Fear Of Bodily Sensations Research Articles

Monitoring, trait anxiety, and panic disorder symptomatology in normal subjects

The present study investigated the relationship between a monitoring coping style and panic disorder symptoms in a normal sample ( N=77). The current study found some positive associations between monitoring, on the one hand, and fear of bodily sensations and agoraphobic avoidance, on the other hand. However, the observed correlations between monitoring and panic disorder symptoms were rather small. Moreover, monitoring was not found to be associated with the catastrophic misinterpretation of bodily sensations. As such misinterpretations are thought to play a crucial role in the etiology of panic disorder, the present findings do not support the idea that a monitoring coping style represents a risk factor for panic disorder.

Psychophysiological, somatic, and affective changes across the menstrual cycle in women with panic disorder.

This study explored menstrual symptoms, somatic focus, negative affect, and psychophysiological responding across the menstrual cycle in women with panic disorder and controls. Women with and without panic disorder completed a psychophysiological task and self-report measures of menstrual symptoms, somatic focus, and negative affect on 4 occasions across 2 menstrual cycles (twice during intermenstrual and premenstrual phases). Women in the panic disorder group exhibited greater skin conductance magnitude and more frequent skin conductance responses to anxiety-provoking stimuli during the premenstrual phase than did controls. Compared to controls, women with panic disorder endorsed more severe menstrual symptoms relating to bodily sensations, anxiety sensitivity, state and trait anxiety, fear of body sensations, and illness-related concerns. The applicability of anxiety sensitivity to understanding the relation of menstrual reactivity and panic disorder is discussed.

Psychophysiological, somatic, and affective changes across the menstrual cycle in women with panic disorder.

This study explored menstrual symptoms, somatic focus, negative affect, and psychophysiological responding across the menstrual cycle in women with panic disorder and controls. Women with and without panic disorder completed a psychophysiological task and self-report measures of menstrual symptoms, somatic focus, and negative affect on 4 occasions across 2 menstrual cycles (twice during intermenstrual and premenstrual phases). Women in the panic disorder group exhibited greater skin conductance magnitude and more frequent skin conductance responses to anxiety-provoking stimuli during the premenstrual phase than did controls. Compared to controls, women with panic disorder endorsed more severe menstrual symptoms relating to bodily sensations, anxiety sensitivity, state and trait anxiety, fear of body sensations, and illness-related concerns. The applicability of anxiety sensitivity to understanding the relation of menstrual reactivity and panic disorder is discussed.

Cognitive Change following Cognitive Behavioural Therapy for Non-Cardiac Chest Pain

Background: Seventeen to 43% of patients with non-cardiac chest pain suffer from anxiety/panic disorders. Cognitive behavioural therapy (CBT) is effective in reducing non-cardiac chest pain. However, no data are available indicating that pain reduction following CBT may be cognitively mediated or whether success of CBT is dependent on the presence of panic. The aim of the study was threefold: (1) does CBT have a differential effect on cognitive measures; (2) does a relationship exist between improvement in non-cardiac chest pain and changes in cognitive measures, and (3) can panic be established as a moderator of the effect of treatment? Methods: Sixty-five patients with non-cardiac chest pain completed a randomised trial comparing study CBT with ‘care as usual’. Dependent measures were: frequency of chest pain, anxiety, the fear of bodily sensations, attributions and catastrophic cognitions. Results: CBT had a differential effect on most of the cognitive measures. Pain reduction was associated with the development of more adequate cognitions with respect to chest pain, independent of anxiety reduction. Although panic patients reported higher baseline scores on the cognitive measures, no differences in treatment results were found between panic and no-panic patients. Conclusions: Pain reduction following CBT may be cognitively mediated. The presence of panic did not affect the outcome of treatment, implying a broad applicability of the cognitive model for treatment of patients with non-cardiac chest pain.

Physiological hyperarousal: Construct validity of a central aspect of the tripartite model of depression and anxiety.

Physiological hyperarousal (PH) is an understudied component of the tripartite model of depression and anxiety. This study contributes to the literature on PH, the tripartite model, and anxiety and its disorders, using data from psychotherapy outpatients (n = 2,448), air force cadets (n = 1,335), and undergraduates (n = 284). Psychometrics and exploratory and confirmatory factor analyses showed that PH is a reliable, cohesive, discriminable, and valid construct. Compared with subjective anxiety, PH was more associated to panic versus mood disordered status, and to panic versus generalized anxiety disordered status. As hypothesized, an aspect of anxiety sensitivity (i.e., fear of body sensations) was particularly related to subjective anxiety in the presence of PH. Results support the PH construct as replicable, valid, and clinically important and support the utility of the tripartite and related models for understanding the relation of depressive and anxious syndromes.

Physiological hyperarousal: construct validity of a central aspect of the tripartite model of depression and anxiety.

Physiological hyperarousal (PH) is an understudied component of the tripartite model of depression and anxiety. This study contributes to the literature on PH, the tripartite model, and anxiety and its disorders, using data from psychotherapy outpatients (n = 2,448), air force cadets (n = 1,335), and undergraduates (n = 284). Psychometrics and exploratory and confirmatory factor analyses showed that PH is a reliable, cohesive, discriminable, and valid construct. Compared with subjective anxiety, PH was more associated to panic versus mood disordered status, and to panic versus generalized anxiety disordered status. As hypothesized, an aspect of anxiety sensitivity (i.e., fear of body sensations) was particularly related to subjective anxiety in the presence of PH. Results support the PH construct as replicable, valid, and clinically important and support the utility of the tripartite and related models for understanding the relation of depressive and anxious syndromes.

Predictability, controllability, and fear of symptoms of anxiety in epinephrine-induced panic

Background: Psychological manipulations (supplied information, safety cues) may influence panic rates during pharmacologic challenge tests in subjects with panic disorder (PD). Psychological panic models assume that fear of stress-related bodily sensations is central to the etiology of PD. Methods: Prior to infusion of epinephrine, 50 subjects with PD were randomly assigned to one out of four experimental conditions: with or without extensive information and with or without external control, according to a 2 × 2 design. The panic rate was hypothesized to be lower in subgroups possessing extensive information and/or control. Fear of bodily sensations was used as a predictor. Results: Thirty-four out of 50 patients (68%) panicked during the infusion. Subjects who received extensive information were marginally less likely to panic, but manipulation of control did not influence panic rates. Panickers did not differ from nonpanickers in measures of fear of fear. Anxiety sensitivity best predicted baseline anxiety and cognitive symptom scores, but was not associated with other outcome measures in panickers. Only baseline partial pressure of CO 2 discriminated between panickers and nonpanickers. Conclusions: Manipulating external safety cues appears to be of limited value in modulating responses to epinephrine challenge. Together with our finding that fear of anxiety symptoms does not predict panic rates, these data argue against “fear of fear” as a key mechanism in epinephrine-induced panic.

Epinephrine infusions in Panic Disorder: A double-blind placebo-controlled study

Twenty-four subjects with Panic Disorder were infused with epinephrine in physiological doses or placebo according to a double-blind design. The panic rate in the epinephrine group (67%) was higher than in the placebo group (25%). Placebo panic occurred early during the procedure and was apparently associated with anticipation anxiety and stress-provoking situational factors. Panickers were characterized by a greater increase in heart rate as well as a drop in pCO 2. Fear of bodily sensations was only weakly associated with state anxiety levels at point of panic. It is concluded that cognitive factors may not be important in epinephrine-induced panic.

Epinephrine and fear of bodily sensations in panic disorder and social phobia

Fear of bodily symptoms of arousal has been implicated in the pathogenesis of both spontaneously occurring and experimentally provoked panic. Fear of bodily symptoms may be characteristic for panic disorder (PD) and is hypothesized to predict state anxiety and panic frequency during experimentally induced peripheral arousal. Twenty-eight subjects, 14 with PD and 14 with social phobia (SP) were infused with placebo and epinephrine (20, 40 and 80 ng/kg bodyweight/min) according to a fixed schedule in a single blind design. Fear of bodily symptoms was higher in subjects with PD, who also reported more bodily symptoms and higher state anxiety scores during the experiment. The panic rate (five out of 14), however, was the same in both groups. Panickers did not differ from non-panickers in trait- or baseline measures except for fear of bodily symptoms, which was marginally higher in panickers. Panickers showed greater reactivity in heart rate, diastolic blood pressure and capillary PCO(2). Our data do not support the hypothesis of a major role for fear of bodily symptoms in epinephrine-induced panic. Also, our results do not demonstrate a different reaction to epinephrine in PD and SP with situational panic attacks.

Anxiety sensitivity and depression: how are they related?

Anxiety sensitivity is the fear of anxiety-related bodily sensations, which arises from beliefs that the sensations have harmful somatic, psychological, or social consequences. Elevated anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI), is associated with panic disorder. The present study investigated the relationship between anxiety sensitivity and depression. Participants were people with panic disorder (n = 52), major depression (n = 46), or both (n = 37). Mean ASI scores of each group were elevated, compared to published norms. Principal components analysis revealed 3 factors of anxiety sensitivity: (a) fear of publicly observable symptoms, (b) fear of loss of cognitive control, and (c) fear of bodily sensations. Factors 1 and 3 were correlated with anxiety-related measures but not with depression-related measures. Conversely, factor 2 was correlated with depression-related measures but not with anxiety-related measures.

L'impact des relations interpersonnelles et familiales sur les personnes souffrant d'agoraphobie: L'état de la question.

AbstractMany authors have suggested that interpersonal relationships play an important role in the development, the maintenance and the behavioural treatment of agoraphobia. The literature is reviewed to study the impact of interpersonal relationship on agoraphobia, specially familial variables, agoraphobic's social characteristics, and marital relationship. On the basis of the available data and critical review of the literature, we conclude that interpersonal relationships plays some role in the agoraphobic pathology, mainly for the onset of agoraphobia and the presence of social anxiety. However, it would seem that its importance is less than what has been suggested in the literature.ReferencesAronson, T.A., & Logue, C.M. (1987). On the longitudinal course of panic disorder: Developmental history and predictors of phobic complications. Comprehensive Psychiatry, 28, 345-355.Arrindell, W.A., & Emmelkamp, P.M.G. (1986). Marital adjustment, intimacy and needs in female agoraphobics and their partners: A control study. British Journal of Psychiatry, 149, 592-602.Arrindell, W.A., Emmelkamp, P.M.G., Monsma, A., & Brilman, E. (1983). The role of perceived parental practices in the aetiology of phobic disorders: A controlled study. British Journal of Psychiatry, 143, 183-187.Arrindell, W.A., Emmelkamp, P.M.G., & Sanderman, R. (1986). Marital quality and general life adjustment in relation to treatment outcome in agoraphobia. Advances in Behavior Research and Therapy, 139-135.Barlow, D.H. (1988). Anxiety and its disorders. New York: The Guilford Press.Bland, K., & Hallam, R.S. (1981). Relationship between response to graded exposure and marital satisfaction in agoraphobics. Behaviour Research and Therapy, 19, 335-338.Bouchard, S., & Gauthier, J. (1992). Les modeles etiologiques du trouble panique. Sciences et Comportement, 22, 93-120.Bowlby, J. (1973). Attachment and loss: (vol 2). Separation: Anxiety and anger. New York: Basic Books.Breier, A., Charney, D.S., & Heninger, G.R. (1986). Agoraphobia with panic attacks. Archives of General Psychiatry, 43, 1029-1036.Brodbeck, C., & Michelson, L. (1987). Problem-solving skills and attributional styles of agoraphobia. Cognitive Therapy and Research, 11(5), 593-610.Brown, G.W., Bifulco, A., & Harris, T.O. (1987). Life events, vulnerability and onset of depression: Some refinements.British Journal of Psychiatry, 150, 30-42.Buglass, D., Clarke, J., Henderson, A.S., Kreitman, N., & Presley, A.S. (1977). A study of agoraphobic house-wives. Psychological Medicine, 7, 73-86.Cerny, J.A., Barlow, D.H., Craske, M.G., & Himadi, W.G. (1987). Couples treatment of agoraphobia: A two year follow-up. Behavior Therapy, 18, 401-415.Chambless, D.L., Hunter, K., & Jackson, A. (1982). Social anxiety and assertiveness in normal and phobic populations. Behaviour Research and Therapy, 20, 403-404.Chambless, D.L., Rennenberg, B., Goldstein, A., & Gracely, E. (1992). MCMI-diagnosed personality disorders among agoraphobic outpatients: Prevalence and relationship to severity and treatment outcome. Journal of Anxiety Disorders, 6, 193-213.Cobbs, J.P., Mathews, A.M., Childs-Clarke, A., & Blowers, C.M. (1984). The spouse as co-therapist in the treatment of agoraphobia. British Journal of Psychiatry, 144, 282-287.de Ruiter, C., & Garsen, B. (1989). Social anxiety and fear of bodily sensations in panic disorder and agoraphobia: A matched comparison. Journal of Psychopathology and Behavioral Assessment, 11(2), 175-184.de Ruiter, C., & van Ijzendoorn, M.H. (1992). Agoraphobia and anxious-ambivalent attachment: An integrative review. Journal of Anxiety Disorders, 6, 365-381.Doctor, R.M. (1982). Major results of a large scale pretreatment survey of agoraphobics. Dans R. …

Effects of high and low anxiety provoking instructions on the responses to the hyperventilation provocation test

This study examined the effect of high and low anxiety provoking instructions in subjects submitted to a Hyperventilation Provocation Test (HVPT). Subjects were 43 out-patients referred to our clinic for a diagnostic examination of Hyperventilation Syndrome (HVS). Results showed that anxiety levels were affected by the instruction manipulation, but the magnitude of this effect was less than expected and the instruction manipulation had no effect on intensity arid type of reproduced symptoms, nor on symptom recognition. Subjects who met Diagnostic and Statistical manual of Mental Disorders (3rd ed., rev,; American Psychiatric Association, 1987) criteria for Panic Disorder (PD) were not more responsive to the instruction manipulation than non-PD patients. It is argued that the small effect of the manipulation is probably not due to the solidity of the HVPT but to the pervasiveness of pretest cognitions and expectations. In line with this, the report of HVS symptoms appeared highly related to psychological trait measures like anxiety, fear of bodily sensations, and a general tendency to report somatic symptoms.

Eye movement desensitization and reprocessing for panic disorder: A case series

Eye Movement Desensitization and Reprocessing (EMDR), a new technique that has shown some promise in the treatment of traumatic memories, was evaluated in this pilot study. Subjects were seven clients suffering from panic disorder who received EMDR treatment for memories of past and anticipated panic attacks and other anxiety-evoking memories of personal relevance. Standardized self-report inventories and behavioral monitoring instruments were employed to measure change with treatment. After five sessions of EMDR, subjects reported a considerable decrease in the frequency of panic attacks, fear of experiencing a panic attack, general anxiety, thoughts concerning negative consequences of experiencing anxiety, fear of body sensations, depression, and other measures of pathology.

Cognitive Factors in Panic Attacks: Symptom Probability and Sensitivity

Psychological models of panic disorder propose that panic attacks result from the patient's fear response to certain body sensations. In the present study, we assessed three aspects of the fear of body sensations: subjective symptom probability, symptom sensitivity, and perceived coping ability (Symptom Probability and Cost Questionnaire, SPCQ). One-hundred-and-ten patients with panic disorder (88 with current panic attacks, 22 in remission), 81 infrequent panickers, 37 patients with other anxiety disorders, and 61 normal controls without a history of psychiatric disorders answered the SPCQ for three groups of bodily sensations: general anxiety, panic, and nonanxiety control symptoms. Significant group differences were found for the anxiety and panic scales, and for control symptom probability. With the exception of panic symptom sensitivity in the patient control group, all anxiety groups differed from normal control subjects on the anxiety and panic scales. Overall, group differences in anxiety and panic symptom appraisal could not be accounted for by differences in trait anxiety or depression scores. Even when these variables were controlled for by analysis of covariance, panic disorder patients and infrequent panickers differed significantly from normal controls. Panic patients endorsed a higher probability of anxiety and panic symptoms and a higher sensitivity and lower coping ability for panic symptoms than infrequent panickers, and higher anxiety and panic symptom probabilities and sensitivities than patients with other anxiety disorders. Subjects with infrequent panic attacks gave similar ratings on the anxiety symptom scales as patients with other anxiety disorders, but had higher probability and sensitivity scores for panic symptoms. The present study provides evidence that a fear of body sensations associated with anxiety is a prominent characteristic of patients with panic disorder, but is also found to a lesser degree in infrequent panickers and patients with other anxiety disorders. Panic attacks are discrete episodes of apprehension or fear accompanied by a variety of symptoms such as palpitations, dyspnea, sweating or dizziness (American Psychiatric Association, 1987). There is agreement among current psychological models that panic attacks result from the patient's maladaptive response to internal stimuli, most commonly body sensations (Barlow, 1986; Beck, 1988; Clark, 1986; Ehlers, Margraf, & Roth, 1988; Foa, 1988; Rapee, 1987; van den Hout, 1988). Evidence supporting this psychological perspective of panic is rapidly accumulating (for a review see Ehlers, Margraf, & Roth, 1988). Current psychological models of panic are related to the older concept that patients with agoraphobia and anxiety neurosis suffer from "fear of fear" (Evans, 1972; Fenichel, 1945; Frankl, 1975, Goldstein & Chambless, 1978). Especially relevant to the study of panic disorder is the idea that patients are afraid of certain body sensations associated with anxiety. Questionnaire studies have demonstrated that panic patients show a bias in the interpretation of bodily cues in that, compared to normal or clinical control groups, these patients report more fear of body sensations and tend to interpret bodily changes as indicators of an immediately impending danger (Chambless, Caputo, Bright, & Gallagher, 1984; Chambless & Gracely, 1989; Clark et al., 1988; Foa, 1988; McNally & Foa, 1987; McNally & Lorenz, 1987; Reiss, Peterson, Gursky, & McNally, 1986; van den Hout, van der Molen, Griez, & Lousberg, 1987). Interview studies concur that catastrophic misinterpretations of body sensations occur during panic attacks (Beck, Laude, & Bohnert, 1974; Hibbert, 1984; Ottaviani & Beck, 1987; Rapee, 1985; Rachman, Levitt, & Lopatka, 1987; Zucker et al., 1989) and that bodily symptoms usually precede the experience of panic (Hibbert, 1984; Ley, 1985; Ottaviani & Beck, 1987; Zucker etal. …

Social anxiety and fear of bodily sensations in panic disorder and agoraphobia: A matched comparison

This study tests the hypothesis that social anxiety and fear of bodily sensations are associated with the development of agoraphobic avoidance behavior in panic disorder patients. Twenty patients with panic disorder were compared to 20 patients with panic disorder with agoraphobia, matched by sex and duration of disorder. The two groups did not differ on measures of fear and frequency of assertive social responses. However, the agoraphobics scored higher on measures of interpersonal sensitivity, depression, feelings of inadequacy, and hostility. They also reported higher fear of bodily sensations. Although definitive conclusions need to be postponed until prospective studies have been conducted, there is evidence suggesting that the development of agoraphobia in panic patients is associated with hypersensitivity to bodily sensations and interpersonal situations.

Breathing retraining, exposure and a combination of both, in the treatment of panic disorder with agoraphobia

The present study investigates the differential effectiveness of three treatment packages for agoraphobia. Patients suffering from panic disorder with agoraphobia (DSM-III-R) received one of three treatments: Breathing Retraining with Cognitive Restructuring (BRCR), graded self-exposure in vivo (EXP), or a combination of BRCR and EXP. Treatments consisted of 8 sessions. Assessments consisted of self-report measures for panic, phobic anxiety and avoidance, depression, general anxiety, somatic complaints and fear of bodily sensations, and of two respiratory measures (respiratory rate and alveolar pCO 2). The treatments resulted in a reduction in symptomatology on all self-report measures, except panic frequency, and in a decrease in respiratory rate. There was no evidence for a differential efficacy for any of the treatments on any of the variables. Contrary to expectation, and at odds with findings from earlier studies, BRCR had no significant effect on panic frequency. A detailed comparison of sample characteristics of patients in our study and previous studies, did not yield insight into possible causes for the failure to replicate earlier results. The limited effectiveness of breathing retraining in reducing panic, as observed in the present study, leads us to conclude that the role of hyperventilation in panic is less important than previously thought.

THE EFFECT OF ADRENALIN AND MECHOLYL IN STATES OF ANXIETY IN PSYCHONEUROTIC PATIENTS

Back to table of contents Previous article Next article ARTICLENo AccessTHE EFFECT OF ADRENALIN AND MECHOLYL IN STATES OF ANXIETY IN PSYCHONEUROTIC PATIENTSErich Lindemann, and Jacob E. FinesingerErich LindemannSearch for more papers by this author, and Jacob E. FinesingerSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.95.2.353AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Register for access Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byBiological and cognitive theories explaining panic disorder: A narrative review30 January 2023 | Frontiers in Psychiatry, Vol. 14Psychological Review, Vol. 108, No. 1General Hospital Psychiatry, Vol. 22, No. 6Epinephrine and fear of bodily sensations in panic disorder and social phobia1 July 2016 | Journal of Psychopharmacology, Vol. 10, No. 4Journal of Anxiety Disorders, Vol. 9, No. 1Archives of Psychiatric Nursing, Vol. 5, No. 6Acta Psychiatrica Scandinavica, Vol. 81, No. 6Biological Psychiatry, Vol. 24, No. 8Psychiatric Clinics of North America, Vol. 8, No. 1Comprehensive Psychiatry, Vol. 24, No. 4Nature, Vol. 228, No. 5272, Vol. 5Psychopharmacologia, Vol. 2, No. 2Journal of Psychosomatic Research, Vol. 5, No. 3The Journal of General Psychology, Vol. 58, No. 1NOR-EPINEPHRINE-LIKE AND EPINEPHRINE-LIKE SUBSTANCES IN PSYCHOTIC AND PSYCHONEUROTIC PATIENTSDANIEL H. FUNKENSTEIN, MILTON GREENBLATT, and HARRY C. SOLOMON1 April 2006 | American Journal of Psychiatry, Vol. 108, No. 9PSYCHOPHYSIOLOGICAL STUDY OF MENTALLY ILL PATIENTSPart I—The Status of the Peripheral Autonomic Nervous System as Determined by the Reaction to Epinephrine and MecholylDANIEL H. FUNKENSTEIN, MILTON GREENBLATT, and HARRY C. SOLOMON1 April 2006 | American Journal of Psychiatry, Vol. 106, No. 1The Psychiatric Quarterly, Vol. 22, No. 1-4Acta Psychiatrica Scandinavica, Vol. 19, No. S31Journal of Neurology, Neurosurgery & Psychiatry, Vol. 5, No. 1-2Journal of Neurology, Neurosurgery & Psychiatry, Vol. 3, No. 1Proceedings of the Royal Society of Medicine, Vol. 33, No. 10 Volume 95Issue 2 September 1938Pages 353-370 Metrics PDF download History Published online 1 April 2006 Published in print 1 September 1938