SUFFOCATION FALSE ALARMS AND EFFICACY OF COGNITIVE-BEHAVIORAL THERAPYFOR PANIC DISORDER

Cognitive behavioral therapy (CBT) is an effective treatment for many but not all patients with panic disorder. This raises the question of whether there are types of panic disorder for which CBT is effective, and other types for which it is ineffective. Klein's (1993) suffocatio n alarm theory suggests two types of panic disordered patient: those w ith intense dyspnea as a frequent panic symptom (suffocation panickers ) and those with little or no dyspnea (nonsuffocation panickers). Klei n's theory suggests CBT will be less effective for suffocation panicke rs compared to nonsuffocation panickers. To test this prediction, 22 u nmedicated panic-disordered patients were classified as suffocation pa nickers (n = 13) or nonsuffocation panickers (n = 9) and received 10 s essions of CBT. Both groups had significant reductions in symptoms fro m pre- to posttreatment, and gains were maintained at 3-month followup . Groups did not differ in treatment response. At 3-month followup 75% of suffocation panickers, and 50% of nonsuffocation panickers were pa nic-free. and 75% of suffocation panickers and 63% of nonsuffocation p anickers were classified as treatment responders. These results fail t o support the prediction from Klein's theory and suggest that panic di sorder with intense dyspnea can be successfully treated with CBT.