Abstract
Background: Panic disorder with agoraphobia (PDA) co-occurs highly with depression. Greater panic symptoms, agoraphobic avoidance, comorbidity and anxiety sensitivity have all been linked to depressive symptoms in PDA. Psychotherapy research has historically linked prognostic and process expectationsto symptom severity. However, no study has explored the relationship of expectancies and depressive symptoms in PDA. The purpose of the present study was to determine the extent to which expectations and panic symptomatology have a differential impact on depressive symptoms in PDA above and beyond the influence of anxiety sensitivity and secondary Axis I comorbid disorders (e.g., generalized anxiety disorder, social anxiety disorder) just prior to entering therapy. Method: The relationship between depressive symptoms, panic symptomatology and expectancies (i.e., prognostic and process expectations) was investigated in 74 patients with a primary diagnosis of panic disorder with agoraphobia. It was hypothesized that expectancy measures rather that panic symptomatology would add to the prediction of depressive symptoms beyond the effects of secondary comorbid disorders and anxiety sensitivity. Results: The findings showed that prognostic and process expectations accounted for significant variance in depressive symptoms beyond that predicted by anxiety sensitivity and secondary Axis I comorbid disorders. In addition, PDA symptomatology failed to significantly enter into our prediction model. Conclusions: These results suggest that expectancies have a greater impact on depressive symptoms in PDA regardless of the secondary comorbid disorders and severity of symptoms in PDA. Implications of these findings on the treatment of PDA are discussed.
Highlights
Panic disorder is frequently accompanied by agoraphobia (American Psychological Association, 1994)
Renneberg and colleagues (1992) reported that 15% of the panic disorder with agoraphobia (PDA) participants in their study suffered from major depression and 27% from dysthymia(a chronic depression that is less severe than major depressive disorder) (American Psychiatric Association, 1994)
The current study examined the differential effect of PDA symptomatology and expectancies on depressive symptoms above and beyond the influence of secondary Axis I disorders and anxiety sensitivity
Summary
Panic disorder is frequently accompanied by agoraphobia (American Psychological Association, 1994). Agoraphobic avoidance, comorbidity and anxiety sensitivity have all been linked to depressive symptoms in PDA. It was hypothesized that expectancy measures rather that panic symptomatology would add to the prediction of depressive symptoms beyond the effects of secondary comorbid disorders and anxiety sensitivity. Results: The findings showed that prognostic and process expectations accounted for significant variance in depressive symptoms beyond that predicted by anxiety sensitivity and secondary Axis I comorbid disorders. Conclusions: These results suggest that expectancies have a greater impact on depressive symptoms in PDA regardless of the secondary comorbid disorders and severity of symptoms in PDA. Implications of these findings on the treatment of PDA are discussed
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