The Implications of Cognitive Change in the Treatment of Panic Disorder with Agoraphobia

This study was an extension of a previous study done by Spiegel, Bruce, Falkin-Gregg, and Nuzzarello (in press), the latter of which tested whether cognitive behavior therapy assisted alprazolam discontinuation in panic disorder patients. The focus of cognitive behavior therapy in relation to benzodiazepine discontinuation placed great emphasis on changing cognitive biases during th~ treatment process. The present study investigated whether groups differed on cognitive factors associated with panic disorder (e,g. catastrophic misinterpretations, sensitivity to bodily sensations, and a feeling of lack of control over emotions and situations) and whether that change predicted discontinuation. The results showed the alprazolam plus cognitive behavior therapy group had significantly greater cognitive change compared to the alprazolam only group. Furthermore, cognitive change, in addition to overall anxiety, was involved in predicting which subjects were able to successfully discontinue alprazolam treatment. Implications for benzodiazepine treatment in conjunction with cognitive behavior therapy are discussed