Catastrophic Appraisal and Perceived Control as Moderators of Treatment Response in Panic Disorder
Open accessAbstract
The purpose of this study was to examine the moderating effects of cognitive risk factors in two mechanistically-distinct interventions. Forty-one patients with panic disorder and agoraphobia were randomly assigned to receive training aimed at altering respiration (Capnometry-assisted respiratory training, CART) or symptom appraisal (cognitive skill training, CT). Using a mixed effects regression model, we assessed whether reductions in panic symptom severity (PDSS) were moderated by the variables of interest. While improvement in PDSS did not differ among treatment modalities, moderating effects emerged. Individuals with greater initial levels of misappraisal showed smaller reduction in PDSS when receiving CT, but larger reduction when receiving CART. Greater lack of perceived control was predictive of worse outcome in CART, but better outcome in CT. Better homework compliance was related to greater reductions in PDSS irrespective of condition. The findings illustrate the complexity of moderating influences within and between distinct interventions.
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Meuret et al. (2010) found that lower perceived control was associated with greater improvement in cognitive therapy for panic disorder.
“Meuret et al. (2010) found that lower perceived control was associated with greater improvement in cognitive therapy for panic disorder.”
From Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators (2014) · cites this paper as Meuret et al. (2010)
The Results (Effect of Baseline Perceived Control) report no significant association between perceived control and improvement within cognitive therapy (CT). The Discussion likewise says initial control did not predict CT outcome. Patients with low perceived control improved more in CT than in CART, but that is a comparison between treatments, not the claimed association within CT. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredThe current results contrast with the prior report in which moderate levels of anxiety sensitivity led to better outcomes from CBT whereas they did not affect ACT, and with the report by Meuret et al. (2010) where higher levels of anxiety sensitivity led to poorer response to cognitive therapy and greater response to capnometry assisted respiratory training.
“Thus, the current results contrast with the prior report in which moderate levels of anxiety sensitivity led to better outcomes from CBT whereas they did not affect ACT (Wolitzky-Taylor et al., 2012), and with the report by Meuret et al. (2010) where higher levels of anxiety sensitivity led to poorer response to cognitive therapy and greater response to capnometry assisted respiratory training.”
From Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators (2014) · cites this paper as Meuret et al. (2010)
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Experimental — accuracy not yet measuredIn a panic disorder sample, lower perceived control was associated with poorer outcomes from a treatment aimed at changing respiration, whereas higher cognitive misappraisal of anxiety symptoms was related to poorer outcomes from cognitive therapy.
“In a panic disorder sample, Meuret et al. (2010) found that lower perceived control was associated with poorer outcomes from a treatment aimed at changing respiration, whereas higher cognitive misappraisal of anxiety symptoms (i.e., anxiety sensitivity) was related to poorer outcomes from cognitive therapy.”
From Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators (2014) · cites this paper as Meuret et al. (2010)
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- Authors
- Meuret, A. E., Hofmann, S. G., & Rosenfield, D.
- Affiliations
- Southern Methodist University (US)
- Boston University (US)
- Venue
- International Journal of Cognitive Therapy
- Published
- 2010-09
- Volume
- 3
- Issue
- 3
- Pages
- 262-277
- ISSN
- 1937-1209 (ISSN-L)
- PMC
- PMC2982256
- OpenAlex
- W1977050079
- Cited by
- 28
- References
- 55
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 3 · 2016: 1 · 2015: 4 · 2014: 3 · 2013: 1 · 2012: 3
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Cognitive Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL089761)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- panic disorder, agoraphobia, perceived control, treatment response, moderating effect, cognitive risk factors, homework compliance
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