{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:00:59Z","timestamp":1772982059086,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Psychology and Psychoth"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The current study investigated bidirectional associations between defense mechanisms and therapeutic techniques in two different psychotherapies for panic disorder (PD). Identifying how technique use facilitates and is facilitated by change in defenses might guide adaptation and improvement of therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patient defense mechanisms and use of therapeutic techniques were measured at early, mid, and late\u2010treatment for 101 patients receiving panic\u2010focused psychodynamic psychotherapy (PFPP) and cognitive behavioral therapy (CBT). Time\u2010lagged associations between use of techniques and psychological defenses were examined using random\u2010intercept cross\u2010lagged panel models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In PFPP, less\u2010organized defense use at mid\u2010treatment predicted higher therapist focus on the patient's moment\u2010to\u2010moment experience and affect at late\u2010treatment. In CBT, greater therapist focus on the patient's thoughts and cognitions at early\u2010treatment predicted use of more adaptive defenses at mid\u2010treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results underscore differential treatment effects in the relationship between techniques and change in\u00a0defensive functioning over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Messages<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>In cognitive behavioral therapy, therapists could focus on patients' thoughts and cognitions to foster adaptive defensive functioning like intellectualization and rationalization.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In panic\u2010focused psychodynamic psychotherapy, therapists might increase affect\u2010focused interventions to target when patients persist in using lower adaptive defenses.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Broadly, therapists can also be aware that their use of therapeutic interventions may be influenced by their patient's defensive functioning.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cpp.70081","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T08:44:29Z","timestamp":1749458669000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bidirectional Associations Between Defense Mechanisms and Therapeutic Techniques in Psychotherapies for Panic Disorder"],"prefix":"10.1002","volume":"32","author":[{"given":"Serena\u00a0Z.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Psychology, The Pennsylvania State University State College  Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nili","family":"Solomonov","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary\u00a0V.","family":"Minges","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center Albert Einstein College of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin\u00a0S.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Psychology Chestnut Hill College  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrik","family":"Falkenstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Psychology Linnaeus University  V\u00e4xj\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianne\u00a0L.","family":"Chambless","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9858-6294","authenticated-orcid":false,"given":"Barbara","family":"Milrod","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center Albert Einstein College of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8762-2595","authenticated-orcid":false,"given":"Jacques\u00a0P.","family":"Barber","sequence":"additional","affiliation":[{"name":"Gordon F. 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