Psychophysiological outcome of cognitive, behavioral and psychophysiologically-based treatments of agoraphobia

Larry Michelson, Matig Mavissakalian, Karen Marchione, Richard F. Ulrich, Norman Marchione, Sandra Testa

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Psychophysiological process and outcome phenomena were analyzed to examine differential temporal patterns within and across cognitive, behavioral and physiologically-based treatments of agoraphobia. Eighty-eight severe and chronic agoraphobics with panic attacks (DSM-III) were randomly assigned to one of three treatments: Paradoxical Intention, Graduated Exposure or Progressive Deep Muscle Relaxation Training. Protocol therapists, whose treatment integrity was objectively monitored, conducted 12 two-hour weekly sessions. All subjects received programmed practice instructions concurrent with their primary treatment. Analyses revealed numerous significant reductions on in vivo psychophysiological measures for the relaxation condition, a few improvements for the exposure treatment and no effects for the paradoxical intention modality. The mediating role of pretreatment physiological reactivity in treatment outcome and follow-up status was examined and revealed no significant associations. Synchrony-desynchrony patterns were found to vary widely according to both treatment phase and the time interval between assessments. No between-group differences were observed on the proportion of synchronizers. However, synchronizers exhibited superior outcome and follow-up compared to desynchronizers on all domains except the physiological measures. Conceptual, methodological and clinical implications of these findings are discussed with recommendations for future research.

Original languageEnglish (US)
Pages (from-to)127-139
Number of pages13
JournalBehaviour Research and Therapy
Issue number2
StatePublished - 1990

All Science Journal Classification (ASJC) codes

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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