Does cognitive behavioral therapy alter mental defeat and cognitive flexibility in patients with panic disorder?

Shinobu Nagata,Keiko Oshiro,Yoichi Seki,Kensuke Yoshimura,Yoichi Hiramatsu,Mizue Yokoo,Naoki Yoshinaga,Akiko Nakagawa,Fuminori Yamada,Takayuki Shibuya,Tomokazu Murata,Soichiro Adachi,Masaomi Iyo,Muga Kusunoki,Michiko Nakazato,Daisuke Matsuzawa,Nobuko Kawasoe,Yasushi Inada,Hanae Ibuki,Yoshiyuki Hirano,Noriko Minamitani,Eiji Shimizu

doi:10.1186/s13104-018-3130-2

Abstract

ObjectiveMental defeat and cognitive flexibility have been studied as explanatory factors for depression and posttraumatic stress disorder. This study examined mental defeat and cognitive flexibility scores in patients with panic disorder (PD) before and after cognitive behavioral therapy (CBT), and compared them to those of a gender- and age-matched healthy control group.ResultsPatients with PD (n = 15) received 16 weekly individual CBT sessions, and the control group (n = 35) received no treatment. Patients completed the Mental Defeat Scale and the Cognitive Flexibility Scale before the intervention, following eight CBT sessions, and following 16 CBT sessions, while the control group did so only prior to receiving CBT (baseline). The patients’ pre-CBT Mental Defeat and Cognitive Flexibility Scale scores were significantly higher on the Mental Defeat Scale and lower on the Cognitive Flexibility Scale than those of the control group participants were. In addition, the average Mental Defeat Scale scores of the patients decreased significantly, from 22.2 to 12.4, while their average Cognitive Flexibility Scale scores increased significantly, from 42.8 to 49.5. These results suggest that CBT can reduce mental defeat and increase cognitive flexibility in patients with PDTrial registration The study was registered retrospectively in the national UMIN Clinical Trials Registry on June 10, 2016 (registration ID: UMIN000022693).

Highlights

Panic disorder (PD) is a mental illness characterized by repeated panic attacks that exert a significant impact on daily functioning [1]
Demographic characteristics There were no significant differences in demographic characteristics between the patients with PD and the control participants, except in the category of “employment status.”
Post-hoc t tests indicated that the average Mental Defeat Scale (MDS) scores decreased significantly between the pre- and mid-cognitive behavioral therapy (CBT) assessments (d = .47) and between the pre- and post-CBT assessments (d = .66)

Summary

Results

Demographic characteristics There were no significant differences in demographic characteristics between the patients with PD and the control participants, except in the category of “employment status.” Patients with PD had a higher unemployment rate (Table 1). The average pre-, mid-, and post-CBT MDS scores of the patients with PD were 22.2 (SD 16.6), 14.5 (SD 16.0), and 12.4 (SD 12.8), respectively (Table 2). Post-hoc t tests indicated that the average MDS scores decreased significantly between the pre- and mid-CBT assessments (d = .47) and between the pre- and post-CBT assessments (d = .66). Post-hoc t tests indicated that the average CFS scores increased between the pre- and mid-CBT assessments (d = .75) and between the pre- and post-CBT assessments (d = .83). Post-hoc t tests indicated that the pre-CBT MDS scores of the patients with PD were significantly higher than those of the control participants (p < .05). Post-hoc t tests showed that the pre-CBT CFS scores of the patients with PD were significantly lower than those of the control participants (p < .05). No significant correlations were observed between the scores on GAD-7, PAS, or EuroQol-D5 in either group

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