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Randomized Controlled Trial
. 2016 Dec:87:142-154.
doi: 10.1016/j.brat.2016.09.007. Epub 2016 Sep 17.

Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial

Jonathan M Feldman  1 , Lynne Matte  2 , Alejandro Interian  3 , Paul M Lehrer  4 , Shou-En Lu  5 , Bari Scheckner  2 , Dara M Steinberg  2 , Tanya Oken  2 , Anu Kotay  6 , Sumita Sinha  7 , Chang Shim  8
Affiliations
Randomized Controlled Trial

Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial

Jonathan M Feldman et al. Behav Res Ther. 2016 Dec.

Abstract

Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improvements in PD severity were mediated by anxiety sensitivity in CBPT and by depression in MRT, although earlier levels of these mediators did not predict subsequent improvements. Attrition was high (40%) in both groups, albeit comparable to CBT studies targeting anxiety in Latinos. Additional strategies are needed to improve retention in this high-risk population. Both CBPT and MRT may be efficacious interventions for comorbid asthma-PD, and CBPT may offer additional benefits for improving medication adherence.

Keywords: Asthma; Cognitive behavior therapy; Latinos; Panic; Patient compliance; Relaxation.

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Figures

Figure 1
Figure 1
Flowchart of Participants CBPT = Cognitive Behavior Psychophysiological Therapy; MRT = music relaxation therapy
Figure 2
Figure 2
Model 2a. Mediated Pathway for CBPT through Anxiety Sensitivity-Physical subscale Model 2b. Mediated Pathway for CBPT through Anxiety Sensitivity-Cognitive subscale Model 2c. Mediated Pathway for MRT through Depression
Figure 2
Figure 2
Model 2a. Mediated Pathway for CBPT through Anxiety Sensitivity-Physical subscale Model 2b. Mediated Pathway for CBPT through Anxiety Sensitivity-Cognitive subscale Model 2c. Mediated Pathway for MRT through Depression
See this image and copyright information in PMC

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