Predicting behavioral treatment outcome for agoraphobia and obsessive compulsive disorder

This paper reviews findings of retrospective studies of factors predictive of behavior therapy outcome immediately after treatment or at follow-up for panic disorder with and without agoraphobia and obsessive compulsive disorder. Despite disagreement on some variables, most predictor variables (most demographic variables, severity of symptoms, depression, general anxiety, assertiveness, expectancy and motivation, and treatment context) were not consistently associated with outcome. Severe avoidance behavior and avoidant personality disorder were problematic for agoraphobic clients. Findings for depressed mood were contradictory, and comorbid major depression and other Axis I and II conditions are understudied. Research on marital quality for PDA is also conflicting. Spouse or family involvement in therapy appears more advantageous for PDA than OCD clients. For OCD, insight into the rationality of obsessions has not proven predictive. Therapist qualities associated with outcome varied somewhat with the disorder. Possible reasons for discrepant findings are discussed and implications for treatment regimens and additional research are proposed.