Symptoms and Cognitions Scales

Panic Frequency

Panic Coping Scale

Confidence in Coping

Is the Comprehensive Panic Profile (CPP) valid?

People mean different things when they ask this question. We have researched the CPP very carefully and have published a number of research articles on the validity of different parts of this questionnaire. To do this we have identified different samples of panic sufferers. We have then conducted a number of tests on these samples using the CPP. Some of the conclusions we have arrived at are sampled from papers delivered at professional meetings of psychologists or published in professional psychological journals

Effects of Feedback

Roodman, A. A., Clum, G. A., Febbraro, G. A. R., & Wright, J. H. (1996). A test of assessment and feedback process measures for individuals with panic attacks. Poster presented at the 30^th Annual Convention of the Association for Advancement of Behavior Therapy, New York City, November.

This study evaluated the effects of providing feedback to panic sufferers using a report based on the Comprehensive Panic Profile (CPP). Seventy (70) panic sufferers were randomly assigned to one of four conditions: 1) face-to-face feedback, 2) a written feedback report, 3) taking the CPP but with no feedback, or 4) delayed taking of the CPP and no feedback. Approximately two weeks after feedback was provided, all participants were assessed on all scales of the CPP. Participants who received feedback were also sent a survey questionnaire designed to evaluate their satisfaction with the feedback report.

Results of this study indicated that panic sufferers were satisfied with the feedback report: 88% indicated they learned they were not alone with their panic problem, 49% noted it provided new insights into their problem, 57% reported it pointed to new directions they could take to help themselves, while 77% reported it provided them with hope of finding a way to make their problem better.

We compared the effectiveness of the four groups for a sub-sample of individuals who had experienced at least one panic attack prior to the initial assessment. Panic sufferers in both feedback groups experienced a significant drop in frequency of panic attacks while no change was found for panic sufferers in the two control conditions.

The results of the study were interpreted as reflecting the importance of providing panic sufferers with specific information regarding their panic problem. (see note)

Note: Since the completion of this study, the feedback report based on the CPP has been expanded and improved. In addition, another post-intervention report has been developed which allows panickers to compare their progress with other individuals who have completed our treatment program.

Symptoms and Cognitions Scales

Clum, G. A., Broyles, S., Borden, J. W., & Watkins, P. L. (1990). Validity and reliability of the panic attack symptoms and cognitions questionnaires. Journal of Psychopathology and Behavioral Assessment, 12, 232-246.

This study compared individuals with panic attacks and panic disorder to individuals experiencing other anxiety problems using two of the scales from the Comprehensive Panic Profile: the Panic Symptoms Scale and the Panic Cognitions Scale. Items defining each of these scales were selected based on the diagnostic criteria for panic attacks, the researchers' own experience with panic-disordered individuals, and by interviewing individuals suffering from panic. In addition to administering these two scales to a sample of 83 anxiety-disordered individuals, standard measures of trait anxiety and depression were also administered.

The results from this study indicated that both the Panic Symptom Scale and the Panic Cognitions Scale were highly reliable, i.e., that the items included in each scale measured the same construct. Results also indicated that each scale successfully discriminated panic-disordered individuals from individuals with other anxiety disorders and that they did this better than standard measures of anxiety and depression.

The results were interpreted as reflecting the high reliability and validity of these two scales. The results were also reflective of the ability of these scales to differentiate panic-disordered individuals from individuals with other types of anxiety problems.

Panic Frequency

Nelson, W. A., & Clum, G. (1999). Assessment of panic frequency: Reliability and validity of a timeline follow-back method. Paper presented as part of a symposium, "Recent advances in the assessment of anxiety disorders", at the annual convention of the Southeastern Psychological Association, Savannah, March.

This study was designed to assess the reliability and validity of two approaches for obtaining retrospective estimates of the frequency of panic attacks. The sample used was 71 college students reporting they were currently experiencing panic attacks. Each of these individuals was asked to estimate the number of panic attacks they had for the previous eight weeks using two different methods for estimation. Half of this group then monitored their frequency of panic attacks on a daily basis for two weeks. At the end of two weeks, each of the individuals again provided estimates of their frequency of panic attacks for the previous 10-week period.

Results from this study indicated that estimating panic frequency using the retrospective recall method used in the Comprehensive Panic Profile was an effective method when used over relatively brief time periods, i.e., the most recent two weeks. Consistency of estimating frequency of attacks over a two-week interval was high (r=.70). The validity of the retrospective recall method of estimating panic frequency, when comparing it to self-monitoring, was also high (r=.74).

The results from this study were interpreted as indicating that the retrospective recall method for estimating panic frequency was both reliable and valid over a period of the most recent two weeks. A more time-consuming approach to measuring panic frequency-The Time Line Follow-back Method-was reliable for periods up to 8 weeks previous.

Panic Coping Scale

There are two versions of the Panic Coping Scale. The first one, described in this article, contained both positive and negative strategies. The second one, currently in use, contains the positive strategies discussed in this article plus additional ones added after further experience with panic sufferers established that additional effective coping strategies could be identified. Both sets of items were generated from the extensive clinical experience of the authors, augmented by having panickers respond to an open-ended question that invited them to identify additional strategies they found helpful in dealing with panic attacks. The sample in this study was comprised of 69 panic-disordered individuals.

Reliability in this study was computed using a measure of internal consistency and was estimated to be .78, a moderately high level of reliability. When comparing panickers to non-panickers, the panickers were found to use more strategies more often than the non-panickers.

The data from this study were interpreted by the authors as reflecting that the Coping Strategies Scale was both reliable and valid. Data on the revised scale, currently in use, is indicative of increased levels of reliability and validity.

Confidence in Coping

This section of the manual summarizes additional research on the Comprehensive Panic Profile, specifically the Confidence in Coping Scale. This scale consists of 10 items, hierarchically ordered, that reflect the panic sufferer's confidence in being able to apply coping strategies under panic situations that are increasingly threatening. The reliability and validity of this scale was tested on community samples of 129 panickers and 66 non-panicking normals.

The internal consistency reliability of this scale was high (alpha=.85), while the stability across time was moderately high (r=.70). An examination of the factoral validity revealed the scale to be composed of three different factors, each representing a stage of confidence in the ability to utilize coping strategies for panic attacks. In addition, lower levels of confidence in the ability to cope with panic attacks were found for panickers as compared to non-panickers, more severely disordered compared to less severely disordered panickers, and individuals with panic who were not treated as compared to individuals with panic who were treated.

These results were interpreted as reflecting both the internal reliability and validity of this scale. They were also interpreted as reflective of the ability of this scale to reflect the confidence of panickers in their coping strategies as well as reflect improvement in this confidence as a consequence of treatment.

Clum, G. A., Hirai, M., & Nelson, W. (1999). The validation and clinical utility of the Panic Coping Inventory. Paper presented as part of symposium at the 45^th Annual Convention of the Southeastern Psychological Association, Savannah, March.

This paper presents reliability and validity data on the Revised Panic Coping Scale. It consists of 28 items, all of which measure positive coping strategies for dealing with panic attacks. In this study, the scale was administered to 128 individuals seeking therapy for their panic problem and 66 individuals selected from the community.

The internal consistency reliability of this scale was high (alpha=.90), while the stability of the full scale (N=84) over a 4-6-week period was moderately high (r=.71). Six subscales were found to comprise the scale, all of which had moderate to high reliability and stability. Concurrent validity of the scale was established by findings that 1) panic sufferers used coping strategies more frequently than non-panickers, 2) more severely disordered panickers used more strategies more frequently than did less severe panickers, 3) treated panic sufferers used more positive strategies than untreated sufferers, and 4) individuals who increased their use of coping strategies improved more than individuals who did not increase their use of coping strategies.

The results of this study were interpreted by the authors as indicating that the Panic Coping Scale could be used in clinical settings to measure panic coping strategies. Results further indicated that the Panic Coping Scale was sensitive to treatment changes and was predictive of response to treatment.