Margraf J, Barlow D H, Clark D M, Telch M J
Free University, Berlin, Germany.
Behav Res Ther. 1993 Jan;31(1):1-8. doi: 10.1016/0005-7967(93)90036-t.
Initial interest in the causes and treatment of panic disorder was triggered by biological theories and investigators. More recently, however, research on newly developed psychological approaches for panic has advanced our understanding of the disorder and has led to the development of specific treatment programs. Typically, these programs consist of a range of treatment components that more or less directly target panic attacks and the fears and behaviors associated with them. The paper reviews four studies evaluating these programs that have recently been completed or are close to completion in different centers in the United States (Albany, New York; Austin, Texas) and Europe (Oxford, England; Marburg, Germany). Conforming to strict methodological standards, these studies report consistently high success rates and temporal stability of the treatment gains. About 80% or more of the patients receiving combined cognitive-behavioral treatments achieved panic free status as well as strong and clinically significant improvement in general anxiety, panic-related cognitions, depression, and phobic avoidance. Furthermore, these gains were maintained at follow-ups of up to 2 years. The success of these psychological treatments compares favorably with the outcome for the established pharmacological treatments. In addition, the studies provide new insights into the active ingredients that may operate in cognitive-behavioral treatments for panic disorder and show the feasibility of group treatments. Together, these studies underscore the fact that cognitive-behavioral treatments rest on firm experimental evidence that justifies their application in everyday practice as well as continued research into their mechanisms of action.
对惊恐障碍病因及治疗的最初兴趣是由生物学理论和研究者引发的。然而，最近，针对惊恐障碍新开发的心理治疗方法的研究增进了我们对该障碍的理解，并促成了特定治疗方案的发展。通常，这些方案由一系列治疗成分组成，这些成分或多或少直接针对惊恐发作以及与之相关的恐惧和行为。本文回顾了四项评估这些方案的研究，这些研究最近已在美国（纽约州奥尔巴尼；得克萨斯州奥斯汀）和欧洲（英国牛津；德国马尔堡）的不同中心完成或接近完成。符合严格的方法学标准，这些研究一致报告了高成功率以及治疗效果的时间稳定性。接受认知行为联合治疗的患者中，约80%或更多实现了无惊恐状态，并且在一般焦虑、与惊恐相关的认知、抑郁和恐惧回避方面有显著且具有临床意义的改善。此外，这些改善在长达2年的随访中得以维持。这些心理治疗的成功与既定药物治疗的结果相比毫不逊色。此外，这些研究为可能在惊恐障碍认知行为治疗中起作用的有效成分提供了新见解，并显示了团体治疗的可行性。总之，这些研究强调了这样一个事实，即认知行为治疗基于坚实的实验证据，这证明了它们在日常实践中的应用以及对其作用机制的持续研究是合理的。
