Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy

Predicting Dropout From Cognitive Behavioral Therapy for Panic Disorder Using Machine Learning Algorithms

Background

Attrition is an important problem in clinical practice and research. However, the predictors of dropping out from cognitive behavioral therapy (CBT) for panic disorder (PD) are not fully understood. In this study, we aimed to build a dropout prediction model for CBT for PD using machine learning (ML) algorithms.

Methods

We treated 208 patients with PD applying group CBT. From baseline data, the prediction analysis was carried out using two ML algorithms, random forest and light gradient boosting machine. The baseline data included five personality dimensions in NEO Five Factor Index, depression subscale of Symptom Checklist-90 Revised, age, sex, and Panic Disorder Severity Scale.

Results

Random forest identified dropout during CBT for PD showing that the accuracy of prediction was 88%. Light gradient boosting machine showed that the accuracy was 85%.

Conclusions

The ML algorithms could detect dropout after CBT for PD with relatively high accuracy. For the purpose of clinical decision-making, we could use this ML method. This study was conducted as a naturalistic study in a routine clinical setting. Therefore, our results in ML approach could be generalized to regular clinical settings.

The Effect of Group-Based Emotional Schema Therapy on Anxiety Sensitivity and Anxiety Severity in Outpatient Females with Generalized Anxiety Disorder

"Purpose: The aim of the present study was to examine the effectiveness of Group-Based Emotional Schema Therapy (GBEST) on anxiety sensitivity and anxiety severity decrease in females with Generalized Anxiety Disorder (GAD). Methods: This was a double-blind randomized experimental study that was carried out with three pretest, posttest, and follow-up stages within an experimental group and the control group. The participants were 50 outpatient females with GAD that they recruited by a random sampling method in each group. The Anxiety Sensitivity Index (ASI) and the Generalized Anxiety Disorder 7-Item Scale (GAD-7) were used in this study. The experimental group was imposed on the GBEST in 10 sessions which were held weekly for 90 minutes; finally, the post-test was applied to both experimental and control groups and three months later, they were followed up. Results: Findings showed that the experimental group had a significant decrease in anxiety sensitivity and anxiety severity compared with the control group during the post-test and the follow-up stages. Conclusions: The GBEST is recommended for the treatment of anxiety sensitivity and anxiety severity in females with GAD."

Anxiety Sensitivity and Panic Disorder: Evaluation of the Impact of Cognitive-Behavioral Group Therapy

Anxiety sensitivity (AS) is a multidimensional construct associated with the etiology and maintenance of panic disorder (PD) symptoms. However, only a few studies have evaluated whether cognitive-behavioral group therapy (CBGT) can modify the condition. The objective of this study was to evaluate the impact of CBGT on AS in patients with PD and to analyze AS and its dimensions as predictors of response to CBGT. In the present clinical trial, an intervention group (n = 37) attended 12 CBGT sessions, while a control group (n = 52) did not receive any intervention. The severity of symptoms and of AS were evaluated before and after CBGT in the intervention group and once in the control group. Significant improvement occurred in all specific PD symptoms and in general anxiety and depressive symptoms. Furthermore, AS scores reduced significantly after intervention. This study confirmed that AS is higher in patients with more severe PD. The effectiveness of CBGT for reducing the physical, cognitive, and social dimensions of AS was also observed, supporting the hypothesis of a positive impact of therapy.

The Effect of Personality Traits on Cognitive Behavioral Therapy Outcomes in Student Pharmacists with Rat Phobia: A Randomized Clinical Trial

Background:

Little is known about which personality traits determine the effectiveness of various types of cognitive-behavioral therapy (CBT) on animal phobia. The objective of the present study was to investigate a possible association between personality traits and the outcome of single- and multi-session CBT.

Methods:

The present randomized clinical trial was conducted from November 2018 to May 2019 in Shiraz, Iran. Forty female students with rat phobia, who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria, were systematically allocated into a single- and a multi-session therapy group (odd numbers one-session treatment, even numbers multi-session treatment). In both groups, the students were gradually exposed to rats as part of the treatment. Psychological measures (state-anxiety, rat phobia, and disgust questionnaires) were used to compare pre- and post-intervention outcomes. Multivariate analysis of covariance was used to assess which personality traits influenced the intervention outcome. The statistical analysis was performed using SPSS (version 20.0) and P values<0.05 were considered statistically significant.

Results:

Rat phobia was positively and significantly affected by conscientiousness (P=0.001) and agreeableness (P=0.003). Of these personality traits, only a higher degree of conscientiousness resulted in a further reduction of state anxiety after the intervention (P=0.005). There were no significant differences between the pre- and post-intervention outcomes.

Conclusion:

The outcome of single- and multi-session rat phobia therapies was associated with specific personality traits of the participants, namely conscientiousness and agreeableness. Both intervention methods had an equal effect on reducing rat phobia.