High Young schema levels predict manualized confrontation therapy outcome in patients with panic disorder

The role of schemas is well established in personality disorders. Their influence on therapy outcome of patients with Axis I disorders remains unclear. Therefore, patients with a panic disorder (PD) with/without agoraphobia varying in their expression of early maladaptive schemas were examined regarding therapy outcomes after exposure therapy. In this study, a sample of 216 patients with panic disorder with/without agoraphobia were recruited in a day clinic. After the initial diagnosis with the Structured Clinical Interview, the patients filled out the Young Schema Questionnaire (YSQ-S2), Beck Depression Inventory and Revised Symptom Checklist. Afterwards, they participated in a five-week manualized exposure therapy by Lang et al. (2011). Subjects with high schema scores showed lower therapeutic success rates than subjects with a weaker pattern score. In addition, it was found that high schema levels, especially of schemas regarding impaired autonomy and achievement (YSQ-S2: domain 2), influenced therapy outcome by either predicting more/severe or less/milder anxiety-, phobicrelated and general symptoms after therapy. The results of this study emphasize the role of schemas not only for personality disorders but also for disorders on Axis I. For PD with/without agoraphobia, schemas regarding impaired autonomy and achievement seem to play the most important role regarding the influence on therapy outcome.