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Booster Sessions after Cognitive-Behavioural Group Therapy for Panic Disorder: Impact on Resilience, Coping, and Quality Of Life

Published online by Cambridge University Press:  10 June 2014

Ana Cristina Wesner
Affiliation:
Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Brazil
Juliana Braga Gomes
Affiliation:
Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Brazil
Tatiana Detzel
Affiliation:
Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Brazil
Luciano S. P. Guimarães
Affiliation:
Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Brazil
Elizeth Heldt*
Affiliation:
Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Brazil
*
Reprint requests to Elizeth Heldt, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Room 400N, ZIP code: 90035-903, Porto Alegre, RS, Brazil. E-mail: [email protected]

Abstract

Background: Panic disorder (PD) has a chronic nature, especially as a result of maladaptive coping strategies to deal with stressful events. Aims: To evaluate the impact of booster sessions with cognitive techniques on coping strategies, resilience, and quality of life (QoL) in patients previously submitted to standard cognitive-behavioural group therapy (CBGT) for PD. Method: A controlled clinical trial with 44 patients with PD (intervention = 20; control = 24) who had previously completed a 12-week CBGT protocol. PD, anxiety, and depression severity symptoms were assessed at baseline and 1, 6, and 12 months after the booster sessions. Coping strategies, resilience, and QoL were assessed by Coping Strategies Inventory (CSI), Resilience Scale, and WHOQOL-BREF respectively. Results: Over time, a significant improvement in PD and depression symptoms was observed in both groups. A significant increase in the QoL social relations domain was found in the booster group, considering a time/group interaction. Coping and other QoL domains did not change after the booster sessions. Changes in resilience were dependent on the intensity of symptoms, with negative but non-significant correlations. Conclusions: The improvement in PD and depression symptoms for both groups may be a result of the group format of the intervention. Group booster sessions after CBGT are useful to maintain the benefits obtained with CBGT.

Type
Empirically Grounded Clinical Interventions
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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References

American Psychiatric Association (2002). Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV-TR) (4a. ed.) Porto Alegre: Artmed.Google Scholar
Amorin, P. (2000). International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. Revista Brasileira de Psiquiatria, 22, 106115. doi: 10.1590/S1516-44462000000300003Google Scholar
Chesney, M. A., Chambers, D. B., Taylor, J. M., Johnson, L. M. and Folkman, S. (2003). Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group-based intervention. Psychosomatic Medicine, 65, 10381046. doi: 10.1097/01.PSY.0000097344.78697.EDCrossRefGoogle ScholarPubMed
Fleck, M. P., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., et al. (2000). Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Revista de Saúde Pública, 32, 178183. doi: 10.1590/S0034-89102000000200012Google Scholar
Gorenstein, C., Andrade, L., Vieira-Filho, A. H., Tung, T. C. and Artes, R. (1999). Psychometric properties of the Portuguese version of the Beck Depression Inventory on Brazilian college students. Journal of Clinical Psychology, 55, 553562. doi: 10.1002/(SICI)1097-4679.Google Scholar
Grotberg, E. H. (2005). Novas tendências em resiliência. In Melillo, A.et al., Resiliência: descobrindo as próprias fortalezas. Porto Alegre: Artmed.Google Scholar
Haddadi, P. and Besharat, M. A. (2010). Resilience, vulnerability and mental health. Procedia - Social and Behavioral Sciences, 5, 639642. doi: 10.1016/j.sbspro.2010.07.157Google Scholar
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 5055. doi: 0.1111/j.2044-8341.1959.tb00467.xGoogle Scholar
Heldt, E., Manfro, G. G., Kipper, L., Blaya, C., Maltz, S., Isolan, L., et al. (2003). Treating medication-resistant panic disorder: predictors and outcome of cognitive-behavior therapy in a Brazilian public hospital. Psychotherapy and Psychosomatics, 72, 4348. doi: 10.1159/000067188Google Scholar
Heldt, E., Manfro, G., Kipper, L., Blaya, C., Isolan, L. and Otto, M. W. (2006). One-year follow-up of pharmacotherapy-resistant patients with panic disorder treated with cognitive-behavior therapy: outcome and predictors of remission. Behaviour Research and Therapy, 44, 657665. doi: 10.1016/j.brat.2005.05.003Google Scholar
Heldt, E., Kipper, L., Blaya, C., Salum, G. A., Hirakata, V. N., Otto, M. W., et al. (2011). Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder. Revista Brasileira de Psiquiatria, 33, 2329. doi: 10.1590/S1516-44462010005000005CrossRefGoogle ScholarPubMed
Hino, T., Takeuchi, T. and Yamanouchi, N. (2002). A 1-year follow-up study of coping in patients with panic disorder. Comprehensive Psychiatry, 43, 279284. doi: 10.1053/comp.2002.33495CrossRefGoogle ScholarPubMed
Hyun, M. S., Nam, K. A. and Kim, M. A. (2010). Randomized controlled trial of a cognitive-behavioral therapy for at-risk Korean male adolescents. Archives of Psychiatric Nursing, 24, 202211. doi: 10.1016/j.apnu.2009.07.005.Google Scholar
Kennedy, P., Duff, J., Evans, M. and Beedie, A. (2003). Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. British Journal of Clinical Psychology, 42, 4152. doi: 10.1348/014466503762842002Google Scholar
Kessler, R. C., Chiu, W. T., Jin, R., Ruscio, A. M., Shear, K. and Walters, E. E. (2006). The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Archives of General Psychiatry, 63, 415424. doi: 10.1001/archpsyc.63.4.415.CrossRefGoogle ScholarPubMed
Kuper, L. E., Gallop, R. and Greenfield, S. F. (2010). Changes in coping moderate substance abuse outcomes differentially across behavioral treatment modality. American Journal Addictions, 19, 543549. doi: 10.1111/j.1521-0391.2010.00074.x.CrossRefGoogle ScholarPubMed
Leopold, B. and Greve, W. (2009). Resilience: a conceptual bridge between coping and development. European Psychologist, 14, 4050. doi: 10.1027/1016-9040.14.1.40CrossRefGoogle Scholar
Liang, K.-Y. and Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 1322. doi: 10.1093/biomet/73.1.13Google Scholar
Lteif, G. N. and Mavissakalian, M. R. (1995). Life events and panic disorder/agoraphobia. Comprehensive Psychiatry, 36, 118122. doi: 10.1016/S0010-440X(95)90106-XGoogle Scholar
Manfro, G. G., Otto, M. W., Mcardle, E. T., Worthington III, J. J., Rosenbaum, J. F. and Pollack, M. H. (1996). Relationship of antecedent stressful life events to childhood and family history of anxiety and the course of panic disorder. Journal of Affective Disorders, 41, 135139. doi: 10.1016/S0165-0327(96)00081-XCrossRefGoogle ScholarPubMed
Moitra, E., Dyck, I., Beard, C., Bjornsson, A. S., Sibrava, N. J., Weisberg, R. B., et al. (2011). Impact of stressful life events on the course of panic disorder in adults. Journal of Affective Disorders, 134 (1–3), 373376. doi: 10.1016/j.jad.2011.05.029Google Scholar
Oei, T. P. S. and Browne, A. (2006). Components of group processes: have they contributed to the outcome of mood and anxiety disorder patients in a group cognitive-behaviour therapy program? American Journal Psychotherapy, 60, 5370.Google Scholar
Oei, T. P. S. and Free, M. L. (1995). Do cognitive-behavior therapies validate cognitive models of mood disorders: a review of the empirical evidence. International Journal of Psychology, 30, 145179. doi: 10.1080/00207599508246564Google Scholar
Oei, T. P. S., Llamas, M . and Devilly, G. J. (1999). The efficacy and cognitive processes of cognitive behaviour therapy in the treatment of panic disorder with agoraphobia. Behavioural and Cognitive Psychotherapy, 27, 6388.Google Scholar
Otto, M. and Deckerbach, T. (1998). Cognitive-behavioral therapy and the treatment of panic disorder: efficacy and strategies. In Rosenbaum, J. F. and Pollack, M. H. (Eds), Panic Disorder and its Treatment. New York: Marcel Dekker.Google Scholar
Padesky, C. A. and Mooney, K. A. (2012). Strengths-Based Cognitive-Behavioural Therapy: a four-step model to build resilience. Clinical Psychology and Psychotherapy, 19, 283290. doi: 10.1002/cpp.1795Google Scholar
Pesce, R. P., Assis, S. G., Avanci, J. Q., Santos, N. C., Malaquias, J. V. and Carvalhaes, R. (2005). Cross-cultural adaptation, reliability and validity of the resilience scale. Caderno de Saúde Pública, 21, 436448. doi: 10.1590/S0102-311´2005000200010Google Scholar
Pollack, M. H. (2005). The pharmacotherapy of panic disorder. The Journal of Clinical Psychiatry, 66(Suppl. 4), 2327.Google Scholar
Saffi, F., Savoia, M. and Lutufo Neto, F. (2008). Terapia comportamental e cognitivo-comportamental. In Cordioli, A. et al. (Ed.), Psicoterapias: abordagens atuais. Porto Alegre: Artmed.Google Scholar
Savoia, M. G. and Bernik, M. (2004). Adverse life events and coping skills in panic disorder. Revista do Hospital das Clinicas Faculdade de Medicina Universidade de São Paulo, 59 (6), 337340. doi: 10.1590/S0041-87812004000600005Google Scholar
Savoia, M. G., Santana, P. R. and Mejias, N. P. (1996). Adaptação do inventário de estratégias de coping de Folkman e Lazarus para o português. Revista Psicologia USP, 7 (1/2), 183201.Google Scholar
Schmalisch, C. S., Bratiotis, C. and Muroff, J. (2010). Processes in group cognitive and behavioral treatment for hoarding. Cognitive and Behavioral Practice, 17, 414425. doi: 10.1016/j.cbpra.2009.08.005Google Scholar
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., et al. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry, 154, 15711575.CrossRefGoogle ScholarPubMed
Snyder, C. R., Ilardi, S. S., Cheavens, J., Michael, S. T., Yamhure, L. and Sympson, S. (2000). The role of hope in cognitive-behavior therapies. Cognitive Therapy and Research, 24, 747762. doi: 10.1023/A:1005547730153CrossRefGoogle Scholar
Songprakun, W. and McCann, T. V. (2012). Effectiveness of a self-help manual on the promotion of resilience in individuals with depression in Thailand: a randomised controlled trial. BMC Psychiatry, 12, 110. doi: 10.1186/1471-244X-12-12Google Scholar
Taylor, S. E. and Stanton, A. L. (2007). Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology, 3, 377401. doi: 10.1146/annurev.clinpsy.3.022806.091520Google Scholar
Wesner, A. C., Gomes, J. B., Detzel, T., Blaya, C., Manfro, G. G. and Heldt, E. (2014). Effect of cognitive-behavioral group therapy for panic disorder in changing coping strategies. Comprehensive Psychiatry, 55, 8792. doi:10.1016/j.comppsych.2013.06.008CrossRefGoogle ScholarPubMed
Woody, S. R. and Adessky, R. S. (2002). Therapeutic alliance, group cohesion and homework compliance during cognitive behavioural group treatment of social phobia. Behaviour Therapy, 33, 527. doi: 10.1016/S0005-7894(02)80003-XGoogle Scholar
Yalom, I. D. and Leszcz, M. (2006). Psicoterapia de grupo: teoria e prática (5th ed.) Porto Alegre: Artmed.Google Scholar
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