Plaisted, Hannah (2021). The applicability of Clark's cognitive model of panic disorder in children and young people. University of Birmingham. Clin.Psy.D.
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Abstract
Systematic Review -
Introduction: Panic disorder is a disabling condition for both young people and adults. Clark’s (1986) cognitive model of panic disorder has led to the development of a highly effective treatment for the condition in adults (Clark, 2004), however, the degree to which the cognitive model is applicable in understanding the development and maintenance of the condition in children and adolescents is unclear.
Method: This systematic review evaluated the current evidence for an association between panic symptoms and cognitive and behavioural processes associated with Clark’s cognitive model of panic in adults, in children and adolescents aged 5 to 19 years. We searched Psych-Info and Medline databases using a systematic search strategy and identified 38 articles.
Results: This systematic review found evidence for an association between panic symptoms and anxiety sensitivity in children and adolescents, and interpretation of bodily sensations in children. There was preliminary evidence for the role of avoidance in the treatment of panic disorder in adolescents, however, there were notably less studies examining behavioural factors. No studies relating to the association between the use of safety seeking behaviours and panic symptoms were identified.
Conclusion: There is evidence that factors associated with the cognitive model are important for understanding panic in children and adolescents. However, methodological issues mean that these findings should be interpreted with caution.
Future Research: Studies of clinical populations (with panic disorder), using longitudinal and experimental methods, and clinically sensitive measures, are needed to establish the applicability of the cognitive model of panic with young people.
Empirical Project -
Background: Panic disorder is a prevalent, disabling condition that often manifests during adolescence. Clark’s (1986; 1996) cognitive model of panic disorder has led to an effective treatment for the condition in adults (Clark et al., 2003). The current study examines the applicability of Clark’s cognitive model for understanding panic symptoms in adolescents.
Method: One-hundred and thirty-one adolescents (aged 13-18 years) recruited from the community completed a set of questionnaires measuring symptoms of panic and variables hypothesised to maintain panic disorder in Clark’s (1986; 1996) cognitive model: fear and catastrophic misinterpretations of bodily sensations, safety behaviours and avoidance. Due to the COVID-19 pandemic/restrictions, and issues concerning the validity of participant responses, avoidance was not included in any inferential analyses.
Results: Panic symptoms were significantly correlated with cognitive and behavioural variables. Linear regression analysis found that cognitive factors (i.e., fear of body sensations and catastrophic misinterpretations of bodily sensations) significantly accounted for 53% of the variance in panic symptoms. Notably, safety seeking behaviours were not a significant predictor.
Conclusion: The findings suggest that Clark’s (1986; 1996) model of panic disorder, particularly fear and catastrophic misinterpretations of bodily sensations, may be applicable to understanding the condition in younger people. While safety seeking behaviours were not found to be a significant predictor, they were significantly correlated with panic symptoms, and may still be an important factor. Future research should seek to replicate the study in a clinical population and determine the role of safety seeking behaviours and avoidance for understanding adolescent panic disorder.
| Type of Work: | Thesis (Doctorates > Clin.Psy.D.) | |||||||||
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| Award Type: | Doctorates > Clin.Psy.D. | |||||||||
| Supervisor(s): |
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| Licence: | All rights reserved | |||||||||
| College/Faculty: | Colleges (2008 onwards) > College of Life & Environmental Sciences | |||||||||
| School or Department: | School of Psychology, Department of Clinical Psychology | |||||||||
| Funders: | None/not applicable | |||||||||
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology | |||||||||
| URI: | http://etheses.bham.ac.uk/id/eprint/11877 |
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