AI Article Synopsis
- Cognitive preparation is essential in cognitive behavioral therapy (CBT) for panic disorder and agoraphobia, as high emotional arousal during this phase can hinder patients' ability to process treatment information, potentially affecting their progress.
- The study analyzed emotional arousal in 197 patients by measuring their vocal pitch during treatment rationale development, finding that higher pitch correlated with poorer understanding and less symptom improvement, though it didn't affect dropout rates.
- Insights gained during therapy were linked to lower dropout rates and helped explain the relationship between emotional arousal and reduced avoidance behaviors, suggesting therapists should manage patients' arousal levels when discussing treatment procedures.
Article Abstract
Background: Cognitive preparation plays a crucial role in CBT with exposure for panic disorder and agoraphobia. High emotional arousal while developing the exposure rationale might impair patients' cognitive capacities for processing information about treatment and impede therapeutic outcome.
Objective: This study investigates whether patients' vocally encoded emotional arousal, assessed by fundamental frequency (f), during rationale development is associated with premature treatment dropout, insight into the rationale, and symptom reduction.
Methods: Patients' (N = 197, mean age 36.1 years, 79.2% female) f during rationale development was measured based on treatment videos from a randomized controlled trial of CBT for panic disorder and agoraphobia. Insight was rater assessed. Symptom severity was self- and rater assessed at the beginning and end of therapy.
Results: Higher f mean during rationale development was associated with lower probability of insight and less reduction in avoidance behavior. f was not associated with dropout. Insight was associated with lower probability of dropout and partially mediated the association between f and avoidance reduction.
Discussion: This study highlights the importance of emotional arousal during cognitive preparation for exposure. Therapists should ensure that patients are not too highly aroused while learning about the exposure rationale as an important step in treatment.
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| http://dx.doi.org/10.1016/j.brat.2020.103728 | DOI Listing |
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