Cognitive and behavioral treatments of agoraphobia: Clinical, behavioral, and psychophysiological outcomes.

39 severe and chronic agoraphobics with panic attacks, diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, were randomly assigned to 1 of 3 cognitive-behavioral treatments: paradoxical intention (PI), graduated exposure (GE), or progressive deep muscle relaxation training (RT). Treatment consisted of 12 2-hr weekly sessions conducted by experienced therapists whose treatment integrity was objectively monitored. All 31 23–63 yr old Ss who completed the program received an extensive rationale emphasizing self-directed exposure and programmed practice in addition to their primary treatment. A comprehensive assessment battery consisting of clinical ratings of severity, phobia, anxiety, depression, and panic, as well as direct measures of behavioral, psychophysiological, and cognitive response systems was administered at pre-, mid- (6 wks), and posttreatment (12 wks) and at 3-mo follow-up. Analyses revealed significant improvement for all Ss. GE and RT tended to evoke more rapid effects. At follow-up, GE and RT evidenced the greatest potency and stability, as compared with PI. The GE condition experienced twice the drop-out rate of PI and RT. The phenomenon of synchrony appeared to be associated with overall improvement at 12 wks and follow-up. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)