Psychophysiologie der Expositionstherapie – eine Pilotstudie bei Patienten mit Agoraphobie und Panikstörung

The Psychophysiology of Exposure Therapy – a Pilot Therapy Study with Patients Suffering from Agoraphobia with Panic Disorder This pilot study investigates individual response patterns in agoraphobic situations. Patients with an ICD-10 diagnosis of agoraphobia and panic disorder underwent ambulatory psychophysiologic monitoring in standardized agoraphobic situations before (n = 14) and after (n = 15) brief standardized cognitive behavioral treatment (pre as well as post values could be collected from 8 patients). Nine controls underwent the same monitoring procedure. The particular design of the ambulatory monitoring allowed very high control of the most important variables. Group means are in accordance with previous findings: in the agoraphobic situations slightly higher psychophysiologic activation for the patients than for the controls, and a reduction of that reaction after therapy. However, the large variance between subjects seems to favor individual response patterns. Examples of proto-typic responses – concordance, asynchrony, prolonged activation, and negative concordance – are presented. Only one of these responses is in accordance with the cognitive model of panic attacks and fits into the habituation model of exposure therapy. Hypotheses regarding the importance of the other patterns for the therapy of agoraphobia and panic disorder are discussed.