Preferences for panic control treatment and panic focused psychodynamic psychotherapy for panic disorder – who chooses which and why?

Figures & data

Figure 1. Participant Flowchart. Abbreviations: PCT = Panic Control Treatment; PFPP

 = Panic-Focused Psychodynamic Psychotherapy; Control = Wait-list control.

Table I. Sociodemographic and clinical characteristics by chosen treatment (PCT or PFPP).

	PCT (n=49)	PFPP (n=60)	Between Groups Comparison
Demographics, n, %			p	SMDs (rpbis)
Female	34 (69.4)	49 (81.7)	.14
Basic level education	3 (6.1)	5 (8.5)	.64
High school	27 (55.1)	27 (45.8)	.33
University education	19 (38.8)	27 (45.8)	.47
Employed	43 (89.6)	55 (90.7)	.71
Age at entry, years, M, SD	36.8 (13)	33 (10.4)	.10
Clinical characteristics
PD Severity (PDSS), M, SD	16.1 (4.7)	15.5 (4.1)	.52
Months since first panic episode, months, Md, IQR	96 (143)	74 (113)	.09
Length of current panic episode, months, Md, IQR	18 (80)	12 (26)	.01	−0.56 (-.27)
Comorbid agoraphobia n, %	43 (87.8)	51 (85.0)	.68
No. of comorbid diagnoses, M, SD	1.82 (2.00)	2.03 (1.63)	.53
Types of comorbidity
Depression n, %	11 (22.4)	14 (23.3)	.91
Any anxiety n, %	23 (46.9)	33 (55.0)	.40
Obsessive compulsive disorder	2 (4.1)	4 (6.7)	.56
Post-traumatic stress disorder	1 (2.0)	7 (11.7)	.06
Any personality disorder n, %	11 (22.4)	16 (26.7)	.61
Previous psychotherapy, n, %	28 (59.6)	35 (58.3)	.90
Current psychotropic medication, n, %	31 (63.3)	27 (45.0)	.06
CORE-OM, M, SD
Total score	1.44 (0.65)	1.57 (0.56)	.27
Subjective well being	1.98 (1.01)	2.10 (0.83)	.51
Anxious	2.21 (0.92)	2.36 (0.79)	.34
Depressed	1.85 (1.08)	1.96 (0.94)	.56
Physical	1.96 (1.07)	2.10 (1.11)	.51
Trauma	1.62 (1.10)	2.23 (0.94)	.00	0.60 (.29)
Close	1.26 (0.90)	1.53 (1.06)	.16
General	1.93 (1.02)	2.19 (1.01)	.19
Social	1.21 (0.92)	1.13 (0.90)	.66
Risk to self	0.23 (0.47)	0.15 (0.30)	.26
Risk to others	0.06 (0.43)	0.13 (0.50)	.48
IIP, M, SD
Domineering	5.32 (5.22)	5.08 (4.47)	.79
Vindictive	6.39 (4.86)	6.91 (5.45)	.60
Cold	6.17 (4.70)	8.40 (6.56)	.04	0.38 (.19)
Socially avoidant	9.06 (5.81)	11.31 (8.22)	.10
Non-assertive	12.36 (6.90)	13.52 (7.34)	.41
Exploitable	12.50 (6.01)	13.62 (6.50)	.36
Overly nurturant	12.44 (6.66)	12.81 (6.69)	.77
Intrusive	8.76 (5.91)	8.77 (5.56)	.99

Notes: Summaries are in bold when the between group test is significant p < 0.05.

Abbreviations: Md = Median; IQR = Inter Quartile Range; PCT = Panic Control Treatment; PFPP = Panic-Focused Psychodynamic Psychotherapy; SMD = Standardized Mean Difference; r_pbis = point-biserial correlation.

Table II. Means, standard deviations, and proportions for questions about treatment, beliefs about therapy (PEX) and learning style (LSI) by chosen treatment group.

	PCT (n=49)	PFPP (n=60)	Between Groups Comparison
			p	SMDs (rpbis)
Beliefs about PCT/PFPP
Credibility PCT, M (SD)	8.00 (1.08)	6.45 (1.85)	.00	−1.00 (-.45)
Credibility PFPP, M (SD)	6.16 (1.98)	8.12 (0.94)	.00	1.31 (.55)
Challenging PCT, M, SD	6.47 (2.35)	5.33 (1.87)	.01	−0.54 (-.26)
Challenging PFPP, M, SD	5.14 (1.96)	6.58 (1.96)	.00	0.74 (.35)
Certain about one’s choice, n, %	31 (63.3)	46 (76.7)	.13
Importance of choice, M, SD	6.06 (2.46)	6.47 (2.50)	.39
PEX
Externalization	4.86 (0.73)	4.51 (0.76)	.02	−0.47 (-.23)
Internalization	3.56 (0.86)	3.90 (0.87)	.04	0.39 (.19)
Catharsis	3.48 (0.83)	3.64 (0.81)	.32
Support	4.12 (0.90)	4.24 (0.81)	.47
Defensiveness	2.51 (1.10)	2.48 (0.88)	.86
LSI
Concrete Experience	2.37 (0.43)	2.34 (0.52)	.76
Reflective Observation	2.26 (0.44)	2.48 (0.52)	.02	0.45 (.22)
Abstract Conceptualization,	2.52 (0.48)	2.55 (0.48)	.78
Active Experimentation	2.90 (0.51)	2.68 (0.54)	.04	−0.42 (-.20)

Notes: Summaries are in bold when the between-group test is significant p < 0.05.

Abbreviations: PCT = Panic Control Treatment; PFPP = Panic-Focused Psychodynamic Psychotherapy; SMD = Standardized Mean Difference; r_pbis = point-biserial correlation.

Table III. Pairwise correlations among variables significantly associated with treatment choice

Variable	1	2	3	4	5	6	7	8	9	10	11	12
1. Episode	-
2. Trauma, CORE-OM	.03	-
3. Cold, IIP	-.14	.23*	-
4. Internalization	-.14	.34**	.21*	-
5. Externalization	.16	.07	-.15	.38**	-
6. Reflective Obs.	-.09	.12	.28**	.11	-.09	-
7. Active Exp.	.10	.00	-.01	.06	.11	-.52**	-
8. Credibility PCT	.11	-.24*	-.18	-.06	.40**	.06	-.05	-
9. Credibility PFPP	-.27**	.19	.12	.19	-.04	.06	-.17	-.15	-
10. Challenging PCT	.10	.04	.08	-.11	.06	.01	.05	.26**	-.20*	-
11. Challenging PFPP	-.15	.13	.34**	.14	.04	.07	-.05	-.20*	.22*	.15	-
12. Choice	-.27**	.29**	.19*	.19*	-.23	.22*	−20*	−45**	.55**	-.26**	.35**	-

*p < .05. **p < .01.

Table IV. Logistic regression predicting participants’ choice of treatment.

	B	S.E.	Wald	Df	P	Odds Ratio	95.0% C.I. for Odds Ratio	Percentage correctly classified
Block 1
Episode	.00	.01	.00	1	.97	1.00	.99–1.01
Trauma, CORE-OM	.60	.39	2.34	1	.13	1.82	.85–3.93
Cold, IIP	-.05	.07	.38	1	.54	.96	.83–1.11	69.7
Block 2
Internalization	.41	.48	.73	1	.39	1.51	.59–3.88
Externalization	-.99	.68	2.13	1	.14	.37	.10–1.40
Reflective Observation	1.63	.97	2.85	1	.09	5.10	.77–33.85
Active Experimentation	-.13	.82	.025	1	.88	.88	.18–4.35	75.2
Block 3
Credibility PCT	-.91	.34	7.18	1	.01	.40	.21 to .78
Credibility PFPP	1.46	.42	12.40	1	.00	4.32	1.91–9.76
Challenging PCT	-.34	.21	2.58	1	.11	.72	.47–1.08
Challenging PFPP	.57	.23	5.91	1	.02	1.76	1.12–2.77	89.9
Constant	−6.64	5.44	1.49	1	.22	.00

Abbreviations: PCT = Panic Control Treatment; PFPP = Panic-Focused Psychodynamic Psychotherapy.

Table V. Participants’ Reasons for Choosing Treatment.

Code	PCT (N=49) n (%)	PFPP (N=60) n (%)
1. I want exercises / concrete / practical work with panic	28 (57)	0 (0)
2. I want to face my fears	18 (37)	4 (7)
3. Focus on the external situation	14 (29)	1 (2)
4. I want to be able to handle panic in a better way	13 (27)	2 (3)
5. Focus on my own activity and work in treatment	13 (27)	8 (13)
6. Just talking doesn't help	6 (12)	0 (0)
7. I do not want to go in the other treatment	9 (18)	6 (10)
8. Focus on the present	4 (8)	1 (2)
9. The treatment is in line with my own theory of the causes of panic	10 (20)	11 (18)
10. The treatment means something new to me	3 (6)	3 (5)
11. Focus on working with relationships	0 (0)	1 (2)
12. I want to avoid homework	0 (0)	2 (3)
13. Focus on unconscious feelings	0 (0)	2 (3)
14. Overall positive / fits me well	21 (43)	29 (48)
15. I've tested the other one already, want something different	1 (2)	4 (7)
16. Focus on the therapist as an expert (and not my own activity)	3 (6)	8 (13)
17. Focus on inner experiences	0 (0)	9 (15)
18. I want to understand my emotional reactions	0 (0)	9 (15)
19. I want to reflect / talk in treatment	0 (0)	15 (25)
20. Focus on the background / past	0 (0)	16 (27)
21. Patterns, how panic is connected to my life and background	0 (0)	18 (30)
22. I want to understand causal reasons for the panic	4 (8)	32 (53)

Abbreviations: PCT = Panic Control Treatment; PFPP = Panic-Focused Psychodynamic Psychotherapy.