This is one of four independent but identical applications for a multi- center treatment study of panic disorder (PD) comprising the first study designed to assess the relative efficacy of a pharmacologic treatment, a cognitive behavioral panic control treatment and their combination for patients with PD. The study is designed as a 12 week acute treatment trial, followed by 6 months of maintenance treatment and 6 months of follow-up. PD is a prevalent chronic and debilitating disorder. Although some studies are available documenting the efficacy of both pharmacological and behavioral treatments for patients with agoraphobia, behavioral treatments for agoraphobia are very different from the newly developed cognitive behavioral treatments for PD. Preliminary studies suggest that these treatments may be quite effective. Surprisingly, few studies exist evaluating pharmacological treatments for PD without agoraphobia. Yet, a variety of evidence suggests that drugs are effective for panic attacks. It is also possible that the combination of psychological and pharmacological treatment will provide the optimal approach for many patients or that relapse rates after treatment discontinuation will differ. Central to this proposal is the collaboration of four research sites (SUNY Albany, Cornell, Hillside/ Columbia and Yale) representing both psychological and pharmacological orientations. The sites will enroll a total of 600 patients over 4 years. Patients will be randomly assigned to one of five treatment cells: imipramine (IMI) with medical management, pill placebo (PLA) with medical management, Panic Control Treatment (PCT) or a combination of PCT with either IMI or PLA. In addition to establishing relative efficacy, this design will allow us to establish guidelines for treatment of PD at site switch somewhat different orientations, identify comparative mechanisms of action of psycho- and pharmacotherapy, and introduce innovative methods to integrate medication and psychosocial treatment modalities for PD patients. An additional goal will be to examine the implication of prior psychoactive substance abuse for treatment outcome as well as the utilization of substances as coping mechanisms for anxiety and panic.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH045965-05
Application #
2246865
Study Section
Treatment Development and Assessment Research Review Committee (TDA)
Project Start
1990-04-01
Project End
1995-06-30
Budget Start
1994-04-01
Budget End
1995-06-30
Support Year
5
Fiscal Year
1994
Total Cost
Indirect Cost
Name
State University of New York at Albany
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
City
Albany
State
NY
Country
United States
Zip Code
12222
Payne, Laura A; White, Kamila S; Gallagher, Matthew W et al. (2016) SECOND-STAGE TREATMENTS FOR RELATIVE NONRESPONDERS TO COGNITIVE BEHAVIORAL THERAPY (CBT) FOR PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA-CONTINUED CBT VERSUS SSRI: A RANDOMIZED CONTROLLED TRIAL. Depress Anxiety 33:392-9
Cassiello-Robbins, Clair; Conklin, Laren R; Anakwenze, Ujunwa et al. (2015) The effects of aggression on symptom severity and treatment response in a trial of cognitive behavioral therapy for panic disorder. Compr Psychiatry 60:1-8
Huppert, Jonathan D; Kivity, Yogev; Barlow, David H et al. (2014) Therapist effects and the outcome-alliance correlation in cognitive behavioral therapy for panic disorder with agoraphobia. Behav Res Ther 52:26-34
Lutz, Wolfgang; Hofmann, Stefan G; Rubel, Julian et al. (2014) Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder. J Consult Clin Psychol 82:287-97
White, Kamila S; Payne, Laura A; Gorman, Jack M et al. (2013) Does maintenance CBT contribute to long-term treatment response of panic disorder with or without agoraphobia? A randomized controlled clinical trial. J Consult Clin Psychol 81:47-57
Gallagher, Matthew W; Payne, Laura A; White, Kamila S et al. (2013) Mechanisms of change in cognitive behavioral therapy for panic disorder: the unique effects of self-efficacy and anxiety sensitivity. Behav Res Ther 51:767-77
Boswell, James F; Gallagher, Matthew W; Sauer-Zavala, Shannon E et al. (2013) Patient characteristics and variability in adherence and competence in cognitive-behavioral therapy for panic disorder. J Consult Clin Psychol 81:443-54
Allen, Laura B; White, Kamila S; Barlow, David H et al. (2010) Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome. J Psychopathol Behav Assess 32:185-192
White, Kamila S; Allen, Laura B; Barlow, David H et al. (2010) Attrition in a multicenter clinical trial for panic disorder. J Nerv Ment Dis 198:665-71
Furukawa, Toshi A; Katherine Shear, M; Barlow, David H et al. (2009) Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depress Anxiety 26:922-9

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