Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial. (December 2016)

• Record Type: Journal Article
• Authors: Feldman, Jonathan M.; Matte, Lynne; Interian, Alejandro; Lehrer, Paul M.; Lu, Shou-En; Scheckner, Bari; Steinberg, Dara M.; Oken, Tanya; Kotay, Anu; Sinha, Sumita; Shim, Chang
• Is Part Of: Behaviour research and therapy. Volume 87(2016)
• Page Start: 142
• Page End: 154
• Publication Date: 2016-12
• Subjects: Asthma -- Panic -- Patient compliance -- Latinos -- Cognitive behavior therapy -- Relaxation; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2016.09.007
• Languages: English
• ISSNs: 0005-7967

Abstract

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. Highlights: Latinos improved on panic disorder severity and asthma control in both groups. CBT had greater improvements on asthma medication adherence than music-relaxation. Improvements in panic disorder severity were mediated by anxiety sensitivity in CBT. Depression was a mediator of change in panic disorder severity in music-relaxation.