COGNITIVE-BEHAVIORAL TREATMENT FOR PANIC DISORDER WITH GASTROINTESTINAL SYMPTOMS - A CASE-STUDY

A 25-year-old woman with a 12-year history of panic disorder with agor aphobia and gastrointestinal symptoms was treated using a cognitive-be havioral program which included: (a) correcting misconceptions about n ormal bowel functioning, (b) graduated in vivo exposure to internal st imuli which she misinterpreted as precursors of loss of bowel control, (c) graduated in vivo exposure to external stimuli associated with fe ars of loss of bowel control, (d) establishment of regular eating patt erns, and (e) bowel control training. Self-ratings of avoidance and di stress, frequency of panic attacks, diazepam use, and negative cogniti ons decreased with treatment. Treatment gains were maintained at 18-mo nth follow-up. Tailoring of cognitive-behavioral treatment to panic wi th fears of loss of bowel control was emphasized.