Predictores y moderadores de la efectividad de la terapia cognitivo-conductual y de la terapia de aceptación y compromiso en formato grupal para pacientes con trastorno de pánico

Abstract

The most common therapy for panic disorder is Cognitive-Behavioral Therapy (CBT). Nonetheless, there is a high percentage of patients who do not successfully respond to treatment. In this context, the study of predictors and moderators of effectiveness in psychotherapy is especially relevant, with Acceptance and Commitment Therapy (ACT) as an alternative with increasing empirical support. In addition, group therapy provides unique quality and advantages, both psychotherapeutically and economizing resources. This work aims to analyze the effect of different potentially predictor and moderator variables in the effectiveness of cognitive-behavioral therapy and acceptance and commitment therapy in a group format for patients with panic disorder. The sample was composed of 91 patients with panic disorder, randomized into two treatment groups: experimental group, which received acceptance and commitment therapy, and active comparator control group, who received cognitive-behavioral therapy. The severity of the panic disorder, the fear of physical symptoms, and the frequency of catastrophic thoughts were evaluated before and at the end of treatment, as well as at three months follow-up. The potential predictors and moderators analyzed were age, gender, evolution time of the disorder, motivation to change, responsibility, and experiential avoidance. The results revealed that both therapies were more effective in older-aged people, women, with a long time of evolution of the disorder, in the contemplation stage, and with high experiential avoidance. However, they were less effective in young men, with a shorter time of evolution of the disorder, in the precontemplation stage, with a medium level of responsibility and with low experiential avoidance. The cognitive-behavioral therapy showed a tendency to be more effective in older aged people, men, and people with a shorter time of evolution of the disorder, while acceptance and commitment therapy do so in young people, women, and people with a long time of evolution of the disorder. In conclusion, there are predictors and moderators of the efficacy of both cognitivebehavioral therapy and acceptance and commitment therapy in a group format for patients with panic disorder. This can ease decision-making by professionals and improve the outcome of treatment and the management of healthcare resources.