Case 1 number of panic attacks per week. This line graph shows Jessica's number of panic attacks per week during the baseline and intervention period. The highlighted band indicates the range of baseline data, which is largely above the range of intervention data. 

Contexts in source publication

Context 1

... hypothesis was partially met. Panic attacks were significantly reduced in frequency (see Figure 1). Beginning with an average of 2.5 panic attacks per week, Jessica's panic attacks were reduced to 1 per week during the intervention period. ...

Context 2

... feelings of goodness did not increase significantly at the .05 level from baseline to intervention period (see Figure 10). A minimal upward trend was evidenced in the baseline, which the majority of the intervention points did not follow. ...

Context 3

... majority of points fell below the celeration line. Figure 10. Case 2 ratings of general feelings of goodness. ...

Context 4

... prescription or recreational substances often triggered Jessica's fears of depersonalization. Jessica then participated in a fifteen-minute brainstorming session with the art therapist about the features of her panic attacks, anxiety, and agoraphobia (see Figure 11). ...

Context 5

... indicated that chest breathing as well as longer breaths made her feel lightheaded. Jessica engaged in the watercolor breathing technique, selecting a relaxing color and painting a stroke with each exhale (see Figure 13). Jessica used preferred shorter breaths, tried for longer, and ultimately found a more moderate length to be most relaxing. ...

Context 6

... chose to use watercolors to paint a scene from her childhood (see Figure 14). During the guided imagery, she had visualized a memory on the beach in Ocean City, MD; Jessica used to sit in the shade under the boardwalk with her grandmother and look out across all the different umbrellas. ...

Context 7

... the latter half of the session, Jessica was asked to create an image of one of her less likely cognitions. Jessica portrayed other people judging her panic reactions (see Figure 15). Jessica used colored pencils to portray several of her common, panic reactions, including blushing, sweating, trembling, and depersonalization. ...

Context 8

... spending several minutes on this first activity, Jessica was asked to sit, color a mandala (see Figure 17), and practice slow, abdominal breathing to reduce her heightened heart rate. After successfully decreasing her heart rate and slowing her breathing, Jessica was next asked to dip her shoes in tempera paint and run and jump on a large piece of butcher paper to cover it within a time limit (see Figure 18). ...

Context 9

... spending several minutes on this first activity, Jessica was asked to sit, color a mandala (see Figure 17), and practice slow, abdominal breathing to reduce her heightened heart rate. After successfully decreasing her heart rate and slowing her breathing, Jessica was next asked to dip her shoes in tempera paint and run and jump on a large piece of butcher paper to cover it within a time limit (see Figure 18). After working further on the mandala and engaging in slow, abdominal breathing, Jessica was successful in reducing a more elevated heart rate than before. ...

Context 10

... was able to successfully calm herself down through several insights, such as the fact that the art therapist had not become intoxicated by the paint. During the second half of session, Jessica spent half an hour depicting and discussing the first situation on her list: a road trip (see Figure 19). She used both magazine cutouts and colored pencils. ...

Context 11

... spent the majority of the latter half of the session, 20 minutes, creating and discussing a visual representation of her anxiety cycle from a choice of various collage and drawing materials. Like Jessica, she chose to find and cut out various magazine photos as well as draw and write with pens (see Figure 21). During processing of the image, Aurelia indicated that she cut out the image of the girl in the upper left, because she looked worried. ...

Context 12

... is possible that Aurelia wished to return to more resistive materials and a structured pattern after using clay. Between sessions 4 and 5, Aurelia also chose 85 to create another mandala (see Figure 31). Like her third mandala created during session 3 (see Figure 27), she used chalk pastels to create an organic, semi-structured pattern. ...

Context 13

... general anxiety, however, does appear to be influenced more by external events and the intervention, decreasing in anticipation of the intervention and remaining relatively low except for during particularly stressful events occurring later in the study. These stressful events, particularly her sister's arrest in week six, caused an extreme rise in general anxiety and a rise to two panic attacks in the same week (see Figure 1). It is notable, however, that Jessica's panic attacks did not rise as high as may be expected given her general anxiety or low general goodness on this week; this suggests that the benefits for her panic attacks may have occurred despite increased general anxiety. ...

Context 14

... participants chose to use magazine cutouts along with drawing materials to create their cycle (see Figure 12, 21). Magazine images are highly structured and resistive, which may reflect the anxiety of both participants. ...

Context 15

... the sessions progressed, both participants moved towards using more fluid, less structured materials when given a choice. Aurelia moved from pen and magazine images (see Figure 21) to colored pencils (see Figure 24) to chalk pastels (see Figure 26) and eventually to tempera paint (see Figure 28). Jessica moved from magazine cutouts and chalk pastels (see Figure 12) to colored pencils without cutouts (see Figure 15). ...

Context 16

... moved from pen and magazine images (see Figure 21) to colored pencils (see Figure 24) to chalk pastels (see Figure 26) and eventually to tempera paint (see Figure 28). Jessica moved from magazine cutouts and chalk pastels (see Figure 12) to colored pencils without cutouts (see Figure 15). ...

Context 17

... moved from pen and magazine images (see Figure 21) to colored pencils (see Figure 24) to chalk pastels (see Figure 26) and eventually to tempera paint (see Figure 28). Jessica moved from magazine cutouts and chalk pastels (see Figure 12) to colored pencils without cutouts (see Figure 15). ...

Context 18

... participants also transitioned back towards more structured, resistive materials near the end, sessions 5-7. Aurelia chose to complete her last five pieces of artwork, not counting mandalas, in colored pencils (see Figures 32, 34-37), and Jessica completed her last image (also her first desensitization image) using magazine cutouts (see Figure 19). The shift to more fluid materials probably reflects decreased anxiety and increased comfort with art materials, but the shift back to more structured materials may be for a variety of reasons. ...

Context 19

... Jessica, the participant with PDA in the reported study, was not panic-free at the end of the brief CBAT intervention, she was maintaining a high-end level of functioning despite anxiety and occasional panic. Due to the declining trend in Jessica's panic frequency (Figure 1), it is likely that she may have been panic- free had she completed the protocol or extended the sessions. Although PCT trials did not report changes in panic-related or general anxiety, a similarity between the results of the reported study and controlled PCT trials are clinically significant reductions in agoraphobic avoidance. ...