"Effects of Attentional Focus on Emotional Responding to a Biological Challenge in Panic Disorder"

Abstract

Abstract : SEE REPORT The principal aim of this study was to assess whether attentional focus affects fearful responding. Specifically, the present study tested a cognitive model of panic (Clark, 1986) to determine whether attentional focus affects fearful responding to heightened somatic cues. The study compared panic disorder subjects and nonclinical controls at baseline during inhalation of 35% CO2 gas on measures of subjective and psychophysiological responding. A 2 (Panic Disorder versus Normal Controls) X 3 (Internal Focus versus External Focus versus No Focus) factorial design was employed to test for main effects of group status, instructional set, and their interaction. All subjects were assessed before and after the experimental manipulation on measures of anxiety, panic, cognition, attentional focus, physical symptoms and psychophysiological measures. Subjects were diagnosed for current and past DSM-IV diagnoses for Axis I disorders through a structured diagnostic interview. Subjects meeting DSM-IV criteria for panic disorder with or without agoraphobia (n=45) were matched to nonclinical controls (n=45) in terms of age and gender. Consistent with prediction, PD subjects were more internally focused before the experimental manipulation and were more internally focused during the biological challenge compared to nonclinical controls. PD subjects also showed more subjective but not physiological distress during the biological challenge. In addition, reliance on emotion focused coping skills increased fearful responding to the biological challenge.