Cognitive-behavioral therapy for panic disorder in patients being treated for alcohol dependence: Moderating effects of alcohol outcome expectancies☆
Section snippets
Participants
All participants were drawn from the incoming patients of a residential community-based 28-day chemical dependence treatment program based within the University-Fairview Medical Center located in Minneapolis (“treatment as usual;” TAU). As described in detail in the Procedure section below, the treatment and control cohorts were obtained at separate times (serially) from the same TAU program. For the treatment cohort, 31 of the 43 individuals (78%) provided follow-up data. For the control
Baseline characteristics
The cohorts were highly similar regarding both clinical and demographic characteristics at the baseline assessment. Regarding the latter, 88.0% in the control cohort and 91.4% in the treatment cohort were self-identified as Caucasian. Approximately half of each cohort was employed (60.0% for control and 51.4% for treatment). The median income and education level in both cohorts was < $30k annually with a high school/GED degree and “some” (i.e., attendance but no degree) college or vocational
Discussion
Anxiety disorders in general and panic disorder in particular are common among substance abuse treatment patients and mark those at a high risk for relapse to drinking following treatment for alcohol dependence. These well-replicated findings provide a background to the hypothesis that treating co-occurring panic disorder should improve substance abuse treatment outcomes. However, this hypothesis is not logically necessitated by the earlier findings and, more importantly, it has not been
Acknowledgement
We acknowledge and thank the director (Jeff Powers) and staff of the Fairview-University Medical Center's Chemical Dependency Treatment Program for their support in the conduct of this work.
References (37)
- et al.
The moderating effects of tension-reduction alcohol outcome expectancies on placebo responding in individuals with social phobia
Addictive Behaviors
(2004) - et al.
Behavioral treatment of panic disorder
Behavior Therapist
(1989) - et al.
A controlled trial of cognitive behavioral treatment of panic in alcoholic inpatients with comorbid panic disorder. (Brief Report)
Addictive Behaviors
(2000) - et al.
The treatment of substance abusers diagnosed with obsessive–compulsive disorder: An outcome study
Journal of Substance Abuse Treatment
(1992) - et al.
The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings
Clinical Psychology Review
(2000) - et al.
A comparison of two treatment interventions aimed at lowering anxiety levels and alcohol consumption amongst alcohol abusers
Drug and Alcohol Dependence
(1991) - et al.
Social learning theory
- et al.
The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations
Journal of Personality and Social Psychology
(1986) Limitations of the application of four-fold tables to hospital data
Biological Bulletin
(1949)- et al.
Quasi-experimentation: Design and analysis issues for field settings
(1979)
Stress and alcohol use: Moderating effects of gender, coping, and alcohol expectancies
Journal of Abnormal Psychology
Methods for analysis of skewed data distributions in psychiatric clinical studies: Working with many zero values
American Journal of Psychiatry
The Brief Symptom Inventory: An introductory report
Psychological Medicine
Measurement of lactate-induced panic and anxiety
Psychiatry Research
The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders
Alcohol and Substance abuse
Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions
Archives of General Psychiatry
Analysis of Count Data using Poisson Regression
Research in Nursing and Health
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This research was supported, in part, by a grant from the National Institute on Alcoholism and Alcohol Abuse (AA12426 and AA015069) awarded to the first author.