Trajectories of Change Across Outcomes in Intensive Treatment for Adolescent Panic Disorder and Agoraphobia

Abstract

Much remains to be learned about typical and individual growth trajectories across treatment for adolescent panic disorder with and without agoraphobia and about critical treatment points associated with key changes. The present study examined the rate and shape of change across an 8-day intensive cognitive behavioral therapy for adolescent panic disorder with and without agoraphobia (N = 56). Participants ranged in age from 12 to 17 (M = 15.14, SD = 1.70; 58.9% female, 78.6% Caucasian). Multilevel modeling evaluated within-treatment linear and nonlinear changes across three treatment outcomes: panic severity, fear, and avoidance. Overall panic severity showed linear change, decreasing throughout treatment. In contrast, fear and avoidance ratings both showed cubic change, peaking slightly at the first session of treatment, starting to decrease at the second session of treatment, and with large gains continuing then plateauing at the fourth session. Findings are considered with regard to the extent to which they may elucidate critical treatment components and sessions for adolescents with panic disorder with and without agoraphobia.

Acknowledgments

This research was supported by National Institute of Mental Health Grant 1 R01 MH068277 awarded to Donna B. Pincus. We thank Jessica Pian and Priya Korathu-Larson for their assistance with early versions of this project.

Notes

Note: Ns = 41–55.

Note: N = 56 individuals. CI = confidence interval.

*p < .05. **p < .01. ***p < .001.