Michelson, Larry, June, Kimberly, Vives, Allan, Testa, Sandra, Marchione, Norman·1998·Behaviour Research and Therapy
DOI 10.1016/s0005-7967(98)00073-4
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Abstract

The relationship between traumatic experiences and dissociation with pretreatment psychopathology and rates of recovery, relapse and maintenance for patients receiving cognitive-behavioral treatments for panic disorder with agoraphobia (PDA) were investigated. One-hundred and forty-seven subjects who met DSM-III criteria for agoraphobia with panic attacks and who completed participation in one of two previously conducted treatment outcome studies were mailed packets containing measures to assess history of trauma, victimization and dissociation. Eighty-nine of these were returned and completed sufficiently to be included in the present study. It was hypothesized that a variety of trauma-related variables (e.g. history of traumatic experience, type of trauma, age at which the trauma first occurred, perceived responsibility, social supports available, self-perceived severity, level of violence, and whether or not the traumatic event was followed by self-injurious or suicidal thoughts and/or behaviors) and dissociative symptomatology would be predictive of (1) greater psychopathology at pretreatment, (2) poorer treatment response and (3) higher relapse rates and poorer maintenance over a 1 year longitudinal follow-up. These hypotheses were supported by the findings and the theoretical, empirical and clinical implications are discussed.

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  • Dissociation can become maladaptive and possibly interfere with treatment.

    “Thereby, dissociation can become maladaptive [10] and possibly interfere with treatment [46–50].”

    From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [46]

  • Cognitive-behavioral therapies can be less beneficial during states of stress or dissociation.

    “and they can be less beneficial during states of stress ( van der Kolk and Fisler, 1995 ; Raio et al., 2013 ) or dissociation ( Michelson et al., 1998 ; Rufer et al., 2006 ; Spitzer et al., 2007 ; Kleindienst et al., 2011 ; LeBois et al., 2022 ; but see also Halvorsen et al., 2014 ; Zoet et al., 2018 ; Vancappel et al., 2022 ).”

    From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as Michelson et al., 1998

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Authors
Michelson, L., June, K., Vives, A., Testa, S., & Marchione, N.
Affiliations
Pennsylvania State University (US)
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
1998-11
Volume
36
Issue
11
Pages
1011-1050
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/s0005-7967(98)00073-4
OpenAlex
W1975683072
Cited by
98
References
116
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 6 · 2016: 5 · 2015: 3 · 2014: 6 · 2013: 7 · 2012: 6
FWCI
1.80
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
panic disorder with agoraphobia, trauma, dissociation, cognitive behavioral therapy, treatment outcomes, relapse, maintenance therapy, victimization, perceived responsibility, social support, predictors of treatment response
MeSH terms
Adult, Agoraphobia, Analysis of Variance, Behavior Therapy, Dissociative Disorders, Female, Follow-Up Studies, Humans, Male, Mathematical Computing, Middle Aged, Psychiatric Status Rating Scales, Random Allocation, Retrospective Studies, Self-Assessment, Sex Offenses, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Multivariate Analysis, Panic Disorder, Treatment Outcome

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