A Cognitive-Behavioral, Biofeedback-Assisted Relaxation Treatment for Panic Disorder With Agoraphobia

A 39-year-old man diagnosed with panic disorder with agoraphobia, comorbid with depression, was treated successfully with cognitive-behavioral, biofeedback-assisted relaxation therapy. Treatment consisted of 22 individual sessions over the course of 10 months. Of those, 18 sessions included biofeedback with electrodermal response as the primarymodality and finger temperature monitored as a general index of relaxation. The core interventions utilized during treatment included psychophysiological monitoring, relaxation techniques, cognitive restructuring, and exposure to feared cues. Results were cessation of panic attacks, full remission of agoraphobia, and alleviation of depressive symptoms. Assessments used during the course of treatment included the Beck Anxiety Inventory, State-Trait Anxiety Inventory Form Y-2, Agoraphobic Cognitions and Body Sensations Questionnaires, and the Beck Depression Inventory-II. A treatment formulation that combined the most effective interventions with cognitive-behavioral underpinnings is discussed along with recommendations for practice.

[1]  D. Moss,et al.  Biofeedback and Biological Monitoring , 2003 .

[2]  C. Spielberger,et al.  Manual for the State-Trait Anxiety Inventory , 1970 .

[3]  David H. Barlow,et al.  Casebook in Abnormal Psychology , 1996 .

[4]  D. Chambless,et al.  Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. , 1984, Journal of consulting and clinical psychology.

[5]  M. Pollack,et al.  A meta-analysis of treatment outcome for panic disorder , 1995 .

[6]  Giuseppe Riva,et al.  Experiential Cognitive Therapy for the Treatment of Panic Disorder With Agoraphobia: Definition of a Clinical Protocol , 2000, Cyberpsychology Behav. Soc. Netw..

[7]  D. W. Sue,et al.  Counseling the Culturally Different: Theory and Practice , 1990 .

[8]  J. Maser,et al.  Panic: Psychological Perspectives , 1988 .

[9]  R. Noyes,et al.  The effect of state anxiety on personality measurement. , 1986, The American journal of psychiatry.

[10]  C. Spielberger.  Manual for the State-Trait Anxiety Inventory (STAI) (Form Y , 1983 .

[11]  J. Overholser.  Cognitive-behavioral treatment of panic disorder. , 2000 .

[12]  A. Beck.  Cognitive Approaches to Anxiety Disorders , 1986 .

[13]  A. Beck.  Cognitive approaches to panic disorder: Theory and therapy. , 1988 .

[14]  S. Hollon,et al.  Defining empirically supported therapies. , 1998, Journal of consulting and clinical psychology.

[15]  M. Hersen,et al.  Encyclopedia of psychotherapy , 2002 .

[16]  J. Dietch.  Anxiety Disorders and Phobias: A Cognitive Perspective , 1986 .

[17]  M. Hagen,et al.  Ethical principles of psychologists and code of conduct. , 2002, The American psychologist.

[18]  B. Shaw.  Anxiety Disorders: Psychological and Biological Perspectives , 1987 .

[19]  Practice guideline for the treatment of patients with panic disorder. Work Group on Panic Disorder. American Psychiatric Association. , 1998, The American journal of psychiatry.

[20]  D. Blair,et al.  Cognitive Therapy: Basics and Beyond , 1996 .

[21]  Paul F. Granello,et al.  Outcome Studies in the Treatment of Panic Disorder: A Review , 1996 .

[22]  D. Shapiro,et al.  A review of biofeedback for mental disorders. , 1986, Hospital & community psychiatry.

[23]  C. Salzman.  ECT, research, and professional ambivalence. , 1998, The American journal of psychiatry.

[24]  D. Moss.  Handbook of mind-body medicine for primary care , 2003 .

[25]  M Fier,et al.  Panic disorder and agoraphobia. , 1990, New Jersey medicine : the journal of the Medical Society of New Jersey.

[26]  A. Beck,et al.  Cognitive aspects of panic disorders , 1987 .