Cognitive-behavioral therapy for panic disorder in patients being treated for alcohol dependence: Moderating effects of alcohol outcome expectancies

Abstract Anxiety disorders commonly co-occur with alcohol use disorders and reliably mark a poor response to substance abuse treatment. However, treating a co-occurring anxiety disorder does not reliably improve substance abuse treatment outcomes. Failure to account for individual differences in the...

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Bibliographic Details
Published in:Addictive Behaviors 2009-06, Vol.34 (6), p.554-560
Main Authors: Kushner, Matt G, Sletten, Sandra, Donahue, Christopher, Thuras, Paul, Maurer, Eric, Schneider, Antonina, Frye, Brenda, Demark, Joani Van
Format: Article
Language:English
Subjects:
Adult
Alcohol
Alcohol use
Alcoholism - psychology
Alcoholism - therapy
Anxiety
Attitude to Health
CBT treatment
Cognitive Behavioral Therapy - methods
Comorbidity
Diagnosis, Dual (Psychiatry)
Drug abuse
Epidemiologic Methods
Expectancies
Female
Humans
Interview, Psychological
Male
Middle Aged
Panic disorder
Panic Disorder - psychology
Panic Disorder - therapy
Psychiatric Status Rating Scales
Psychiatry
Psychometrics
Studies
Substance abuse treatment
Treatment Outcome
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Summary:Abstract Anxiety disorders commonly co-occur with alcohol use disorders and reliably mark a poor response to substance abuse treatment. However, treating a co-occurring anxiety disorder does not reliably improve substance abuse treatment outcomes. Failure to account for individual differences in the functional dynamic between anxiety symptoms and drinking behavior might impede the progress and clarity of this research program. For example, while both theory and research point to the moderating role of tension-reduction alcohol outcome expectancies (TR-AOEs) in the association between anxiety symptoms and alcohol use, relevant treatment studies have not typically modeled TR-AOE effects. We examined the impact of a hybrid cognitive-behavioral therapy (H-CBT) treatment for panic disorder (independent variable) on response to a community-based alcohol dependence treatment program (dependent variable) in patients with higher vs. lower TR-AOEs (moderator). The H-CBT treatment was generally effective in relieving participants' panic symptoms relative to controls. However, TR-AOEs interacted with study cohort (H-CBT vs. control) in predicting response to substance abuse treatment. As expected, the H-CBT was most effective in improving alcohol use outcomes among those with the highest TR-AOEs. The study's primary methodological limitations are related to the quasi-experimental design employed.
ISSN:0306-4603
1873-6327
1573-3602
DOI:10.1016/j.addbeh.2009.03.011