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Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia

  • A. T. Gloster
  • H. U. WittchenEmail author
  • F. Einsle
  • M. Höfler
  • T. Lang
  • S. Helbig-Lang
  • T. Fydrich
  • L. Fehm
  • A. O. Hamm
  • J. Richter
  • G. W. Alpers
  • A. L. Gerlach
  • A. Ströhle
  • T. Kircher
  • J. Deckert
  • P. Zwanzger
  • V. Arolt
Article

Abstract

Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.

Keywords

Panic disorder Agoraphobia CBT Exposure therapy Mechanisms Methods 

Notes

Conflict of interest statement

The following authors report no conflicts of interest concerning the content of this paper: A. Gloster, H.-U. Wittchen, F. Einsle, M. Höfler, T. Lang, S. Helbig-Lang, T. Fydrich, L. Fehm, A. Hamm, J. Richter, G. Alpers, A. Gerlach, J. Deckert, P. Zwanzger, and V. Arolt. A. Ströhle received research funding from the German Federal Ministry of Education and Research, the European Commission (FP6) and Lundbeck, and speaker honoraria from Pfizer, Eli Lilly & Co, Wyeth and Lundbeck. A. Ströhle was the recipient of educational grants by the Stifterverband für die Deutsche Wissenschaft, the Berlin Brandenburgische Akademie der Wissenschaften, the Boehringer Ingelheim Fonds and the Eli Lilly International Foundation. T. Kircher received fees for educational programs from Janssen-Cilag, Eli Lilly, Servier, Lundbeck, Bristol Myers Squibb, Pfizer, and AstraZeneca; travel support/sponsorship for congresses from Servier; speaker’s honoraria from Janssen-Cilag; and research grants from Pfizer and Lundbeck.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • A. T. Gloster
    • 1
  • H. U. Wittchen
    • 1
    • 12
    Email author
  • F. Einsle
    • 1
  • M. Höfler
    • 1
  • T. Lang
    • 1
    • 2
    • 3
  • S. Helbig-Lang
    • 1
    • 2
  • T. Fydrich
    • 4
  • L. Fehm
    • 4
  • A. O. Hamm
    • 5
  • J. Richter
    • 5
  • G. W. Alpers
    • 6
  • A. L. Gerlach
    • 7
  • A. Ströhle
    • 8
  • T. Kircher
    • 9
  • J. Deckert
    • 10
  • P. Zwanzger
    • 11
  • V. Arolt
    • 11
  1. 1.Dresden University of TechnologyDresdenGermany
  2. 2.University of BremenBremenGermany
  3. 3.Christoph-Donier Foundation for Clinical PsychologyMarburgGermnay
  4. 4.Humboldt UniversityBerlinGermany
  5. 5.Greifswald Ernst-Moritz-Arndt UniversityGreifswaldGermany
  6. 6.Department of PsychologyUniversity of WürzburgWürzburgGermany
  7. 7.Department of PsychologyUniversity of MünsterMünsterGermany
  8. 8.Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin BerlinBerlinGermany
  9. 9.Philipps UniversityMarburgGermany
  10. 10.Department of Psychiatry, Psychosomatics and PsychotherapyUniversity of WürzburgWürzburgGermany
  11. 11.Department of PsychiatryUniversity of MünsterMünsterGermany
  12. 12.Department of Psychology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany

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