Universität zu Köln

Trautmann, Sebastian ORCID: 0000-0002-8976-3244, Richter, Jan ORCID: 0000-0002-7127-6990, Muehlhan, Markus ORCID: 0000-0002-8855-8724, Hoefler, Michael, Wittchen, Hans-Ulrich, Domschke, Katharina, Stroehle, Andreas, Hamm, Alfons O., Weber, Heike ORCID: 0000-0002-9421-1292, Kircher, Tilo ORCID: 0000-0002-2514-2625, Arolt, Volker, Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Alpers, Georg W., Fydrich, Thomas, Lang, Thomas and Reif, Andreas (2019). Does prior traumatization affect the treatment outcome of CBT for panic disorder? The potential role of the MAOA gene and depression symptoms. Eur. Arch. Psych. Clin. Neurosci., 269 (2). S. 161 - 171. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-8491

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Abstract

Although cognitive behavioral therapy (CBT) is highly effective in the treatment of anxiety disorders, many patients still do not benefit. This study investigates whether a history of traumatic event experience is negatively associated with outcomes of CBT for panic disorder. The moderating role of the monoamine oxidase A (MAOA) gene and depression symptoms as well as the association between trauma history and fear reactivity as a potential mechanism are further analyzed. We conducted a post-hoc analysis of 172 male and 60 female patients with panic disorder treated with CBT in a multi-center study. Treatment outcome was assessed at post-treatment using self-report and clinician rating scales. Fear reactivity before treatment was assessed via heart rate and self-reported anxiety during a behavioral avoidance test. Among females, we did not find any differences in treatment response between traumatized and non-traumatized individuals or any two-way interaction trauma historyxMAOA genotype. There was a significant three-way interaction trauma historyxMAOA genotypexdepression symptoms on all treatment outcomes indicating that in traumatized female patients carrying the low-activity allele, treatment effect sizes decreased with increasing depression symptoms at baseline. No such effects were observed for males. In conclusion, we found no evidence for a differential treatment response in traumatized and non-traumatized individuals. There is preliminary evidence for poorer treatment outcomes in a subgroup of female traumatized individuals carrying the low-active variant of the MAOA gene. These patients also report more symptoms of depression symptomatology and exhibit a dampened fear response before treatment which warrants further investigation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Trautmann, Sebastian UNSPECIFIED orcid.org/0000-0002-8976-3244 UNSPECIFIED Richter, Jan UNSPECIFIED orcid.org/0000-0002-7127-6990 UNSPECIFIED Muehlhan, Markus UNSPECIFIED orcid.org/0000-0002-8855-8724 UNSPECIFIED Hoefler, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittchen, Hans-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Domschke, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Stroehle, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamm, Alfons O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Heike UNSPECIFIED orcid.org/0000-0002-9421-1292 UNSPECIFIED Kircher, Tilo UNSPECIFIED orcid.org/0000-0002-2514-2625 UNSPECIFIED Arolt, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, Alexander L. UNSPECIFIED orcid.org/0000-0001-6794-5349 UNSPECIFIED Alpers, Georg W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fydrich, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Reif, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-155535
DOI:	10.1007/s00406-017-0823-9
Journal or Publication Title:	Eur. Arch. Psych. Clin. Neurosci.
Volume:	269
Number:	2
Page Range:	S. 161 - 171
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-8491
Language:	English
Faculty:	Faculty of Human Sciences
Divisions:	Faculty of Human Sciences > Department Psychologie
Subjects:	Psychology
Uncontrolled Keywords:	Keywords Language COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; ANXIETY DISORDERS; CHILDHOOD MALTREATMENT; MONOAMINE-OXIDASE; EXPERIENTIAL AVOIDANCE; REFLEX PHYSIOLOGY; MENTAL-DISORDERS; TRAUMA; STRESS Multiple languages Clinical Neurology; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15553