Catastrophic misinterpretation of bodily sensations and external events in panic disorder, other anxiety disorders, and healthy subjects: A systematic review and meta-analysis.

Barnabas Ohst,Brunna Tuschen-Caffier,Ethan Moitra

doi:10.1371/journal.pone.0194493

Barnabas Ohst, Brunna Tuschen-Caffier + Show 1 more

Open Access

https://doi.org/10.1371/journal.pone.0194493

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Journal: PloS one	Publication Date: Mar 20, 2018
Citations: 15	License type: CC BY 4.0

Affiliation: University of Freiburg

Abstract

The catastrophic misinterpretation model of panic disorder (PD) predicts that the catastrophic misinterpretation of bodily sensations is a distinctive characteristic of PD. Existing research on this prediction has produced mixed findings. This paper presents a systematic review and meta-analysis of studies comparing the strength of catastrophic misinterpretation of bodily sensations and external events in patients with PD, patients with other anxiety disorders, and healthy controls. Following a systematic screening, seven studies were included in the meta-analysis. For the catastrophic misinterpretation of bodily sensations, analyses showed medium to large effects between patients with PD and healthy controls and between patients with PD and patients with other anxiety disorders. For the catastrophic misinterpretation of external events, analyses showed medium to large effects between patients with PD and healthy controls and a small negative effect between patients with PD and patients with other anxiety disorders. The findings support the assumption that the catastrophic misinterpretation of bodily sensations is a distinctive characteristic of panic disorder and thus lend support to the catastrophic misinterpretation model of PD.

Highlights

Catastrophic misinterpretation plays a central role in the cognitive model of panic disorder [1]
The catastrophic misinterpretation of bodily sensations is assumed to be the cognitive process that is causally responsible for the emergence of fear that leads to a panic attack
A systematic search for articles on the strength of catastrophic misinterpretation in patients with PD compared to healthy controls and/or patients with other anxiety disorders was conducted by the first author in three major databases (PsycINFO, PubMed, and MEDLINE) on February 18, 2016 using the following search term: (“catastrophic interpretation” OR “catastrophic belief” OR “catastrophizing” OR “misinterpretation”) AND (“panic” OR “panic disorder” OR “panic attack” OR “anxiety attack”)

Summary

Introduction

Catastrophic misinterpretation plays a central role in the cognitive model of panic disorder [1]. It is assumed that panic attacks result from the interpretation of (per se) harmless bodily sensations as signs of an impending physical, mental, or social catastrophe (e.g., interpreting a pounding heart as sign of an upcoming heart attack). The catastrophic misinterpretation of bodily sensations is assumed to be the cognitive process that is causally responsible for the emergence of fear that leads to a panic attack. It is further assumed that the catastrophic misinterpretation of bodily sensations is an enduring characteristic of patients with panic disorder (PD) and can be measured in non-panic situations.

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