Department of Clinical Psychology and EMGO Institute, VU-University, Amsterdam, the Netherlands.
Acta Psychiatr Scand. 2010 Jul;122(1):20-9. doi: 10.1111/j.1600-0447.2009.01530.x. Epub 2010 Jan 13.
This study investigated cognitive mediation of improvement in panic disorder (PD) symptomatology during and after an early intervention for panic symptoms in subthreshold and mild PD.
We executed a pragmatic, pre-post, two-group, multi-site, randomized trial of an early intervention for panic symptoms, based on cognitive-behavioural therapy, vs. a wait-list control group in a sample of 217 participants with subthreshold PD or mild PD.
First, two of the three subscales of the mediator variable Panic Appraisal Inventory (PAI-anticipation and PAI-coping) significantly mediated residual change in PD symptomatology on the PD Severity Scale-Self Report. Second, preintervention to postintervention PAI-anticipation and PAI-coping change scores significantly predicted postintervention to follow-up change in PD symptomatology after controlling for other change scores. However, the converse association was also significant.
The results suggest that changes in cognitions may mediate changes in PD symptomatology and that the process of change is circular.
本研究旨在探讨认知在阈下和轻度惊恐障碍（PD）患者惊恐症状早期干预过程中和之后改善惊恐障碍症状中的中介作用。
我们对基于认知行为疗法的惊恐症状早期干预进行了一项实用的、前后测、两臂、多地点、随机对照试验，将其与阈下 PD 或轻度 PD 患者的 217 名参与者的等待名单对照组进行比较。
首先，中介变量惊恐评估量表（PAI-预期和 PAI-应对）的三个分量表中的两个在 PD 严重程度量表-自我报告中显著中介了 PD 症状学的残留变化。其次，在控制其他变化分数后，干预前到干预后的 PAI-预期和 PAI-应对变化分数显著预测了 PD 症状学的干预后到随访的变化。然而，相反的关联也是显著的。
研究结果表明，认知的变化可能介导了 PD 症状学的变化，而且变化过程是循环的。
