Subjective Reports Of Anxiety Research Articles

When dyspnea gets worse: Suffocation fear and the dynamics of defensive respiratory responses to increasing interoceptive threat.

In patients with anxiety and/or respiratory diseases, body sensations, particularly from the respiratory system, may increase in intensity and aversiveness and thus lead into defensive action (e.g., escape) or panic. The processes, however, that might contribute to the culmination of symptoms and the switch into defensive action have not been well understood yet. The current study aimed at evaluating an experimental paradigm to characterize the dynamics of defensive mobilization to body sensations increasing in intensity and aversiveness. Persons reporting low and high suffocation fear (SF; N = 69) were exposed to increasingly unpleasant feelings of dyspnea induced by inspiratory resistive loads and a breathing occlusion requiring voluntary breath holding. Respiratory responses were assessed along with subjective reports of anxiety and panic symptoms. Presentation of respiratory loads with increasing physical resistance led to increasingly unpleasant feelings of dyspnea. Twenty-eight participants terminated the exposure prematurely at least once. When dyspnea was severe, high compared to low SF persons exhibited an increased respiratory rate that was accompanied by reports of more intense panic symptoms. Premature terminations of exposure were preceded by a surge in anxiety, breathing frequency, and mouth pressure, and a decrease in tidal volume. We successfully established an experimental paradigm to assess changes in defensive responding with increasing intensity of an interoceptive threat. The current data foster our understanding of behavioral expression patterns observed in patients with anxiety and/or respiratory diseases and the processes involved in the culmination of bodily sensations and anxiety into panic.

Anxiogenic effects of repeated administrations of 20% CO 2-enriched air: stability within sessions and habituation across time

Increasingly carbon dioxide-enriched air is being used as an aversive unconditioned stimulus in laboratory examinations of anxiety. Yet, little is known about the stability of the autonomic and subjective effects of this stimulus across repeated inhalations and sessions. We examined whether repeated administrations of high concentrations of CO 2-enriched air produced either habituation, stability, or sensitization across several autonomic and self-report indices within one session (Experiment 1) and then several sessions (Experiment 2) of exposure. Results suggest that non-clinical participants do not habituate to CO 2 within sessions, but do show habituation on cardiac and subjective report of anxiety across sessions. Individual difference factors such as anxiety sensitivity and suffocation fear seem to moderate some of these effects, including self-reported distress and anxiety in response to the challenge. These results support the use of CO 2 as a panicogenic aversive stimulus in laboratory models of fear onset and in clinical settings for interoceptive exposure treatments of panic.

A novel radiant heat test for assessing pain threshold in human subjects: Measurement stability

New methodologies to assess analgesic response in humans are needed to better integrate preclini­ cal and clinical data. In the present study we examined the test-retest stability of an innovative radi­ ant heat methodology compared with an electrical stimulation methodology. For the radiant heat task, a modified rodent tail flick apparatus was used, The latency for fmger withdrawal was recorded. For the electrical stimulation tasks, subjects placed two fingers on two electrodes from which they received a brief series of increasingly intense electrical stimulations. Maximum stimulus intensity (in milliamps) delivered was recorded. On each of 4 test days, the subjects received five test trials with a lO-min in­ terval between trials. Allthe subjects were tested twice on eachapparatus in a counterbalanced design. Finger withdrawal latencies for the radiant heat task did not differ significantly across test trials or test days. Finger withdrawal scores for electrical stimulation increased significantly across test trials as well as test days. These data show that the radiant heat method generates consistent latencies across trials and days, whereas shock produces trends over time. The radiant heat task, which is convenient to operate and inexpensive to build, appears promising as a reliable test of pain threshold in humans. Many attempts have been made to develop a simple and reliable laboratory method to assess pain thresholds in human volunteers. Some ofthese methods include ice water hand immersion, thermal heat, electrical stimula­ tion, and skin pressure tests (Chery-Croze, 1983; Collier, Mehta, & Spear, 1990; Harris & Rollman, 1983). Among these different stimuli, thermal heat and electrical stim­ ulation have been chiefly used to induce experimental pain (Chery-Croze, 1983). Additionally, these methods have been frequently used in nonclinical studies in which repeated exposure to the stimulus is often required. How­ ever, considerable variation in pain threshold values have been reported with electrical stimulation. For instance, Collier et a1. reported significant variation in threshold responses following repeated exposure to electrical stim­ ulation. This may be due to a developed tolerance or adaptation that may occur over time to the sensations pro­ duced by electrical stimulation. Additionally, Harris and Rollman reported that electrical stimulation is often ac­ companied by subjective reports of anxiety and stress. Hence, the psychological components associated with electrical stimulation may lead to variability in responding. Thermal heat tests have been successfully used to de­ termine pain threshold in human volunteers for the last three decades (Hardy, Goodell, & Wolff, 1952). The two most commonly employed methods of delivering ther­ mal heat are radiant heat (use ofa beam of light or laser pulse) and conducted heat (use of Peltier thermodes on

Continuous physiological changes and subjective reports in panic patients: A preliminary methodological report

Six panic disorder patients and six matched control subjects were studied using a new technique allowing continuous and simultaneous monitoring of physiological responses (blood pressure, heart rate, respiration) and subjective reports of anxiety and panic. This was done before, during, and after CO 2 inhalation. Panic patients had significantly higher variability in their heart rate, blood pressure, and breathing rate than the control subjects. They also had irregular breathing patterns with frequent pauses. We identified three different patterns of response to CO 2 inhalation in the panic patients. Some patients who panicked on CO 2 showed a definite association between changes in physiological responses that preceded their subjective ratings of anxiety; however, others did not show this pattern. The possibility of different physiological mechanisms of panic in different patients is discussed.

Golfers' cramp: clinical characteristics and evidence against it being an anxiety disorder.

The clinical characteristics of 20 golfers suffering from golfers' cramp or the "yips" are described. The typical description is that of a middle-aged golfer who has played competitive golf since his teens and develops the problem during a tournament in the form of a jerk, spasm, or freezing of movement while putting or chipping, with the rest of the game being relatively unaffected. The problem generally takes a chronic fluctuating course, and a number of 'trick' strategies are partially or fully successful. In this study, the subjects were compared with a matched group of 20 unaffected golfers on a number of indices of psychopathology; no significant differences emerged. The more severely affected golfers also did not differ significantly from the mildly affected ones, except on the subjective report of anxiety. These data support the argument that golfers' cramp is not an anxiety disorder or a neurosis. The important role of anxiety and arousal in its manifestation is, nevertheless, recognized and its pathophysiology speculated upon.

Stress Management in the Process of Occupational Stress Reduction

A growing number of studies have demonstrated the efficacy of worksite stress management training for reducing worker psychophysiological arousal and subjective reports of anxiety, depression, and somatic complaints. The role of stress management in the larger context of occupational stress reduction, however, has not been addressed. An application of stress management as one component of an organisational stressor reduction programme is described. Other components in the process which have been completed include the formation of a stress reduction committee and conduct of a stress assessment survey. Future plans include the formulation and implementation of recommendations for reducing organisational stress and repeated evaluations of their efficacy. The purpose is to depict element of the overall process and to report progress to date in this effort.

Autonomic correlates of the subjective anxiety scale

The subjective anxiety scale is an assessment tool commonly used in behavioral research and therapy to quantify verbal report to private events, usually states of fear. An investigation was undertaken to determine the extent of relationship between the subjective anxiety scale and two concurrent measures of autonomic arousal, peripheral vasoconstriction and heart rate. Measures were recorded during baseline, surgical film and second baseline phases for 20 subjects. The subjective and autonomic measures indicated increased anxiety during the film phase and significant correlations were found between subjective report of anxiety and the two physiological indices. The results support the continued use of the subjective anxiety scale as a clinical assessment tool. Practice and research implications are discussed.

Physiological and subjective measures of anxiety during flooding

Patterns of physiological arousal and subjective reports of anxiety were examined during individual sessions of imaginal flooding of five phobic subjects. A curvilinear pattern of increased, followed by decreased, arousal characterized changes in heart rate, respiration rate and subjective anxiety. Heart rate tended to reach its peak level before respiration rate and subjective anxiety. Intercorrelations between these measures were generally positive and significant. Comparisons between periods of high and low subjective arousal revealed a significantly greater correlation for low than for high arousal only for the subjective anxiety by respiration-rate correlation.

Biofeedback in the treatment of anxiety disorders

Studies which have used various forms of biofeedback in the treatment of anxiety disorders are summarized and examined in regard to whether biofeedback-mediated physiological changes are responsible for reductions in subjective reports of anxiety. The evidence suggests that frontal EMG biofeedback training to reduce muscle tension is the most promising biofeedback training technique to date. Studies of heart rate and EEG alpha biofeedback offer only minimal support for the use of these methods to facilitate anxiety reduction. The limited literature on the application of skin resistance level, finger pulse volume, and temperature biofeedback in the treatment of anxiety disorders suggests that these may be viable treatment techniques. The role of factors other than physiological change that may render biofeedback a successful treatment are discussed.

A cognitive‐behavioral treatment for disproportionate dental anxiety and pain: A case study

Abstract An 11‐year‐old dental phobic girl was treated by a “stress inoculation”; treatment program. The cognitive‐behavioral assessment and treatment procedures are described in detail in that they were tailored specifically for both the anxiety and pain frequently associated with dental work. Improvements in actual “in‐chair”; behavior and subjective reports of anxiety were noted immediately after the self‐control training was conducted and were maintained up to a period of approximately 5½ months. The need for a multi‐channel assessment approach is described in light of the present findings as are future research implications.

Instructional Demand and Anxiety Level

The effects of instructional expectancy (fear testing in a clinic versus simulated effects of relaxation therapy in a clinic) on behavioral, physiological, and self-report indices of speech anxiety were tested for three levels of speech-anxious subjects. Sixty-five subjects (32 male, 33 female) who reported being "speech anxious" completed a preliminary test battery and were assigned to anxiety levels (high, medium, or low) according to their scores. Within sex and anxiety level, subjects were randomly assigned to one of the instructional demand conditions. During a second experimental session two weeks later, each subject received the appropriate demand instructions, completed a subjective report of anxiety, and performed a four-minute speech in front of four raters. The results indicated that the low-anxiety subjects exhibited more anxiety under the simulate therapy instructions than did low-anxiety subjects in the fear assessment condition or medium-anxiety subjects in the simulate therapy condition. Subjective report data reliably distinguished between high, medium, and low anxiety levels as determined by the preliminary test battery. Implications of these findings for analogue and clinical outcome research were discussed.