Agoraphobia, Panic Attacks, Panic Disorder
Conditions
Keywords
Panic disorder, agoraphobia, panic attacks, exposure based learning, interoceptive exposure exercises, fear augmentation, in vivo exposure
Brief summary
Investigation of mechanisms of exposure based learning by 1. Investigating the effects of fear augmentation by interoceptive exposure during in vivo exposure 2. Disentangling the effects of interoceptive exposure exercises in panic disorder
Detailed description
The study aims on investigating the effect of fear augmentation during in-vivo exposure by adding interoceptive exposure (e.g., hyperventilation) in PD/AG patients. By comparing the fear augmentation group with the therapist-guided CBT exposure, and by measuring autonomic arousal during and between exposure sessions, it will be possible to study the mechanisms of exposure based learning. A second aim is to disentangle effects of specific interoceptive exposure exercises (e.g., respiratory vs. vestibular stimulation). Finally, by including patients without agoraphobic avoidance it will be possible to investigate whether interoceptive exposure alone will have any effect. This might open the door for early interventions for individuals after experiencing an initial panic attack to prevent the development of a severe panic disorder with agoraphobic avoidance.
Interventions
BEHAVIORALCognitive Behavioural Therapy (CBT)
12 sessions of CBT including psychoeducation, behavioral analyses, interoceptive exposure and in-vivo exposure with interoceptive exposure during in vivo exposure
Sponsors
German Federal Ministry of Education and Research
University Medicine Greifswald
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-65 years old * Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of panic disorder, panic disorder with agoraphobia OR initial panic attacks * CGI ≥ 4 (except persons with initial panic attacks) * Informed Consent
Exclusion criteria
* Acute suicidality * Current substance use disorder * Lifetime diagnosis of psychotic disorders, bipolar disorders, borderline personality disorders * Severe medical condition (chronic conditions) * Current psychotherapeutic or psychopharmacological treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hamilton Anxiety Rating Scale (HARS) | up to 32 weeks (follow up) | structured clinician rating assessing the severity of an anxiety disorder |
| Clinician Global Impression Scale (CGI) | up to 32 weeks (follow up) | clinician rating assessing the severity of panic disorder and agoraphobia |
| Panic and Agoraphobia Scale (PAS) | up to 32 weeks (follow up) | PAS is self-rating assessing panic disorder and agoraphobia severity with five factor analytic derived subscale scores (panic attacks, anticipatory anxiety, agoraphobic avoidance, health concerns, functional impairment) and a total score indicating the global severity. The questionnaire was specifically developed for monitoring changes during psychotherapy or psychopharmacological treatments. |
| Mobility Inventory | up to 32 weeks (follow up) | Self-rating assessing the extent of situational avoidance. The questionnaire comprises 27 situations that have to be evaluated in regard to frequency of avoidance, when alone or when accompanied. |
| Number of panic attacks | up to 32 weeks (follow up) | Number of panic attacks experienced during the last week is assessed. |
Countries
Germany
Contacts
Primary ContactAlfons O Hamm, PhD
Outcome results
None listed