PROGNOSTIC FACTORS IN THE BEHAVIORAL TREATMENT OF PANIC DISORDER WITHAND WITHOUT AGORAPHOBIA

Pretreatment and early treatment variables were evaluated as predictor s of outcome for the behavioral treatment of panic disorder (PD) with and without agoraphobia. The following variables were examined: severi ty of agoraphobic complaints, catastrophic agoraphobic cognitions, lev el of depression, quality of the therapeutic relationship, motivation for treatment, personality psychopathology, and marital dissatisfactio n. Sixty patients, diagnosed with PD, received a standardized exposure -based behavioral treatment program. Severity of agoraphobic complaint s, level of depression, motivation for treatment, personality psychopa thology, and catastrophic agoraphobic cognitions were related to treat ment outcome, whereas the quality of the therapeutic relationship and marital dissatisfaction were not. Catastrophic agoraphobic cognitions were the strongest predictor of poorer outcome. Patients frequently di stressed by maladaptive cognitions tended to improve less with an expo sure-based treatment program. Based on several predictors taken togeth er, 75% to 85% of the patients were correctly classified as treatment failures or treatment successes. A decision model based on multiple pr ognostic variables may lead to a reliable screening method of PD patie nts who are unlikely to improve. Treatment programs can then be adapte d for these patients.