Richter, Jan ORCID: 0000-0002-7127-6990, Pane-Farre, Christiane A., Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Gloster, Andrew T., Wittchen, Hans-Ulrich ORCID: 0000-0002-6311-7711, Lang, Thomas, Alpers, Georg W. ORCID: 0000-0001-9896-5158, Helbig-Lang, Sylvia, Deckert, Jurgen, Fydrich, Thomas, Fehm, Lydia, Stroehle, Andreas, Kircher, Tilo ORCID: 0000-0002-2514-2625, Arolt, Volker and Hamm, Alfons O. (2021). Transfer of exposure therapy effects to a threat context not considered during treatment in patients with panic disorder and agoraphobia: Implications for potential mechanisms of change. Behav. Res. Ther., 142. OXFORD: PERGAMON-ELSEVIER SCIENCE LTD. ISSN 1873-622X

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Abstract

Further developments of exposure-based therapy (EBT) require more knowledge about transfer of treatment to non-trained everyday contexts. However, little is known about transfer effects of EBT. Using a standardized EBT protocol in 275 patients with panic disorder and agoraphobia we investigated the transfer of EBT to a highly standardized context during a Behavioral Avoidance Test (BAT; being entrapped in a small and dark test chamber) and not part of the exposure sessions. Patients of a treatment group underwent the BATs before treatment (t1), after a preparatory treatment phase (t2), and after an agoraphobic exposure phase (t3) and were compared with wait-list control patients, who repeated BAT assessments across the same time period. We found stronger reductions in avoidance behavior, reported fear, and autonomic arousal during the BAT from t1 to t3 in the treatment group patients who were anxious during t1 relative to the anxious but untreated patients. Fear reduction was related to treatment outcome indicating the contribution of transfer effects to successful EBT. Interestingly, reduction varied for different fear response systems suggesting different processes to may be involved in transfer effects. Importantly, final BAT assessment still evoked residual fear in the treatment group as compared to BAT non-anxious control patients, suggesting limited transfer effects - one possible reason for the return of symptoms in new situations.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Richter, JanUNSPECIFIEDorcid.org/0000-0002-7127-6990UNSPECIFIED
Pane-Farre, Christiane A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerlach, Alexander L.UNSPECIFIEDorcid.org/0000-0001-6794-5349UNSPECIFIED
Gloster, Andrew T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wittchen, Hans-UlrichUNSPECIFIEDorcid.org/0000-0002-6311-7711UNSPECIFIED
Lang, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alpers, Georg W.UNSPECIFIEDorcid.org/0000-0001-9896-5158UNSPECIFIED
Helbig-Lang, SylviaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deckert, JurgenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fydrich, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fehm, LydiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stroehle, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kircher, TiloUNSPECIFIEDorcid.org/0000-0002-2514-2625UNSPECIFIED
Arolt, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamm, Alfons O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-602216
DOI: 10.1016/j.brat.2021.103886
Journal or Publication Title: Behav. Res. Ther.
Volume: 142
Date: 2021
Publisher: PERGAMON-ELSEVIER SCIENCE LTD
Place of Publication: OXFORD
ISSN: 1873-622X
Language: English
Faculty: Faculty of Human Sciences
Divisions: Faculty of Human Sciences > Department Psychologie
Subjects: Psychology
Uncontrolled Keywords:
KeywordsLanguage
COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; ANXIETY DISORDERS; MOBILITY INVENTORY; MULTIPLE CONTEXTS; FEAR; AVOIDANCE; RETURN; EXTINCTION; ETIOLOGYMultiple languages
Psychology, ClinicalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/60221

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