Department of Psychology and Behavioural Sciences

The mediational role of panic self-efficacy in cognitive behavioral therapy for panic disorder: A systematic review and meta-analysis

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal article

Cognitive models of panic disorder (PD) with and without agoraphobia have stressed the role of catastrophic beliefs of bodily symptoms as a central mediating variable of the efficacy of cognitive behavioral therapy (CBT). Perceived ability to cope with or control panic attacks, panic self-efficacy, has also been proposed to play a key role in therapeutic change; however, this cognitive factor has received much less attention in research. The aim of the present review is to evaluate panic self-efficacy as a mediator of outcome in CBT for PD using descriptive and meta-analytic procedures. We performed systematic literature searches, and included and evaluated 33 studies according to four criteria for establishing mediation. Twenty-eight studies, including nine randomized waitlist-controlled studies, showed strong support for CBT improving panic self-efficacy (criterion 1); ten showed an association between change in panic self-efficacy and change in outcome during therapy (criterion 2); three tested, and one established formal statistical mediation of panic self-efficacy (criterion 3); while four tested and three found change in panic self-efficacy occurring before the reduction of panic severity (criterion 4). Results for panic-self efficacy were generally on par with results for catastrophic beliefs in comparative mediational studies. Although only a few studies were designed to test all mediational criteria, this review supports panic self-efficacy as a mediator of outcome in CBT for PD.
Original languageEnglish
JournalBehaviour Research and Therapy
Volume60
Pages (from-to)23-33
Number of pages11
ISSN0005-7967
DOIs
StatePublished - Sep 2014

See relations at Aarhus University Citationformats

ID: 68788724