THE ROLE OF NEGATIVE SELF-STATEMENTS DURING EXPOSURE IN-VIVO - A PROCESS STUDY OF 8 PANIC DISORDER PATIENTS WITH AGORAPHOBIA

The purpose of this study was to evaluate the pattern of cognitive cha nge, and in particular the role of negative self-statements, in relati on to improvement during an in vivo exposure treatment. Eight panic di sordered patients with agoraphobia, of whom 4 were most and 4 were lea st improved on a composite measure, were exposed to standardized agora phobic situations. During the exposure, heart rate, self-statements, a nd subjective anxiety were registered throughout the sessions. Fixed c riteria were set for habituation of heart rate and reduction of subjec tive anxiety within a session. Results showed that the total frequency of negative self-statements at the start, during, as well as at the e nd of treatment differentiated best between the most and least improve d patients. These results suggest that it may be therapeutically wise to continue exposure therapy not only until habituation of anxiety (su bjectively and physiologically) is achieved, but also until the freque ncy of negative self-statements is reduced until zero.