Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-18T01:07:20.829Z Has data issue: false hasContentIssue false
  • English
  • Français

Attentional Bias in Adolescents with Panic Disorder: Changes over an 8-day Intensive Treatment Program

Published online by Cambridge University Press:  24 October 2011

Courtney Wiener ,
Alexandra Perloe ,
Sarah Whitton  and
Donna Pincus
Courtney Wiener*
Affiliation:
Boston University, Massachusetts, USA
Alexandra Perloe
Affiliation:
McLean Hospital, Massachusetts, USA
Sarah Whitton
Affiliation:
University of Cincinnati, Ohio, USA
Donna Pincus
Affiliation:
Boston University. Massachusetts, USA
*
Reprint requests to Courtney Wiener, Boston University, Department of Psychology, 648 Beacon Street, 6th Floor, Boston, Massachusetts 02215, USA. E-mail: clweiner@bu.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The present study evaluated attentional bias in adolescents diagnosed with panic disorder. Although a large body of research exists in the area of attentional bias in adults, this feature of panic disorder is not well understood in adolescents. Method: Twenty-five adolescents, aged 12–17, with a panic disorder diagnosis were included in the study. An emotional Stroop task was utilized to assess whether: (1) adolescents with panic disorder exhibit an attentional bias to panic-relevant stimuli; (2) this bias diminishes after completing a course of CBT; and (3) a specific attentional bias towards disorder-relevant stimuli exists. Results: An attentional bias to panic-relevant stimuli was found at pre-treatment but was no longer present following an intensive CBT intervention. Contrary to some findings in the adult literature, no significant differences were found between panic-relevant versus other threatening stimuli. Conclusions: These results suggest that adolescents with panic disorder, similar to adults, do exhibit an attentional bias towards panic-relevant stimuli, and treatment seems to normalize this cognitive process.

Keywords

Anxiety disordersadolescentsattentioncognitive behavioral therapypanic disorder with agoraphobia
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 2 , March 2012 , pp. 193 - 204
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barlow, D. H., Gorman, J. M., Shear, M. K. and Woods, S. W. (2000). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: a randomized controlled trial. Journal of the American Medical Association, 283, 2529–2536. doi: 10.1001/jama.283.19.2529.CrossRefGoogle ScholarPubMed
Beck, A. T. and Clark, D. A. (1997). An information processing model of anxiety: automatic and strategic processes. Behaviour Research and Therapy, 35, 49–58. doi: 10.1016/S0005-7967(96)00069-1.CrossRefGoogle ScholarPubMed
Bouton, M. E., Mineka, S. and Barlow, D. H. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychological Review, 108, 4–32. doi: 10.1037/0033-295X.108.1.4.CrossRefGoogle ScholarPubMed
Buckley, T. C., Blanchard, E. B. and Hickling, E. J. (2002). Automatic and strategic processing of threat stimuli: a comparison between PTSD, panic disorder, and nonanxiety controls. Cognitive Therapy Research, 26, 97–115. doi: 10.1023/A:1013897805918.CrossRefGoogle Scholar
Clark, D. M., Salkovkis, P. M., Gelder, M., Koehler, C., Martin, M., Anastasides, P., et al. (1988). Tests of cognitive theory of panic. In Hand, I. and Wittchen, H. U. (Eds.), Panic and Phobias 2 (pp.149–158). Berlin: Springer.CrossRefGoogle Scholar
Diler, R. S., Birmaher, B., Brent, D., Axelson, D. A., Firinciogullari, S., Chipetta, L., et al. (2004). Phenomenology of panic disorder in youth. Depression and Anxiety, 20, 39–43. doi: 10.1002/da.20018.CrossRefGoogle ScholarPubMed
Doerfler, L. A., Connor, D. F., Volungis, A. M. and Toscano, P. F. (2007). Panic disorder in clinically referred children and adolescents. Child Psychiatry and Human Development, 38, 57–71. doi: 10.1007/s10578-006-0042-5.CrossRefGoogle ScholarPubMed
Eide, P., Kemp, A., Silberstein, R. B., Nathan, P. J. and Stough, C. (2002). Test-retest reliability of the emotional Stroop task: examining the paradox of measurement change. Journal of Psychology: Interdisciplinary and Applied, 136, 514–520. doi: 10.1080/00223980209605547.CrossRefGoogle ScholarPubMed
Ginsburg, G. S. and Drake, K. L. (2002). Anxiety sensitivity and panic attack symptomatology among low-income African-American adolescents. Journal of Anxiety Disorders, 16, 83–96. doi: 10.1016/S0887-6185(01)00092-5.CrossRefGoogle Scholar
Gotlib, I. H. and McCann, C. (1984). Construct accessibility and depression: an examination of cognitive and affective factors. Journal of Personality and Social Psychology, 47, 427–439. doi: 10.1037/0022-3514.47.2.427.CrossRefGoogle ScholarPubMed
Hafner, J. and Marks, I. (1976). Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation. Psychological Medicine, 6, 71–88. doi: 10.1017/S0033291700007510.CrossRefGoogle ScholarPubMed
Hale, L. R. and Calamari, J. E. (2006). Panic symptoms and disorder in youth: what role does anxiety sensitivity play? In Velotis, C. M. (Ed.), New Developments in Anxiety Disorder Research (pp. 131–162). Hauppauge, New York: Nova Science.Google Scholar
Hayward, C., Killen, J. D., Kraemer, H. C. and Taylor, C. B. (2000). Predictors of panic attacks in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 207–214. doi: 10.1097/00004583-200002000-00021.CrossRefGoogle Scholar
Hunt, C., Keogh, E. and French, C. C. (2007). Anxiety sensitivity, conscious awareness and selective attentional biases in children. Behaviour Research and Therapy, 45, 497–509. doi: 10.1016/j.brat.2006.04.001.CrossRefGoogle ScholarPubMed
Kearney, C., Albano, A. M., Eisen, A. R., Allan, W. D. and Barlow, D. H. (1997). The phenomenology of panic disorders in youngsters: an empirical study of a clinical sample. Journal of Anxiety Disorders, 11, 49–62. doi: 10.1016/S0887-6185(96)00034-5.CrossRefGoogle ScholarPubMed
Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.CrossRefGoogle ScholarPubMed
Lang, A. J. and Sarmiento, J. (2004). Relationship of attentional bias to anxiety sensitivity and panic. Depression and Anxiety, 20, 190–194. doi: 10.1002/da.20030.CrossRefGoogle ScholarPubMed
Last, C. G. and Strauss, C. C. (1989). Panic disorder in children and adolescents. Journal of Anxiety Disorders, 3, 87–95. doi: 10.1016/0887-6185(89)90003-0.CrossRefGoogle Scholar
Maidenberg, E., Chen, E., Craske, M., Bohn, P. and Bystritsky, A. (1996). Specificity of attentional bias in panic disorder and social phobia. Journal of Anxiety Disorders, 10, 529–541. doi: 10.1016/S0887-6185(96)00028-X.CrossRefGoogle Scholar
Masi, G., Favilla, L., Mucci, M. and Millepiedi, S. (2000). Panic disorder in clinically referred children and adolescents. Child Psychiatry and Human Development, 31, 139–151. doi: 10.1023/A:1001948610318.CrossRefGoogle ScholarPubMed
McNally, R. J. (2002). Anxiety sensitivity and panic disorder. Biological Psychiatry, 52, 938–946. doi: 10.1016/S0006-3223(02)01475-0.CrossRefGoogle ScholarPubMed
Merikangas, K. R., He, J. P., Burstein, M., Swendson, J., Avenevoli, S., Case, B., et al. (2011). Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50, 32–45.CrossRefGoogle ScholarPubMed
Peterson, R. A. and Reiss, S. (1987). The Anxiety Sensitivity Index Manual. Orland Park, IL: International Diagnostic Systems.Google Scholar
Pincus, D. B., Ehrenreich, J. T., Mattis, S. G., Craske, M. and Barlow, D. H. (2008). Mastery of Anxiety and Panic for Adolescents: riding the wave, therapist guide. New York: Oxford University Press.CrossRefGoogle Scholar
Pincus, D. B., Whitton, S. W., Angelosante, A. G., Buzzella, B., Cheron, D., Weiner, C., et al. (2010). Intensive Treatment of Adolescents with Panic Disorder and Agoraphobia. Paper presented as part of symposium, “Intensive and Effective Treatment of Anxiety Disorders” (Lars Goran Ost, Chair) at the World Congress of Behavioral and Cognitive Therapies (WCBCT), Boston, MA.Google Scholar
Rapee, R. M, Barrett, P. M. and Dadds, M. R. (1994). Reliability of the DSM-III-R childhood anxiety disorders using structured interview: interrater and parent/child agreement. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 984–992. doi: 10.1097/00004583-199409000-00008.CrossRefGoogle ScholarPubMed
Reinecke, A., Coopera, M., Favarona, E., Massey-Chase, R. and Harmera, C. (2011). Attentional bias in untreated panic disorder. Psychiatry Research, 185, 387–393. doi: 10.1016/j.psychres.2010.07.020.CrossRefGoogle ScholarPubMed
Reiss, S., Peterson, R. A., Gursky, D. M. and McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the predictions of fearfulness. Behaviour Research and Therapy, 24, 1–8. doi: 10.1016/0005-7967(86)90143-9.CrossRefGoogle ScholarPubMed
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, 1571–1575.CrossRefGoogle ScholarPubMed
Silverman, W. K. and Albano, A. M. (1997). The Anxiety Disorders Interview Schedule for DSM–IV, Child and Parent Versions. San Antonio, TX: Physiological Corporations.Google Scholar
Silverman, W. K. and Eisen, A. R. (1992). Age differences in the reliability of parent and child reports of child anxious symptomatology using a structured interview. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 117–124. doi: 10.1097/00004583-199201000-00018.CrossRefGoogle ScholarPubMed
Silverman, W. K., Fleisig, W., Rabian, B. and Peterson, R. A. (1991). Child Anxiety Sensitivity index. Journal of Clinical Child Psychology, 20, 162–168. doi: 10.1207/s15374424jccp2002_7.CrossRefGoogle Scholar
Silverman, W. K. and Nelles, W. B. (1988). The Anxiety Disorder Interview Schedule for Children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 772–778.CrossRefGoogle ScholarPubMed
Silverman, W. K., Saavedra, L. M. and Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 937–944. doi: 10.1097/00004583-200108000-00016.CrossRefGoogle ScholarPubMed
Von Korff, M., Eaton, W. and Keyl, P. (1985). The epidemiology of panic attacks and panic disorders: results of three community surveys. American Journal of Epidemiology, 122, 970–981.CrossRefGoogle ScholarPubMed
Westling, B. E. and Ost, L. G. (1995). Cognitive bias in panic disorder patients and changes after cognitive-behavioral treatments. Behaviour Research and Therapy, 33, 585–588. doi: 10.1016/0005-7967(94)00078-X.CrossRefGoogle ScholarPubMed
Whitaker, A., Johnson, J., Shaffer, D., Rapoport, J. L., Kalikow, K., Walsh, B. T., et al. (1990). Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a non-referred adolescent population. Archives of General Psychiatry, 47, 487–496.CrossRefGoogle Scholar
Wittchen, H. U., Reed, V. and Kessler, R. C. (1998). The relationship of agoraphobia and panic in a community sample of adolescents and young adults. Archives of General Psychiatry, 55, 1017–1024. doi: 10.1001/archpsyc.55.11.1017.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.