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
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
180
12 sessions of CBT including psychoeducation, behavioral analyses, interoceptive exposure and in-vivo exposure with interoceptive exposure during in vivo exposure
12 sessions of CBT including psychoeducation, behavioral analyses, interoceptive exposure and in-vivo exposure without additional fear augmenting strategies
Prof. Dr. Alfons Hamm
Greifswald, Germany
RECRUITINGHamilton Anxiety Rating Scale (HARS)
structured clinician rating assessing the severity of an anxiety disorder
Time frame: up to 32 weeks (follow up)
Clinician Global Impression Scale (CGI)
clinician rating assessing the severity of panic disorder and agoraphobia
Time frame: up to 32 weeks (follow up)
Panic and Agoraphobia Scale (PAS)
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.
Time frame: up to 32 weeks (follow up)
Mobility Inventory
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.
Time frame: up to 32 weeks (follow up)
Number of panic attacks
Number of panic attacks experienced during the last week is assessed.
Time frame: up to 32 weeks (follow up)
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