Group treatment of nonclinical panic attacks in late adolescence: a comparison of education/support and cognitive-behavioral approaches
Mattis, Sara Golden
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Nonclinical panic attacks have been defined as "panic reported by individuals not seeking treatment" (Norton, Cox, & Malan, 1992). The purpose of this study was to assess the prevalence of nonclinical panic attacks and associated symptomatology in a university sample of 576 late adolescents (ages 18-19), and to compare the effectiveness of two group treatments [Education/Support (ES) and Cognitive-Behavioral (CBT)] and a self-monitoring Waitlist (WL) condition in reducing the frequency and severity of nonclinical panic attacks, daily anxiety, and associated symptomatology. Nonpanickers (71.4% of the sample) reported no history of panic on the Panic Attack Questionnaire (PAQ; Cox, Norton, & Swinson, 1992). Past Panickers (16.5%) reported at least one panic attack prior to the past month. Recent Panickers (12.2%) reported at least one panic attack in the past month. Recent Panickers evidenced higher levels of trait anxiety, state anxiety, and depression, with a trend toward higher levels of anxiety sensitivity and internal negative attributions, relative to both Past Panickers and Nonpanickers, who did not differ. Thirty-four Recent Panickers were randomly assigned to the WL, ES, or CBT conditions. The entire sample, regardless of condition, showed a reduction in frequency of panic attacks, as well as their associated symptoms and cognitions, severity of daily anxiety, and three measures of general psychopathology (Le., depression, trait anxiety, and state anxiety). However, both active treatment groups were superior to the waitlist in producing improvement in panic-related self-efficacy, avoidance, and anxiety sensitivity. There was evidence that ES was slightly more effective than CBT in improving panicrelated self-efficacy, while CBT was somewhat more effective in reducing avoidance. Finally, while both treatment conditions combined fared significantly better than the waidist in producing high endstate functioning, assessed via a constellation of variables conceptually related to panic (i.e., panic-free status, high panic-related self-efficacy, low avoidance, low anxiety sensitivity), ES appeared most effective in promoting high ends tate functioning at Post-Treatment and Follow-Up (two months following treatment). Implications of these findings for the treatment of nonclinical panic attacks in late adolescence are discussed.
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