Positive Side-Effects of Psychotherapy: The Influence of Cognitive-Behavioral Therapy on Self-Concept in Patients With Panic Disorder.

Objective: Past studies show a strong association of the self-concept (SC) and symptom burden for many mental disorders including anxiety disorders. Cognitive behavioral therapy (CBT) is a highly effective treatment for anxiety disorders that has also been shown to improve SC in patients suffering from such. However, whilst CBT has been shown to be an effective intervention for treating panic disorder (PD), the effects of CBT on SC in patients with PD as well as the predictive role of SC for therapy outcome in these patients remain unclear. This is hence the first study investigating the effects of CBT on SC in patients with PD.

Methods: PD-patient's SC (N = 215) was assessed through the Frankfurter self-concept scales before and after a 5-week semi-residential manualized CBT intervention not specifically targeting SC. Therapy outcome was assessed through the Symptom Checklist and the Beck Depression Inventory.

Results: 8 out of 10 SC scales including self-esteem (SE) significantly changed from pre- to posttreatment assessment (d = 0.12 to 0.36). Regarding symptom severity, patients showed reduced general symptom burden (d = 0.89) and depressive symptoms (d = 0.79) following CBT intervention. SE before receiving CBT predicted therapy outcome with regard to general symptom burden but not depressive symptoms.

Conclusion: Results indicate that CBT enhances different facets of SC in patients with PD as a positive side-effect, suggesting that improving SC may offer the potential to optimize treatment outcome. Further studies are required to better understand the underlying mechanisms of CBT influencing SC and to identify what aspects of SC are key with respect to symptom burden in patients with PD.