| Popis: |
Panic disorder (PD), characterised by recurrent, unexpected panic attacks and a persistent fear regarding future attacks, has a prevalence of 1 - 3% in adolescents (Sadler et al, 2018; Bittner et al, 2007). The cognitive model of panic (Clark, 1986) provides an explanation of the psychological mechanisms underpinning the development and maintenance of PD. The factors included in the model are panic cognitions, avoidance behaviours, bodily sensations, and safety-seeking behaviours. Well-validated in adult populations, a highly effective treatment has been developed based upon this model (Clark et al, 1999). However, this model remains under-researched in adolescent populations. Adolescence is a critical period of biological, psychological, and social development (Jaworska & MacQueen, 2015). It is therefore plausible that the factors contributing to the presentation and maintenance of psychological disorders in this population may differ compared to adults and younger children. A recent systematic review (Plaisted, 2021) found some preliminary support for a relationship between cognitive factors (e.g. anxiety sensitivity) and panic symptoms in young people, largely in community (non-clinical) groups. However, they found no evaluations of the cognitive model of panic in adolescents with clinical diagnoses of PD. Certain factors of the model, such as safety-seeking behaviours and interpretation of bodily sensations, are yet to be explored in this group in the context of panic disorder. Evaluating the applicability and specificity of this model to adolescents with PD will improve understanding and, potentially, treatment outcomes for this population. It is also important to determine whether the components of the cognitive model of panic are specific to panic disorder over and above other anxiety disorders. Panic disorder is often diagnosed alongside other disorders such as social anxiety disorder and/or generalised anxiety disorder (Doerfler et al., 2007). Determining the model’s specificity to PD will establish whether disorder-specific treatment approaches are needed. In this study we will explore the components of the cognitive model of PD in an adolescent clinical PD group compared to a clinical control group (adolescents with other anxiety disorders excluding PD) and a community control group (non-anxious adolescents). This will provide a first look into the applicability and specificity of the cognitive model of PD to adolescents with PD. We will discuss the implications of the findings for future research, and how they may inform the development and practice of psychological treatment of adolescent PD. |
